March 8, 2008 § Leave a comment

Old surgeon

Time passes relentlessly in any profession. Retirement may come as a welcome reward after a long working life, or it may come as an unwanted end. Or so I guess. I’m not even halfway there. Lately I’ve had the pleasure of working with two recently retired surgeons. It seems to me retirement can be a more drastic moment in mentor based professions like surgery.

At teaching hospitals, like the one I’m working at, surgery is formally organized as a continuing learning/teaching process. Your seniors teach you and you teach your juniors – throughout your entire career. This form of learning and working was more common before, when apprenticeship was the way you learnt your trade. Nowadays most lines of work require a formal education – you apply for a position – and it’s mostly coincidental if you get to work with experienced people from whom you can learn. No formal way of handing over the tricks of the trade to the next generation. But apprenticeship lives on, mostly in handicrafts like carpentry, sewing, plumbing and surgery (which at times involves both carpentry, sewing and plumbing).

Unlike a lot of other professions, old age is not considered a disadvantage in surgery (photo credit). The more clinical experience you got, the better foundation for surgical decisions. The oldest surgeons are commonly the most experienced and respected. I see this all the time. This week four attending surgeons where standing in the OR, not able to decide which course to take in a difficult case. So they called their senior. The one who’d trained them all. He’d seen more similar cases than them. It makes perfect sense. In other professions you might be at your peak when you’re 35. In surgery you’re in many ways at your peak the day before you retire.

What made me think of this in the first place, happened a few weeks ago. It started with the filming of an operation. One of the retired surgeons asked if he could tag along. I was delighted, knowing that he could guide me through it, making it easier to anticipate important points in the procedure. After about 15 minutes in the OR, he was not able to just stand there anymore. He asked the surgeon (who he’d trained) if he could assist. I couldn’t help but think that was why he wanted to join me in the first place. To get back in.

The next day I went to a weekly interdisciplinary meeting where surgeons, physicians, radiologists and pathologists discuss patients, findings and treatment. The younger doctors presented the imaging and biopsy findings, but when it was time to decide on a course of action they all turned to the senior surgeon. He couldn’t be far from retirement.

Two surgeons on either side of the line.

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