Amidst a turbulent storm of professional upheaval, John found himself teetering on the brink of despair. Recent incidents, like the accidental destruction of a light fixture in the operating room and being reprimanded for disorderly conduct, painted him as yet another surgical liability, casting shadows over his marriage, career, and self-esteem.
But unbeknownst to him, the blame didn’t entirely rest on his shoulders. (We’ll delve into that shortly.)
His outburst had been a culmination of mounting frustration. Despite his prowess in surgery, navigating the complexities outside the operating room had proven to be his Achilles’ heel. The incessant demands from nurses, the struggles to secure operating room time, and the challenges of managing dissatisfied patients waiting for non-urgent procedures had worn down his patience. One day, in a fit of exasperation, he snapped at a nurse, “Just do as I say, and do it now!”
John hadn’t embarked on his surgical journey with such a short fuse. Yet, two years into his tenure as an attending surgeon, that’s precisely where he found himself. From his perspective:
“The nurses were a constant source of frustration, always pestering him to revise orders, oversee wound care, expedite patient discharges…”
“The non-clinical administrators were equally vexing, scheduling block times at inconvenient slots, disregarding his instructions for add-on cases, and nagging him when his paperwork wasn’t completed…”
“And the patients—where did these non-compliant, entitled individuals even come from?”
He had little tolerance for any of it. After all, he was the leader, the captain of the ship, the one expected to steer the course.
This narrative echoed through the experiences of numerous surgeons I’ve counseled over the past 14 years. Different faces, same storyline. It painted a grim picture of exceptional surgeons, masters of their craft, struggling to assimilate into a system where the very behaviors ingrained during their training were deemed unacceptable.
While the manifestations of this phenomenon differed for female surgeons, they represented the flip side of the same coin. Imposter syndrome and an incessant need to prove oneself manifested as anger and outbursts for male surgeons, and as fear and self-doubt for women.
Of course, not all surgeons were affected, but a significant portion grappled with these challenges.
The truth is, much of the toxic residue left by medical training—perfectionism, an ingrained need to always be in control, a deep-rooted fear of failure, and a sense of superiority—were amplified in how surgeons were trained and treated.
What did surgeons learn during their training?
As one surgeon lamented, “I learned to become a monster, Gail.”
“I learned that all that mattered was getting the job done and avoiding the wrath of another punitive attending. An attending who was all too eager to throw me under the bus, whether I erred or not. And admitting failure was the cardinal sin. Whatever the task, whatever obstacle stood in my way, seeking assistance was out of the question. Asking for help was never an option.”
Another lesson ingrained: kindness and strength were mutually exclusive. Strength meant being tough, always. Showing any sign of weakness equated to failure. Another surgeon phrased it succinctly, “Gail, I was trained to be a bulldog, plain and simple. Don’t stand in my way, or you’ll get trampled.”
Coaching emerged as a constructive intervention in dismantling these beliefs, and that was the journey John and I embarked upon. It was a daunting task. There was much he needed to unlearn if he sought a successful, harmonious career, not only professionally but also within his family life.
Over the subsequent six months, unlearning (and learning) became our focus.
John realized that the perfectionism ingrained in him during his medical training was detrimental to his current aspirations. He discovered more effective ways to motivate himself than through harsh self-criticism. He embraced the paradox of motivation—that dwelling on shortcomings drained his energy, while focusing on accomplishments fueled his drive.
He also learned the importance of seeking help. In his personal life, he began to open up to his wife and children, understanding that he didn’t have to have all the answers.
Developing mindfulness of his emotional triggers enabled him to anticipate and manage his outbursts. He cultivated a mindful approach, redirecting his emotions rather than succumbing to them during high-pressure situations in the operating room.
Through coaching, John realized the toll his reactivity had taken on him. External pressures persisted—understaffing, challenging administrators, difficult patients—yet, internally, he found equilibrium. He began to shed the “monster-like tendencies” acquired during his training. His mastery within the operating room now extended to all facets of his life. As he reflected, “I’ve found a balance between strength and kindness. That, I believe, is the key to my success, both as a surgeon and as a human being.”
