Chapter Nine: Anesthesia Practice, Mentors, Ego

Chapter 9 Sub-sections


As an academic at Mayo, teaching residents and nurse anesthetist students was rewarding (I was voted Teacher of the Year), but never as much as personally providing a patient's anesthesia. An anesthesiologist eases stresses, treats or prevents pain, and, in addition, participates in research that helps further understanding of the complexities. But few of today's graduate residents have the skills to perform worthwhile research, as there simply isn't time and a mentor available to educate them. In the absence of a mentor, initial efforts are wasted and their efforts rejected. Nothing kills their enthusiasm as totally as rejection, for that undercuts ego.

Ego Controls, Not the Person

Ego is peculiar. Those who strive for great ego support in medicine, perhaps most commonly surgeons, lose effectiveness once they achieve a measure of success. This is because ego, like gravity to the out-of-control downhill bicycle rider or skier, takes over, and from then on, control and judgment are lost. This is obvious in entertainers, academics, politicians, writers -- you name it. In some, it's tolerable, because of their gifts or talent. In those with modest gifts, they revel in it and misjudge their limitations, which is unbearable. It's important to control ego and to decide things rationally. A mentor is invaluable in preventing a crushed ego and the associated loss of esteem due to poor decisions or actions.

Whether in academia or private practice, all newcomers need a mentor. This provides a basis for rational attempts at success, and limits errors in judgment. A mentor helps you avoid minor to major mistakes, and aids in working out practical solutions prior to exposing your ideas to the sometimes confidence-destroying critiques of others. You need to be methodical and careful, but especially, disciplined, and ease into the awareness of others by letting your results or skills speak for themselves. Mentors tend to eat their young, if the mentor is not properly motivated. I saw that on several occasions in ego-driven mentors totally focused on self, or in young who did not develop an area of interest separate from that of their mentor.

Some self-motivated mentors appear to help their young, but caustically expose them to early mistakes without guidance. This guarantees failure in early research, and loss of confidence. A mentor is not a part-time or multi-person function. You need a mentor who is available virtually every day, and who can focus on you personally and perhaps you alone (Kahn, 1994). You need the mentor's unselfish experience and generosity. Private practice and academic persons in clinical areas, and especially academics in beginning research, can fail utterly because their supposed mentor left them afloat, for whatever the reason. Some mentors are vulnerable, and become mentors because they can eliminate someone who might in time threaten them. It's an effective way to suppress potential competition. In virtually everything, once you show signs of succeeding and begin to do well, there are those eager to bolster their challenged ego by undercutting your progress. This has been a recurring lesson.

My mentors were valuable. Neena B. Schwartz, Ph.D., hired me during my first week of medical school to a 20-hour per week job in her endocrine physiology laboratory for the entire four years. Robert Virtue, Ph.D., M.D., Chair in Anesthesiology at the University of Colorado, had a focused interest in science and excellence. Lou Lopez, M.D. was my friend and godfather in residency and private practice. Julia Kassanchuk – aka "Casey" – was our University of Colorado phenomenal nurse anesthetist in teaching clinical anesthesia. Dick Theye, M.D., research, and Jack Michenfelder, M.D., neuroanesthesia and research, were two mentors at Mayo. Yet my two heroes in life, not specifically mentors, were surgeons: Art Prevedel in Denver, and Thor Sundt at Mayo.

While I was curious, loved stimulation, worked hard, and developed research in depth as much as possible, I was really just plain lucky and recognize that much of my success was in finding things I had not sought. It included the move from an excellent private practice to Mayo, the Viet Nam draftee stationed at the army burn unit, the savvy, direct, and at times painful mentor Dick Theye, and the realization of research ideas, at Mayo and again at UC Davis.

I can't consciously explain why I moved on these several occasions, I just knew that it was time. I couldn't know how things would work out, and simply adapted to the new situation. At certain times, you must leave wherever you are, and the US Government arranged my next move.