Hi folks, well I found this nice information about the joy of surgery on another website and felt compelled to share it here.
http://www.ctsnet.org/sections/residents/newhorizons/article-1.html
By Harold C. Urschel, Jr. MD
In 1995 Hal Urschel, MD, past president of the Society of Thoracic Surgeons, served as the Schuster Visiting Professor at The Brigham and Women's Hospital and Harvard Medical School. During that visit he delivered Surgical Grand Rounds, and his address was entitled "Let's Bring the Magic Back". His remarks were insightful and stimulating, and they are pertinent to many of the issues facing the profession of Cardiothoracic Surgery today. We are pleased to reproduce them on CTSNet.-Dr. Walter Merrill
Let's Bring the Magic BackBy Harold C. Urschel, Jr. MD
TWO YEARS AGO ALLEN GREENSPAN WAS THE KEYNOTE SPEAKERAT HARVARD’S COMMENCEMENT,
- WHETHER CONSIDERING GLOBALIZATION OR INDIVIDUALRELATIONSHIPS,
HE DEEMED THE MOST CRUCIAL CONDITION FOR SUCCESS WAS
- TRUST.
FOR THE PAST 8 YEARS IT HAS BEEN SORELY LACKINGNOT ONLY FROM ECONOMIC TREATIES, BUT WITHIN OUR FOREIGN POLICY
TRUST IS ALSO FUNDAMENTAL TO THE DOCTOR-PATIENT RELATIONSHIPAND HAS BEEN ERODED SIGNIFICANTLY BY THE MULTIFACETED THIRD PARTY INTERFERENCE.
THE EROSION OF DOCTOR-PATIENT TRUSTHAS PROVOKED SEVERE DEPRESSION AND “CREPE HANGING” IN PROFESSIONS.
WHAT HAPPENED TO THE “JOY OF SURGERY” (CLEM HIEBERT)
“THE MAGIC STUFF,THE GRAIL THAT ONCE MOVED EVERY DOCTOR IN THIS ROOMTO BECOME A SURGEONAND THAT EVEN NOW BECKONSTHROUGH THE JADING MISTOF TEDIUM AND TIME.STRIP AWAY THE CORRUPTING DULLNESSAND LOOK AFRESH AT OUR PROFESSION.I STILL CONTEND THAT IT IS THE MOST SPLENDIFEROUS OF ALLPROFESSIONS.”
WHY DID WE GO INTO SURGERY?
WE WANTED TO HELP OTHER PEOPLE AND WE WANTED TO MAKE ADIFFERENCE.
CERTAINLY THE DECISION WAS NOT MADE BECAUSE OF DOLLARS AND CENTS.
SURGERY EMBODIES THE SCHOLARSHIP OF SCIENCE,
THE SKILL OF A FINE ATHLETE,AND THE NECESSITY TO MAKE A PRECISE DECISION– THE SURGEON IS THE “FIGHTER PILOT” SO TO SPEAK OF OURPROFESSION.
WHEN I WAS IN SCHOOL HIPPOCRATES’ APHORISM, CHIZELED IN STONEON BLDG D, PRECISELY CHARACTERIZED THE SURGEON’S DAILY DILEMA:
“LIFE IS SHORT.THE ART LONG.THE OCCASION INSTANT.THE EXPERIMENT PERILOUS.AND THE DECISION DIFFICULT.”
MY BOOT CAMP TRAINING WAS TOUGH – SACRIFICE WAS PRIMARY.
AT THE HOSPITAL.
MY PATIENTS ALWAYS CAME FIRST .
MY WIFE, MY FAMILY, MY EMOTIONS ALWAYS REMAINED SECOND –36 HOURS ON, 12 HOURS OFF, FOR $25.00 A MONTH.
ONCE WHEN I CAME HOME ON A RARE WEEKEND, TO MY TWO SONSWHO HAD BEEN GIVEN TOY RAZORS FOR CHRISTMAS I SAID, “LET’S SHAVE TOGETHER.”
THEY IMMEDIATELY BEGAN TO SHAVE THEIR LEGS. THAT PRETTY MUCH SUMMARIZED MY INFLUENCE ON THE FAMILY ATTHAT TIME.
IN THOSE DAYS OUR POSITION WAS REVERED“THERE ARE MEN AND CLASSES OF MENTHAT STAND ABOVE THE COMMON HERD-THE SOLDIER, THE SAILOR, THE SHEPHERD NOT INFREQUENTLY,THE ARTIST RARELY, RARELIER STILL THE CLERGYMAN,THE PHYSICIAN ALMOST AS A RULE.
