Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
Cardiothoracic Surgery: Jason Han
54 Plays2 months ago
Season 4, Episode 3: Dr. Jason Han is a cardiothoracic surgeon at Cooper University Healthcare and a writer for the Philadelphia Inquirer. Listen to Jason discuss the importance of creativity in surgery, the state of surgical education and the stereotypes that have traditionally defined the surgical profession.
Recommended
Transcript
Podcast Introduction
00:00:09
Speaker
You're listening to The Wound Dresser, a podcast that uncovers the human side of healthcare. I'm your host, John Neary.
Meet Dr. Jason Hahn
00:00:21
Speaker
My guest today is Dr. Jason Hahn. Dr. Hahn is a cardiothoracic surgeon at Cooper University Healthcare in Camden, New Jersey. Dr. Hahn is also an avid writer who has previously written health columns for the Philadelphia Inquirer and Doximity.
00:00:36
Speaker
He currently heads The Modern Surgeon, a website that hosts a variety of surgical education content. Dr. Jason Hahn, welcome to The Wound Dresser. Thank you. Thanks, John. Thanks for having me.
Significance of Arts in Surgery
00:00:47
Speaker
um So I know you're you have an interest in the arts and the humanities. can you talk more about like um why the humanities and arts matter in surgery? Yeah, it it all developed kind of organically. um It's not like I chose a surgical career and intentionally decided to simultaneously have a creative aspect to it. It's just that as I started training in cardiac surgery and that had a lot of impactful experiences um firsthand and observed a lot of things around the hospital throughout the spectrum of patient care, I realized that
00:01:25
Speaker
those two things were like entwined together already. you know And so much of the things that I was seeing were like very human experiences, even though the job training and the way that the job description is, is highly technical.
00:01:39
Speaker
Really like somebody coming in with a cardiac surgery problem is having one of the biggest health crises of their lives, right? And the way that they approach it is gonna be fundamentally
Emotional Journey of Surgery
00:01:51
Speaker
human. And the whole trajectory of caring for somebody,
00:01:55
Speaker
with a cardiac surgical disease is taking them through that emotional rollercoaster and their families along with it, right? So like fundamentally, I think when you approach cardiac surgery, even though what I'm doing is sewing and tying and and cutting, like I think of the experience of treating someone with cardiac surgery as like a very normal human trajectory.
00:02:18
Speaker
And a set of experiences that come with that. And for me, processing all of that, whether you're a surgeon or a patient, is going to be things that require reflection, coping strategies, ways of wrapping your mind around all the extremes of it, right?
Therapeutic Writing
00:02:37
Speaker
And that's when I started leaning more into the creative realm because... Because that's what we do, right? When we have experiences that don't fully make sense to us, we try to make sense of it or cope with it in some way.
00:02:49
Speaker
And for me, that was writing. You know, I'm not a talented artist. You know, I sang when I was growing up, but I still haven't figured out how to weave singing into cardiac surgery. But writing for me came like very naturally while training and ultimately working as a cardiac surgeon.
00:03:08
Speaker
Because I'm not you know trying to write something that is divorced from my job. I'm simply writing about the thoughts that are going through my mind about the job, about my day-to-day.
00:03:23
Speaker
Like, could I have done that surgery better? Or like, oh, I had a complication. How can i learn to sit with that and then somehow come back to work the next day and do the exact same procedure all over again?
00:03:35
Speaker
Those are all things that were going through my mind again and again. Those are the thoughts and the questions that keep you awake at night. So inherently, the way that I process it was was through writing.
00:03:45
Speaker
And obviously, not all surgeons use the same coping mechanisms as I do. you know I don't actually know that many surgeons who write as regularly as I do, but I think a lot of us do. um Maybe it comes in the form of having conversations or maybe some people just prefer to go home and play their guitars and stuff. But for me for me, when I put thoughts down on a piece of paper and then I kept on reflecting on that experience, by the time I was done with that essay, i felt like I had a clearer sense of that experience and who I am as a result of it.
00:04:20
Speaker
And that made me feel better. So that's that's how it's tied together for me. um I think the... idea of writing in my surgical career is constantly evolving.
00:04:31
Speaker
So I can never say to somebody that like, I know where I'm headed or like, this is all part of my plan. You know, there, there isn't a set roadmap for a surgeon who enjoys writing.
00:04:42
Speaker
But I found that as long as my intentions or ideas are coming from are organic and it is something that I genuinely enjoy writing and thinking about.
00:04:55
Speaker
And it keeps taking me to interesting projects. Yeah, you use the word ah processing. um Do you feel like that that, that's kind of code for like almost burnout prevention? Or is that is it something different than that?
00:05:09
Speaker
yeah I think it's therapy. um Yeah, because you experience things during surgical training and beyond that, that will really test your core values.
00:05:22
Speaker
And, yeah, you know, these are going to be questions that
Intensity of Cardiac Surgery
00:05:26
Speaker
you don't have answers to for years, right? Like fundamentally cardiac surgery in order to heal somebody, the job that we perform is incredibly high risk, high stakes. And, and frankly, if you think about it in like the most raw way, it's kind of a violent procedure, right?
00:05:51
Speaker
I mean, Blood is everywhere during cardiac surgery. um There's a lot of cutting and sewing. The human body cavities are split open before your eyes, right? I mean, when you frequently talk to patients about performing a sternotomy to do cardiac surgery, I mean, there're they're appropriately afraid of the idea because they refer to it as, quote unquote, cracking the chest open, right?
00:06:18
Speaker
But for me, that's just a part of a routine day that I so that i do virtually in every operation. So when I think about that aspect of my job, like, yeah, i I do need a way of processing that at the end of the day, right?
00:06:32
Speaker
Like when I come away from the OR table, I'm finished with the procedure, but I'm not finished with how I felt from it and and what kind of changes it's put through.
00:06:48
Speaker
you know, what kind of changes that has induced on my body and mind over the years, right? I think that requires active maintenance. And in that sense, yeah, it is therapy, it's maintenance, it's something that I do so that I can keep going back to my job with a fresh and positive perspective.
Preventing Surgeon Burnout
00:07:06
Speaker
Because it's just as possible that you could walk away from any of these very trying and and sometimes stressful experiences and be burnt out from it, or ultimately carry a negative perspective.
00:07:19
Speaker
you know, fundamentally when you're tired, when you haven't slept enough or when you haven't eaten or drank water in a while or haven't sat down in a while or if you really want to go to sleep but then you also have to get up and you still have to get up and go take care of another surgical issue.
00:07:35
Speaker
Like every human being is going to feel irritable or impatient or I don't know, over time, those types of experiences related to scarcity will trend you towards becoming a more burnt out and a self-interested person. But in order to prevent these types of trying experiences from making me change in that direction, I think that every surgeon could benefit from healthy coping strategies. And for me, this is in that sense, like you said, it's anti-burnout, it's ah it's therapy.
00:08:12
Speaker
I'm sure everybody says that like, you know surgery is a very rational field. Do you feel like in real time though, while you're doing surgery, you kind of engage those creative parts of your brain as well and, um you know, do things that are against rationality?
00:08:26
Speaker
Yeah, i think I think surgery in some ways like has to be a hyper rational field, right? Because you don't want your emotions in the middle of an operation or a complication or some kind of a stressful scenario to jam up very logical ways of problem solving in in the middle of an operation, right? So in that sense, like surgery has to be that way. But the way that we behave during an operation is not by any means dry, right? People are engaging a very creative aspect of their brain. Like people, I think, sometimes think that surgery is, you know, follow steps one through 10 and then do not deviate in any way.
00:09:12
Speaker
But it's actually a lot more dynamic than that. It's almost like you have to accomplish goals one, two, three, and you're reacting to different things as they happen in your surroundings.
00:09:24
Speaker
So, you know, you start your operation and then you come across something that you didn't expect to see. in that situation, you're not a rigid robot just sticking with your original plan.
00:09:36
Speaker
You kind of have to be flexible and creative, you know? Yeah. maybe the instrument that you're planning on using for this exact purpose isn't doing it, then in that moment, you kind of have to be like, well, let me improvise a little bit and see what I want to try differently.
00:09:50
Speaker
Right? So I actually find that the day-to-day work of surgery um is planned rationally, but executed in a much more creative way than people people think it's going to be.
00:10:03
Speaker
Right? it's a It's improvisational, A lot of it is sort of artistic. Like you don't really know how sewing something together going to look.
00:10:16
Speaker
There's some artistic brain. There's some artistic part of your brain that engages with what you see and feel and then tries to put something together. And it's not a mathematical process. You just kind of have a feeling that it's going to look right.
00:10:30
Speaker
and then And then hopefully it does, right? Yeah. Like that I don't think is ah is a rational part of my brain. That I think is a creative part of my brain. Like some sort of like a multimodal aspect of my brain that engages in the process.
00:10:45
Speaker
Do you, like as AI is slowly taking over medicine, do you feel, you knew you were going get this question, right? Because you got to get this question. But like, um I guess in general, how does AI affect surgery? And like, how does that um eventually down the road, you know?
00:11:03
Speaker
um Do you you see it being helpful on some of those creative parts or it's only on the very like robotic parts like you said?
AI and Surgery
00:11:10
Speaker
Yeah, I don't know. um It's funny. There was a podcast that I listened to recently where someone probably like half jokingly said, ah with this AI revolution, the only people who are safe from losing their jobs are probably cardiac surgeons.
00:11:24
Speaker
You know, I think that so much of what we do in cardiac surgery, um even though maybe it could be boiled down to a set of formulas one day is is so much more variable than people think it's going to be.
00:11:40
Speaker
you know i um like In the middle of an operation, even though what's planned may be a quote-unquote straightforward valve replacement or quote-unquote straightforward triple bypass surgery, the number of micro decisions that are made along the process um are too many to count.
00:12:03
Speaker
you know For instance, you may go in thinking, oh, I'm going to throw a stitch here and then put the graft here and then size it this way and whatnot. And you may think that.
00:12:15
Speaker
And then the kind of things that get adjusted along the way are just infinite. Yeah. Like I might go into an operation thinking, oh, this is going to be a pretty straightforward case, quote unquote.
00:12:27
Speaker
So straightforward that maybe ah an algorithm or a robot could do it. But then I'm always like very humbled by that end of the case. And I step away thinking like, oh man, like this is really hard.
00:12:39
Speaker
All because of things that i could not have, you know, predicted in some sense, you know, and I don't know, maybe one day, 20 years from now and my career is at its end.
00:12:53
Speaker
AI could do that job. I mean, cardiac surgery does have a shortage problem of surgeons. So I'm sure some aspect of the work will change, but ah I don't know. In the era of ai right now, I think it'll probably just augment the way that we function for a long time.
00:13:12
Speaker
At the end of the day, I guess it's a question of how many years will it take for a patient to shake the hand of a robot and say, oh I trust you to do my heart surgery, right? Like there's a human factor to that. Like I think when a patient comes into your clinic and says, ah great. I trust you, doctor.
00:13:29
Speaker
You can do open heart surgery on me. There's like, there's some aspect of that that is not transactional. That is above that. So, um, I think as long as that human connection exists in this field, i you know, people will probably want the touch of a surgeon um when dealing with complicated problems like this.
00:13:51
Speaker
Have you seen it at least kind of infiltrate like surgical education a little bit? Yeah, and I mean, without a doubt. I mean, even there's there's a ton of research right now, even on how to utilize AI more effectively in surgical education, right?
00:14:06
Speaker
And I think That is a huge component of where it could be very effective actually because coming up with study materials, for instance, you know, for a cardiac surgeon, let's say like myself who has to take his boards.
00:14:21
Speaker
If I wanted to come across a question bank, Maybe a good question bank doesn't exist, right? And unlike studying for the USMLEs or whatever, where there's tens of thousands of students taking it, where there's a market for it and good question banks exists, it doesn't exist for us because who's gonna make, who's gonna spend a thousand hours making a question bank for a market of 80 surgeons, right?
00:14:51
Speaker
But AI can. you know like i mean, if I asked ChatGPT, like, hey, can you come up with five realistic cardiac surgery board questions for me and explain why that's the correct answer?
00:15:01
Speaker
Like that could do that for me. you know And if I use something like open evidence, because let's say, oh, like, I can't off the top of my head remember what this guideline says about this very specific criteria.
00:15:16
Speaker
In the old days, I would have to open up a book or find the guideline document and then scroll down. You know, you you must have opened up like a guideline document before, but for any procedure, it's like a hundred pages.
00:15:30
Speaker
And then I would have to find exactly where it refers to this particular pathology and then read the text. But now I ask that question and then it just answers it for me. Like it pulls it up for me, right?
00:15:42
Speaker
So in that sense, it's been incredibly powerful. It makes my day-to-day self-education and even teaching others much more efficient. um Because I think so much of our days used to be lost going through materials, like swimming through tons of materials and not finding exactly what we needed, right? That's kind of like medical information at large, right?
The Modern Surgeon Project
00:16:07
Speaker
As I understand, you have a a website called The Modern Surgeon. Is that kind of some of the stuff you're you're trying to put forth multimedia-wise? Yeah, it was an it was an experiment, really. i mean, um like some of these frustrations that I was feeling and also the fact that if you work as a surgeon long enough, you get asked all the time how to perform certain particular things.
00:16:32
Speaker
And also, ah when you're training cardiac surgery, you realize that may have taken you six months to find an answer to a very straightforward question.
00:16:43
Speaker
you know, so for instance, like in the beginning, I couldn't really understand the difference between like a true difference between like why a knot was slipping in some instances and why it wasn't.
00:16:57
Speaker
And it took me a long time at home. of experimenting with sutures and threads and stuff and seeing if I move my left hand this way, does it work better, et cetera, et cetera, to figure out why that happened.
00:17:12
Speaker
And, you know, I think that wasn't a waste of my time, but it took me a long time to learn something very basic. And those are the types of questions that I was getting asked almost every single day from like countless students and other junior residents and stuff. Like, what's the difference between a forehand and a backhand?
00:17:32
Speaker
What's the difference between a square knot and a slip knot? Those types of questions are universally important to everybody right in education. But if you wanted to find an answer to that online, you weren't going to find a straightforward answer.
00:17:46
Speaker
You're probably going to find a hundred different websites that have that point you to different textbooks, at dense materials, and photos that kind of capture the question, but it doesn't really tell you the three-dimensional and the the temporal aspect of what you're doing and solving.
00:18:06
Speaker
So in my mind, you know I was working with a med student named Josh Chen at the time who was at at Jefferson, and he had already been very experienced in social media and wedding videography. So in our minds, we were like, well, why don't we just make videos that are instructional in a way that is super simple and well edited, well lighted, stable, aesthetically pleasant, engages your eye, has labels, slows down in the appropriate moments, speeds up in the appropriate moments, like the basic things that you would see in in any movie making.
