Episode 8: What We Would Tell Our 25 Year Old Selves About Building A Sustainable Career As A Surgeon.
Notes On Midlife FitnessShow Notes
The Three Boneheads sit down to answer one question: What would you tell your 25-year-old self about building a career that lasts? The answer isn’t what you’d expect. It’s not about technical skill or case volume. It’s about protecting your humanity while doing hard work for decades. It’s about the sleepless nights that never stop, the weight of worrying about every patient, and learning that you can’t pour out compassion endlessly without refilling yourself. It’s about holding onto your values when the healthcare system shifts around you, learning to listen in a way that makes people feel safe, and understanding that vulnerability isn’t weakness - it’s what keeps you human. It’s about the loneliness of practice and why you need a resource group from day one. It’s about how psychology matters more than you thought - because anxiety and depression magnify pain, and most patients need reassurance they’ll be okay. The complicated cases fade. The titles fade. What sticks are the small moments: a patient dancing because their knee works, someone serving at tennis because you fixed their shoulder, a family who felt heard. A sustainable career isn’t about being invincible. It’s far more than that.
Show Notes: This is a podcast episode from “Three Boneheads” - three orthopedic surgeons (Howard Luks, Jeffrey Berg, and Jonathan Hirsch) with 75+ years combined experience discussing what they’d tell their younger selves about building a sustainable career in surgery. Central Theme: Success in orthopedic surgery isn’t about volume, speed, or accolades - it’s about sustainability, maintaining humanity, and protecting what matters while doing hard work for decades. Key Insights from Jeff Berg: Loneliness of Practice * Training is collaborative, but practice is isolating - everything falls on you alone * Early advice: Build a resource group of trusted colleagues immediately * This group becomes essential for support throughout your career Psychology Matters More Than Expected * Initially, I thought orthopedics was “anti-psychology.” * Reality: interpersonal relationships are crucial - doctor-patient, doctor-family dynamics * Anxiety and depression are pain magnifiers - understanding psychology is essential for treating orthopedic patients * Many patients just need reassurance that they’ll be okay Sleepless Nights Never End * Expected during training, but persists throughout the career * Constant worry about patients, questioning decisions, self-blame when outcomes aren’t perfect * Patients don’t realize how much surgeons worry about them The Job is Hard - Don’t Be Hard on Yourself * Bad outcomes happen despite your best efforts * Self-compassion is essential for longevity in the field Key Message from Howard Luks: You Can’t Pour Endlessly Without Refilling * Protect patients, but protect yourself too * Can’t absorb everyone’s fear and expectations without boundaries * Serve patients best when you’re steady, rested, and supported - not carrying the world alone Values Are Your Compass * Hospitals, administrators, chiefs change - your values must stay constant * Hold onto them when efficiency crowds out empathy, when paperwork overwhelms purpose * The healthcare landscape is complex and evolving, but values keep you from losing your way Listen in a Way That Makes People Feel Safe * At 25, you think being a good doctor is about knowing things * What patients remember decades later: whether they felt heard, seen, understood * Listening is the most powerful (and cheapest) intervention - but most straightforward to forget when busy Vulnerability Isn’t Weakness * You’re allowed to be human, say “I don’t know, but I’ll find out,” and ask for help. * Trying to be invulnerable makes you brittle; staying human keeps you flexible and connecte.d Identity Beyond the Job * When you die, no one cares about titles, papers published, or patient volume. * They care about how you made them feel. * Build life outside hospital walls: relationships, interests
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