A Career in Surgery

Emily Goddard

Alburger

English III Honors

18 February 2018
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Emily Goddard

Alburger

English III Honors

18 February 2018

Careers in Surgery

The purposes of modern surgical procedures involve the curing of a disease, the

correction of malformations, diagnosis, tissue examination, reduction of pain or suffering, and

extending life. In each of these various types of operations, the lives of patients rely on the

skilled hands of medical professionals known as surgeons (“Surgery”). In addition to that great

responsibility, surgeons must constantly adapt to new practices and present themselves as a

valuable resource for their patients as well as other doctors in their workplace. Working within

the surgical field requires impressive amounts of commitment and dedication to the career,

making it a very difficult title to achieve (Gay). These qualities of life as a surgeon contribute the

large amounts of respect and admiration only the most successful within the field receive. After

years of education and collaborating with other professionals in the field, surgeons work to

utilize and advance surgical technology, grow and learn with the constant change made within

their field, and to improve the surgical experience of patients.

The history of surgeons and surgical technology dates back thousands of years. Surgical

practices have continued to evolve due to the introduction of new techniques and tools into the

field. Ancient Egyptians established procedures and obtained necessary skills in order to

successfully perform various surgical operations in an effort to solve some of the most common

and deadly health problems within their civilization (“Surgery”). Surgeons in early Egypt
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developed procedures such as limb amputations, castrations, cataract surgery, and urinary tract

stone removals. While these types of operations seem simple in comparison to modern surgery,

they had an impressive effect on the advancements of surgical practices and technology

(“Surgery”). Prior to the use of antibiotics and proper sterilization of tools, even basic surgical

procedures had high mortality rates. Problems including extreme blood loss, postoperative

infections, and damage to other organs often resulted in fatalities of surgical patients because of a

lack of knowledge or technology to prevent them. Yet, many patients suffering from these

medical problems willingly took the chance because of the low likelihood of survival regardless

of whether or not they underwent treatment (“Surgery”). Operations that would now take very

little time or skill thanks to modern medical equipment and treatments, like the suturing of minor

wounds, meant the difference between life or death in ancient civilizations.

In early Indian societies, surgeons performed similar procedures to those of the ancient

Egyptians regularly because information travelled with trade between the two civilizations.

Additionally, medical professionals of the time made advancements in the area of healing

injuries such as bone fractures or dislocations (“Surgery”). The Hindus improved procedures

including the removal of bladder stones that originated in ancient Egypt. Historians specializing

in the evolution of medical technology have concluded that the practice of plastic or cosmetic

surgery likely originated in India, leading to an expansion of the surgical field and the

establishment of new procedures (“Surgery”). Techniques used by surgeons continued to grow

and develop following the origination of surgery; however, some of the most impressive

advancements did not occur until recent decades.

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Between ancient and modern surgery, the medieval era saw little advancement in

medicine. People in this time period began to differentiate between surgery and other divisions

of the medical field. However, many believed in old forms of healing that had little to no

scientific basis until the Bubonic Plague forced Europeans to turn to actual medicine

(“Surgery”). As a result of the millions of deaths from this plague, doctors began practicing new

forms of medicine; including surgery to treat diseases. Surgeons became more respected for their

specialized skills and Kings granted them very high honor (“Surgery”). This new wave of

medical practices inspired questioning of old ways of thinking and increased productivity of

scientists to make new discoveries in surgery and medicine as a whole.

From the sixteenth to the nineteenth centuries, hundreds of developments helped to

improve the surgical field. Following the refinement of microscope design by Antoni van

Leeuwenhoek, scientists and surgeons could broaden their understanding of the human body

significantly (“Surgery”). By looking at the human body at a cellular level, medical professionals

could more effectively find solutions to infections that had previously caused panic and death in

ancient civilizations. New technology also showed great potential in the field as it improved

understanding of blood circulation and the human body in its entirety. For example, Ambroise

Paré, sometimes referred to as the father of modern surgery, discovered a way to tie an artery

rather than cauterizing it completely. This new technique allowed for the temporary interruption

of blood flow during a procedure rather than permanently damaging the blood vessel

(“Surgery”). Various other famous surgeons and scientists also contributed to the advancements

of the time period as the Age of Enlightenment brought new, more scientific ways of thinking all

over the world.

