Stalin, Heart Surgeons, and Ben Carson

 

DSC05950So as you can imagine, my family has been having a lot of conversations lately about cardiology and cardiac surgery. My father was already quite well-informed about the subject, because his own father suffered from cardiac disease (confirming the well-established wisdom that such things run in the family, and making me think it might be wise one of these days to have my own ticker checked out: What keeps me from doing it is not wanting to know, which I know isn’t the most courageous way to approach these matters. I’ll get around to it. I think I’m okay for now.)

Anyway, we’ve been talking about the personalities of people who go into cardiac surgery as a speciality. There are lots of stereotypes, of course: I liked this blog, written by a woman who in no way would I consult for any medical problem, given that she’s “a physician who is intuitive and a Reiki Master/Teacher discusses healing from ‘the front lines’ of the mind-body connection in the hospital setting.” But her description of the temperaments of cardiovascular surgeons seemed interesting to me:

Cardiovascular surgeons are the last of the “old boys school” for the most part. There are notable exceptions, which I will discuss later. They are emotional, angry titans who split sternums and work on some really sick people. Some contain it better than others. … I have seen patients die from pride of the surgeon and the anesthesiologist and the rest of the team. … Pride is an element in the heart room. Ego reigns. Dominance, aggression, control, continuity. There is no compassion. Not for anyone…

On this blog, Aaron Singh asks why surgeons have such big egos:

[The surgeons] were the ones who walked past you with a sense of purpose, with an expression that sent lesser medical personnel scurrying out of their paths in terror, and with eyes whose gaze could physically melt medical students if you weren’t careful. Several walked past us, instantly recognizable, and those who bothered to look at us did so with a disdainful expression, dismissing our existence as being too trivial to bother their exalted minds. They were Lords of their Domain; entire operating theatres were built as shrines to their greatness. Why shouldn’t they walk around as if they owned the place?

I’ve always wondered why surgeons seem to be more affected by the famous God complex that seems so prevalent in the medical profession. Recently, my cousin brother underwent surgery, as I talked about in my previous post, and the surgeon who operated on him, whilst perfectly competent, also demonstrated this uppity demeanour. She strode into the OT (fashionably late) without seeing him pre-op, and didn’t even check on him post-op. During the surgery she didn’t bother to reassure him; it was the nurses who did this.

Or take this quote from Frank C. Spencer, MD, FACS, Cardiothoracic Surgeon:

“Stepping into the operating room to perform heart surgery on a sick patient, being fully in control of the large team of people who are required to do the procedure, and feeling totally prepared to perform the task at hand is an unbelievable feeling that can barely be described.”

Or this one from Dr. Paul Corso:

Heart surgeons are aggressive, intelligent, driven people who have mental, emotional and physical endurance. We are born with all of these factors, but need to develop them into their highest form. Some people say heart surgeons are jerks, and we’re probably that, too.

“Cardiac surgeons,” writes Kathleen Doheny, “driven and dedicated, tend to see things in yes or no terms, says a physician in another specialty. ‘Fish or cut bait. They tend to be stalinpushy.’ When a cardiac surgeon decides it’s time to head to the operating room, stand back.”

Anyway, this morning my brother and I were wondering how this personality type — and it is, it seems, a distinct one — would translate into a politician’s leadership style. We were playing a little game, trying to decide which figures from history would have been good cardiac surgeons. Perhaps Stalin missed his calling: Might he have been a fine cardiac surgeon instead of a bloody tyrant?

What about Ben Carson? I imagine that neurosurgeons and cardiac surgeons share CarsoninOR-590x398similar temperaments, as a rule. Is a neurosurgeon’s temperament the right temperament for the President of the United States?

Are any of you cardiac surgeons? Neurosurgeons? Know any? Are the stereotypes true? Would knowing that surgeons share a personality type seem relevant to you in trying to figure out what kind of politician a surgeon might be? In Carson’s case, after all, knowing that he was a great surgeon is really all we know: So would that kind of personality be an asset in the White House or a liability?

