I have devoted 43 years of my life to surgery. This experience brought me to several basic conclusions.
The first one involves the choice of profession. My choice seems to
have been correct. It is no exaggeration to state, that in all my
professional life I did not have one single day of boredom. There were
times of satisfaction and joy, and others, of sad, even tragic events.
But never boredom. Surgery was always attractive and always interested
me. Have I chosen the world’s most interesting occupation? Yes,
for me surgery was just that. Of course, it is not for everybody. The
interest in vocation depends on every individual’s character. Not
everybody likes to see blood, to cut human flesh or to examine a sick
I remember well a conversation with my friend, more than 50 years ago.
We were close to graduation from high school, and we were discussing
choice of our future occupations. I always wanted to be a doctor and
never had any doubts about my choice. My friend wanted to study Chinese
culture. I told him that one has to make a living from one’s
occupation. Can one do that from studying Chinese culture? My friend
did not take this argument seriously, and said: “I can repair
shoes. If necessary, I will make a living from that. But I will study
what interests me.” He was consistent, studied Chinese culture
and became a great expert on China and professor at a famous
university. Of course, he did make a living from his vocation. In
retrospect, it is obvious that he was right.
None of my four children has chosen surgery, although I have one
physician-daughter. But like me, they all have chosen whatever
interested them. My son studies Japanese culture. I believe that he, as
my old friend, will make a living from his profession, because this is
the one thing that interests him most. My conclusion is, that whoever
chooses an occupation based on genuine interest, assures himself of
success. My work was interesting, and I enjoyed it. Those who chose an
occupation because of ill-founded considerations, such as prospective
wealth, prestige or any other concern not based on true curiosity,
condemn themselves to a life of boredom, disappointment and failure.
The second point concerns the choice of the branch of medicine. This
consideration stretches beyond mere interest, because any person with
interest in medicine should be able to adjust himself to one or another
branch. However, the choice involves the psychological background and
disposition of each person.
As a rule, clinical investigation in internal medicine entails
gathering of the greatest possible amount of information, which
requires time. In surgery, the time factor is much more limited. Under
threat of emergency, the surgeon is forced to restrict his
investigation and must make a decision on the basis of data available
at the moment. Hence, surgery attracts a different type of person than
internal medicine – one who wants to see results quickly.
According to William Nolen, the surgeon prefers the quick cure of a
scalpel to the slow healing by pills. But what he lacks in patience, he
makes up in decisiveness. 26
When in a hurry, one is prone to make
mistakes. Later, in retrospect, many volunteering
“consultants” are ready to give advice and point to what
could have been done better, but at the time they were not present. In
the moment of crisis, when there is no time for consultation, the
surgeon must decide by himself and immediately.
I like decisiveness, hate hesitations, and usually make my decisions
quickly, sometimes perhaps too quickly. These features predispose to
surgery and they led me to make my choice. I believe, that choice
The third point pertains to gaining experience. One cannot learn
surgery by just observing others and reading books. One learns from
experience, and this comes from practical work. Experience of others is
good for others. While working and gaining experience, we make
mistakes. Our errors may result in somebody’s death. But can
experience be gained without it? Some errors, particularly those
resulting from lack of experience cannot always be prevented, but it is
important to learn from them and to avoid them in the future.
Progress in surgery is a slow and complicated process, but it creates a
mature surgeon, confident of himself. I enjoyed this process all along.
26 William A. Nolen
: The Making of a Surgeon. Random House, New York, 1968.