By Sebastian Guenkel, MD

Do you experience enough? Are you fulfilled enough? Do you question whether you are enough? What are your expectations? And those of your family, friends, colleagues, and patients? Do you fulfill these expectations?

Frankly, I think all of us might have asked ourselves these questions. These might be questions that are crucial to our mental health, ultimately leading to happiness. But what is happiness? Am I happy? If so, why? Or why not?

One of my much valued colleagues needed to take some time off from surgery. This fine gentleman did almost 30 years of work and calls as a surgeon. In the current setup, when on call, he still sleeps on a mattress in the hospital office despite being an experienced senior consultant. He takes such great care of his patients that this colleague now suffers from being burnt out. He is a skilled and well accepted surgeon. He is a beloved father and has been happily married for over 20 years. At home, he found his peace. But not at work.

As a still somewhat young surgeon, I ask myself what it is that makes us happy at work, or conversely, what it is that makes us feel not so good, unhappy, lost, alone, insecure, or even sometimes desperate? Why is it that one of my most experienced colleagues finds himself in an unexpected place, where he can’t function as he would want to anymore? What are the underlying mechanisms? What can we do to see and prevent such disastrous feelings among us surgeons?

What always helped me was biking, running, skiing, and enjoying the outdoors. My father, a retired cardiac surgeon and role model for me, always ran. The day I was born he was running an ultra-marathon. I followed him on my bike as a kid when he was training. Later we ran together. For years we enjoyed running marathons together.

There are many surgeons I know that find their freedom in endurance sports. My mentor Vaughan Bowen is competing at the world championships in Duathlon. I met James Chang at the Haleakala, a 10,000 foot volcano on Hawaii, both of us cycling to the top. It seems a lot of us can relax and find our freedom when working out and finding some time to be alone with our thoughts.

Years ago I read the Dalai Lama’s book about happiness. It substantially helped me understand that I have a choice; I can view the glass as half empty or half full.

All of us have proven to be strong and successful. We are always competitive and hardworking, putting in endless hours. But it is hard to show weakness. I am deeply impressed by James Chang’s 2018 presidential address. I thank him very much for his honest talk. As professionals, we need to speak more frankly about our sorrows and fears. About the good cases, and the ones that did not go so well. With medicine being a very old profession, the surgeons often act as dinosaurs. But we might have to change our culture a little bit; we might have to accept our flaws and shortcomings. Starting to talk about fears, failures, and breakdowns will help to de-stigmatize symptoms and diseases like burnout and depression. This will hopefully enable us to reduce the number of burnt out colleagues.

And, as James Chang stated, and the ASSH helps to support this idea, we need to find once again our joy in hand surgery. We need to, as best as we can, eliminate stress factors in our jobs.

I wish for my colleague to return healthy and to find happiness in his job again. And I hope we can all find our daily joy in hand surgery and stay healthy and satisfied. I wish us to appreciate that we are allowed to live every day for our patients and for us. Let us appreciate that it is important to look after our own health and not only that of our patients.