“Seeking success” is the theme of the 2015 Resident and Associate Society of the American College of Surgeons (RAS-ACS) issue of the Bulletin. While writing this introduction, I realized how difficult it can be to define that simple word—success. In fact, when you look up success in the dictionary you’ll find it has a variety of definitions. It is the end goal for which most, if not all, of us strive. However, for me, it is the goals we set out to accomplish that drive us forward and determine a true measure of success.
Some surgeons decide success means achieving a work-life balance so they have time to participate in their children’s activities, such as football and hockey games. Others might dedicate their lives to accomplishing specific career goals, such as maintaining the triple-threat physician model of researcher, teacher, and clinician that Sir William Osler described in the latter half of the 19th century.1 And there are those of us who, in our quest to do it all, find ourselves hovering around the mean of the proverbial bell curve, even as we continue to work toward our goals.
Regardless of one’s individual definition of success and the underlying motivators that drive each of us toward it, high achievers share some commonalities. The following five concepts, described in this article, are, I believe, essential to success not only in surgery, but life in general:
- The power of listening
- Striving for purpose, not position
- The importance of emotional intelligence (EI)
- Imperfection as a source of strength
- Every day is Super Bowl Sunday
The power of listening
“Listen with the intent to understand, not the intent to reply.”2
One of the most important components of communication is listening—a skill that is often taken for granted and one that is surprisingly difficult to apply. Some individuals confuse hearing with the act of listening. Hearing is one of five natural senses, whereas listening requires mental focus.3 In fact, active listening is a skill that can be learned and needs to be practiced.
A number of barriers can impede active listening, including personal bias or judgment. Many of us have experienced being in a conference room or other setting where an individual makes a statement with which we disagree or that we perhaps find thoughtless. When this happens, typically we stop the active listening process and end up severing that path to great communication. Considering that some researchers suggest that up to 90 percent of communication is nonverbal, this type of reaction can obviously disrupt the flow of productive communication.4 Taking the time to minimize preconceived notions and reserve judgment at the beginning of a conversation can significantly enhance our ability to communicate. Being an active listener does not necessarily mean you agree with the comments that someone is making; rather, it positions you to ask the right questions and better solve the issues at hand.
Strive for purpose, not position
“True happiness……is not attained through self-gratification, but through fidelity to a worthy purpose.”5
This past year I had the opportunity to study public policy with a tremendous group of diverse individuals. Several of my classmates expressed an interest in running for public office. My first question was always, “Why?” The various responses were fascinating. Some individuals wanted to attain a certain status (such as governor, congressperson, president, and so on) with no clear underlying motivation other than to attain the prestige associated with these positions. Others viewed serving in public office as a means to achieving a greater purpose; it was this group that most impressed me because they appeared to have a deep understanding of the underlying values that set them in pursuit of their broad vision. Understanding our goals and how to achieve them keeps us focused and sets us on a clear pathway toward success.
Those of us who are honest with ourselves will admit that ego plays a role in our pursuit of success, but it cannot be the sole motivating factor. Rather, let finding the answer to the question that weighs on your mind as you fall asleep, the one that wakes you up in the middle of the night or gets you out of bed in the morning, be the driving factor, and let it guide you to success.
The importance of EI
“If your emotional abilities aren’t in hand, if you don’t have self-awareness, if you are not able to manage your distressing emotions, if you can’t have empathy and have effective relationships, then no matter how smart you are, you are not going to get very far.”6
Over the last decade or so, EI has become increasingly important in the professional world and may be as important, if not more so, in determining success as an individual’s intelligence quotient (IQ). Daniel Goleman, a science writer who is credited with having brought EI into the mainstream, describes the five components of EI as follows:6
- Self-awareness: The ability to recognize one’s own emotions and how they might affect his or her behavior and decision making
- Self-regulation: The ability to control one’s impulses and adapt to dynamic circumstances
- Internal motivation: The ability to complete a task despite potential adversity
- Empathy: The ability to put oneself in other people’s shoes when making decisions
- Social skills: The ability to identify social cues while building networks and managing relationships to move people in a desired direction
Few would argue that a certain level of fundamental knowledge and technical skill is not required in order to succeed in surgery—ours is a profession of scholars, after all. However, it seems that the manner in which we interact with our colleagues may, at times, be more important than having the right idea. For young surgeons entering practice in new and unfamiliar environments, it is especially important to take the time to understand the atmosphere in which you are working. As the adage goes, if you drop a frog into boiling water it will jump out, so the key is to slowly warm the pot. You might be the smartest person in the room, you might have an incredible idea, but taking an approach that is out of sync with the setting in which one is functioning is a sure path to failure.
