When "nice" is a surgical skill

Heather Logghe
@LoggheMD

“You’re too nice to be a surgeon.”

I have heard this comment—and its variations—from patients, families and more frequently, other healthcare practitioners. Yet the underlying implication—that surgeons have no need to be “nice” or display social skills is misguided. In fact, I would argue that the exact opposite is true—that social skills and emotional intelligence are essential to maximize the healing skills of surgeons. I consider bedside manner to be the surgeon’s second most powerful tool to promote health and wellness. Particularly when the blade has failed to cure disease, kind words and understanding may be all the surgeon can do to foster healing and a sense of wellbeing.

When the gunshot victim arrives to the hospital without a pulse and the ED thoracotomy is fruitless, the only healing a surgeon can offer is to be emotionally present when telling the family of the loss of their loved one. When a patient is faced with surgery that may or may not cure his disease, it is the surgeon’s intuition and emotional intelligence that guide her in explaining the options to the patient in a manner that empowers confidence and peace in his decision. When surgery fails the patient and she enters the journey of dying, it is the surgeon’s bedside manner that can bestow the family with courage to let go.

These are all privileges unique to the surgeon and they all require nuanced interpersonal skills and emotional intelligence. Just as surgically entering the body is one of the most intimate experiences a person can share with a fellow human being, to share with the patient and their family the psychological impact of their disease is a similarly intimate experience. 

As surgeons, we often have the privilege to be present with patients and their families as the patient hovers between life and death. While surgery and expert technical skills can tip the patient towards life, there are inevitably times when even the most expert hands and advanced technologies of modern medicine can not bring back the patient from the process of dying. At these times, only our words and capacity to bear witness to suffering enable us to comfort families and promote healing through graceful acceptance of the natural process of death.

It is these experiences that keep me from ever feeling “too nice” to be a surgeon. My “niceness” is not wasted by my choice to be a surgeon; rather it is an essential tool in my armamentarium to offer health and healing to patients and their families. I look to my mentors on a daily basis for ways in which I can be nicer to my patients and their families. I am inspired by surgeon bloggers, Mary L. Brandt, Amalia Cochran, and Kathryn A. Hughes and grateful for the mentorship and influence on the evolving culture of surgery. I close with links to their words of wisdom and experience.

Resilience, Grief, and Remarkable Wisdom by Dr. Brandt

Hanging on to better ourselves and Sometimes by Dr. Cochran

Like a Surgeon: About That Surgical Stereotype by Dr. Hughes