HE IS THE FLOWER SUCH AS IT IS OF OUR CIVILIZATION ANDWHEN THAT STAGE OF MAN IS DONE WITH ANDONLY TO BE MARVELED AT IN HISTORY, HE WILL BE THOUGHT TO HAVE SHAREDAS LITTLE AS ANY IN THE DEFECTS OF THE PERIODAND MOST NOTABLY EXHIBITED THE VIRTUES OF THE RACE.”
ROBERT LOUIS STEVENSON
I WOULD HOPE THAT IS STILL TRUE
WHO ARE OUR HEROES?
I WILL GIVE YOU A FEW OF MINE – WHILE YOU THINK OF YOURSWHAT LESSONS OF THEIRS WILL HELP?
DR. CHURCHILL ALWAYS FELT THAT“WE STAND ON THE SHOULDERS OF GIANTS,WE ARE CUSTODIANS OF A TRADITION. KNOWLEDGE IS HANDED TO US AND WE MUST PASS IT ON, SCRUBBED CLEAN, SO AS TO LEAVE THE PLACE BETTER AND BRIGHTER THAN WE FOUND IT. THINK OF YOUR HEROES – HOW CAN THEY HELP US?”
CHURCHILL FELT THAT THE MAIN STRENGTH OF THE SURGEON RESTED IN HUMANISM.
EINSTEIN, ONE OF HIS HEROES, ARTICULATED MANY OF CHURCHILL’S PRINCIPLES.
“TIME DOES NOT EXIST - THE DISTICTION BETWEEN THE PAST & FUTURE IS AN ILLUSION.”
ONE OF OUR MAJOR SATISFACTIONS AND COMPLIMENTS IS THE TRUST THAT OUR PATIENTS COMMIT TO US BY PLACING THEIR LIVES IN OUR HANDS FOR CARE. THIS IS WHAT MAKES OURS A PROFESSION, AND NOT A TRADE.
OUR BOND IS WITH OUR PATIENTS, SURGERY IS AN IRREVOCABLY INVASIVE REMEDY WHICH LINKS PATIENTS WITH US MORE CLEARLY THAN OTHER AREAS OF MEDICINE. DECADE’S LATER PATIENTS MAY RECALL THE VERY DATE OF THE EVENT, ESPECIALLY IF WE HAVE ADDED CARING TO THE CURING.
IN TRYING TO EXPLAIN WHY SOMEONE GETS THE NOBEL PRIZE JOE MURRAY – ANOTHER ONE OF MY HEROES TOLD ME THE LAST TIME I WAS HERE,
IT’S NOT JUST ONE GOOD IDEA CARRIED TO FRUITION – BUT RATHER A SERIES: THAT DEVELOPS A SYSTEM OF CARE
IN HIS CASE: RENAL TRANSPLANT: IDENTICAL TWINS – (MY 3rd YR HMS)
RELATED DONOR CADAVER
JOE IS A GREAT EXAMPLE OF EINSTEIN’S CONVICTION
“IMAGINATION IS STRONGER THAN KNOWLEDGE,MYTH IS MORE IMPORTANT THAN HISTORYDREAMS ARE MORE POWERFUL THAN FACTSHOPE ALWAYS TRIUMPHS OVER EXPERIENCELAUGHTER IS THE ONLY CURE FOR GRIEFLOVE IS STRONGER THAN DEATH.” - EINSTEIN
IN 1985 DICK BASS ASCENDED MT EVEREST AND BECAME THE FIRST PERSON TO CLIMB THE SEVEN SUMMITS - THE TALLEST MOUNTAIN ON EACH CONTINENT HE TOOK US TO MT. EVEREST IN 1987 TO PUT THE 1ST AMERICAN WOMEN ON THE SUMMIT AND AS ONE OF MY HEROES SAID:
“OUR DOUBTS ARE TRAITORS, AND MAKE US LOSE THE GOOD WE OFT MIGHT WIN, BY FEARING TO ATTEMPT.”
