Beyond Surgery: Treating the Whole Person

Abstract

To rise in the ranks of a profession, onemust transcend the technical aspects and appreciate the whole patient and the context of the patient. Establishingmeaningful relationships with patients is the hallmark of a great physician. It was not idle thinking that led Joseph Murray, the Nobel Prize winning plastic and reconstructive surgeon, to title his memoir ‘‘Surgery of the Soul.’’ As Professor Francis Moore states in the Foreword to Dr. Murray’s book, there is ‘‘.a very special kind of pain, one that many of us have never experienced: the anguish of facial and bodily distortions that make the beholder turn away. In children, such an appearance makes the child an outcast, vulnerable to isolation and rejection by their classmates, to weeping on the way home from school, to a devastating loss of self-esteem. For a child with an embarrassing facial deformity.a simple repair [perhaps not so simple].truly heals a wound of the soul.’’ Following in the footsteps of Drs Kazanjian, Guralnick, and Murray, Professor Leonard Kaban has embraced the totality of the patient. Clinicians encounter many unknowns. Being too cautious to avoid potential problems can lead to incomplete results and less than satisfactory outcomes, particularly in the most complicated of cases. Being too daring can result in unrealistic expectations for the patient and family and potential complications. It takes not only surgical skill, but also the emotional capacity of the surgeon to bring the patient and the patient’s family along into this journey of the unknown. Oral and maxillofacial surgery is perhaps uniquely affected by the psychological state of the patient, family, and surgeon owing to the visibility of the deformities and the functional limitations that accompany the conditions the surgeon must treat. Leonard Kaban exemplifies the qualities of the surgeon who excels at the integration of psychological understanding, surgical expertise, and the