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My Thoracic Surgeon Comes to Dinner

I've survived a lot of medical treatment. The most sophisticated and creative was while in the care of an extraordinarily gifted, courageous and talented surgeon. We invited him and his wife to dinner to renew our acquaintance and review the bidding.  The dinner was memorable.

I could launch into the details of my 8 surgical procedures performed by this brilliant man but that story is told elsewhere. Of more interest to this community is what are the indicators of brilliance in a surgeon?  Unlike general medicine or oncology, surgical encounter time is brief.  One can ask about reputation, but thoracic procedures are risky and outcomes are variable involving heart, lungs, vessels, transplants and a myriad of complex procedures to the engine compartment of the body.  Using my surgeon as a model, it might be useful to develop a means test of thoracic surgical competence that a survivor might use to evaluate suitability during the span of a short pre-surgical consultation.  Here is my list.

  1. Is your surgeon friendly?  Is this man or women one you’d enjoy having a coffee or a beer with?  Does conversation flow easily?  Does the surgeon respond to your elements of conversation?  Does he or she listen?  Do other practitioners or office staff enjoy being around him?  A surgeon that is pleasant is likely to be a surgeon that is sympathetic, benevolent and a true believer of the tenants of the Hippocratic Oath.
  2. Is your surgeon inquisitive? Surgery is a melding of art and science. The art is “what” to do and the science is “how” to do it. Thoracic surgeons are a small tribe that practice in a complex environment. When something new is discovered, your surgeon should be very interested in investigating it for application. If your surgeon already thinks all the “what” questions are answered, find another.
  3. Is your surgeon respectful? In your pre-surgical consultation, you ought to feel like the important one. Your medical condition needs to be acknowledged as important and your feelings, fear, anxiety, and uncertainty should to be taken into account.  If your surgeon doesn’t use your name or look at you or attempt to help you relax during the consultation, find another.  If your surgeon makes a grand entrance, surrounded by a posse of assistants, and talks to them about your case, find another quickly!
  4. Is your surgeon decisive? At the pre-surgical consult, there is one key decision to be made: operate or do not operate.  This ought to be made then and there. If your surgeon feels the need to discuss your case with others, find another.  There is so much uncertainty in lung cancer surgery and each encounter will require a decision. Your surgeon needs to come equipped for making decisions, alone.
  5. Is your surgeon acutely intelligent? Compose a non-surgical question on the surgeon's interest or hobbies ahead of the consultation. Listen for passion and detail that indicates sincere interest and evidence of accomplishment. Intelligence starts with curiosity and leads to ability to assimilate knowledge and use it in cross functional ways.  A surgeon with a photography interest would know depth of field (the f-stop setting on a camera) is analogous to layers in skin, tissue structure, and visual focus precision.  Photography concepts relate to surgery yet it is a diverse field of intellectual pursuit. Avoid those who are interested only in surgery or who say they don’t have time for anything in their life but surgery.    

We had a wonderful reunion made even more special by the attendance of my daughter, son-in-law and granddaughter.  My daughter met my surgeon 15 years ago while I was near death. She is also a beneficiary of his skills.  Ten years after my surgeries, I asked my surgeon to help find a skilled brain surgeon to remove my daughter’s complex meningioma. He moved heaven and earth to do so. Add compassion to my list.

Stay the course. 



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You are blessed to have this surgeon in your life. He sounds amazing! I feel blessed to have the man who did my VATS surgery at M D Anderson. On a day when appointments were doubled up due to an ice storm abating in Houston, he answered all my questions and at my request drew me a picture of what he was describing. He was focused, friendly, amazing! 

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Tom,

Thank you for this link (you provided in a reply to my post yesterday).  Very well-written and beneficial - encompassing so much more than what clinic or med school the practitioner has attended. Thank you for reminding me to keep that perspective as well in this journey.  Your surgeon sounds wonderful. I can't imagine the mutual bond you both must have as a result of your experiences and history, and the help he provided for your daughter as well.  That was uplifting to read. Really enjoying your posts, information and willingness to help others on this path.  Thank you.

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Tom,

I just got to read this and it is spot on.  I found myself nodding to each of the qualifiers you listed above.  I was really blessed with my pulmonologist and surgeon.  The surgeon was almost like an athlete...moving around full of energy, listening deeply to my concerns and questions, being fully open and honest with me about my disease.  He was well-versed on recent research and offered solid reasons why a resection was preferable to a wedge approach (I was thinking about).  I have access to him through a medical website and the one time I Needed to ask a question he called me back personally (rather than a written response) so that he could respond and make sure I had no further concerns.  

Anyway, nice piece, well written.

Thanks,

Lou

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