Medicine From The Trenches

Experiences from undergradute, graduate school, medical school, residency and beyond.

Holding Out For a Hero

Occasionally, I have an opportunity to do a case with my senior partner,  a surgeon who spent the first 15 years of his career in the United States Army, having graduated from West Point before attending medical school. He retains many of the armed forces characteristics; not the least of which would be his closely cropped grey crew cut/buzz, no facial hair, excellent physical condition and minimal chatter with a clipped mid-western accent. When he walks into any room, we all tend to “stand at attention”.

On this occasion, he asked me to place a vascular access port for chemotherapy, for this patient who had cancer. He had another portion of the case to perform with a resident but thought it would be more efficient for me to place the port while they completed their portion of the case. Of course, this was a chance for me to enjoy the pleasure of doing a case with another physician; always a pleasure for me.

As I entered the operating room, I heard the wonderful sounds of one of my holiday albums (I realized that he had purloined my “Come to the Celebration” CD by the Birmingham Southern College Alumni Choir) thus, the atmosphere in the room was joyous and wonderful. A twinkle in the eyes of all participants in this case (light anesthesia); positive sounds for the patient.

I set about the work of placing the chemo port, finished and then took a seat at the circulator’s table. The lights were then lowered; the laparoscopic portion of the case began. The resident was in the middle of his first year; still becoming comfortable with the mechanics of the operation of the foot controls for the electrocautery. My partner, ever patient and calm, spoke encouraging words as the resident struggled with nerves and the foot pedal a bit.

Here I sat, an opportunity to listen to soft and melodious holiday music along with observing a master teaching surgeon. “How about if you hold the cautery this way, you can have more control,” he spoke softly as he corrected the hand position of the resident. I could see the nervousness of the intern start to dissipate with the touch and words of the professor. The dimmed lights, the soft holiday music and voice of the professor.

“Try to keep the instruments in the center of the field”, he said to the physician assistant who was driving camera for the first time on this case. “Move slowly but follow the case,” he said. I was reminded of my first camera drive when I was a medical student. Certainly, my professor back at that point wasn’t as nice or as instructive. He took the time to correct the PA too.

As the case moved on, the professor and student took turns making the repairs that were needed; hundreds of moves in almost perfect choreography. It became time to close the small incisions from the procedure. “Have you closed these before?”, he asked. The intern said that he had watched but hadn’t actually closed. “Let me show you the technique,”, my partner said. He took the suture from the scrub nurse and explained every hand position, needle angle and move that he made.

“Now you close the other one,” he said to the resident. He softly talked the resident through the simple stitch to close the small incision. He adjusted the hand position and kept encouraging the young surgeon. “I will show you a couple of ways to practice this at home so you won’t forget what you have learned today. You are coming along fine.” he said.

I was lost in absorbing the encouragement, the teaching and the affirmation that the professor imparted to his trainee. I was reminded that surgery is taught from master to apprentice. The better we teach, the better our residents become. It was wonderful to watch this master at work and savor every moment!

I was listening to a couple of the senior residents talk about the confidence factor that every physician has to develop. “Sometimes you have just be a jerk in order to get respect,” one of them observed. As I watched my partner teach his intern, I realized that being a jerk is the last way to earn the respect of others.

Here was a surgeon who had spent time in Army hospitals in Europe and the Middle East. He had attained the rank of Lieutenant Colonel before leaving the Army for the life of a civilian surgeon. He stood arrow straight most of the time with his 6’3-inch slender frame but readily adjusted the height of the operating table to accommodate the 5’7″ height of the resident.

As I watched my partner teach a relatively simple case to an inexperienced intern, I had nothing but infinite admiration for this father, husband and physician. I realized that with his day-to-day performance of his teaching and patient care, he is the “hero” that those of us in an academic practice should seek to become. With my years of experience, I had picked up a couple of new bits of knowledge by just observing  this case. I hadn’t said a word because the conversation from master to apprentice was a great instructive experience for me. “You still here?” he questioned when he finally looked up from the case.

There was never a time, even when the intern didn’t know the answer to a question, that this professor uttered a negative word. Perhaps it was the affirming holiday music, perhaps it was my presence in the operating room but I suspect that it was the result of just being an “everyday” hero.

 

Advertisements

9 January, 2016 - Posted by | general surgery residency, intern, medical school |

No comments yet.

Leave a Reply or ask a Question.

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: