Is it possible to love two professions beyond reasonableness and be unable to distinguish which one delights you more? This romantic dilemma can occur with humans, but among professions? A recent “recurrent” gave new instruction about such a love triangle.
I thought I had enjoyed a 40-plus-year career in surgery about as much as anybody I knew. I liked the technical — what operation to perform, how to strategize the flow of the case, the minute details of the cutting and sewing. I loved the visceral — this was a very earthy business, what with your hands inside another human being. I loved the camaraderie — not many get to experience the responsibility, the triumphs and the defeats in the same way. Being a cancer surgeon seemed to magnify all this even more. It was a hard thing to describe to others.
But when I walked away from the operating table two and a half years ago, I raced toward a new career — flying professionally. A pilot for almost 50 years by then, and a professional pilot wannabe for most of that time, I knew that my window of chance to fly a jet for hire was going to close if I didn’t bust a move.
By the good and generous graces of JetSuite I was hired on the Cessna CJ3 as a first officer. Recently I upgraded to captain. I have loved every minute of the flying, if not every crew hotel. I have not missed the operating room once. Other retired surgeons tell me they don’t miss it either, even if they didn’t become pilots. Forty years of that responsibility is enough. There was relief in hanging up the knife and shedding the anxieties about the outcomes.
In my old world of surgery I was required to pass a written exam every 10 years to maintain my status as a board-certified surgeon blessed by the American Board of Surgery. This exam stirred worry as failure would surely affect my hospital privileges, not to mention be a huge embarrassment in my role as a departmental chairman. In my new world of professional aviation I am given an instrument proficiency check every six months (297 check ride), and I go to CAE’s training facility in New Jersey for a weeklong refresher course referred to as “recurrent.” No noun follows the adjective. Recurrent is all you’ve got to say.
Recurrent follows a predictable pattern, and the routine is both reassuring and cause for boredom. Fuel and flight controls follow electrical as surely as f follows e in the alphabet. Hydraulics, ice and rain, landing gear, power plant and pneumatic are all part of the recurrent parade.
I enjoy these sessions. I like being in class with other pilots. Their eyes have seen some low approaches in snow. Now, I’ve been there too; I know what they have seen. I like to think about the systems in the comfort of the classroom, rather than in a dark cockpit. I especially like the companionship of O’Neil Smith, a fellow captain with whom I have been paired the past two years, and, if all holds, we’ll be paired again this month. O’Neil is the consummate aviator and an all-around good man. I’ve learned a lot from him and it’s not just about airplanes. We have a good time in the sim, kidding around to reduce the tension, and mostly nailing our altitudes, memory items and system “emergencies.” Then we have dinner.
Recently I have decided that I’d like to try to become an aviation medical examiner. It seems like a great way to stay active in medicine without the stress of big-time cancer surgery. When I’m done with full-time flying, this seems like a logical next step, if I can pull it off. Furthermore, it should put me in proximity of pilots, whom, as a group, I find to be exceptional company.
To become an AME I must have an active state license, and to maintain that I need, guess what, recurrent, of the medical variety. In Florida I need 40 hours of continuing medical education.
So, last November I decided to take a course organized by the Osler Institute, which provides courses for surgeons taking the recurrent American Board of Surgery exam.
This experience found me comparing the two professions, the different ways in which proficiency and competency are maintained in each, and had me falling in love with surgery all over again.
It is one thing to sit in class and memorize that the CJ3 is powered by Williams FJ44-3A engines, and it is another thing to push the thrust levers up to takeoff power. Similarly it is nice and tidy to describe the indications for operations for stab wounds of the three zones of the neck. What will we find, you always wonder, and can I fix it?
As the recurrent marched on, I found myself falling back in love with the power of surgery. The syllabus wasn’t that different from CJ3 recurrent when I thought about it. Like a man in love with two women, I wondered if I had left surgery too soon, but then again, I was so enamored with my flying job I came away happy with my decision. Fortunately it is socially acceptable to love two professions; it is more problematic to love two women.
Fortune has been kind to me. Many people have never had a passion for any line of work. I got to experience it twice. Many with passions never consummate them. I know a talented young man who wanted to be a filmmaker, but his parents insisted he be an engineer. He’s a good one, but he wonders. A friend of mine got to painting late in life. He always wanted to be an artist, but commonsense parents steered him into mechanical engineering. My wife and I own the largest “private collection” of his gifted work.
