In this excerpt Dr. Paul Ruggieri gives readers an introduction to what they’re in store for when he shares what life as a surgeon. He shares the successes, failures, remarkable advances, and camaraderie that make it exciting. He uncovers the truth about the abusive, exhaustive training and the arduous devotion of his old-school.
When I meet someone for the first time in a social setting and reveal (sooner or later) that I’m a surgeon, the reaction is often something close to awe (at least among those who don’t spend their days in the world of healthcare). This unearned respect can be flattering, but the truth of the matter is I’d rather have my new acquaintance realize that I’m a human being, that I’m not perfect, that I’m not a demigod, and that surgery (as well as the rest of medicine) is an art as much as a science. And some days, calling it an art is a stretch.Becoming a surgeon was the most difficult thing I’ve ever done. The training is designed to test your mental and physical endurance as much as your intelligence or skill with a scalpel. Those without a deep reservoir of desire and drive need not apply. Yet – once through the fire, the years and years of school and residency – working as a surgeon has provided the most exhilarating times of my life. I wouldn’t trade it for anything. Most days, that is…

On the good days, I delight in being a member of a unique club of extraordinarily talented, complex, brilliant, driven, and compassionate professionals. We’re saving lives. On the bad days, I realize I’m part of a world inhabited by flawed, greedy, egotistical, and insecure practitioners (and I include myself in that description). We’re making mistakes but (usually) correcting them before lasting  damage is done. The middle ground looks like this: I get to work with a motley crew of healthcare professionals, surrounded by diseased organs, blood, pus, and guts, in a room without windows hidden behind a set of swinging doors, where we spend too much time on your feet but get to improve the quality of someone’s life or (maybe) extend someone’s life. At the end of the day, it usually feels pretty good.

My profession is complex and complicated. It demands a dedication to a way of life that is like no other. For me, the road leading into the operating room is a lonely one, the path to a place where I am responsible for all that transpires, be it good, bad, or complicated. Most days in the O.R. do go well (thankfully), whether the crew and I experience exhilaration, fear, boredom, satisfaction, or humiliation before we call it quits. I love being surgeon.

I love being able to make a clear, tangible difference in the quality of a person’s life. Sometimes I even save a life. I am honored every time a patient comes to me, and I’m humbled at the trust that’s given. Confessions of a Surgeon is my love letter to all of them, but it’s more than that, too. What you have in your hands is the result of my desire to share an honest, open look at this startling profession, an occupation so unfamiliar to most it may as well be taking place on the moon.

More than thirty million people a year in this country enter hospitals to undergo surgery, for conditions including bad joints, clogged heart arteries, and diseased gallbladders. Once you are wheeled into an operating room, a host of factors – the most important of which is your surgeon – come together to influence the condition in which you will leave that room. I’ve long wanted to push open the O.R. doors and show the public the mysterious place where lives are improved, saved, damaged, and sometimes, lost.

I wrote this book to take you right up to the operating room table and give you an up-close  view of what I see as a surgeon. I want you to meet the person behind the surgical mask.  I also want you to get a glimpse of the array of demands and constraints and desires that tug at working  surgeons today: A patient’s conflicting family members, each with a different idea on how a loved one’s condition should be addressed. Repugnant criminals whose lives you are charged with saving. Lawsuits. The uneven, nonsensical reimbursement system. The cost of running a business (most surgeons are in private practice and, therefore, running a business). Practicing surgery today is much more  than being a surgical professional – and a lot of it is stuff we never bargained for in medical school.

This book is my story, and my examination of a unique occupation – truly a “calling” in many aspects – that requires years of arduous training, followed by years of arduous work,  where fatigue and malpractice lawyers take turns attempting to distract us from the job at hand: a  person’s life.

What in the world possessed me to write this book? This question has floated through
my mind ever since the idea was conceived. Even now, I ask myself. I ask, yet I continue to write. I write because I seek the truth about myself and about those I have affected for better or worse. I believe the truth will set you
free. It has for me.

PAUL RUGGIERI, MD, FACS is a practicing general surgeon, writer, husband, and stepfather. His practice specializes in general, advanced minimally invasive, and thyroid surgery. Throughout his active twenty year career, Dr. Ruggieri has held department of surgery chairman positions at several community hospitals. He has also been a clinical instructor at Harvard Medical School. He is board certified in his specialty and a Fellow of the American College of Surgeons.

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