“What is the price of experience? Do men buy it for a song? Or wisdom for a dance in the street? No, it is bought with the price of all the man hath, his house, his wife, his children.” (William Blake, poet).

If I was to ask you what it meant to be a surgeon or what a surgical life was like, what would you answer? At the end of last year we discussed the concept of relationship centered care, a concept which describes our orientation to clinical interactions with those we care for but also those with whom we work and with whom we exist in larger communities. I was preparing for another clinical practice observation this week when I got back to reading an article by Drs Beach and Inui and published in the Journal of General Internal Medicine. In their re-framing of relationship centered care, Beach and Inui argue that relationship centered care is founded on 4 principles — the recognition and appreciation of participant personhood, the importance of affect and emotion, the content of reciprocal influence and the moral value that we construct and reward through these relationships.

Yet in our own lay uses of the word ’surgical’, one of the last connotations many would ascribe to the term would be ‘relational’, or even ‘emotional’. There is almost nothing in there about ‘moral’ either. No, the term ’surgical’ is often used adjectivally to communicate ‘control’ or ‘incisiveness’. How then, would you describe your ’surgical life’? In what ways, do you find yourself performing ’surgically’ with your clients, peers and community members? How might this performance of the ’surgeon’ or ’surgical’ impact the ways in which you work and live? How are you a ‘rock’? An ‘island’? How do these professional demands affect your ability to perform surgery in a team frame? As William Blake asks, what is the price of your surgical experience? Or your experience being a surgeon?

Over the holidays, I read a blog post by Berci Masko on ScienceRoll about a film called The English Surgeon.  The film follows eminent UK brain surgeon Henry Marsh as he openly confronts the dilemmas of the doctor patient relationship on his latest mission to the Ukraine and asks the following questions — What is it like to have God like surgical powers, yet to struggle against your own humanity? What is it like to try and save a life, and yet to fail? The trailer here shows Henry struggling to accomplish relationship centered care in the Ukraine.

As 2009 begins, what would you like to do differently in your practice this year? What would you like to learn? Where would you like to go? What would make your surgical life easier? Here at Syndicom, surrounded by snow, we are planning for the Spring, for conferences to attend, new friends to meet, new colleagues to find, new tools to develop. Over the next few months we look forward to exploring co-mentoring, forming alliances within the spinal community, growing and highlighting our community partners and work as well as contributing to discussions on medical education, professional development, collaborative communities and research, and conference conversations. We look forward to your input on the way, and if you have a chance to see the film, would love to hear your reflections/thoughts!

In appreciation, as always, to Amanda Mac, maxipaq and Curious Expeditions for their images!

Together we rise!

Kirsten Broadfoot

Tags: collaboration, collaborative communities, doctor-patient relationship, Henry Marsh, medical education, medical surgical, mentoring, new tools, patient doctor relationship, patient-centered care, professional development, relationship centered care, research, scienceroll, surgery, surgical teams, syndicom, teamwork, the collaboration, the english surgeon

This entry was posted on Monday, January 5th, 2009 at 12:08 pm and is filed under Blog.