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Goodbye to a cruel mistress
It’s been 35 years since I took my first faltering steps out of surgical residency. I had hoped to accomplish great things back then. I wanted to run with the big dogs and sample all that surgery had to offer. So, I worked long and hard and often late at night.
I realize now that my ambitions were unrealistic. I aspired to operations with no complications and patients who always survived. I wanted to operate a little faster and better than everybody else—always make the right decision, always stay ahead of the man. But it didn’t pan out. The numbers caught up with me, and they took their toll. I eventually learned I wasn’t any better than anybody else. I was just another soldier in an army of surgeons.
Running with the big dogs had its price. The calls from the intensive care unit came almost every night. I stopped sleeping. My blood pressure went up. I worried about everything. I’d underestimated the effects of the dark moments. I was a second victim before anyone knew what that meant. I didn’t want to admit it, but the stress was killing me. I ignored it like a good soldier should.
At age 56, I had angina for the first time while in the operating room doing a colectomy. I stepped back and took a few deep breaths. After the pain settled down, I did what all of us would do—I finished the case.
I called the cardiologist from the recovery room, and two weeks later I was in the operating room again. This time, I was lying on my back, hoping I’d wake up. I had a lot to think about.
After my bypass, I was grateful I wasn’t one of the guys who dropped dead in the hospital parking lot after a night on call. I realized that surgery was like a downtown, high-end mistress. She had tempted me with her own brand of martinis, cocaine, and mirrors on the ceiling. I was in love with her, and I thought she loved me too. But she was, in fact, indifferent toward me. She could bring me great pleasure for sure, but she could also break my heart anytime she wanted to. She could slap me in the face, even when I did everything right.
I came back to her for another 10 years after I recovered from my operation. She was just as beautiful, but I was more careful the second time around. I visited her less often, and I drank her martinis slowly. I realized that I was one of many suitors and that she treated me with no special favors. I kept my guard up and my expectations down, so she couldn’t hurt me as often or as badly as before. We had a much better relationship those last 10 years. There were still highs for sure, but the lows were less frequent and the pain and disappointment easier to bear.
One of my attendings used to say: “The best thing about surgery is that you can make a decent living using your hands.” I thought that was a strange thing to say. It all seemed like so much more at the time.
But on my way out the door for the last time, I can’t think of a better way to sum it up. There is always reflection with change. But I have no intention of looking back. Life is too short for just one mistress.
George N. Beito, MD, FACS
Kirkland, WA, firstname.lastname@example.org
While I’m glad you are ok, and that you have had some reckoning with your work-life balance and made some adjustments, the extended and uncomfortably-detailed metaphor in your letter should not have a place in medicine today. The objectification of women (“like a downtown, high-end mistress”), the strong sexual innuendos (“mirrors on the ceiling,” “I visited her less often”), and the apparent glorification of infidelity (“life is too short for just one mistress”) come across as misogynistic and downright creepy. This type of public musing is not appropriate in the modern era, and frankly should not have been published by ACS. Do better. #HeForShe