Thursday, March 14, 2013


Yesterday I worked with one of our part-time attendings.  She had two cases scheduled.  The first went smoothly.  It was a bit complex and atypical of an operation but it went well and the patient did well. The second case...different story.

Back story: This attending is a part time surgeon, an enigma that you hear about but never see.  She became part time after her second child was born and I've been told I should get to know her ever since my daughter was born.  Now, I've finally gotten the opportunity to work with her.  Mom surgeon mentors are still still nearly impossible to find, especially those that are relatable.  She is a regular person - her husband isn't independently wealthy, she doesn't have 4 live-in nannies and a stay at home dad, she is a regular person, awesome surgeon and a mom.  With a bit of timidity, I've had the occasional opportunity to pick her brain about her career choices when I've taken call with her and she's been an amazing resource.  I also know that she recognizes the career advancement sacrifices that come with her choice to work part time.  She seems a little frustrated by the trade-off but not at all regretful.  

Back to the present: Ok, second case, she decides to try out a different approach she read about to increase exposure.  Unfortunately the change in the approach makes some parts of the operation a lot more difficult.  However, we press on.  Then we hit a key part of the case where a structure needs to be identified to ensure that it isn't injured, and we just couldn't find it!  She called for back-up.  I hear her mutter under her breath: "Can I just get through one case without asking for help!"  One of the senior surgeons came in and helped out.  The remainder of the case proceeded with continual second guessing her every move - "does this look right" "I think I'll go here"  "do you think this looks okay?"  She was reduced to what I like to call 'resident uncertainty.'  We finally finished.  All went well, the patient was fine, the final result actually looked great but I could tell she was defeated. She apologized to me at the end of the case.

Its not uncommon that attendings help each other out and scrub together.  Its one of the things I like about the group of surgeons at this hospital.  I tried to tell her I thought the case was fine that no apologies were needed.  But, I could tell she was disappointed in herself.  I wanted her to know what a great teacher she is, what a great role model she is to her residents and her children.  I wanted to remind her of how her patients gush about how amazing she is.  This attending trained at my institution and I have literally NEVER met a single person - faculty, resident, nurse, administrative staff, who had anything but extremely positive comments about her skill and her judgement.  I wanted her to know that I have operated with senior surgeons who have come to work every day for the past 20 years and still occasionally need to call in back up.  When I think about the two cases we did that day, I think that there are two people that may no longer have cancer because of her.

I read an article recently about how motherhood completely and utterly changes your life.  No matter what you have invested in your career prior to having children, being a mom will profoundly change your career and who you are and every decision you make.  This is so true.  I feel like I'm struggling with it every day.  Fulfillment in two places, work and home, often at odds with each other.

As she walked out of the OR my attending told me that she was on call tomorrow night and that unfortunately I would be stuck with her again.

My response ..."It would be my pleasure"


  1. yay for awesome attendings, thanks for the spreading the word!

  2. Tell her those things. All of them. It's uncommon for people at the upper echelons to hear that they are competent and skilled. It is assumed that they know it, but that often is far from the case. It sounds as if she needs some support from someone who is speaking honestly rather than gushing or sucking up.


  3. Print this article. Give it to her. You can't fix someone else's self esteem though.

  4. Ever since I started to work part time, I feel doubt creeping in. I wonder if I am getting rusty. I wonder if I am not valued by my partners. If a case feel difficult, I wonder if I am losing my touch. Thanks for the article. I hope your attending reads this and feel a bit better.

  5. Great post. I beat myself up whenever I'm not certain of something, and I feel guilty if I'm not constantly reading at home. It's so easy to start doubting yourself when you know you're not working as hard as other colleagues.

  6. I agree with those above. Tell her how much you appreciate her.
    BTW, awesomeness is my favorite 'non-word.'

  7. Yes, yes, yes. Cutter, this (what you wrote) is the story that tells it all. Mothers in surgery tend to be SO critical of themselves. Mothers are critical, surgeons are critical... the two together.

    I might disagree with an above commenter who may have suggested that this surgeon has issues with her self esteem. Perhaps she believes that she could have done better if she had seen more cases. I would love to know more about this woman's career path. Yours as well, actually. I haven't finished reading your entries here. I am a mother of two kids. I'm finishing up my PhD and will return to MD in July- I find myself drawn to surgery, but unwilling to sign my kids away for 7 years. I wish there were some guarantee that I could spend just one day a week with them! It sounds grueling. I'll keep reading for any sparks of hope.
    Thank you so much for telling your stories, and describing things from your perspective. It helps me immensely.

    1. I just saw your post. Surgery is so fulfilling and it becomes more so as I get further along. But the life balance is a constant struggle for which there are no answers. But my daughter already has interest in my work and ask me about my "op-a-ray-suns." I'm just having faith that I'm going whats best for her and us.

    2. I just saw your post. Surgery is so fulfilling and it becomes more so as I get further along. But the life balance is a constant struggle for which there are no answers. But my daughter already has interest in my work and ask me about my "op-a-ray-suns." I'm just having faith that I'm going whats best for her and us.


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