Finding your surgical persona 

Finding your surgical persona 

“Work me” is not the same as “home me”, but both these people are true and genuine people. Many of my colleagues are the same at all times and have the same demeanour and seriousness about wrapping a birthday gift as they do about a laparotomy, but that wouldn’t work for me sadly and much like I have separate clothes for work and home I have had to separate out some of my behaviours. 

Being “fake” is hugely unpopular amongst people nowadays and that you might not be being true to your authentic self is a crime in the eyes of modern magazines for women and widely disparaged in society in general. I disagree, I have to have a professional persona in order to make people feel I am in control. Leadership of the team (despite the anaesthetists thinking they are the leader)  and taking responsibility for difficult decisions is part of my job. The real me, when left alone and unobserved, likes lying on the couch in ill fitting clothes, texting people and swearing. Real me is a dreadful person, with a smutty and childish sense of humour who prevaricates endlessly and can waste hours of time achieving nothing. 

At a friends last weekend I was drinking wine and chatting about nonsense when someone suddenly wanted medical advice. I immediately switched into doctor mode and everyone was amused at the change that came over me when faced with a serious question. I don’t have a problem with this split personality, I have worked out a way of being “me” but being professional. 

I’ve complained before about irritating altricial people who are seemingly born consultants and arrive at medical school with the gravitas and seriousness of  a professor. They don’t want to laugh and giggle and have silly games with their colleagues; they fascinate me in a way because I am so easily distracted and diverted from what I’m meant to do by the slightest bit of nonsense and novelty and find it makes the day more enjoyable. And as a recently personality profile has told me, I need to be amused and constantly stimulated in order to do any work. 

Finding the balance between being yourself and being a professional takes time and trial and error. I have spent lots of time behaving like other people I admire or was in awe of. In this way, mentors are hugely important, but watching people do things you don’t like is just as valuable as those you do wish to emulate. 

You put on clothes to make you look like the professional that you are expected to be and there comes a degree of professionalism when I walk in the door of Bighospital wearing my work clothes. 

Some people erroneously assume that to be treated as a professional you cannot be called by your first name. None of the scrub staff and only a very few, new, junior nurses call me Mrs KBW and they are corrected immediately. I am on first name terms with everyone and it’s only with patients that I will introduce myself with title and surname and I don’t hugely mind if they go on to call me by my first name. 

I’m not a nurse because I didn’t want to be a nurse, I wanted to do this. A nurse is a nurse because they wanted to be a nurse. It doesn’t fit with my philosophy on life to assume that they are nurses because they couldn’t be doctors or that being the surgeon makes me better in any way. I have a leadership role and decision making falls to me but we are a team and we need every member of the team, all are important. The NHS is not the army, or the police, we are a team. We are the public’s servants,  all working to the same goal, I absolutely abhor the idea that one of us in the team thinks that they are better than any other member. 

My surgical persona has not changed with moving from trainee to the boss, I’ve been warned not to develop new consultantitis (seemingly decent registrars lose the plot with their new role and start demanding things and having tantrums) but it really isn’t in me to behave like that. I genuinely have affection and respect for my colleagues, they are mostly brilliant and a pleasure to work with.

We have to move away from thinking that the way (men) of between 55 and 65 conduct themselves is the way to behave as a consultant. They are probably copying how their bosses behaved 40 years ago when they were my age and that is far from where society and teamworking and patients are now. 

I am as professional and credible and competent as any man in a bad suit and college tie combo and I am no longer apologetic for being nothing like that. It has taken a long time to reach this conclusion and have that degree of confidence and I wish I’d realised it sooner. 

Some people think that being professional is about what people call you, it isn’t. It’s how you behave, how you treat other people, how you operate, how you treat your patients, how you speak to colleagues. Respect is earned and not asked for and not wanting to be called by your first name by adult colleagues whose assistance and cooperation your job depends on is totally fucking weird. 


What’s in a title?

Surgery was historically performed by barbers without medical training and as such they were not addressed as “doctor” but as “mister”. Surgeons in the UK have retained this quirk of losing the title doctor on obtaining surgical membership, hence all surgeons are not addressed as doctor but as Mr, Miss or Mrs.  It has taken me a long time to feel grown up enough to use my grown up titles but now it is second nature to be Miss KBW and not introduce myself by first name. In some circumstances I do say my full name minus the title especially with kids. At a recent medical wedding we were discussing how we all introduce ourselves and without exception we all keep the barrier up now with use of titles and surnames whereas as juniors we did not. Those of us who had worked in a and e recalled how we never introduced ourselves with surnames back then, it was first name only.
Inevitably there are some patients that you come to be on first name terms with due to a long relationship built over time and I like this very much but I don’t like when it is faked or forced upon me. One patient I looked after with whom I shared a first name and year of birth died after a few years of illness necessitating frequent surgical admissions. She and her family built up a relationship over that time with many of us and crossed into the realms of first names. Many of us were distressed when she died and sat crying with her family and friends. This sort of thing stays with you and would have been impossible to go through using professional titles.
We have got a new consultant in our unit who is keen on the informal, he has all his patients addressing him by his first name. It’s nice whilst the going is good but as soon as something goes wrong or there is a complaint you don’t have your professional identity to hide behind and your laid back attitude suddenly seems unprofessional and sloppy. This is especially true when it is in contrast to the behaviour of your peers, suddenly the other surgeon who looks immaculate, is always professional and is treated with respect by the nurses and his colleagues looks like the man who should have done your operation and not the chatty guy with the hoody.

This is Dave.




This is Sir Winston Churchill.