By Frank Chen, MD

Two characteristics come to mind when discussing strengths of hand surgeons. These are perseverance and humility. Both attributes are inherent and further influenced by experiences in our training. Without such qualities, success in hand surgery, let alone any field, would be curtailed.

I think that any individual who pursues a career in medicine must have some degree of perseverance not only studying long hours in school but also subsequently enduring sleep- deprived nights in residency. To my chagrin, my perseverance was tested early in my medical training. After only the first week on the wards as a medical student, I was already questioning whether I would succeed as a physician. My first rotation as a medical student was in internal medicine. Compounding my anxiety on my first day in the hospital, I was told that I would be on call that night. Needless to say, I was woefully inefficient and at a loss of what to do. The intern on call was overworked and had little time for me, so I was sent to evaluate a new admission on my own. I spent the entire night working up one patient, writing the H & P, and preparing for morning presentation. The next day, with lack of sleep and feeling overly stressed, I was full of self-doubt and contemplating a career change. 

 In facing difficult challenges, I believe that we strategize to convince ourselves to adapt and continue on. To address my predicament, I decided to focus on getting through each rotation week by week. Fortunately, I was able to persevere and have since strengthened my resolve with experiences starting with internship, sometimes spending 100+ hours a week in the hospital (taking staggered every other night call) to finishing with working late hours in hand fellowship helping to see 75+ patients a day. Though some may have sailed through training, I found it stressful overall, mainly due to the time commitment. However, in retrospect, I believe those experiences bolstered my perseverance, which has helped me throughout my career. 

Concerning the quality of humility, I think it is sometimes underrated in the field of surgery. Humility has been referred to as the midpoint between arrogance and incompetence. With our medical knowledge, we as physicians are in an advantaged position compared to our patients. Without humility, arrogance can set in, as we can readily influence our patients regarding treatment recommendations. However, we don’t have all the right answers. Despite best intentions, not all treatment outcomes turn out as expected. Such circumstances often strain the physician-patient interaction, adding stress to our lives. Therefore, rather than dictate to the patient what needs to be done, I often provide options to the patient and listen to their input. For example, even if surgery is indicated, I have, in a number of instances, acquiesced to the patient’s desire of nonoperative treatment. Giving my patients a greater role in decision making has not only helped to strengthen the physician-patient relationship but also helped to reduce my stress. In addition, a collateral benefit of listening to our patients is to weed out those that are poor candidates for surgery. This reminds me of an adage passed along in my fellowship. To paraphrase, “Do not operate on problem patients; if you do, their problem will become your problem.”