What's Important: Self-Belief, Serenity, and Self-Awareness in Orthopaedic Surgery Residency.

Abstract

A long time ago, I sat at the dinner table of my girlfriend’s family. At one point during the meal, to size me up, my girlfriend’s father asked me why studying literature is important. At that time in my life, I wanted to be a professor of English literature, steeped in Shakespeare and the like. I loved literature. However, despite my love of reading and discussing novels, plays, and poetry, his question caught me off guard. I stuttered through what must have been a semi-coherent response. To put it bluntly, I choked. As time went on, my desire to study and understand literature transformed into a desire to understand people, health, and the biology of the human body. Now, more than 3 years into residency in orthopaedic surgery, I wish I were back at that dinner table so I could give a proper answer to the question, “Why is studying literature important?” Literature and its sibling disciplines, history and philosophy, are so important to me that I sometimes forget that they are influencing me and keeping me moving in a high-stress, high-excitement world. Of the numerous lessons or influential concepts that a study of the humanities has taught me, 3 have been particularly important during my residency so far. They are self-belief, serenity, and self-awareness. I came to think about each through different figures in history or pieces of literature. With respect to self-belief, one historical figure stands out in my mind: U.S. President Theodore Roosevelt (T.R.). Aspects of his legacy are rightly being discussed in today’s light, and I do not seek to diminish the importance of those conversations. Yet lessons from T.R.’s life also guide the observant student of history. As the wealthy son of a famous business magnate and philanthropist, T.R. had every privilege in life, from private tutors to multiple homes. Nonetheless, he was a sickly child. When he finally overcame this obstacle and emerged into the political arena as a promising young adult, he lost both his wife and his mother in the same night. It took time, but he came back from unspeakable grief to return to politics and fight unjust political enemies, often with resounding success. As Police Commissioner, he took on New York City political machine bosses. As President, he regulated monopolies that would otherwise have been detrimental to business and competition. What underscored his ability to keep moving through hardship were self-belief and confidence in what he could do given the right amount of knowledge and work. He became, in his own words, “fearless by sheer dint of practicing fearlessness.”1 In residency, self-belief is vital, preparing the resident for inevitable challenges, such as new diagnoses, unfamiliar surgical techniques, complex case presentations, and hard hours. Serenity came into my life through the Roman philosopher-emperor Marcus Aurelius. He is famous for being a Stoic. One can pick up his Meditations and flip to almost any page to encounter gems that bespeak peace. “If you are doing your proper duty let it not matter to you whether you are cold or warm, whether you are sleepy or well-slept, whether men speak badly or well of you,”2 he says. He also gives agency or power to the reader amid the Stoic serenity. “Who is there to prevent you being good and sincere?”3 he asks. As a resident, I have come to accept that certain situations will not change and that all I can do is my proper duty. I have the choice to be good and sincere. Self-awareness underlies every important action. In the Apology, or Trial of Socrates, Plato makes sure to have the protagonist Socrates emphasize self-awareness as central to his life. Socrates is on trial because he challenges people to think critically about what they say they know. His curiosity and inquisitiveness were relentless and made him a public nuisance. It is from the Apology that we get the axiom, “The unexamined life is not worth living.”4 In our pursuit of knowledge that will benefit patients, we in orthopaedic surgery can learn from Socrates by examining what we think we know, and by being persistently curious. It only took more than 10 years, but I have developed at least a partial answer to the important question posed to me at that dinner table. I know that I will keep reading literature, studying philosophy, and learning from history, as the humanities provide a foundation for residency in orthopaedic surgery and for life more broadly.