JOHN KNOWLES FELT
"HUMOR IS ESSENTIAL IN OVERCOMING MONUMENTAL CHALLANGESMANKIND’S MOST ENDURING AVENUE TO EMPATHYSHARED INSIGHT BINDING FAMILIES, FRIENDSAND EVEN STRANGERS TOGETHERSTARK, PAINFUL TRUTH DELIVERED IN WORDS OFAFFECTION AND ABIDING TRUSTSHUNS POMPOSITY, SHAM AND ALL FALSEHOODHE THINKS IT’S THE BROADEST EXPRESSIONOF HUMAN FAITH THAT WE HAVE"
“WHEN I DIE I WANT TO GO PEACEFULLY, LIKE MY GRANDFATHER DID,IN HIS SLEEP,NOT SCREAMING LIKE THE OTHER PASSENGERSIN THE BACKSEAT OF HIS CAR.” (HCU)
DICK BASS LIKE RICHARD SWEET REMINDS US THAT: - THE MAJOR GOAL OF THE SURGEON AS THE MOUNTAINEER IS TO “OVERCOME DIFFICULTY.”
STANLEY MARCUS - FRIEND PATIENT WORLD TRAVELING COMPANION
HAS BEEN A CONSTANT INSPIRATION AND HIS
LEGENDARY BOOK:
– QUEST FOR THE BEST
“- THE RIGHT TO BELIEVE FREELY. TO BE A SLAVE TO NO MAN’S AUTHORITY. IF THIS BE HERESY – SO BE IT. IT IS STILL THE TRUTH TO GO AGAINST CONSCIENCE IS NEITHER RIGHT NOR SAFE. I CANNOT – WILL NOT – RECANT. HERE I STAND – NO MAN CAN COMMAND MY CONSCIENCE.
MARTIN LUTHER
- MARTIN LUTHER’S FAMOUS CREDO IS ONE OF THE NOBLEST EVER MADE BY MAN. IT REPRESENTS MY PERSONAL PHILOSOPHY EXACTLY. IT IS BY MY SUBSCRIPTION TO IT THAT I HOPE TO BE REMEMBERED.”
STANLEY MARCUS
REMINDS US THAT:WE MUST INSIST ON “WHAT IS BEST” FOR OUR PATIENTS -AS THEIR PRIMARY ADVOCATE.
THE EDITOR OF THE DAYTON FLYER NEWSPAPER WAS CHAGRINED AT REPORTING ONLY MURDERS, TRAGEDY AND DEPRESSION - MUCH AS WE SEE TODAY.IN THE LATE 1800’S HE STARTED PUBLISHING ON THE FRONT PAGE A STORY TWO OR THREE TIMES A WEEK OF A GREAT HERO, INVENTOR, OR SCIENTIST. THIS CONTINUED FOR FORTY YEARS – THE REST IS HISTORY. DAYTON HAS PRODUCED MANY MORE INVENTORS, LEADERS AND SCIENTISTS THAN ANY OTHER MAJOR CITY IN THE COUNTRY PER CAPITA.
YOU’RE FAMILIAR WITH THE WRIGHT BROTHERS, AND THOMAS EDISON, BUT WHAT ABOUT CHARLES KETTERING? HE DESIGNED A MOTOR TO OPEN THE CASH REGISTER DRAWER FOR NCR WITHOUT THE CRANK.HOWEVER HIS MOST DRAMATIC ADAPTATION ELIMINATED THE CHAUFFEUR’S FRACTURE.HOW MANY KNOW WHAT THAT IS? THIS WAS A FRACTURE OF THE RADIUS STYLOID AFTER “CRANKING THE MODEL T TO START THE ENGINE” – THE SELF-STARTER. HE USED THE SAME MOTOR OF THE CASH REGISTERTO REVOLUTIONIZE AND POPULARIZE THE CAR INDUSTRY.
SOME OF YOU REMEMBER: TO START THE CAR YOU HAD TOSET THE SPARK & THROTTLE – JUMP OUT, TURN THE CRANK – RUN BACK, RESET THE SPARK & THROTTLE BEFORE IT STALLED. THE SELF-STARTER DID MORE TO EMANCIPATE WOMEN’S LIBERATION THAN SUSAN B. ANTHONY.
KETTERING SUBSEQUENTLY GAVE MUCH OF HIS FORTUNE TO SLOAN- KETTERING MEMORIAL CANCER HOSPITAL IN NEW YORK.
OFTEN A SOLUTION TO A SIMPLE PROBLEM MAY HAVE A MUCH WIDER APPLICATION ONE ESSENTIAL TO SUCCESSFUL SYSTEMS DEVELOPMENT.
