Saturday, October 06, 2007
I'm about to do a reading of my book, which I haven't done for nearly a year. Having looked it over for the first in a long time, I find these paragraphs from the "afterword" relevant to my recent post about student blogs, and the comments that resulted. So, for those of you who haven't read THE BOOK (I find it all but unthinkable), I re-print them here:
"When I left Judy at Travis Air Force Base and headed off to Vietnam, I surprised myself by sobbing like I’d never stop. Three decades later, I’m glad I went. It was the seminal event of my generation; I know it from a perspective held by few of my friends. The analogy to surgical training is imperfect; I chose to be a surgeon, and didn’t cry on my way to San Francisco. But it was a tough slog, through a system set up by people over whom I had no control, and with whose conduct within that system I didn’t always agree. Nevertheless, I was among the last participants in an era now over for good. I felt part of an unbroken chain of teachers and learners tempered in that same cauldron, walking through the same halls, awake through the same nights, going back for much more than a century. Across the country, the old county hospitals are gone, and the residents are getting a little sleep. I won’t argue that it was better then; in fact, it probably wasn’t. But my training, which informed the lives of generations of surgeons, in many ways brutal and inhumane, is an experience I feel privileged to have had before it disappeared forever.
I wonder if Dr. Dunphy and his WW II buddies, and those before them, actually had thought it out like this, as they fashioned the modern rules of training surgeons: beat them down, overwork them, hold back the rewards, so that only those who really love it, who find being a surgeon irresistible—like surrendering to a disease—will push on into the senior years of residency. If people burn up and drop out, good riddance. Take their mistakes and wave them like semaphores, visible for miles. There are no brighter lights than those in an operating room. You’d better get used to it, because there’s no separating from the pleasure of dramatic success the misery of abject failure.
Fear of failure is the surgeon’s safety net, and his dead weight. If you haven’t had driven into your essence the sweaty recognition that failure is just around the corner, you ought never pick up a knife. But if you aren’t the kind to overlook that fear and plow ahead believing you’re prepared, you’ll never get out of bed in the morning, much less in the middle of the night."
It goes on from there, in other directions, and perhaps a little too long. But the above is a good crystalization of my thoughts about the inherent (and, to a significant extent, disappearing) toughness of surgical training. For what it's worth. Nor do I mean to belabor the point. I just came across the words again and found them relevant to the recent post. In addition to which, as readers will see, I'm running low on ideas...
Oh, and the book is a lot funnier than those paragraphs suggest. And entertaining.