00:18:40
Speaker
And why don't we just apply that to some basic surgical principles? Could in AI in theory generate some of that animated content? I think so. I mean, I hope so. I haven't tried.
00:18:52
Speaker
You know, ah we worked on it for a while and then that was before the AI boom. and And I haven't had as much time to revisit it in the last three or four years because your training gets busy and then starting a new job gets really busy.
00:19:08
Speaker
But at some point, I'd like to get back to this question in my career for sure. um The tricky thing about ai representation of surgery um is at the end of the day,
00:19:23
Speaker
going to be you know like how realistically how realistically can they draw upon these types of materials from existing content out there and the on the internet. right It's not like countless streams of surgical videos exist out there right now. like Where do you pull it from? like TV shows? you know i mean There are some videos out there, but inherently it's a limited material.
00:19:47
Speaker
um OR videos are like ah like something that's hard to come by. So we'll see. Maybe there will come an age where every operation that's performed in the hospital gets recorded on a more regular basis.
00:20:03
Speaker
But that's complicated too, right? yeah Yeah. It's like the concept of having a black box in the ah OR. It's a highly controversial notion. you know From a safety perspective, it makes a lot of sense. But you also don't realize that like, I mean...
00:20:19
Speaker
like the thought of being recorded for every single thing that's done and said in the OR is like such a big change in the workflow of individuals that um that it'll probably take some time.
00:20:32
Speaker
We've alluded to a number of times, you know, obviously and medicine's a busy busy profession and within medicine, like surgery is considered very grueling, very rigorous.
Work-Life Balance Evolution
00:20:43
Speaker
So how do you, in your mind, frame, ah you know, work-life balance as a surgeon so that you can, ah you know, live your best life? Yeah. um For one,
00:20:56
Speaker
I don't push my body and mind the way that I used to. ah When you sign up for a surgical residency, like everyone comes into it with a sprint mindset because when you're in your twenties and you want to be a cardiac surgeon and like, you know, you're fit, you are haven't had any gray hairs, you, you know, your joints don't hurt and Maybe you have a kid at home, but most of us you know at that age, starting cardiac surgery residency, didn't have a baby at home. you know
00:21:31
Speaker
So you're really just kind of approaching training and work like it's the singular defining thing in your life. So when I first started training, I just pushed and ah like 120%.
00:21:46
Speaker
It didn't really matter how many consecutive days I worked or you know like Whether i was working out regularly or eating healthy, just all I thought about was cardiac surgery.
00:21:58
Speaker
I don't view it that way anymore. like Conceptually, the idea has changed in my mind. like I'm not trying to sprint anywhere. As a cardiac surgeon, the way you become the most helpful cardiac surgeon in the world is not being extreme right now. It's by having a long and safe and fulfilling career without your body breaking down or without you stopping work because you burnt out in some way, you know?
00:22:27
Speaker
um If you think of it as a race, it's not a race where you have to finish five laps as quickly as possible. It's more like an endurance race where you have to keep the machinery running for 24 hours.
00:22:41
Speaker
Kind of like like the Le Mans example. Like it's like that, like your body has to rest. Your body has to last your entire career. And no human being going at 120% capacity could could go your full career without having some problems.
00:22:57
Speaker
you know Cardiac surgeons have a lot of musculoskeletal issues. i so All surgeons in general have those problems, but cardiac surgeons are no exception.
00:23:08
Speaker
you know like You're standing in the ah OR for many, many, many hours in a day. We have you can name a joint and we probably have pain at some point in our lives, you know, and furthermore, because you're not, you know, drinking enough water or you're exposed to a high level of stress or your diet's highly variable. Like these are all things that at some point in your life are going to cost you.
00:23:33
Speaker
So now the way that I approach work-life balance is that you're totally okay for being kind of moderate, you know, Like i prescribe myself enough work knowing that I'm going to have energy left over at the end of it because it's not acceptable for me to drain every ounce of my energy at my job anymore.
00:23:58
Speaker
And like, if that doesn't sound hardcore, I think that's okay. But that's the only way that I know that like, I'm going to be able to take care of my own body and also have something left for my family when I go home.
00:24:10
Speaker
You know, like it's not meant to be in my mind, at least, Even a cardiac surgeon is not meant to be so drained every day that you don't have anything left for anybody else anymore, you know?
00:24:22
Speaker
So the way that I define work-life balance has has shifted conceptually. And then because my mind shifted, I'm okay with adjusting my days and my schedules and expectations based on that.
00:24:34
Speaker
That's probably the most meaningful shift. ah And then, you know, every cardiac surgery resident or surgeon tries to come up with like, hacks and tricks throughout their day try to keep themselves as healthy as possible. But that's variable for everybody.
00:24:49
Speaker
You know, for some people, like it's like healthy snacks. You know, for some people, it's like taking the stairs or going for a run in between cases. You know, i know surgeons who go for a swim in between cases. Like those things all exist. But really, by by and by far the most important thing that I learned and implemented in my career as I switched from a trainee to an attending is that I decided to take on a very long-term perspective.
