When you think of a surgeon, what comes to mind? A man striding in his white coat, barking imperiously, staff trailing behind? A self-important man (usually it’s a man right?) exiting the doctor’s parking lot in his black Jaguar? Most likely, you aren’t picturing what I saw last weekend, a group of surgeons sharing, singing, and skiing.
Last fall, my surgeon, Dr. Eberwein, asked me to keynote for a “ski society.” It turned out that her “ski society” was a professional group of burn doctors, and allied professionals, who gather each year to inform, teach and support each other. My job was to speak about my experiences as a burned child, about psychological resiliency, and how to build it. In the end, I received so much more than I gave.
For those of you not familiar with burn care, I should set the stage. Taking care of burn survivors is a grim and overwhelming task. Staff are presented with terrible injuries; facial features obliterated, legs burned so badly that the tendons are exposed, fingers melted and fused together. Burn patients howl in pain, considered the worst physical pain of all. Burns are sudden, traumatic, harrowing. And it is the staff’s job to manage all of this: the pain, the wounds, the blood, the disfigurement, the psychological trauma. They do this every day.
This “ski society” impressed me. Each morning, the physicians presented their research or case studies. You might think that surgeons would offer their great success stories. Some did, smiling modestly while their colleagues took furious notes on how their accomplishment was achieved. The presentations that moved me the most, however, were not success stories.
One doctor (all identifying info has been changed) stood up, and announced he was presenting his case humbly, looking for feedback. His patient was a toddler, not even three years old. She had a scald burn, which was sad enough. Then the baby had a terrible kidney issue (I don’t understand any of it, but it was bad). Then it turns out the baby had been abused. At the end of the case, the baby was on dialysis. The physician stood and asked his colleagues, “What did I miss?” “What would you have done?’ “What should I have done differently?” The other doctors addressed each question calmly, offering both suggestions and reassurance.
This scenario played itself out again and again. “What do you think of my work? This looks like a great success, right?” said another surgeon. The photos overhead showed a teenage girl, whose wounds were red but clearly healing. Then came the next photo. The burn case that had looked so promising, one year later, was now a disaster. The teenager’s scars had become "hypertrophic", puffed up two inches from her chest wall into an angry scarlet mass. “What should I have done?” the surgeon asked. “What would you do now?”
I learned something I had never known before. Burn care is as much an art as it is a science. Each burn is entirely unique. No one is burned exactly on the same parts of their body, in the same thickness of their skin, from the same method. Because each burn is unique, the surgeons have to figure out what to do for each patient. Some burns require surgery right away. Some burns require waiting to see what the wound does. Some burns require a certain kind of dressing. Others require artificial skin, and there are several different kinds of that skin to choose from. Each surgeon approaches each new injury with fresh eyes, relying on his/her experience and assessing what to do. No two cases are the same. Not ever.
These surgeons served as each other’s memory bank, like a living library. “What would you do in this scenario?” They flashed photos on the screen and all the doctors leaned in. One raised his hand, “I would try ___”. The next might say, “I’ve had luck with ___.” They worked as one to offer their wisdom, collectively moving toward an opinion. It takes trust to stand up in front of colleagues and ask for help.
If there were egos in the room, I never saw one.
In the mornings and evenings, they presented cases. But this was only part of the day. The group had another equally important agenda: emotional replenishment. Their afternoon was reserved for skiing. On the slopes, they continued to share information and ideas. As one doctor told me, “A lot of medicine is practiced on that mountain.” Others went ice-skating or snow-shoeing. In the morning, they shared their wisdom. In the afternoon, they drank in emotional replenishment. I’m not sure which activity was more important.
One night, there was a party. A surgeon brought his band with him from Texas. They played “Sweet Home Alabama" and Crosby, Stills and Nash covers. I watched my own surgeon, usually attired in green scrubs, cut the rug in her black skirt, blonde hair swirling. Another doctor juggled. One medical student earnestly sang an aria. Her soprano voice was extraordinary. We all stood up and cheered.
Being a dedicated health care provider requires its own kind of resiliency. You need to be kind and caring, but also professional. You need to keep your wits about you and think clearly at the drop of a hat, despite calamity and chaos. And you need to constantly replenish your spirit, so that you can keep going. Here are some resiliency lessons I gathered from my weekend:
1) Form a group of trusted colleagues, with whom you can be honest about your struggles, and share your expertise.
2) Be a life-long learner. Challenge yourself to learn new things no matter how good you already are.
3) Visit beautiful places. Get outside. Exercise.
4) Dance! Sing! Juggle! Do whatever creative activities will fill your spirit back up again so that you can continue to do your work. (Or, as my childhood burn surgeon once called it, "God's work.")
5) Most important: if you have a good doctor, trust them. You are in good hands. Doctors urgently wish to help their patients get better. They think about us all the time. When our health fails, they are crushed. And when we heal, they rejoice. They may even dance.