Odysseys of George

As life cruises along; vita non est vivere sed valere

50 Tips for Coping With Burnout, Aging in Surgical Practice

By Moshe Schein, MD, FACS

Much has been written recently about burnout among surgeons and how they can cope with it (Ann Surg 2009;3:463-471; Adv Surg 2010;44:29- 47). Although some studies point to a higher rate of burnout among younger surgeons, common sense suggests that the more we engage in a demanding activity, the more likely we are to become fed up with it. The same can and does happen in any arduous and stressful profession. An infantryman rotting in the trenches—without significant periods of rest and relaxation—will develop physical and emotional fatigue. He will burn out.

When general surgeons finally become well trained and self-sufficient after medical school, residency, fellowships and early years in practice, they are not so young anymore. Just take a back seat in the auditorium at an American College of Surgeons meeting or in your own departmental Morbidity and Mortality conference, and calculate the small percentage of attendees who do not sport a bald spot or gray hair—yes, dyed hair is easy to spot. This sight may make many of you ponder your imminent senescence, if it’s not already at the gate.

This article presents a few points, not in order of importance, to help you combat burnout and to achieve graceful aging in surgery. The list is based on my own experience of 32 years in this profession. Having survived the chaos of moving across continents, counties, various practices, and political upheavals, I have found peace of mind and some degree of stability while in the pre-winter of my surgical career.

This list of recommendations may sound tacky or cheesy, pretentious, repetitive and cliché-laden to the highbrows among you. Without doubt, only saints could comply with all the stipulations. Surgeons, including myself, are rarely saints; nevertheless, I hope these observations and recommendations might be beneficial to some of you. I’ll bet that many of you could add more items to the list. (Note: All quotations and aphorisms
by surgeons in this article are from my books: Aphorisms and Quotations for the Surgeon [2004] and A Companion to Aphorisms and Quotations for the Surgeon[2008].)

How Doctors Die

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It’s Not Like the Rest of Us, But It Should Be
by Ken Murray|November 30, 2011

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds–from 5 percent to 15 percent–albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

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Puerto Galera, the main city in Oriental Mindoro, means Port of Galleons, probably in those many years ago many such ships from Spain used to dock here. We went for a dive there and this was our second visit there and the waters were very cold reaching 21°celcius.


Death do us fear….

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Death, lately too many…. relatives, friends, citizens …… life seem so without value as they drop like dried leaves in autumn..sad…. unsure how to feel… worried…. yes.


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Lichfield Angel (Ausrelate)
David Austin Recommended Variety


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Category English Roses
(English Rose Collection)
Bred By David Austin

Flower Type Double/Full Bloom

Size Medium Shrub
Hardiness Hardy
Fragrance Light
Repeating Excellent

The flowers of this rose commence as charming peachy pink cups, gradually opening to form neatly cupped rosettes. Each bloom has a perfect ring of creamy-apricot waxy petals enclosing numerous smaller petals. Eventually the petals turn back to form a large, domed, creamy-white flower. The overall effect in the mass in sunshine is almost pure white. Lichfield Angel will form a vigorous, rounded shrub which, with its blooms nodding attractively on the branch, will make a fine sight. It is very useful in a border, as it harmonises well with all other colours and will act as an intermediary between pinks and yellows. The fragrance is generally light but has strong elements of clove at one stage. Lichfield Angel is a limestone sculptured panel, from the 8th century, which was recently discovered in Lichfield Cathedral. It depicts the Archangel Gabriel and still bears the remnants of Saxon paint. (English Musk)



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