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Early origins of surgery laid a solid foundation for thousands of years of improvement

and evolution. In the past one hundred years or so, innovations such as general and local

anesthetics improved the surgical experience of patients and made for more successful

operations. Introduction and widespread use of antibiotics, blood transfusions, and

anticoagulants also significantly contributed to lower mortality rates following surgical

procedures (“Surgery”). In addition to lowering the number of people dying in surgeries, these

advancements have also improved patient comfort and satisfaction which is of the utmost

importance to the outcome of an operation. Minor improvements within the surgical field have

led to significant leaps in success rates of operations from a simple wound closure to

complicated heart transplants.

In the past decade, the development of unique, highly advanced technology has expanded

the capabilities of surgeons dramatically. The 3D printer has become a noteworthy device in the

surgical field as a whole because of its potential uses in education of students or patients and also

in the planning of surgical procedures (Karas). Additionally, surgeons have the ability to use 3D

printed models to aid in practicing for a complicated operation. Other modern technology

includes surgical simulators, robots that perform procedures independently, and various other

basic tools and techniques that surgeons have standardized in all procedures (Gkegkes).

Continuous progress made in the surgical field shows great potential for future generations of

surgeons because of the never ending need for improvement and endless possibilities for the field

in the near future.

Surgeons have become some of the most disciplined and studious of all the different

medical professionals in the field, and in return they receive one of the most impressive salaries
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in the country due to their specialized knowledge. Before becoming a surgeon, a student must

persevere through many strenuous years of education and hard work to reach their goal

("Medical Education”). Aspiring surgeons spend upwards of sixteen years total, depending on

the complexity of their specialty, following high school graduation. This includes four years

working to an undergraduate education, followed by another four years through doctoral studies,

and lastly up to eight or more years of residency (Dobbins). Before even touching a patient,

surgical students work with cadavers and animal organs. In more recent years, surgical

simulation dummies or virtual patients have emerged as popular tools for teaching. All of this

preparation guarantees that students will receive as much training as possible and completely

familiarize themselves with the human body before putting a patient’s life at risk in an operation.

In addition to the extreme amount of time spent in school, future surgeons must also pay

for all of their years of education. Surgical students can accumulate an average of half a million

dollars in student loan debt before ever earning the title of a surgeon or the six figure salary that

goes with it (PR). Paying for such an education often requires students to work an additional job

in their first few years. The amount of money, time, and effort these healthcare professionals put

into their career even before it has begun contributes to their importance within the medical field

(PR). Even after students have finally achieved their goal, they continue to learn throughout their

career by gaining experiences and advancing their knowledge to keep pace with the introduction

of new systems and approaches.

The variety of tasks surgeons must perform outside of the operating room provides

another aspect that makes life as a surgeon difficult and exhausting. They examine and analyze

the health and medical history of their patients in addition to working as supervisors for other
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doctors and nurses within their workplace (Dobbins). Day to day work tends to vary greatly

depending on the type of surgeon and the cases that are expected for the day. Those working

within the surgical field typically work an average of forty hours weekly. Shift times average to

between eight and twelve hours long. However, certain long and complicated procedures may

require eighteen to twenty four hours of work in the operating room (Gay). High levels of

education and large workloads add to the reason the salary of surgeons has gradually increased to

become one of the highest in the entirety of the United States and the second highest in the

medical field (“Highest-Paying…”). Unfortunately, all of the responsibility placed on surgeons

on a day to day basis may impact their emotional wellbeing. Due to the extreme workload of

such a demanding career and the difficulty of working under extreme amounts of pressure,

surgeons have some of the highest rates of alcoholism and many report that they have considered

suicide at some point in their career (Dobbins). The difficulty of losing a patient often results in

aspiring surgeons changing their career choice very late in their medical education journey and

some even choose to abandon medicine altogether. Students who have the ability to persevere

through the difficult process discover that saving multiple lives makes their accomplishments

increasingly more valuable. Surgeons strive for greatness and by putting in large amounts of time

and effort they receive many benefits because of their work. However, surgeons can also incur

lawsuits from malpractice totalling thousands of dollars of debt throughout their career (PR).

Every time a surgeon begins operating, they must recognize that they have the life of another

person in their hands, and when they succeed they receive the well deserved satisfaction of

saving that life.

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The patients themselves constitute one of the most important aspects of the surgical field.

Surgeons hold the life of their patient in their hands throughout the entire operation. Although,

the before and after of an operation are also essential to determining the overall success based on

the satisfaction of the patient. Prior to receiving their operation, a surgical patient must make

decisions so their surgeon can target the procedure to fit individual needs (“Health Plan…”).

Surgeons often have complications when it comes to interacting with their patients as they find it

difficult to simplify the complex ideas of the operating room to a stressed and distracted patient.