00:25:14
Speaker
Whereas as a trainee, I was just trying to make it to the finish line. Yeah. You'll see. um As a surgeon, it's hard not to feel the pulls of your ego.
00:25:31
Speaker
You know, like, can I be the best cardiac surgeon in the region? Or... can I somehow prove that I'm willing to work harder than the next guy or or someone else, right?
00:25:45
Speaker
Like I want to be the highest volume surgeon in this hospital or everywhere else because it it feels good temporarily, right? To have that kind of pat on the back. It's like a dopamine rush, right? Somebody tells you, an administrator comes to you and says, gosh, Jason, you are the highest RV producing surgeon in this healthcare system. Like we are so happy for you and I'm so proud of you.
00:26:08
Speaker
feels good right but um at the end of the day that's that's your ego wanting that but the cost that you pay for that cost of not tempering your ego is your is your body and your schedule you know because no one i mean the fact that you're the highest volume surgeon in the world is not going to make you happy forever At some point, we all grow out of that, I think, right?
00:26:36
Speaker
So for me, I think I just decided to look at it very soberly in that context. Do you feel like the system sort of, if you don't want to go 120% all the time, like you were saying, that the system punishes that or rewards that or is sort of neutral?
Balancing Productivity & Well-being
00:26:55
Speaker
i don't know if it's explicitly punishing me or rewarding me for it, but I know that everything is kind of built like a like a game, right? In some sense, like surgeons love optimizing things, right?
00:27:08
Speaker
And many of us want to go into a day and be like, how can I build that perfect schedule? How can I make it so efficient that I'm done rounding at this hour and then I do my first case and then I stagger into my second case and then I can fit a third case and maybe I can even bounce to a catheter unit.
00:27:28
Speaker
you know, a cat into a catheter-based case in between and somehow juggle all of that. And then at the end of the day, like, wow, like, I optimized my day spectacularly. That feeling, I think every surgeon is to some extent addicted to it.
00:27:43
Speaker
Similarly, like, every single person who works in medicine and surgery can relate to the feeling of how good it is, to how good it feels to to get through all of your checklists or...
00:27:57
Speaker
Just like take care of item after item after item, right? In some ways for a surgeon, if you have seven cases that you have to get through, it's hard for you to relax until you've gone through all of them, right?
00:28:11
Speaker
It's extremely hard to pace yourself because in your brain, you're like, I just want to stack them and get through all of them and just keep checking off the things that I have to do. Like that's the mindset that we were groomed in.
00:28:25
Speaker
Like we ah we feel a dopamine rush when we get through an incredibly optimized day or when you get a lot done, right? It's that productivity mindset. So I think sometimes the system is set up inherently to reward those types of behaviors, ah the the types of behaviors where you want to maximize experiences, add on more things to do, get them done efficiently, et cetera,
00:28:51
Speaker
Obviously, um you have to draw a line at some point because you can't just you know endlessly work. But as a surgeon, it is really, really hard to moderate that kind of feeling that you want to keep on adding more productivity, adding more productivity. Oh, I did five cases this week. Maybe next week i want to do six.
00:29:15
Speaker
That growth, that desire for increased productivity and increased efficiency is just so... you know, inherently built into our minds, I think, that oftentimes in a system that is built around our views and productivity units and number of cases that need to get done, it feeds into that, right?
00:29:38
Speaker
And also, like, it feels good when someone comes up to you and says, hey, Dr.
Changing Stereotypes in Surgery
00:29:42
Speaker
Han, like, this patient's really sick and you're the only person who could help this person right now. Like it really, really draws you in, you know, it's like incredibly rewarding from that perspective. So it's so hard to balance something like that inherently, you know?
00:30:03
Speaker
You mentioned the the productivity, the optimizing. What are some other stereotypes of surgeons? And do you think they're true or or not true, I guess? Yeah. I mean, there's lots of stereotypes of surgeons out there, right? And they're portrayed in the media a lot. I think
00:30:21
Speaker
i think surgeons historically... have carried a lot of those stereotypes. But I don't think that those stereotypes are as are as simple as they used to be because the surgical workforce has diversified a lot.
00:30:37
Speaker
you know So for instance, a lot of the stereotypes I think come from like the sort of old school era of surgery. um But if I had to think about the types of people who are going into surgery right now,
00:30:49
Speaker
I can tell you that, you know, a lot of people can love being a surgeon and then at the same time still find it incredibly important to have hobbies outside of it, you know, um still find it an incredible aspect of their commitment to be a family man.
00:31:08
Speaker
or a parent or a sibling or spouse, whatnot. Like I think a lot of the old school stereotypes portray surgeon as a singularly focused, work-driven and potentially a little bit like, you know, emotionally removed and disciplined.
00:31:28
Speaker
Those are the stereotypes, right? But i I don't think that's necessarily what I see in my workforce, what I see in this community anymore. um probably because stereotypes are not immutable, right? I mean, stereotypes only exist because it reflects the prior culture, but that can change as soon as some people who decide to go into it decide not to abide by that stereotype. It's as simple as that.
