What does philosophy have to do with surgery? Surgery is a discipline of medicine in which masters of the craft diagnose, treat and cure people with operations. Philosophy is an esoteric field filled with the pondering of academics and ancient figures.
How can stoicism help solve the problems that residents, students and physicians face daily? How can it help you keep your cool when dealing with an inappropriate consult? How do you handle balancing the insane learning curve as an intern? Let alone studying, maintaining your family and personal relationships, and staying healthy and fit.
Stoicism has a long history of solving these types of problems. I propose that it can help medical students, residents and physicians obtain the good life. A life of balance, mastery, connection and contentment.
Not all philosophy is the same
First is understanding that not all philosophy commands the same domain. Yes, there are fields such as epistemology - how do we know what we know? Monism vs dualism - is the body the mind, or the mind the soul? Freewill vs determinism - do we have the power to control our fate?
There are disciplines of philosophy dedicated to the abstract. There are also ones that study and prescribe practical applications of philosophy. Stoicism is a prime example for what it means to apply philosophy to daily living.
Stoicism is applied philosophy
Stoicism is an ancient philosophy. It budded and blossomed in the civilizations of the ancient Greeks, and then the Romans. The modern idea of “stoic” conjures up visions of emotionless ancient men. Men who must have striven to be as cold as the statues that the Greeks and Romans left behind. Luckily stoic philosophy has little resemblance to the modern idea of a “stoic” person.
Stoic philosophy is a framework for how to live a productive, just, resilient, wise and loving life. The foundation is the idea that you cannot control the outside world, but you must control yourself and your thoughts. From the foundation are the pillars, the four stoic virtues, wisdom, justice, courage and moderation. Draped over is the idea of “memento mori” or “I will die”, understanding that the good life cannot wait until tomorrow. The structure that results comforts the stoic like a home. It is a place for reflection, preparation, insight and connection.
Unlike a home, we never have to leave stoicism behind. We can take it with us across the country, to the lab, to the hospital, to the meetings, to the consultations, to the intensive care unit, to the operating room.
Marcus Aurelius was the ancient emperor of Rome and the most powerful man in the world at the time. He wrestled with the same daily challenges of life we experience today. How do I get up early, stop procrastinating, lead others, stay fit, cherish time with my loved ones, serve my community, and master my craft? These ideas are not unique to a king. Epictetus, a slave, tackled similar questions in his stoic writings.
Some of the great minds throughout history studied and applied stoicism in some form including Thomas Jefferson, Theodore Roosevelt, and George Washington. It’s a tool to help achieve what we are all after - the good life.
The beauty of stoicism is that it is not enough to know the virtues, to read the books, to talk the talk. You must practice what you learn in your daily life. Marcus Aurelius wrote;
Waste no more time arguing what a good man should be. Be one.
The Stoics understood that knowledge without application adds very little to normal human life.
Stoicism is needed in medicine and surgery
Nassim Nicholas Taleb, a mathematician turned philosophical essayist said this about stoic philosophy;
A stoic is someone who transforms fear into prudence, pain into transformation, mistakes into initiation and desire into undertaking.
I challenge anyone within the field of medicine, surgery and academia to claim that they do not experience fear, pain, mistakes and desires. In fact, these are sure to make up a large part of daily life as a physician. How amazing then is a tool that would allow us to understand, process, grow from and overcome these daily trials.
Stoic philosophy can’t cap your patient load. It can’t force your Attending to give you more operative independence, prepare your grand rounds, or write your manuscripts. It can’t do your work for you. What it can do is give you a framework for your life in which you can comprehend the world, remain resilient, and grow and thrive in the face of any challenge.
It’s 3 am and the consult pager beeps again. It’s the ER, again. As the resident drones on about another “bullshit” consult, your anger grows. How do you handle this anger?
How do you find time to study, work out and have normal relationships during residency? How can you even begin to master a craft as complex as surgery? How do you handle doubt or mistakes? Will you be ready when you graduate?
Stoicism can provide a framework in which to comprehend, learn from, and conquer these challenges.
The ancient stoic philosophers, some of which were Marcus Aurelius, Seneca, Epictetus (an emperor, power broker and playwright, and a slave respectively) left behind writings that have been translated, summarized, expanded upon and prepared for us to take in the immense sum of wisdom they contain.
What follows is one person’s living interpretation and application of stoic philosophical teachings in the context of medicine and surgery, residency and academia.
Join me
I encourage those interested to read this article by best-selling author, Ryan Holiday, for additional history and insight on what it means to be a stoic.
Take this journey with me, in some form, throughout residency and beyond.