People have commented on some of my posts, expressing appreciation for my ‘patient advocacy.’ I hate that term. Let’s get something straight. I am not a patient advocate. Patient advocates are nurses and social workers with a Mother Teresa complex who see their mission as protecting the patient from evil uncaring doctors who would subject them to unnecessary pain and indignity. I have little tolerance for such people. If I am anything, I am an honest craftsman.
When a patient comes to my office seeking surgical care, I am making a pact with them, a contract if you will. I pledge my honor as a surgeon, as an honest man, that I will do the right thing for them. The right operation for the right reason at the right time. I will be conscientious in the operating room and will do my utmost to give them a smooth and uneventful recovery. To the extent that I do these things, my patient will do well and recover. If there is a complication, the first question I ask is “What did I do wrong?”
Note that in all of that, the real issue is my personal duty and integrity. If I do all those things right, the patient will recover and do well. But in the end, it’s not about the patient—it’s about the integrity of the work. The patient’s recovery is a happy side effect. It is the work that is the real motivation.
My personal integrity is at stake each time I go to the operating room. I have pledged to that patient to do my best. I don’t want to know them as people, I don’t have to like them or understand them. Sometimes it’s better if I don’t. I treat the gangbanger with the gunshot wound to the abdomen with the same attention to detail that I bring to the colon resection on the 70-year-old grandmother who bakes cookies for all the neighborhood kids. In the operating room, none of that matters. What matters is the skill I bring to my craft. The highest complement anyone can pay me isn’t to say, “ He’s a good surgeon.” Or “He looks out for his patients.” The true recognition of what I’m about is, “He does what he says he’ll do.”
Bruce Davis, MD, is a Mesa AZ based general and trauma surgeon. He finished medical school at the University of Illinois College of Medicine in Chicago way back in the 1970’s and did his surgical residency at Bethesda Naval Hospital. After 14 years on active duty that included overseas duty with the Seabees, time on large grey boats and a tour with the Marines during the First Gulf War, he went into private practice near Phoenix. He is part of that dying breed of dinosaurs, the solo general surgeon. He also is a writer of science fiction novels. His works include the YA novel Queen Mab Courtesy, published by CWG press (and recently reissued by AKW Books as the e-book Blanktown). Also published through AKW Books are his military science fiction novel That Which Is Human and the Profit Logbook series, including Glowgems For Profit and Thieves Profit.