(By the way, although I didn’t get to spend much time with him, my father’s surgeon seemed to defy these stereotypes: He’s a gentle and very devout Catholic who goes to Mass every morning, and seemed in no way a bully or a jerk. So obviously, there are exceptions.)

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  1. CB Toder aka Mama Toad Member
    CB Toder aka Mama Toad
    @CBToderakaMamaToad

    I am having trouble getting my head around this post: Stalin has the temperament of a cardiac surgeon. Hey, Ben Carson is also a cardiac surgeon! Not that they’re the same or anything…

    Huh?

    • #1
  2. Capt. Aubrey Inactive
    Capt. Aubrey
    @CaptAubrey

    I think each discipline has a distinct set of characteristics that are somewhat formed by the nature of what they do. I am only aware of this because my own father was a family doctor and he used to joke about various friends of his; orthopedists were sort of rough, sports guys who didn’t mind pulling out the saw; gas-passers i.e. anesthesiologists had another set of quirks. The heart surgeons were, far and away the fighter pilots of the hospital just as you describe. I don’t know where to place Dr.Carson in this menagerie. He strikes me as very cerebral and deliberate. Perhaps too much so for the job.

    • #2
  3. Man With the Axe Inactive
    Man With the Axe
    @ManWiththeAxe

    This is not directly on point, but I was reminded of a story from my local newspaper from the late 90s. They published the survival rates of all the local heart surgeons. There was one who had the worst record. It just so happened that my daughter had been a nanny for his children. My wife was a patient of a well-liked cardiologist, and having read the story, asked him about the surgeon’s poor record.

    He explained that this particular surgeon was the most highly regarded of those in the area, and he was the only one who would take the most seriously ill patients. He saved many that perhaps any other surgeon wouldn’t have, but he also lost more than the other surgeons. The doctors and nurses all said that they would choose him for themselves or their family members.

    But the newspaper story didn’t explain any of that.

    • #3
  4. Tuck Inactive
    Tuck
    @Tuck

    Doctors, as a profession, are the priests of the Progressive movement.  The apostles of “expertdom”, if you’d like.  As a profession, they’re horribly overconfident, unwilling to examine new ideas, or to admit they or their profession are more often in error than not.

    So yes, they’re pretty much the perfect match to socialist politicians, although I don’t think Stalin’s a fair comparison, as they tend to hurt people through overconfidence and a misguided “knowledge” that keeps them to error, but they don’t have the willingness to sacrifice others in large numbers that Stalin did—which, thank God, is a pretty rare trait among humans.

    • #4
  5. Zafar Member
    Zafar
    @Zafar

    Cancer rather than heart surgeon, but India’s very own Praveen Togadia is not an encouraging illustration of the type.

    [Edit: wrt politics. When it comes to surgery I’m their number one fan.]

    • #5
  6. EJHill Podcaster
    EJHill
    @EJHill

    Very few of us have jobs where failure comes cloaked in death. And there will be failure and death.

    Surgeons often will either wrap their own hearts in concrete and steel or they will wrap them in faith and prayer. It’s the only way to cope. Carson seems to be the latter.

    So it is with politicians and military men who make life and death decisions. I really don’t know where Obama’s heart is, there is no doubt where Bush 43 stood. Give me a C-in-C who spends as much time on his knees as he does thinking on his feet.

    • #6
  7. Manfred Arcane Inactive
    Manfred Arcane
    @ManfredArcane

    Ms. B, how does your exercise regime compare to your dad’s?  And he smoked didn’t he?  Maybe your risk factors are much lower than his for this disease on these two accounts.  Just a thought.

    • #7
  8. Claire Berlinski, Ed. Editor
    Claire Berlinski, Ed.
    @Claire

    EJHill: Very few of us have jobs where failure comes cloaked in death. And there will be failure and death. Surgeons often will either wrap their own hearts in concrete and steel or they will wrap them in faith and prayer. It’s the only way to cope. Carson seems to be the latter.

    I think that’s a good insight. It makes intuitive sense to me.

    • #8
  9. Claire Berlinski, Ed. Editor
    Claire Berlinski, Ed.
    @Claire

    Manfred Arcane:Ms. B, how does your exercise regime compare to your dad’s? And he smoked didn’t he? Maybe your risk factors are much lower than his for this disease on these two accounts. Just a thought.

