“Look at every path closely and deliberately, then ask ourselves this crucial question: Does this path have a heart? If it does, then the path is good. If it doesn't, it is of no use.” ~Carlos Castaneda

Saturday, February 17, 2007

Stay off the pedestal because the fall hurts

“The self-confidence of the warrior is not the self-confidence of the average man. The average man seeks certainty in the eyes of the onlooker and calls that self-confidence. The warrior seeks impeccability in his own eyes and calls that humbleness. The average man is hooked to his fellow men, while the warrior is hooked only to infinity.”
~ Carlos Castaneda



One of my favorite things to see is the maturation of young surgeons. Watching the 26 year old intern who is unsure of his/herself, blossom into a confident surgeon is like watching you kids grow up. It almost makes you want to cry. With growth come growing pains. Like teach you teenager how to drive, the temptation to take the wheel is great; and as an educator, there is a fine balance between allowing for the growth of surgical skill and creating more grey hair.

Residency is filled with triumphs and failures. Perfect reduction of a fracture on first attempt or getting the guide pin in just perfect position, these are moments that make you fell like you are the "man" or "woman." With these triumphs, come a lot of failures and disappointments. The humbling experience of your chief resident or attending taking the knife out of your hands because it is just not going your way is probably one of the must ego deflating things in residency. You may hear in the background, "first day with your new hands," or "your hands are moving, but nothing is happening." As the years go on, most residence experience more positive experiences than negative. They begin to develop their own style.

As the residents progress in their years of training, the young surgeons become more and more confident. The trick is not to become over confident and overstep your skill level or skill set. It is important to know your own strengths and weaknesses. This self-awareness will make you over all a better surgeon. In a mostly male dominated specialty, we naturally know how to do it; we don't need help, it is a sign of weakness. Unfortunately, the patient in the end may suffer. It is important to know when to ask for help.

Some people are more self-aware than others. Competing for years in sports and in education, it is hard to let that part of your personality go. We are use to being the best. It is that confidence that has gotten to this point. Who would go to a surgeon who was unsure of him/her self? There is a difference from being confident and cocky. Young surgeons tend to get a little cocky after they have several good experiences. It may have to do with the young male mentality. These are usually residents somewhere between the 2nd and 3rd orthopaedic year. They usually overstep their level or skills set, and are quickly humbled. It is not until they are chiefs do they realize that they won't be perfect every time. Those who have operated over many years understand you will have good days and bad days. Hopefully, you will have more good than bad.

So, I will put out a plea to all those in training currently; stay off of the pedestal, remain teachable / trainable. You will never be the BEST at everything; there will always be someone better at one thing or another. Stay open to new things and opinions; this in the end will make you a better physician and surgeon.


“Intellectual growth should commence at birth and cease only at death”
~Albert Einstein

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