Intended for healthcare professionals

Letters Excising the “surgeon ego”

A surgeon’s view of excising the “surgeon ego” to accelerate progress in the culture of surgery

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l58 (Published 07 January 2019) Cite this as: BMJ 2019;364:l58
  1. Kevin J H Newman, consultant orthopaedic trauma surgeon (retired)
  1. Guildford GU4 7EU, UK
  1. kevinnewmanortho{at}mac.com

Myers and colleagues dwell on the tiny percentage of “super ego” driven surgeons who give the surgical dog such a bad name.1 I know of no other surgeons arrogant enough to have branded their patients.

Surgeons can be shy people, often in some degree of emotional turmoil after tragedy but adept at concealing it from colleagues.

Surgeons literally have patients’ lives in their hands. This visceral connection to death is less common among physicians and psychiatrists. Doctors are unlikely to have had an experience that can match, for sheer horror, their patient dying on an operating table, a direct consequence of using a scalpel to try to save a life. Aortic aneurysm surgery is one of the more graphic examples: alive one minute, dead within seconds.

Most surgeons have had at least one such horrific event in their careers; if they haven’t then they probably haven’t operated on enough people or had a long enough career to avoid such a calamity.

Not even the most skilful surgeons can avoid a “death on table” in their career.

Do the surgical team get counselling afterwards, or are they expected to “man up” and send for the next case as though nothing dreadful has happened? Post-traumatic stress disorder is more common in medicine and surgery than we are prepared to admit.

These tragic outcomes leave scars. Surgeons are asked to “play God.” It is no surprise if they “act like they are God” at times of stress and fulfil the arrogant stereotype of physicians’ jokes.

Another solution is to encourage more women to enter surgical specialties. Lack of excess testosterone and abundance of common sense (and talent) may just help balance things out for the weaker sex (men).

Be kind to surgeons please.

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