    My dad’s been a hardcore exerciser all his life — and a smoker. Only one of my parents had heart disease, so who knows. I honestly don’t worry about it. (But then again, neither did he.)

    • #9
  10. Manfred Arcane Inactive
    Manfred Arcane
    @ManfredArcane

    Claire Berlinski, Ed.:

    Manfred Arcane:Ms. B, how does your exercise regime compare to your dad’s? And he smoked didn’t he? Maybe your risk factors are much lower than his for this disease on these two accounts. Just a thought.

    My dad’s been a hardcore exerciser all his life — and a smoker. Only one of my parents had heart disease, so who knows. I honestly don’t worry about it. (But then again, neither did he.)

    Yeah, Clint Eastwood movie characters smoking those cheroots killed more people (my dad included).  But a heart can be fixed.  Emphysema, COPD, no.

    • #10
  11. civil westman Inactive
    civil westman
    @user_646399

    Thirty-five years in the front lines of anesthesiology have given me some perspective on this. The observations are quite accurate for most cardiac surgeons. There are a few outstanding exceptions, however. I have found the same to be true of neurosurgeons.

    Over the years, I have come to better understand the need to armor one’s self against suffering and death, which some physicians witness more then others. As well, medicine is still shame-beset to a large extent. Fixing the blame, rather than the problem remains all too common. In medicine, where things are often fuzzy and accountability still extant, there remains a tendency to point fingers at others. I once witnessed a neurosurgeon blame an anesthesiologist (not me!!!) for a dissection of a carotid artery, next to which he was operating and which he retracted during surgery (anterior cervical discectomy). He said it was due to the intubation. Trust me, this was a stretch.

    Although the authority/expertness appeals to progressives, many physicians remain conservative and resent the crushing regulation by the state.

    The real Stalinists-in-waiting are found in Graduate Schools of Public Health. These folks know just exactly how you and I ought to live and they, in turn, live for acquiring the power to enforce their choices “for our own good.” I’ll say this. Surgeon tyrants are more honest. They do it for the power. Public health progressives pretend they only do it because “it is good for you.”

    • #11
  12. Claire Berlinski, Ed. Editor
    Claire Berlinski, Ed.
    @Claire

    civil westman: Over the years, I have come to better understand the need to armor one’s self against suffering and death, which some physicians witness more then others. As well, medicine is still shame-beset to a large extent. Fixing the blame, rather than the problem remains all too common. In medicine, where things are often fuzzy and accountability still extant, there remains a tendency to point fingers at others. I once witnessed a neurosurgeon blame an anesthesiologist (not me!!!) for a dissection of a carotid artery, next to which he was operating and which he retracted during surgery (anterior cervical discectomy). He said it was due to the intubation. Trust me, this was a stretch.

    I’m so glad I started this thread after my father was safely home from the hospital, not before. It wouldn’t have been wise to dwell on stories like this before.

    • #12
  13. Claire Berlinski, Ed. Editor
    Claire Berlinski, Ed.
    @Claire

    Manfred Arcane: Yeah, Clint Eastwood movie characters smoking those cheroots killed more people (my dad included).  But a heart can be fixed.  Emphysema, COPD, no.

    Yes — a heart can be fixed. But not always, and let me tell you: From what I’ve seen of it, open-heart surgery is hell. It is not worth even the pleasure of a lifetime of smoking, and as a former smoker who knows how much pleasure that really is, I can say that confidently now.

    • #13
  14. OkieSailor Member
    OkieSailor
    @OkieSailor

    Ben Carson strikes me as a man who is smart enough to recognize  what  he doesn’t know and wise enough to seek counsel when he needs it. So I would trust him to actually get and listen to amazingly great advisers. I would not trust a man like Donald Trump to do the same as he is a braggart who seems to think he already knows more than anyone else could possibly teach him about anything.
    I don’t, however, think either of them is ready to be President, especially when the next President will need to clean up the major messes left by Mr. Obama. I think most any of the rest of the Republican field is more qualified and more prepared to do the hard job ahead, even Jeb who is my dead last, vote for him because Hillary would be another four years of disaster, choice.

