Tuesday, June 24, 2008

The Close of a Chapter...

A chapter of my life has come to a close today. On Friday, the department of surgery at my hospital had a small ceremony to mark the graduation of the senior residents before they head off in their different professional directions. I look forward to this event every year, as it is generally a very festive celebration and highly entertaining party with the residents doing their best to put on a good show.

But this year was most special, because I was one of the eight graduates being honored. As always, it was fun and filled with laughs, hugs, and congratulations. And while the excitement of graduating and seeing all of my colleagues there to support me was thrilling, a part of me was disheartened about leaving an institution that had grown to become part of me.

After all the funny skits, it was time for us to take our place at the front of that room that we had all given countless case presentations in. This time, we spoke about ourselves instead of about a patient. One by one, my classmates walked up, and they all made the most earnest and heartfelt remarks about their time as surgical residents. If you are not a surgeon, this sounds like what you would expect at a graduation ceremony. However, one rarely finds surgical residents not armed with sarcasm and wit, but the occasion proved too moving to allow even the most disaffected of graduates to escape the stage without at least some honest emotion breaking through.

Since my last name starts with a “W”, I am often last in these types of ceremonies, which was good, because I had not really gathered my thoughts about what I would say. Normally, this would cause me great anxiety since I am not a natural public speaker. But for some reason, time seemed to slow down as I listened to my classmates, and my mind became clearer and calmer than it had been all night.

I began to reflect on the last seven years of training. I thought back to when I interviewed for surgical residency. I told the chairman that I wanted to be a resident in a premier surgical department. I wanted my training to be second to none. I wanted the institution to make me the best surgeon possible. But in addition to my expectations of the residency, I expressed my desire to make sure that I gave something back to the residency as well. I wanted to leave the institution better for having trained me.

Well the residency certainly did its part and allowed me to learn the things needed to begin a solid career as a surgeon, but I had not really considered what would be my legacy to the hospital. I don’t think my surgical knowledge, clinical judgment, or technical skill had been particular exceptional. If anything, I think I was about average in these areas. Now, I would never admit to being an average surgeon in a room full of my peers, because that is not consistent with our culture. All eight of the surgical graduates pronounce themselves to be outstanding, and despite the mathematical improbability, we all rate our clinical skills to be at least one or two standard deviations above the mean. But for now, I will make a sober assessment of myself, and say that I am neither the best nor the worst graduate to finish the program.

So what did I bring to the MGH? I have won no national awards. I did not develop any new surgical techniques or clinical insights. My research was interesting to me, and I published a modest number of papers, but I don’t think my scientific career would distinguish me as exceptional. Despite the self-deprecating litany above, I actually feel very proud of my time here. I am proud, because I came to work faithfully for seven years, and I did “surgery” the best way I knew how. Don’t get me wrong, I had lazy moments, I had frustrated moments, and I had cynical moments, but through it all, I tried to hold onto my idealism about being a physician, and I gave it my all…most days.

In the final analysis, what I gave to the residency was me. I gave it my twenties. I gave it time with my family. I gave it weddings, funerals, and graduations of my loved ones. I gave it blood. I gave it sweat. And yes, I gave it tears. I worked when I was healthy and upbeat. I worked when I was sick and depressed. I worked when I was refreshed, and I worked when I was exhausted. I operated when it was a pleasure, and I operated when it was torture. I took care of patients who were kind, respectful, and appreciative. I took care of people who were violent, mean, and unlovable. I gave it everything within me, and it hurt me sometimes. The residency caused pain in my body. It played tricks with my mind. And more than once it broke my heart and nearly broke my spirit.

Now I would be bitter if I had given all of that, and all I had become was an average surgeon, but the balance sheet is not complete. Because my seven years gave me some things I never would have expected. It gave me friends too numerous to count. It gave me more than a dozen surrogate mothers who “looked after me” while I was here. It taught me that endurance is more important than speed and strength. It taught me that service is the highest calling. It confirmed my faith that flawed people are capable of showing flawless character. It gave me an appreciation for my own health. It made me a professional. It made me a man. It gave me the exhilaration of saving someone’s life. It gave me the sobriety of watching someone die. It gave my mind focus. It gave my hands power. It gave my heart fortitude. And it gave my life meaning…

Sure enough, my time came to stand before the crowded amphitheater and express my final thoughts. I cannot remember exactly what I said. I do remember that I told the people in the audience that to me, they were family, and that I would miss them. I did not have the words then and really don’t have the words now to say exactly what this place has meant to me. It has shaped me in ways I never would have guessed, and I walk away with no regrets. I will never forget what I have learned in the last seven years.

Although we all had different ways of expressing it, the words of the graduating senior residents all had one thing in common: A deep respect for the process of training a surgeon and a fondness for the institution that had trained us. I hope the new interns who were in the audience that night remember our words. They have some tough days and long nights ahead for the chapter is just starting for them as it closes for us.

Turning the page,

I would like to see the day when somebody would be appointed surgeon somewhere who had no hands, for the operative part is the least part of the work.
~Harvey Cushing


At Thu Jun 26, 10:40:00 AM, Blogger Bola said...

Hey Chad! I don't get many opportunities to view what my friends are up to in their lives on facebook, but when I found the link to your blog, I couldn't put my laptop down until I read every last word. I was moved to tears. I can't wait to see how this new chapter in your life unfolds. I am sure when you get to Kenya, the love and smiles of those you meet will leave a mark etched in your heart for a lifetime. I am so excited for you and what God has in store.

God Bless you in all your endeavors Chad! The world definitely needs more people like you. Enjoy and be safe.

-Bola :)

At Thu Jul 10, 10:19:00 PM, Blogger patience said...

Congratulations Dr. Wilson,

You've never been average and I'm sure your experience in Kenya will be superior. I'm quite sure you will pick up where Ben Carson left off many years ago. Best wishes!!!!!



Post a Comment

<< Home