By not fully comprehending their options or completely misunderstanding the possible result of

an operation, patients can experience serious dissatisfaction following their procedure (“Health

Plan…”). To solve these issues, the development of new technology specifically targets patients

by attempting to assist in their understanding of the operations that their surgeon will perform on

them.

Visual aids including diagrams or 3D printed models may help the patient, and even the

surgeon, get a clearer idea of their operation. In many hospitals, surgeons utilize these aids to

create accurate models of defective organs or to show the location of cancerous cells in the body

of the patient (Karas). Additionally, these techniques can also speed up operation times by giving

surgeons a glimpse of what they should expect once inside the operating room prior to opening

up their patient. Therefore the patient's body will be experiencing less trauma and blood loss as a

result of a more efficient procedure, helping further speed up recovery time (Karas). Improving

patient education has become one of the many tasks of surgeons that help to improve the medical

field from every angle. By properly and completely explaining the details of procedures to
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patients, they recover more rapidly and cost the hospital, and themselves, less money as a result

(“Health Plan…”).

Satisfied patients often do not require a second operation because they completely

understood the result of their initial operation and had the ability to make changes to fit their

needs by discussing a plan with their surgeon. By eliminating any unrealistic expectations the

patient may have for the result of their procedure, the patients feels satisfaction rather than

disappointment when the surgery is completed (“Health Plan…”). The surgical field has also

accomplished enormous amounts of progress by beginning with improving the education of

surgical students in creating a more prepared generation of future surgeons. New technologies

available to surgical students have drastically improved the effectiveness of procedures and the

satisfaction of patients. Devices similar to Simantha, a realistic surgical simulator, allow students

to get hands-on experience with operations they will perform on actual patients later on

(Comarow). Simantha's programming makes it one of the most realistic surgical simulators

currently available. It mimics the regular functions of the human body and has the potential to

simulate a patient of any age or gender with a medical status that changes as students operate

(Comarow). By using this type of technology future surgeons can become accustomed to

conducting many basic procedures, therefore reducing the potential for future lawsuits.

Additionally, familiarizing students with the human body early in their surgical career may

improve their success in learning simple procedures and makes it easier for them to comprehend

new procedures as they grow and improve within the profession. Developing a better prepared

generation of aspiring surgeons and improving the care and education of patients indicates the
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surgical field will likely see impressive amounts of growth and innovation within the next few

years.

One of the most intriguing aspects of the future of the surgical field involves potential

integration of new robotic systems into the profession. Currently, a majority of conversation

involving this topic in surgery surrounds the Da Vinci surgical robotic system. This system

consists of a large machine that converts a surgeon's hand motions into small and precise

movements (Tampone). The Da Vinci system allows a surgeon to operate multiple arms and

cameras inside the body of their patient. Cameras used can display small structures otherwise

invisible to the human eye (Tampone). This system also simplifies some complex procedures

because the less invasive approach can result in less trauma to the body of the patient. Operations

that typically require the complete opening of the body cavity only require an incision less than

one inch in length (Tampone). The cost of the Da Vinci system and various others may deter

some investors, however the amount of money saved by the hospital in the long run help the

system pay for itself (Gkegkes). Increasing success in procedures can result in lower chance for

recurrence of the issue, which would require multiple other operations, and lower mortality rates

in high risk patients.

The minimally invasive techniques used in robotic surgeries have overall shorter

recovery time and increased satisfaction ratings from patients, resulting in fewer lawsuits over

basic procedures and less spent on care for recovering patients. In elderly or obese patients,

whose recovery times typically extend well beyond average, the number of days they remain in

the hospital post-surgery reduces significantly because of the lowered risk of complication in

surgeries using robotic systems such as the Da Vinci (Gkegkes). This system currently requires a
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surgeons hands in order to operate its abundance of features. Within the next decade, new

programming may become available to hospitals that will allow these systems to operate

unattended (Dobbins). While this technology will require many years of testing and evaluation

before developers expect the use of this technology on actual patients, it does present a long

ignored question. How much longer will the operating room require actual surgeons to perform

these types of procedures?

Despite the uncertain future of surgeons, the miraculous accomplishments and

advancements within the field still attract many medical students toward such a difficult yet

exciting career. Each day, surgeons save hundreds of lives all over the world in procedures both

simple and complex as a result of hundreds of years of development within the surgical field.

This desirable career has many appealing characteristics that inspires medical students to work to

become a surgeon. Qualities such as the enhancement of the education of aspiring surgeons, the

progress made in technology used by students and surgeons alike, and upgrading patient care

have all contributed to the overall success of the modern surgeon. Each of these aspects of life as

a surgeon contribute to the impressive and much desired reputation of these medical

professionals.
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Works Cited

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