The 2017 RAS-ACS annual Communications Committee essay contest: Gravitas

Robert A . Swendiman

Dr. Swendiman

It took less than 24 hours for our world to be turned upside down. My wife was five months pregnant. A routine ultrasound ended abruptly and, shortly thereafter, we were at the children’s hospital meeting specialists. We lost our baby so quickly.

The ensuing days were a blur of grief and pain, but certain moments remain indelible. The obstetrician pressed the ultrasound probe gently on my wife’s pregnant belly, as he pointed out the catastrophic anomalies in our baby’s heart. A loud knock on our front door marked an unexpected but heartfelt visit from my program director to share his condolences. For weeks, I tossed and turned in bed, sometimes hearing my wife sob softly as she tried to fall asleep. I wished it was all a bad dream.

And the guilt: I remember the overwhelming, inappropriate guilt.

As a partner, I knew my wife needed me as she recovered physically and emotionally. I also needed time to grieve. But I could not help but feel that I was letting down my patients and colleagues. I was the chief on my service. Someone would have to cover my shifts.

Not wanting another resident to be called in on their weekend off, I told my program director that night, “I will be there this weekend.”

“No, you won’t,” he replied firmly.

Of course, he was right, and I was later grateful for his guidance. My colleagues covered for me without question. The attending surgeon on my service made arrangements for future cases. Mid-level heath care professionals picked up my clinic time.

But as a surgeon, I felt like a failure because I could not do it all.

I chose surgery because of the intensity of the surgeon-patient relationship. The trust required to go under the knife is unique in medicine, and this intensity permeates all of residency. The bond I feel with patients is matched by the camaraderie with my colleagues. We are the first ones in the hospital and the last ones out. We are unafraid to care for the sickest patients. Holding a scalpel is an honor, and the work that comes with the reputation is a prerequisite.

This professional gravitas is so strong that I felt guilty when I needed to put my family first.

My wife—who also happens to be a physician—and I went back to work not long after our loss. In retrospect, the time away was not long enough. I struggled then, and still do now, to find the balance between work and family, as do many physicians.

I make it a point to cover co-residents who have needed to put their loved ones first. I can empathize; our profession is too challenging to take it all on alone. I have found that acknowledging this fact makes me a better physician, strengthening my bond with patients, colleagues, and family.

After all, surgeons are human, too.


The author would like to thank his wife, Brenda Ritson, MD, MPA, a pediatrician at the Children’s Hospital of Philadelphia, PA, for her support, thoughtful comments, and editorial suggestions in crafting this manuscript.

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