    • #14
  15. Man With the Axe Inactive
    Man With the Axe
    @ManWiththeAxe

    EJHill: Very few of us have jobs where failure comes cloaked in death. And there will be failure and death.

    As Ben Franklin didn’t quite say, “In this world nothing can be said to be certain, except negative patient outcomes and revenue enhancements.”

    • #15
  16. Manfred Arcane Inactive
    Manfred Arcane
    @ManfredArcane

    Man With the Axe:

    EJHill: Very few of us have jobs where failure comes cloaked in death. And there will be failure and death.

    As Ben Franklin didn’t quite say, “In this world nothing can be said to be certain, except negative patient outcomes and revenue enhancements.”

    MWtA:  We were all kind of wondering here at Ricochet, is your axe, er, sterilized?

    • #16
  17. Eric Hines Inactive
    Eric Hines
    @EricHines

    Claire Berlinski, Ed.: Perhaps Stalin missed his calling: Might he have been a fine cardiac surgeon instead of a bloody tyrant?

    Well, he certainly cut the heart out of the Kulaks.  Not much on resuscitation, though.

    Claire Berlinski, Ed.: Are any of you…Neurosurgeons?

    I did a fair amount of neurosurgery–entirely in the brain; the lesser body was of no interest–for my graduate psych degree.  Never lost an animal to the knife.

    I also was a reasonably successful USAF officer in one of the combat AFSCs.

    In both endeavors, the lives of the animals and of the men and women for whom I was responsible were my immediate…responsibility.  It takes no small measure of self confidence–of arrogance–to do either group justice.

    Carson as President?  Yes, he has the willingness to deliberate and the willingness to act and not deliberate some more.  And an understanding of the nature and necessity of acting on incomplete information.  Whether he can gather a sufficiency of information before he takes office is a separate question.  Whether he can gather an adequate kitchen cabinet of advisors (because the Senate will have a serious impact on his collection of official advisors) is an additional question.  Whether he has the arrogance needed to control those advisors of either group and to work effectively with a Congress populated with its own arrogant personalities is a third question.

    Eric Hines

    • #17
  18. Nick Stuart Inactive
    Nick Stuart
    @NickStuart

    Whatever else we Ricochetti may or may not agree on, I’m fairly sure we can all agree we’re thankful you & your family are OK, and your dad seems to be doing well.

    • #18
  19. Fastflyer Member
    Fastflyer
    @Fastflyer

    Capt. Aubrey: The heart surgeons were, far and away the fighter pilots of the hospital just as you describe.

    Heart surgeons are at least a step below fighter pilots. If fighter pilots make a mistake, they die (sometimes even if they don’t make a mistake). Surgeons mistakes get buried. It would be interesting to see how haughty and aggressive surgeons would be if their lives were on the line every time they stepped into the operating arena. Just saying.

    • #19
  20. Man With the Axe Inactive
    Man With the Axe
    @ManWiththeAxe

    Manfred Arcane:

    Man With the Axe:

    EJHill: Very few of us have jobs where failure comes cloaked in death. And there will be failure and death.

    As Ben Franklin didn’t quite say, “In this world nothing can be said to be certain, except negative patient outcomes and revenue enhancements.”

    MWtA: We were all kind of wondering here at Ricochet, is your axe, er, sterilized?

    Yes, it underwent a vasectomy in 1983.

    • #20
  21. Songwriter Inactive
    Songwriter
    @user_19450

    My wife suffered a heart attack almost one year ago. She inherited aggressive coronary artery disease from her father and her father’s father. (The fact she has never smoked is the primary reason she’s lived 20 years longer than her father did.)

    Her cardiologist seems to be the exception that proves the rule: He gets high marks from his patients and his peers. He is soft-spoken and willing to spend real time with his patients discussing their medical issues. We feel fortunate he was the doctor on call the night of her heart attack.

    • #21
  22. Misthiocracy Member
    Misthiocracy
    @Misthiocracy

    I tend to dislike it when a talented surgeon/doctor enters politics up here in the Great White North.

