AANS Neurosurgeon | Volume 29, Number 1, 2020


Psyche Revealed

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Growing up in neurosurgery, from medical school through fellowship, I remained focused on doing it all and getting it right. I needed to know everything about neurosurgical diseases, the literature to support treatments and the correct surgical approach. I had to learn to turn my wrist just-so in order to sew in a deep space, to dissect the arachnoid without causing bleeding and to keep my hands from shaking under the magnification of the microscope. It was well into my years as a faculty member that I began to realize the impact this narrow focus had on my psyche. 

My Psyche

As staff, with the ability to provide continuity from clinic to the hospital and back, I developed relationships with my patients and their families in a new way. I rooted for them to rehab quickly enough to walk a daughter down the aisle or travel for a grandchild’s graduation. I laughed with joy when a patient played a trick on me and tears still well-up in my eyes when sharing heartbreaking news. Most of all, I deeply felt every treatment failure as my personal failure. As a young faculty member, I struggled to manage these new dimensions and their impact on my psyche. 

Dad’s Psyche

My transition from resident to attending coincided with my father’s retirement from practice as an orthopedic surgeon. He had always been the perfect example of someone who cared deeply about his patients, while remaining cool and calm, taking it all in stride. In the months after retirement, he admitted to me that he was sleeping better than ever, the weight of worrying about his patients’ health lifted. I was taken aback. How had I lived in the same house with this man for almost 20 years and watched him so carefully as my role model without ever seeing a crack in his stoic façade? 

Neurosurgery’s Psyche

Our thoughtful and open conversations about the non-technical aspects of being a surgeon have made me a better surgeon, wife, family member and friend. I now make a specific effort to discuss these aspects of practice with trainees and colleagues, alongside technical discussions of anatomy, diagnosis and treatment. We have so much to learn from one another beyond the next technical pearl or clinical trial. I am grateful to the contributors to this issue of AANS Neurosurgeon for sharing their insights and experiences covering the spectrum of the life of a neurosurgeon (as a medical student, resident, in mid-career and retirement) as well as other crucial aspects of how we insure we can do our job well on behalf of our patients. I have found it enriching and hope you do too. 


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