00:31:54
Speaker
Like you can choose whether to perpetuate the stereotype or not. So I think in this generation, at least, people are a lot more dynamic. I think um people are a lot more intentional.
00:32:06
Speaker
about who they are as a surgeon and what kind of identity that means for themselves. and And because of that, I think that thoughtfulness carries through. you know I admire a lot of surgeons from a prior era, but in many ways, having grown up and when I grew up with my particular set of circumstances, I also acknowledge that I can't relate to them in every single way.
00:32:28
Speaker
We're very different human beings. And some days I admire them so much, I think to myself like, oh, I really wish I could be more like that. But I also know that I'm living in fundamentally different circumstances.
00:32:41
Speaker
You know, I'm married to another surgeon. And then we had two kids while we were in surgical training. That fundamentally is a part of my identity that is different from some of the people that I look up to. You know, that's an experience that like changes who you are forever.
00:33:00
Speaker
um I know that I'm in an all-demanding and all-consuming job, but I also know that my wife is in that same circumstance. So we are inherently going to have to figure out how to do it 50-50.
00:33:15
Speaker
No one in our family can come home and say, my job is so important. This is where our priority is. You know, it's, we're going to have to figure out a way to balance both of our careers in a way that we're both fulfilled and respect each other.
00:33:31
Speaker
Right. In some ways, one could say that that's also very different from a traditional stereotypical surgical lifestyle. Right. I think a lot of surgeons in the past used to be the primary sort of breadwinner for the family and therefore could work all hours of days and nights and weekends and It was kind of expected that they could do that because at the end of the day, the work that they did was supporting their family at the same time, right? For me, it's not as simple as that.
00:34:06
Speaker
You know, for us, we have to figure out a way to make it balanced in some way. And that means one person takes a step back when the other person takes a step forward, or we figure out a way to prioritize our careers in different chapters, you know, like,
00:34:20
Speaker
someone says, Oh, the next five years, or this particular role is so important to me. Can you support me during that? And then we would have to negotiate that going forward. You know, that's a very different archetype.
Team Dynamics in Healthcare
00:34:33
Speaker
You can notice sometimes that there's a tension between like medical teams and surgical teams, like is that a tension that you you notice? And how do you think perhaps they're writing perhaps through are the humanities, even like, how how can you make those relationships stronger, provide better care for the patients? Yeah,
00:34:49
Speaker
You know, I think tension is everywhere. And it's not even just between medicine and surgery. It's within surgery, between neurosurgery and cardiac surgery, between cardiac surgery and vascular surgery. You know, like anytime I think you have a team that specializes in something or knows something better than another team or has a different culture than another team, there's tensions among them because you're like, oh, look at that team. Like,
00:35:16
Speaker
gosh, I can't believe they thought that they missed this nuanced cardiac surgery condition. you know like's ah Or like a medicine team could say, oh, like these surgeons, all they care about is surgery, et cetera, et cetera.
00:35:30
Speaker
And I think those types of tensions naturally exist because that's how we express differences in opinions and frustrations during the day. right But like you said, yeah, like I have been in a hospital setting long enough and have interacted with these teams long enough that that you look beyond the superficial stuff.
00:35:49
Speaker
Like, let's say that I was interacting with a junior resident um and that person, not in cardiac surgery, but in medicine.
00:36:02
Speaker
And that person, you know, asked me a question that many cardiac surgeons would be, would consider to be too basic, right? Oh, like, why are you wasting my time with this kind of question, right?
00:36:15
Speaker
If that's your initial reaction to that situation, then you're always going to have that tension and you're always going to respond to those types of situations as if it's unfair to you, right?
00:36:26
Speaker
But the more you reflect on these types of things, ah the more you realize that like the the questions that you need to be asking need to be one step removed from that. ah You can't react to a situation that annoys you.
00:36:40
Speaker
You have to take one step back and And then look at the question from a larger perspective and say, why should someone in that position know this nuanced thing about cardiac surgery?
00:36:53
Speaker
And why is it a problem that that person is asking me? Like, technically, am I not the person to be able to answer these types of questions? You know, like, is it a waste of my time? It's not, right? I mean, yeah at the end of the day, like all the things that cause tensions around the hospital,
00:37:08
Speaker
if you take a step away from it and like cool yourself down and, and think about it, it's not that serious, right? It's not like, it's, it's not physically injurious, you know, it's not morally injurious.
00:37:23
Speaker
Somebody may have just done something or express something that's a little different from you, you know, like, ah doesn't make them bad people doesn't make them dumb. Certainly, you know, just everyone just has,
00:37:35
Speaker
different sets of expertise. And then I think we're just all going around in circles talking about how that other person, you know, is some, you know, it could not figure out this thing that I'm really good at, you know, like in a, that's a lot of that tension between surgery and medicine, right?
00:37:55
Speaker
And the really it's probably unnecessary. I'm not gonna say that it'll ever fully go away because i think that's just what a workplace dynamic is sometimes, right? I'm sure it's similar in corporate environments to some extent, like, oh, like I can't believe so-and-so did this and that. I think that's just part of any human society.
