“You Have to be a Surgeon with Testicles”
The issue I want to present here is whether there is something special in the orientation and behavior of surgeons that separate them from all the other specialties in medicine or from folks in entirely different occupations. Does it have something to do with their ego, a greater attention to themselves and perhaps their manliness? Or is this simply a reflection of the surgeon’s self-confidence (??or lack of self-confidence??) Or is it, if present, a consequence of the immediate and personal responsibility to preserve their patient's life while the surgeon has hands inside the patient's body. Has anyone found that women surgeons display any similar egotistical behavior.
Read the excerpts below which were written by medical students in the
Medscape Medical Student Blog Let me know what you think about surgeons and whether this analysis of them is really fair and realistic. If so, is it a surprise? ..Maurice.
Nasstasjia, actually a year and a half out of medical school and awaiting a surgical residency, wrote her comment on Feb 1, 2007. While performing a hernia operation, the supervising surgeon told her "You have the skills but if you want to remain a woman in a man's world, you have to be a surgeon with testicles!!!! Or don't be a surgeon at all.!!!"
Bob wrote on Feb 2, 2007:
I work in cardiothoracic surgery w/ a surgeon who is excellent at his job. Having said that he can also be one of the most immature individuals I have ever met! I have never seen a grown man actually 'pout' when he doesn't get what he wants. On one hand you respect him then on the other you just want to yell "GROW UP!!"
There are alot of great surgeons out there but the best are the ones that treat everyone like a human being. One heck of a concept huh? If you are a doc reading this take notes.
imamedicalstudentgetmeoutofhere wrote on Feb 2, 2007:
One neurosurgeon who recently taught us actually introduced himself as god, and he wasn't taking the piss! I love surgery and hope one day that I’ll make it through the ranks myself. Will I develop an ego? Probably.
posted by Maurice Bernstein, M.D. @ 1:42:00 PM
3 comments
3 Comments:
I entered this thread posting on a bioethics listserv and an ethicist Lance K. Stell, Ph.D. wrote the following response to the list. I reproduce it here with Lance's permission.
Maurice,
Stereotypes actually are helpful. They exist because knowledge is costly and humans have limited time and ability to acquire it. So we must employ "general ideas" as deTocqueville called them.
Acknowledging that there are many types of surgeon, there are character-traits that the discipline tends to select for and individuals with those tendencies tend to self-select as well.
In surgery, "definitive repair" is often in the cards, provided one diagnoses quickly, and acts decisively. Dithering, ambivalence, vacillation are rightly regarded as much worse in a surgeon than those traits might be viewed in medicine where caution, study, reflection, and multiple rule-outs are more appreciated, and where many patients will get better on their own, provided that the medical doctor doesn't screw up by treating when s/he shouldn't.
Taking charge and making decisions promptly are characteristics associated with an increased risk that one will tend to take more responsibility than one should.
If one thinks of errors, timorousness/shirking on the one hand and arrogance/bravado on the other, on which side would it be better to err as a surgeon?
If we assume that human beings will err, not only technically but also personally, it's fair to ask on which side (of defect and excess) it's better to err for different sorts of health care professionals.
I think we have the funny/unflattering stereotypes of different medical/surgical specialties b/c of the defects/excesses that it's better for its practitioners to have.
My two cents, Lance
In a humerous way to characterize the stereotypes of the various specialties, Lance reminded us of a classic joke, which I present below, to which another ethicist on the list added a specialty missing from Lance's original posting. ..Maurice.
Joke:
Internal medicine doctors know everything, but can't do anything.
Surgeon's can do everything, but don't know anything (what do you call two surgeons looking at an EKG? - a double-blind study).
Psychiatrists know nothing and do nothing
Pathologist know everything and can do everything - but it's too late.
I will try to ignore the deeply offensive chauvinistic and sexist aspects of this thread title and postings to address the crux of your question (I am a man and I am deeply offended by these aspects).
Based upon my experiences I would say that surgeons may indeed be more egotistical than other doctors. I do feel that surgeons rapport with patients tends to be worse than other doctors. While this egotism may motivate some surgeons to work for their patients, I cannot believe that it is, or should be, the primary motivator for surgeons in general. Egotism my help in some instances, but it will also be counter-productive in other instances.
Competence is certainly very important for surgeons, and confidence can be one of many aspects that has a bearing on this. Generally the best surgeons in most specialties are the ones who have performed the greatest number of procedures, therefore confidence and familiarity must be relevant. Egotism is something very different, and I believe that competence with humility is much more desirable since egotism and arrogance can lead to mistakes and coverups that don't serve the patient.
Of course women can be excellent surgeons and "manliness" is not a requisite trait. It is sad that medical students and residents are still being innundated with sexist attitudes (as indicated by the postings you provided).
In medical school I was the top student in anatomy and always had a strong aptitude for visuospatial reasoning. Some thought that I should naturally be a surgeon including some in the surgery department. I did not like the competetive and often mean social atmosphere there and made a different choice. For many years I wondered if I had missed my calling.
I now see clearly however that I would have never made a good surgeon despite the intellectual aptitude for the anatomical/technical aspects. I am much more at home with clinical work that benefits from reflection and patience--and am, while I can act with alacrity when the situation demands it, find it more stressful than I should. In short, I could easily learn the technical skills but don't have the temperament to optimally perform the kind of judgements called for.
I think perhaps the chauvinistic traditions in surgery serve a useful function in forcing a self-selection of just the personality type most suited to the work. I think specialty selection in medicine is largely a matter of matching personality to work, we all pretty much have the aptitude to learn any of it. It would be interesting to see more research on personality and specialty selection.
The flip side of the egotism allowing surgeons to make bold and irreversible decisions--with much necessarily sometimes be wrong--without developing crippling self-doubt, is that they acquire a strong susceptibility to certain other kinds of clinical errors and relationship problems both at home and hospital.
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