    After all, we need surgeons/doctors a heck of a lot more than we need politicians. Moving a surgeon from the operating theatre to the legislature seems like an unconscionable waste of human resources.

    It may be different in the United States what with your higher level of private sector involvement in the medical industry. Maybe y’all have so many surgeons that you can afford to lose a few to non-productive work?

    • #22
  23. Lucy Pevensie Inactive
    Lucy Pevensie
    @LucyPevensie

    I work closely with cardiac and thoracic surgeons (bet you didn’t know that was a distinction) and can say that the stereotypes tend to be true, but with some exceptions. My work brings me into closer contact with the general thoracic surgeons than with the cardiac ones, but they’re all similar in temperament.

    They all have to have the ego to keep plugging along when they lose a patient.  That’s not easy. If I had tried to be a  surgeon, I’d have given up early on.  Patients die in these procedures, even in the best hands, and you can’t be the kind of person who goes home and frets about your mistakes if you want to do this for a living.

    But, honestly, the best of these surgeons are respectful of others and have the humility to recognize their limits.  I’m a radiologist, and sometimes I know more than they do about what’s going on in the patient’s imaging. I’ve known a few really skilled surgeons who won’t listen to me, but most of those who won’t listen to others have a bit of the Emperor with no clothes about them. They put on an overconfident attitude to hide their insecurities, and because they won’t accept feedback, they don’t get wiser or more skilled with time.

    Neurosurgeons in the old days were like thoracic surgeons, I think. There are some old-school neurosurgeons around, and there’s probably the same split among them between the confident and the bluffers. I read Ben Carson as being among the first group: the kind of guy who comes down and asks the radiologist exactly what is going on.  He operated on the daughter of some friends of mine, and I know they saw him as being like that, a truly humble and gifted man.

    In more recent years, neurosurgery is attracting a different kind of person, I think. Neuroanatomy is extraordinarily difficult, and I think the current neurosurgery group tends to be dominated by the most intellectual of surgery-minded folk.

    • #23
  24. Lucy Pevensie Inactive
    Lucy Pevensie
    @LucyPevensie

    Misthiocracy:I tend to dislike it when a talented surgeon/doctor enters politics up here in the Great White North.

    After all, we need surgeons/doctors a heck of a lot more than we need politicians. Moving a surgeon from the operating theatre to the legislature seems like an unconscionable waste of human resources.

    It may be different in the United States what with your higher level of private sector involvement in the medical industry. Maybe y’all have so many surgeons that you can afford to lose a few to non-productive work?

    As far as Ben Carson goes, I think he planned to retire from surgery relatively early because he did not want to wait until he started to lose his skills. Surgeons do lose their skills as they get older.

    • #24
  25. Harrison Flynn Member
    Harrison Flynn
    @

    “[Redacted],”” he said. “”There go the music lessons.”” That may be the quote of the year in medical circles. … (There’s hardly any surgical procedure that doesn’t produce at least a mini-erection.)”
    https://www.kirkusreviews.com/book-reviews/lawrence-shainberg-2/brain-surgeon-an-intimate-view-of-his-world/
    Merely reading reviews and excerpts of this book long ago as an undergrad was enough to extinguish whatever admittedly faint flicker of a notion I may have had towards a pre-Med curriculum. The top-of-the-ziggurat meritocrat as sociopath: it’s all here. Still, it’s trends, anecdotes, and generalizations, not ironclad law, and, as has been already articulated in this thread by others far more ably than I can, transcendental belief overcomes egoism and materialism. So I’d leave the good Dr. Carson out of this (not that I want him as President; that’s another matter entirely).

    • #25
  26. Larry Koler Inactive
    Larry Koler
    @LarryKoler

    Thanks for the update on your dad, Claire. I will keep him in my prayers. He’s a unique public intellectual — very brave and willing to stand up and be heard. He’s a truly great man and we need him around for a few more decades.

    Fastflyer:

    Capt. Aubrey: The heart surgeons were, far and away the fighter pilots of the hospital just as you describe.