Imperfection as a source of strength
“There is something perfect to be found in the imperfect: the law keeps balance through the juxtaposition of beauty, which gains perfection through nurtured imperfection.”7
It has been said that no two snowflakes are alike; each one takes on a certain composition that maximizes its journey. Despite heading toward the same destination, the journey can be completely different for each snowflake, and some will combine forces while others collide.8 And yet, each is perfectly shaped to complete its unique journey.
As surgeons, each of us may be well-formed for our individual journey as health care professionals, but we are unlikely to possess all the positive attributes of our esteemed colleagues, making us perfectly imperfect. While some might view this as a point of weakness, I would argue it is a strength. Each one of us alone might be imperfect, but collaboration with colleagues who can compensate for our weaknesses allows for genuine success and positive outcomes. Over the years, we have seen the results of building multidisciplinary teams that encourage innovative thinking and lead to the development of products or solutions that are more robust than any one individual could produce independently. We need to understand the barriers that divide us so that we can ultimately get past them and work as a cohesive unit with our colleagues and teams. When we do, we build strength in numbers and ultimately enhance our own professional journey.
Everyday is Super Bowl Sunday
“Good is the enemy of Great.”9
Sometimes we find ourselves sitting in a meeting thinking about a variety of things other than what the speaker is saying. Who’s next on the schedule? What should I have for dinner tonight? How many cases do I have on the books for tomorrow? In many ways, it is natural for the mind to wander to what lies ahead. However, if we are always thinking ahead, then we can never really take part in the present. What would happen if we were able to give 100 percent of ourselves to whatever the task at hand might be? Michael Lipkin, a South-African motivational speaker, describes the Nine Star Social Values, which focus on bringing the best to whatever you happen to being doing every day.10 We should live each day as if it is Super Bowl Sunday, and we are in the game.
Bringing your best to the table also means being willing to view things from an unfamiliar perspective. Executives at successful companies, such as Jeff Bezos, founder and chief executive officer of Amazon.com, apply unique and innovative approaches to their work. A reporter once asked Mr. Bezos how far he believes his company has come and how far it can go. His response was, “It’s day one,” meaning he views every day as if it is the very first day of the business being open.11 To keep moving forward, surgeons need to view each day as if it is day one.
Each of us defines success differently, and only you—with guidance from experienced mentors—can determine what it means to you and how to achieve it. This RAS-ACS issue of the Bulletin explores a variety of topics related to “seeking success,” ranging from effective communication, teaching in the operating room, surgical advocacy, training for future leaders, and providing feedback for trainees.
Having nearly been killed at the age 17, I am often reminded of how fortunate I am to have had this second chance at life. I am also reminded of the limited and unknown amount of time we each have on this earth. As surgeons, we have the special ability to profoundly affect people and society. Applying some of these common principles of success will allow us to better achieve the desired impact. When the time comes to take that last breath, one can only hope to have achieved success on his or her own terms.
- Stone MJ. The wisdom of Sir William Osler. Am J Cardiol. 1995;75(4):269-276.
- Covey SR. The 7 Habits of Highly Effective People: Restoring the Character Ethic. New York, NY: Free Press; 2004.
- Robertson K. Active listening: More than just paying attention. Aust Fam Physician. 2005;34(12):1053-1055.
- Mehrabian A. Silent Messages: Implicit Communication of Emotions and Attitudes. Belmont, CA: Wadsworth; 1981.
- Keller H. To Love This Life: Quotations by Helen Keller. New York, NY: AFB Press; 2000.
- Goleman D. What Makes a Leader? Harvard Business Review. 2004;82(1):82-91.
- Stojanovic D. Mastery. Available at: https://en.wikiquote.org/wiki/Dejan_Stojanovic. Accessed July 6, 2015.
- Maraboli S. Life, The Truth, and Being Free. Port Washington, NY: A Better Today Publishing; 2009.
- Collins JC. Good to Great: Why Some Companies Make the Leap and Others Don’t. New York, NY: Harper Business; 2001.
- Lipkin M. Star power: How to Be Unstoppable through the Nine Star Social Values. Available at: www.mikelipkin.com/new/wp-content/uploads/2014/07/StarPower_BookPreview30.pdf. Accessed June 17, 2015.
- Steiner I. Amazon CEO Jeff Bezos: It’s still day-one, 20 years later. EcommerceBytes.com. April 14, 2014. Available at: www.ecommercebytes.com/cab/abn/y14/m04/i14/s02. Accessed June 17, 2015.