ROSS PEROT OFFERED TO HELP IN 1994 AGAINST CLINTON’S SOCIALIZATION OF MEDICINE.BETSEY & I BROUGHT HIM TO THE KENNEDY SCHOOL OF GOVERNMENT (KSG) AT HARVARD FOR A 2 DAY ORIENTATION - MEDICAL - PUBLIC HEALTH – LAW – BUSINESS – TO BRING HIM UP TO SPEED.
ROSS PEROT CHALLENGED US DURING THE CLINTON HEALTH CARE SCARE TO “PUT OUR PATIENTS FIRST ” AND PROVIDE LEADERSHIP FOR HEALTH CARE REFORM. FEW OF US COMPLIED.WE ARE VICTIMS OF OUR PERSONALITIES AND OUR TRAINING. WE DON’T FOLLOW ANYONE. IT WAS THE RESTAURANT OWNER AND WORKERS’ UNION WHO SUCCESSFULLY LOBBIED AND DEFEATED THE CLINTON HEALTH REFORM CHALLENGE.LEADING SURGEONS IS LIKE HERDING CATS. – ONE OF OUR MAJOR HURDLES TO DEVELOP SYSTEMSGIVING OUR PATIENTS PREMIERE BILLING IS CARDINAL TO FUTURE SUCCESS.
BASED ON THE SUCCESS OF PEROT’S ORIENTATION AT THE KSG, BETSEY AND I ARRANGED A HEALTH POLICY COURSE THERE TWO TIMES A YEAR FOR CARDIOVASCULAR LEADERSHIP AND INDUSTRY.
PEROT POINTED OUT:“THERE ARE AT LEAST THREE AREAS IN WHICH AMERICA EXCELS IN THE WORLD.”“OUR FARMER IS THE BEST -ONLY 6% OF OUR POPULATION IS REQUIRED TO FEED ALL OF US -IT TAKES 65% OF RUSSIANS AND 75% OF CHINESE FARMING –WE BUILT THE FIRST, AND BEST AIRPLANES, IN THE WORLD.OUR MEDICINE AND RESEARCH ARE WORLD-CLASS. PEOPLE COME FROM ALL CORNERS OF THE EARTH FOR OUR HEALTH CARE. ALL THREE OF THESE SHINING STARS ARE BEING CRIPPLED BY THE SAME FORCE – THE PARASITIC MIDDLEMAN .”
WE MUST REDUCE THE POWER OF THE MIDDLEMAN. -THE INSURANCE COMPANY. WHO HAS THE TALLEST BUILDING IN EVERY CITY? – HE WHO CONTROLS THE DATA AND INFORMATION CONTROLS THE SYSTEM.
HENRY CISNEROS DESCRIBED THE INEVITABILITY OF CHANGE,“IF NO ONE LIFTS A FINGER OR NO ONE CARES, THINGS CHANGETHE HUMAN BODY GROWS OLDER, MACHINES GROW RUSTY,FRIENDSHIPS FALL APART, FOUNDATIONS BEGIN TO SETTLE.LEFT UNATTENDED, THE DYNAMIC OF CHANGE IS ‘DECLINE’ ”.THE TRICK IS TO CONVERT CHANGE INTO A POSITIVE FORCE AND THAT TAKES POSITIVE ACTION. GENERAL DOUGLAS MACARTHUR MADE IT VERY CLEAR:
“THE HISTORY OF THE FAILURE OF WAR CAN BE SUMMED UP INTWO WORDS: TOO LATETOO LATE IN COMPREHENDING THE DEADLY PURPOSE OF APOTENTIAL ENEMY;TOO LATE IN REALIZING THE MORTAL DANGER;TOO LATE IN PREPAREDNESS;TOO LATE IN UNITING ALL POSSIBLE FORCES FOR RESISTANCE;TOO LATE IN STANDING WITH ONE’S FRIENDS”.
WE MUST RECAPTURE THE:
“THE JOY OF SURGERY THE MAGIC STUFF, THE GRAIL THAT ONCE MOVED EVERY DOCTOR IN THIS ROOM TO BECOME A SURGEON, AND THAT EVEN NOW BECKONS THROUGH THE JADING MIST OF TEDIUM AND TIME. STRIP AWAY THE CORRUPTING DULLNESS AND LOOK AFRESH AT OUR PROFESSION. IT IS THE MOST SPLENDIFEROUS OF ALL PROFESSIONS.”
IT’S TIME TO TAKE THE MAGIC BACK .
Publication Date: 27-Aug-2004Last Modified: 18-Jul-2005
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