Veith's Views

Dealing with adversity in vascular surgery



Adversity is part of life and everyone must deal with it. How one manages adversity matters, separates the winners from the losers, and is a major determinant of success.

Dr. Frank J. Veith

Adverse challenges may be minor, intermediate or major. Although everyone is faced with such challenges, they are particularly relevant in a vascular surgery career. This is because of the serious nature and consequences of vascular diseases which can threaten loss of life, limb, and neurological function, and because of the complicated administrative world in which vascular surgery functions.

Minor frustrations are almost daily occurrences in a busy vascular surgeon’s life. They occur in and out of the operating room or angio suite, and many of them relate to other coworkers and associates making errors that interfere with smooth work flow or even good patient care. An angry response to these minor frustrations can exacerbate the problem and lead to strained, unpleasant working relationships and further errors. In contrast, a calm, measured response to these minor frustrations can minimize the damage caused and lead to a tranquil and effective work place.

Moreover, the individuals who control their responses are destined to be more effective and well liked. Equanimity when things go wrong during a stressful procedure in the operating room or angio suite is an even more valuable asset. Such composed responses will usually yield a better outcome than will loud and angry expressions of blame. The more serious the situation, the greater will be the value of composure.

Intermediate adversity in a work environment can take the form of rejection of a paper, denial of a grant request, or failure to get a sought promotion or assignment to a particular area of one’s interest. The latter two failures can best be managed by quietly continuing to work and strive. Success should only be regarded as delayed not denied. Rejection of grants and articles is almost routine despite the amount of time and hard work required to prepare them. Calm persistence can overcome many of these adverse events. Rewriting the paper or grant to correct the deficiencies detected by the reviewers followed by resubmission, even re-resubmission or submission to another journal, will ultimately result in publication of the work. To paraphrase Winston Churchill’s credo: Never, never, never, never, never, never give up.

A particularly challenging case can also be stressful and disheartening. It can appear at first to be an adverse event to the person faced with it. By staying calm and thinking clearly, it is sometimes possible to devise a new solution to the problem – one never described before. Thus, by meeting the challenge of this adversity, the vascular surgeon serendipitously turns adversity to his or her advantage and becomes an innovator. The seeming adversity becomes a creative opportunity. Many new developments and progress in vascular surgery have begun this way. No problem should be viewed as unsolvable despite so-called current wisdom.

More major adversity in a job setting can take the form of firing or termination. Such termination may be warranted or not. Often it is totally unjustified and based on personality differences or ego issues. Jealousy or negative bias are often involved. Such firings may take the form of a witch hunt based on a clinical or administrative superior highlighting selective and unrepresentative bad outcomes in a few difficult cases – something every good vascular surgeon has because of the difficult nature of the diseases we treat.

How should one deal with such a termination – unfair or not? Do not seek revenge. Get over it. Get another job and move on. Fortunately other jobs are abundant in the United States. Moreover, the new job often turns out to be better than the one left behind. The termination actually becomes a blessing in disguise, although it may take time for this to become apparent. Interestingly, many first-line leaders or biggest names in vascular surgery have profited in this way from the apparent major adversity of a termination. As one door closes, another may open if one is alert to the possibilities that may arise from change. Furthermore, the best revenge for an unfair termination is gained by achieving great success in one’s next position.

Although the discussion about dealing with adversity has thus far dealt largely with professional issues, the same principles can be applied to dealing with other aspects of life in general. Vigorous and excessive responses to adversity often result in greater pain and enhancing the wealth of lawyers. Equanimity, minimizing reactivity, and succeeding in the new venture one is forced into – even if unfairly – usually produce the best long-term outcome. It is an imperfect world, and how one deals with the many adversities that are part of it can make it less imperfect.

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