Imparting and Receiving Wisdom

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This issue of AANS Neurosurgeon provides advice for neurosurgeons on a variety of topics. We are blessed to be surrounded by individuals with a wealth of knowledge and experience in neurosurgery and should be mindful and humble enough ask for help or advice when needed. In a crisis, too often we tend to try to “go it alone” when we could benefit dramatically from the counsel of colleagues and superiors. We have all seen this strategy backfire and should strive to maintain relationships of trust within our professional community, so that we do not feel the need to handle problems solo. 

It seems that those who maximally benefit from advice routinely consult others for insight, and then synthesize the information along with personal insights to make sound decisions made upon the best available information. Particularly when in positions of leadership, it is important to seek the opinions and judgements of others when crises or problems arise. Likewise, it is important to respectfully and honestly give feedback to leaders to help them understand the impact of their decisions and direction-setting.

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We should also be mindful enough to ask for information before it is needed. The Boy Scout motto, “Be Prepared,” applies as much to leadership, life-skills and professional activities as it does to outdoor exploration. Lord Robert Baden-Powell of Gilwell and Agnes Baden Powell, in Scouting for Boys and The Handbook for Girl Guides, admonished their scouts and guides to, “Be prepared for what is possible, not only what is probable,” and they emphasized the importance of rehearsal as an aspect of preparedness. “It is not enough to read about it in a book and think that you know what to do. You must actually practice, and practice often, the things to be done.” We have all embraced this concept in our medical and surgical training, of course. Vis-à-vis life decisions and reactions to crises, but rehearsal does not necessarily mean “learning the hard way.” It includes being attentive to the problems and obstacles faced by others in similar circumstances and carefully observing the consequences of their decisions, so we can avoid negative events in our own lives and careers.

Giving advice is trickier. When asked for advice, it is important not to project one’s personal values and worldview on the person asking, but to give an honest assessment of one’s own experience, the ramifications of the decisions made and offer hindsight about the outcome. Giving unsolicited advice is another scenario entirely and is best avoided, unless done from a caring position of trust for someone whose behavior or actions appear to be self-defeating or destructive to a group. Unsolicited advice can too easily be received as unwarranted criticism, a personal affront or, at its worst, completely undermining. These situations call for compassion and the preservation of people’s dignity, and a recollection that no matter what stage of life or career they are in, they may well be experiencing something deeply personal that is putting them in a vulnerable place.

Naturally, there are other ways of seeking input than direct conversation, including reading about it in a book, and this AANS Neurosurgeon issue aims to provide information on a variety of both thorny and workaday issues. Readers will benefit from the insights of colleagues on involvement with advocacy, philanthropy, global neurosurgery and entrepreneurship, as well as the routine professional hurdles of residency training, establishing the ideal employment situation, seeking additional educational opportunities during one’s career and achieving academic promotion. Crisis management for surviving a lawsuit or a personal medical problem and situational challenges, such as a media blitz or pregnancy are also covered. Practical tips on dealing with the everyday professional realities of building cultural competence, understanding and using social media, enhancing writing skills and incorporating personal fitness and health regimens into a busy career will be addressed. Finally, we will hear reflections on pathfinding over a neurosurgical career, incorporating the concept of “if I only knew then what I know now.” 

My advice? Enjoy the issue, use the contents to spur further conversation and be prepared!

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