THE LOST SUMMER OF 2001
Physicians especially surgeons are known for their near maniacal devotion to a 24/7 work week schedule year round with two weeks of vacation. The origin of this grueling life style can be attributed to a misguided notion of superiority, which develops early on during the individual’s surgical residency training. This postgraduate educational program averaging five to eight years following graduation from medical school unfortunately foster a demanding schedule of hard work, study and self-discipline. In addition, there is an unreasonable expectation of grit, commitment and scholarly productivity. This full commitment to a professional life of continuous hard work and self-sacrifice sooner or later create a perceived aura of invincibility capable of generating a super human strength and endurance in response to the demands of the profession.
Unfortunately, the ultimate consequence of such a schedule is total physical and mental burn out which sooner or later may lead to self-destructive practices. It is therefore not surprising that a recent surgical manpower study (Kirby I. Bland, M.D., Department of Surgery, University of Alabama, Birmingham) suggests that in the next twenty years there will be a shortage of general surgeons in this country. This year, only one out of twenty U.S. medical school graduates have applied for surgical residency training compared to one out of twelve in previous years and only seventy-five percent of categorical residency positions in general surgery were filled by graduates of U.S. medical schools during the most recent residency match – a dramatic change from the eighty-five percent previously observed.
Self-destruction in the surgical profession with all its serious ramifications to the individual and his or her family is an exception to the rule. In the majority of cases, reality soon sets in and the “myth” of an indestructible and unwavering surgeon turns out to be just that, a “myth” and the surgeon either slows down with his or her schedule, change specialty to a less stressful job or retire early, not to mention the early onset of death from stress related diseases.
Early retirement became a reality for me at the end of August 1998, 40 years after I started a career in surgery, beginning as an intern in this country in 1958, followed by an appointment as the first foreign medical school graduate to the general surgery residency program at the same institution where years later I became the Chairman of the Division of Pediatric Surgery and for eleven years prior to my retirement, I was privileged to serve as Chairman of the Department of Surgery. In between this professional journey was a series of practice settings; ranging from a brief sojourn as a member of the faculty at my alma mater in the Philippines after completing my postgraduate training in the US, followed upon my return to the US with a private pediatric surgical practice with responsibilities for graduate medical education in surgery and finally to a full time academic University practice and medical administration.
During the summer of 2001, having just completed three years of “permanent vacation” from surgical practice, teaching, research and administration, I came to the painful conclusion that a physician, especially a surgeon never really gives up completely his or her professional career, at least not completely. Despite the sudden abundance of time available in retirement for enjoying one’s family and the unexpected leisure engaging in recreational activities, there was a constant longing of things past and there was an eagerness to participate in future activities related to my profession. For this reason I went into a part time practice after completing the requirements for medical licensure in the State where my wife and I retired.
During the annual meeting of the SPSA in July 2001, held at Amelia Island, Florida, while observing in obvious admiration the continued commitment of our Society’s leadership to continuing medical education and listening to their experiences of volunteerism, I began to formulate my future options for service during the incoming months and years.
Unfortunately, some of the best-laid plans fall victims to unforeseen circumstances. Late summer, the dreadful event of September 11 reared its ugly head in the horizon. As a first generation immigrant to this country during the later half of the twentieth century, the notion of self-destruction by a group of evil people in order to inflict death and devastation to innocent people was simply unthinkable. Ever since the founding of this Nation, thousands of immigrants flock to this country to escape the scourge of religious strife and ethnic persecution in their native countries. Immigrants arrive daily to seek a better life for themselves and their families and aspire to benefit from job opportunities provided by a system that recognizes individual performance and places a premium on excellence and hard work, regardless of race, creed and religious belief.
As physicians, we constantly face death as we minister to the needs of people who suffer from the ravages of disease and malformations. While death from fatal illness is inevitable, the life preceding the final event can be made full, productive and blessed. Death from war and violence on the other hand is senseless regardless of its origin or presumed justification.
As we reflect on the full meaning of life, despite the conflict and turmoil that surrounds us, we also recognize that life can be a wonderful experience especially when lived in an environment of love for mankind and faith in the goodness of men. And while the senseless tragedy of last September 2001 deprived us, a nation and a people, of joys of that summer, there are still simple pleasures around us that can certainly bring a smile should we stop and notice them. I cannot help but think of little things, easily forgotten or ignored, that can enhance our daily lives and those around us. How often have we observed the swaying of the leaves to greet the dawn of a new day; the lovely flower as it begin to blossom; the first steps of a grandchild and the coos of a baby rocked to sleep? When was the last time we shared a smile with loved ones, a friend, and even a total stranger? A quotation posted in the operating room by an unknown author years ago appear appropriate today as it was then, to quote: “A smile cost nothing but gives much, it can not be begged, bought, borrowed or stolen for it is of no value to anyone until it is freely given away.
Life can be a wonderful journey of love, peace and goodness devoid of anger yet; it can also be a sad trail of hatred, war and evil. To any decent human being, the choice is not difficult to make.
This event has reminded me that retirement should not be wasted on trying to recapture the glories of the past but rather a stage in life where service and love for humanity must remain foremost in our thoughts and actions.
In retirement, as it has always been in my life, I continue to marvel at the beauty around us, dream of places I have never traveled and think of helping others in need and giving oneself to alleviate human suffering.