00:38:12
Speaker
But when I think about these types of issues, the longer that I've been in it, the less personal anything feels. You know, i'll ah I'll give you an example. So like when I first started here at Cooper, like no one knew my name, right? Because like, you know, um'm yes, I'm an attending cardiac surgeon, but but it's not like they had any any reasons to know that like I was a cardiac surgeon. So when I was on a lot of phone calls for the first time with like people in training roles or people who are students calling consults or residents calling consults or APPs,
00:38:49
Speaker
And I introduced myself and I said, hey, like, I'm Jason. You know, i have a question about this kind of thing. You know, I got brushed off a lot. Like, um oh, yeah, we'll get around to that later. it's not that important. Like it was, you know, the the tone of the phone was kind of rude.
00:39:06
Speaker
Like, oh, like, like, why are you bothering me with this? It's not that important kind of thing. But it's funny because like four hours later, they would realize that like they were talking to like the attending cardiac surgeon of that patient.
00:39:20
Speaker
And then somebody would call back and be like, oh my God, like I'm so sorry. I didn't realize that that you're a cardiac surgeon. This is my response. like I'll make sure that gets documented. I'll i'll take care of this right away.
00:39:34
Speaker
And then i I used to find that situation so funny because- like First of all, like you know you don't have to change how you treat somebody based on their title. And secondly, i could have been offended at that original conversation.
00:39:47
Speaker
right I could have been offended and I could have snapped back at them and said, do you know who you're talking to? I'm the new cardiac surgeon here, blah, blah, blah. But I didn't feel the need to do that at all. right Because if you step away from the whole thing, it's kind of kind of comical, isn't it?
00:40:00
Speaker
It's not that they did something egregiously wrong to me. I mean, maybe they could have been a little nicer to me, but at the same time, like I don't have to take that personally, you know?
00:40:12
Speaker
And, uh, but I laughed because, because those phone calls happen pretty often. And then, uh, And then if I were maybe 10 years younger, i could have reacted to them in a more rash way, like in a more emotional way, like, oh, like, how can you do this to me? I'm upset with you, et cetera, et cetera. Like, you shouldn't be so rude to me.
00:40:32
Speaker
But being older and having been raised in a healthcare system that has so much of that tension, now I look at it and say, oh, like, I could choose not to get offended. This is really not a big deal.
00:40:45
Speaker
At some point, they're going to feel sorry. when they realized that they didn't have to be short or or brush it off. And sure enough, like they would call back all the time, like I said, you know?
00:40:56
Speaker
So, so much of the tension and and and that exists in surgical cultures and more than beyond in the hospital, I think is self-generated.
Mindfulness and Wellness Practices
00:41:05
Speaker
I think it's, I think it festers because because we maybe sometimes choose to let it fester.
00:41:15
Speaker
Sounds like you're advocating for some mindfulness in the medical and surgical community that, um yeah, I guess maybe, maybe that's something, you know, as your career progresses, like you, you can, you can have more of those breaths throughout the day and say, Hey, oh, that's not actually a big deal. But like when you're a resident or or a fellow or something, you kind of maybe just knee jerk react to a lot of things. It's so hard. Yeah.
00:41:39
Speaker
Especially like I can tell when you haven't slept in a while, and you have a million things to do and you're stressed at home because your kid's sick and your bank account is empty, like, and your house is dirty because you haven't been home to like clean it in two weeks.
00:41:59
Speaker
If somebody annoys you, you're much more likely to snap, right? um Right now I get to be an attending. So like, I think I have ah decent amount of emotional security, you know, like I, uh,
00:42:12
Speaker
have a more flexible schedule. My home is a little more under control, although not totally. So when I get into those types of situations, I think I can find room for humor because I have reserve.
00:42:24
Speaker
Yeah. But totally like in ah in a situation of scarcity, like anything goes, you know, like the best versions of ourselves that we wish you were projecting all the time, you know, sometimes don't make it to the surface.
00:42:37
Speaker
Yeah. Um, But yeah i think i think yeah, I think a lot of it is about mindfulness because in surgery, how I choose to interpret a certain stressful situation really, really just depends on my perspective.
00:42:53
Speaker
So I'll give you an instance. Let's say that I was doing an operation that was going to take me an hour, right? If I told myself that I can do on an operation that takes me an hour, but it's okay if it takes a little bit longer,
00:43:09
Speaker
Versus a second mindset, which is i got to figure out a way to finish this operation in 45 minutes because I scheduled another meeting 45 minutes from now.
00:43:19
Speaker
And then I have a flight at 4 p.m. So I got to finish all my cases before then so I can get to the airport. Totally different mindsets, right? And that changes the experience of your entire day. Not only the you and the patient, but the entire group of people around you.
00:43:34
Speaker
You're snappy. You're less willing to teach. If somebody makes a mistake in front of you, you're like not forgiving at all. You take it away. You're like, i need to come on, let's go, let's go, let's go. Like that mindset is artificially generated by the fact that you chose to do more in a day than you were supposed to do.
