I recently had the good fortune to read a commentary written by Dr. Peter Angelos in ACS Surgery News entitled, The Right Choice? Surgeons, confidence, and humility (2017, February, p. 11). The essay touches on the philosophy, psychology, and attitudes that surgeons adopt and express in their daily interactions with the public.
The article refers to “the balance between lack of confidence and overconfidence, and between thoughtful introspection and paralyzing fear of future complications.” This is a critically important struggle in the mind of the surgeon. I would like to propose an exercise to bolster self-esteem in the psyche of the surgeon, particularly in the formative stages of one’s career, without fostering false or pathological bravado.
I certainly see the benefit in this tradition of analyzing and reviewing surgical misadventures and discussing the proper management of uninvited complications. It is a process rooted in the concepts of honesty, transparency, introspection, reflection, collaboration, and trust.
What I would like to propose is not the cessation of the M & M conference, but the addition of a complementary conference, which I refer to as Success and Survival conference. This meeting would showcase clinical scenarios in which a given patient should have succumbed to his illness but, instead, thrived as a result of the exemplary care provided by the surgical team involved. This would shine a bright spotlight on what it is that we do, and why our profession is so extraordinary. It would serve as a wonderful reminder for surgeons at all stages of their careers as to why we chose such a rigorous, challenging, and difficult vocation as our life’s work.
Such a venue would provide young surgeons an opportunity – not to flaunt – but to share and take well-deserved pride in their victories. I believe this conference would be as effective in terms of its educational value as the M & M, but it would not be associated with negative emotions of guilt, shame, and fear. The S & S would be a setting in which the young surgeon could shine in front of his or her peers as well as the attending staff and faculty.
The academic culture that prides itself on adages such as, “Whatever doesn’t kill you makes you stronger,” “The only problem with being on call every other night is that you miss half the pathology,” and “Eat when you can, sleep when you can, and don’t mess with the pancreas,” is long overdue in celebrating the accomplishments of surgeons publicly and on a regular basis
In the end, we should want to promote future generations of surgeons who are technically sound, demonstrate excellent judgment under the most difficult circumstances, and who are able to achieve, ideally, their full surgical potential by arriving at a true harmony between self-assurance and uncertainty.
Dr. Chuback is a vascular surgeon in private practice in Paramus, N.J.