Doing the Right Thing
People have commented on some of my posts, expressing appreciation for my ‘patient advocacy’. I hate that term. Let’s get something straight. I am not a patient advocate. Patient advocates are nurses and social workers with a Mother Teresa complex who see their mission as protecting the patient from evil uncaring doctors who would subject them to unnecessary pain and indignity. I have little tolerance for such people. If I am anything, I am an honest craftsman.
When a patient comes to my office seeking surgical care, I am making a pact with them, a contract if you will. I pledge my honor as a surgeon, as an honest man, that I will do the right thing for them. The right operation for the right reason at the right time. I will be conscientious in the operating room and will do my utmost to give them a smooth and uneventful recovery. To the extent that I do these things, my patient will do well and recover. If there is a complication, the first question I ask is “What did I do wrong?”
Note that in all of that, the real issue is my personal duty and integrity. If I do all those things right, the patient will recover and do well. But in the end, it’s not about the patient – it’s about the integrity of the WORK. The patient’s recovery is a happy side effect. It is the work that is the real motivation.
My personal integrity is at stake each time I go to the operating room. I have pledged to that patient to do my best. I don’t want to know them as people, I don’t have to like them or understand them. Sometimes it’s better if I don’t. I treat the gangbanger with the gunshot wound to the abdomen with the same attention to detail that I bring to the colon resection on the 70-year-old grandmother who bakes cookies for all the neighborhood kids. In the operating room, NONE OF THAT MATTERS. What matters is the skill I bring to my craft.
The highest complement anyone can pay me isn’t to say, “ He’s a good surgeon.” Or “He looks out for his patients.” The true recognition of what I’m about is, “He does what he says he’ll do.”