00:43:53
Speaker
In some ways, isn't that just mindfulness? Like, isn't that just something that... You could have chosen to approach differently from a mindset perspective. It's not like no one gave you a choice to be more relaxed.
00:44:05
Speaker
It's that we constructed it that way. And then when we react to it accordingly, trying to make something that takes 60 minutes in 45 minutes, ah trying to do something that takes 60 minutes in just 45 minutes, we're surprised when we're so impatient and stressed the entire time, right? Yeah.
00:44:23
Speaker
So like so much of my day, I think is actually under my control. And then how I react to situations is actually under my control. And everything that I thought was just a knee jerk reaction and beyond the realm of choice is probably actually a choice. Yeah, it's kind of that shift from like, things have to go a certain way to things don't have to go a certain way that you can have that like space where you're a little more accepting of how things are in the moment how things go.
00:44:51
Speaker
I think so. I think as you get more experienced, you're sort of like, oh, does it have to be like this? Maybe not. Why did I think that way for 10 years? Did someone tell me to think that way? Was it a rule written somewhere? And then like you all of a sudden one day you're like, i guess not. All right.
00:45:08
Speaker
I mean, those types of realizations happen in medical education all the time, right? We come into the field and then we kind of mimic the conventions that are before us. An MS1 learns how to be an MS2 from m watching MS2s. And similarly, a resident figures out how to be a resident from imitating other residents' behaviors who imitate attending behaviors, right? And then at some point along the way in your career, you look up at the sun and you're like, huh, did someone tell me that this has to be done a certain way? Like, is this the only way to do something or think about something?
00:45:43
Speaker
And then you're like, well, not really. That was just something that you picked up along the way. and And at that moment, I think that's very powerful as a realization when you realize that like some of the rules that you have internalized are not actually laws of physics or gravity, you know something that's immutable. like It's just something that you chose to internalize.
00:46:09
Speaker
And then when you realize that I think you can really deconstruct them and choose to define it in your own way, depending on your values. like But that it's time for a lightning round, a series of rapid fire questions to tell us more about you.
00:46:21
Speaker
So not cardiac surgeon, what's your favorite procedure? Coronaries. Coronaries. It's the only procedure that like, is so fine and minuscule that it totally quiet, it's not in your mind.
00:46:34
Speaker
It puts you in a flow state. What's your vice or guilty pleasure? i buy a lot of plants.
00:46:46
Speaker
It's like something that I do as like a coping mechanism. Like if I have a bad week, like I go home and I buy a plant and like, and then I keep buying plants and then it creates more work.
00:46:59
Speaker
And, ah but yeah, it's, you'd be surprised. ah do you plant, are they indoor plants or are they outdoor plants? I live in a condo right now. I live in like a townhome, so I don't even have a yard. oh okay. So indoor plants.
00:47:13
Speaker
What's your favorite, ah what are your favorite winter and summer activities? My favorite summer activities, ah you know honestly, they're not season dependent because it's not like I say I go to the shore. Like I don't, you know, like it's not one of those.
00:47:30
Speaker
Like when it's warm outside, I think I just like nowadays going to like a like a garden or an arboretum and just kind of walking around with my family and my kids. Yeah. um Because they can f fully run freely run around and stuff. Like as you get older, it's just funny because whatever makes your like little kids smile is like your favorite activity for a while, you know?
00:47:58
Speaker
In the winter, i mean, I really like going to concerts, like orchestra concerts. what's your go-to wellness practice?
00:48:09
Speaker
Hmm. Um, it's something that I'm so obsessed with that it's like really hard to choose one. Um, I love saunas.
00:48:21
Speaker
It's like the place where I stretch and meditate and then, I don't know, enjoy the sauna all at the same time, but I don't have access to a sauna that readily. So unfortunately that's going to have to wait until later.
00:48:32
Speaker
Um, In terms of wellness, like I really like nowadays, like the older you get, the more you just enjoy stretching at the beginning of the day.
00:48:47
Speaker
And it's something that I never, ever did growing up and took for granted and that your body is just so tight without it. So like there's nothing better for me now than just if I have a chance to wake up early in the morning and stretch for like 15 minutes.
00:49:03
Speaker
It's like it makes a difference in my day. And lastly, what's one change you would like to see in the surgical community? hu um I wish that surgeons could feel more freedom to bring about a dimension of their lives into their specialty than they do right now.
00:49:28
Speaker
you know So for instance, I think a lot of surgeons... feel the need to be a surgeon in a particular way because that's how rigid the field can be. If you're a surgeon who loves baking, let's say, or who loves musical performance, I wish that there was some allowance in the field of surgery to be respected for those two things equally, you know?
00:49:59
Speaker
Like to so to somehow find a way to incorporate music into surgery instead of feeling like you have to come up with a more legitimate surgical interest. Dr. Jason Hahn, thanks for joining The Wound Dresser.
00:50:13
Speaker
Thanks for having me.
00:50:24
Speaker
Thanks for listening to The Wound Dresser. Until next time, I'm your host, John Neary. Be well.