Working for Free

Surgeons believe in certain ideals. We believe we belong to a profession with intrinsic standards. These beliefs involve our duties to patients and our obligations to find the truth and patiently explain what we think in a way people can understand. We are translators and truth seekers and even though this sounds self-exalting, this is who we are. This explains the attractiveness of our work to idealistic young people, and even though the training is long, the goal is worthwhile. After extended training the time to earn a living has come, but it is a mistake to suppress our idealistic natures and concentrate only on finances. It is too easy to forget Wordsworth’s observation: “getting and spending, we lay waste our powers.” The best kept secret is: volunteer jobs are the best jobs. True, you don’t get paid, but you don’t pay tax either and you can learn things you would never learn any other way. You will develop a breadth of experience that your specialty practice would never allow. A specialty is focusing and that is one of its problems, it can be too focused. Doctors hate hospital committees, but committees are a good place to understand the bureaucratic mind and the world we live in. Hospitals need us to tell them when they have gone too far, and when they are proposing something doctors will not accept. Many draconian ideas are stopped in committee, and this is where your voice is needed. Imagine teaching plastic surgery. You might be the first plastic surgeon a medical student meets. Your inspiration could inspire a lifetime career. Explaining your experience to a trainee is an exercise in clarity and analysis. You will learn a great deal as a teacher. Imagine being chairperson of the ethics committee of a national surgical association. You would have the chance to find out what ethics are, how complaints are managed, and how ethics ideas change. No longer could you grumble about rules from Mount Olympus; you are now on the mount feeling fallible but understanding many sides of the questions and wondering how best to judge. You are seeking wisdom and fairness; representing and leading at the same time. The beauty of not being paid, even though the job is onerous and time consuming, is quite simple. You can never be successfully charged with staying in the job to feather your nest or as a paid lobbyist for one point of view. It is good to move on after a time and pass the job on to other colleagues. Imagine travelling to another country with a team of surgeons, nurses, and anesthetists to teach surgical techniques. You will make a difference and gain an understanding of the skill of surgeons abroad and what they need to improve outcomes. You will learn that surgeons abroad are very well trained, know many techniques, but don’t have the staff, equipment, drugs or instruments which you take for granted. You will understand, “it’s the economy, stupid.” You will learn that the surgeons you meet are far better at innovation and using what they have than you are. You will go to teach and be taught. You will be humbled by the gratitude shown by patients you help. Imagine working your way up the executive ladder of a local, provincial or national surgical association doing whatever duty is required and being involved in the debates of the issues as you take on various jobs along the way. These jobs are all unpaid, but think of the experience and insight you will gain. Imagine sitting on the governing councils of the provincial college as it decides issues regarding our profession. You will realize that the issues involved are far more complex and have greater implications than coffee room rants we enjoy as “stand-up entertainment.” Consider being on the board that chooses scholarship winners. You will find it very difficult to decide because the candidates are so well qualified, but you will bring your seasoned judgment to the task. Why volunteer? There is no pay, it takes time from your practice, and costs you money. You do it because you want to find out how things work. You do it to find out if you have skills other than surgery, and you do it because you believe it is worthwhile. In a cynical world where many actions are seen as self-promoting, you are an idealist and seek others like yourself. That is the reason you have to keep what you do quiet, for the more acclaim you get from volunteering, the more the reward ruins its intrinsic value. You do it because it is a good thing to do. If you find your practice less satisfying as the years go by, try some volunteering. It might be what the doctor ordered. John R Taylor

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