    Heart surgeons are at least a step below fighter pilots. If fighter pilots make a mistake, they die (sometimes even if they don’t make a mistake). Surgeons mistakes get buried. It would be interesting to see how haughty and aggressive surgeons would be if their lives were on the line every time they stepped into the operating arena. Just saying.

    Well said. I do think it makes sense that surgeons are standing aloof from the pain and fear associated with these seriously invasive procedures — and they need to have this distance. It’s required.

    I watched my wife during a Caesarean section and when the surgeon plunged that razor sharp knife in and sliced very quickly — my only and exclusive thought was “I hope you know what you just did because what you did is absolutely irreversibly serious.” I admired that woman surgeon immensely as I watched her methodically and confidently move from step to choreographed step. I ended with, “What a profession she is in!” These are people with the heroic attributes.

    But, your point is well taken, too. Fighter pilots are both the surgeon and the patient — in that they commit themselves bodily into the fray and expect to be shot back at when they commence their attacks. I worked on the Fiberoptic Guided Missile (FOG-M) and the greatest thing about it was that — unlike the TOW missile — you could fire it (or several) and not be as easily detected as the TOW gunner was. And the TOW gunner had to stay at his station and keep the optical sights on the target for the duration. Very exposed. Well, fighter pilots have it worse, don’t they?

    • #26
  27. Carey J. Inactive
    Carey J.
    @CareyJ

    Surgeons, in general, are a cocky lot. This is a good thing. After all, would you want someone cutting you open if he appeared unsure in the slightest degree that he could cut out the correct bits and sew everything back up properly?

    Indeed, they practice one of the few forms of medicine that actually repairs injuries the body cannot. Most non-surgeons simply rely on, or prescribe medications to support, the body’s natural healing processes. Whether it’s a heart valve replacement, a knee replacement, or removing a cataract, the surgeon is intervening in a situation where the body’s natural processes have failed to heal the patient.

    In view of the fact that America is at war, I think a President with the confidence and decisiveness of a surgeon could be a very good thing. This is not a time for wishy-washy nonentities like Jeb Bush or John Kasich.

    • #27
  28. Claire Berlinski, Ed. Editor
    Claire Berlinski, Ed.
    @Claire

    Fastflyer: Heart surgeons are at least a step below fighter pilots. If fighter pilots make a mistake, they die (sometimes even if they don’t make a mistake). Surgeons mistakes get buried. It would be interesting to see how haughty and aggressive surgeons would be if their lives were on the line every time they stepped into the operating arena. Just saying.

    I think it would be much more frightening to have someone else’s life on the line. I suspect my feeling as a fighter pilot would be “At least I’ll be buried with my mistakes.” It’s the idea of living with them that would terrify me — that is, if the mistake involved a slip of the hand or an error of judgment that took the life of someone I was trying to save.

    • #28
  29. Claire Berlinski, Ed. Editor
    Claire Berlinski, Ed.
    @Claire

    Carey J.: Surgeons, in general, are a cocky lot. This is a good thing. After all, would you want someone cutting you open if he appeared unsure in the slightest degree that he could cut out the correct bits and sew everything back up properly?

    I probably wouldn’t, but if offered a choice between someone who appeared unsure that he could do it (but had an excellent track record of doing it, successfully) and someone who appeared very sure he could do it (but had a measurably worse track record), I hope I’d be rational enough to pick Surgeon B. We tend to trust self-confident people, but not always to our benefit: Lots of self-confident but incompetent (or even psychopathic) people out there.

    • #29
  30. civil westman Inactive
    civil westman
    @user_646399

    Although I didn’t mention him in an earlier comment, I do want to chime in on Ben Carson. In my experience, the cardiac/neurosurgeons of whom we are speaking lack humility. To me, an honest acceptance of one’s human limitations is the hallmark of a mature physician. It is that capacity, which some develop over time and some never develop, which makes for the kind of physician most of us want for ourselves. I have a strong sense that Ben Carson is that kind of physician. I believe his lack of certain factual knowledge is of little consequence when it comes to his ability to be President. He is surely a quick study. He has character (it’s absence is only OK in progressives). Does anyone seriously suggest that the present occupant of the office was prepared for the office? Does anyone detect an abundance of humility in the political class?

    • #30

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