Pilots and Surgeons: What Does A Really Good One Look Like?

Pilots and Surgeons: What Does A Really Good One Look Like?

Linda R. Duska, MD, MPH

Aug 12, 2014
A few days ago I had the opportunity to fly in a small passenger (9-person) plane. I’m not a good flyer in general and really small planes make me nervous. I sat directly behind the pilot and decided he must be a good pilot based on his appearance and demeanor (the only data I had). He looked old enough, he wore a uniform, he seemed self-assured, and addressed the passengers in a confident manner. We all trusted him with our lives as he was the only crew member on that flight. That situation made me think about how my patients judge my ability as their physician, and how much of this trust has to be based on appearance and manner, the only data they have.

Some of my patients research me before they come to see me. They look me up on the internet, they know where I went to school and where I trained. They certainly know where I work. But (because I work in a state hospital) most of my patients don’t have any of this data. They are referred to me by their own doctor, or they have no doctor and they arrive in my office because they have no other choice. And then they have to trust their lives to me based on my appearance and my manner, as I did the pilot.

I’m a small woman, and I don’t always dress well, mostly because I don’t have the time or energy to keep up a nice wardrobe. I don’t wear makeup and can’t remember the last time I had my nails done or went to the hairdresser. I am often overbooked in clinic, and sometimes rushed. But I’ve been doing this job a long time, I’m good at it, and I am confident in my abilities. I like interacting with patients and hearing their stories and their fears. And somehow my patients put their trust in me: to debulk their ovarian cancer, perform surgery for endometrial cancer, prescribe chemotherapy, discuss clinical trials, relieve their pain, help them die. I hope that this trust is well placed and well earned. It always humbles me, and it makes me wonder what I’ve done to inspire and sustain it.

The pilot got us safely to our destination and we thanked him as we left the plane. In a very similar way, my patients and their families often thank me for their care: a cancer treated, pain relieved, a good death. It is an awesome responsibility and I am hopeful their trust is not misplaced.

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