Part-Time Surgeon

I say often that I’m lucky to be able to work part-time, but what I don’t often mention is that it’s also harder to be good at what you do when you work part-time. Any part-timer has less experience than someone working full-time, but this is painfully true when it comes to operating, where volume matters. The more cases you do, the more skill and confidence you build. I suppose one could be high-volume but still a poor surgeon, but no matter how naturally gifted one is, it’s hard to rise to the skill level of those with drastically greater volume. I do in one month one-third of the cases that my full-time colleagues do in one week. I know I could be someone churning out thirty cataract surgeries a day, but there is simply no way to do that if I only work two days a week.

And it’s more than the volume. It’s the fact that I’m less available outside of the OR to follow-up on perioperative issues. I have less time or space to innovate or teach. I have less interaction with colleagues to debrief scenarios. And operating can be stressful: if I’m not on top of my game, someone is blinded (I suppose there are no part-time neurosurgeons or cardiothoracic surgeons for a reason).

And personally, it’s a hard thing to know I’m not the best at what I do: I’ve worked towards that my whole career. I found my niche, my passion, and exceled: if I wasn’t always the smartest, I was a quick learner who worked hard; I was naturally good with my hands and an effective teacher. But now, the most remarkable thing I can say about my operating is that I do it at all. I do find my work meaningful, and I know I still offer a lot, but I’m in some ways no longer the best, and it takes only the occasional complication to remind me of that.

Dave said once to me, “you have to really be humble.” And that’s true. Maybe this season is about learning to walk in humility with cheerful grace: admitting without shame when I need help, accepting unexpected outcomes as learning opportunities, counseling patients with thoughtful foresight rather than brash brevity. Reacting to judgment from colleagues with openness and a willingness to learn rather than defensiveness.

Learning how to walk in this place, though, without beating myself up or losing heart, is tough. I used to stay up all night replaying surgeries I did if they hadn’t gone perfectly, second-guessing every step, worrying since I wouldn’t be around to follow-up the next day. The loneliness, the not knowing any other part-time surgeons, was hard. This, more than anything, is what it means to me that I can’t have it all. I feel a deep, nearly inexplicable conviction that I should be home with the kids as much as I am, but this walking in career-humility is what it takes.

I see myself growing in it, though. I’m getting better at learning without beating myself up; I’m becoming less concerned with reputation; and through it all I do see the gift of being able to do what I do. As paltry as it may seem to full-timers, it is a privilege to be able to speak into and change the lives of the patients I have, to be in a world outside of the home where I can exercise different gifts, and I don’t take that for granted, however much I’ve had to give up.