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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 human being.

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 was correct.

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.

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