The Making of a Surgeon in the 21st Century [Hardcover]

Craig A. Miller (Author)

Book Description

ISBN-10: 157733115X | ISBN-13: 978-1577331155 | Publication Date: January 15, 2004 | Edition: 1st

The Making of a Surgeon in the 21st Century is a highly personalized description of one individual's experiences during a five-year residency in general surgery at a major university hospital. It describes the personal challenges and rewards, the drama of triumph and tragedy, the agony of indecision and the thrill of success. Residency is the most profoundly life-altering sequence of events in a surgeon's life. What does it take to make a surgeon? It takes a college degree and a medical school education, followed by a residency. And it takes a willingness to subordinate one's personal life to acquiring the skills and knowledge which a surgeon must possess. This sacrifice takes its toll - on families, on mental health, on life-style. A surgical trainee may not get out on his own until well in his thirties - living, in the meantime, a meager existence at best. Post-graduate training in surgery is longer than that of any other medical specialty, five years at least. Tortuous on-call schedules often demand exceedingly long work hours - 100-hour work weeks being the norm. Compounding the problem are very high stress levels, the burdens shouldered by the resident's family in his frequent absence and often an enormous educational debt. Nevertheless, every year hundreds of fresh medical school graduates compete for the few available positions. They are consistently the very best of their classes. Why would otherwise intelligent, highly motivated individuals actively seek such a miserable existence? Surgeons have, of course, been glorified in the mass media as the swaggering, brilliant, fiercely independent cowboys of the medical profession. Their compensation has also been great. But beyond this is a personal quality best defined as decisiveness. They want to make the difference, in no uncertain terms. In surgery, when the patient enters the operating room he is suffering from disease. Thanks to the surgeon, he may be wheeled out cured. It doesn't happen every time, of course, but the possibility is there (in other disciplines of medicine "cure" is, unfortunately, an unusual event). Who wouldn't want to be such a healer, making a palpable, tangible difference? Endorsements "Honest, hard-hitting and tremendously entertaining ... an unvarnished look at surgery residency." Louis M. Messina, M.D., Professor of Surgery, University of California, San Francisco "Terrific stories ... we [surgeons] live through this every day but it hardly ever comes out like this ... [Dr. Miller] got it right." Phillip Caushaj, M.D., Chief of Surgery, The Western Pennsylvania Hospital

Editorial Reviews

From the Inside Flap

"Honest, hard-hitting and tremendously entertaining ... an unvarnished look at surgery residency." Louis M. Messina, M.D., Professor of Surgery, University of California, San Francisco

"Terrific stories ... we [surgeons] live through this every day but it hardly ever comes out like this ... [Dr. Miller] got it right." Phillip Caushaj, M.D., Chief of Surgery, The Western Pennsylvania Hospital

About the Author

Craig A. Miller, M.D., was born in Columbus, Ohio. He attended college at Northwestern University in Evanston, Illinois, graduating with honors in Physics. Dr. Miller completed medical school and surgery residency at the Ohio State University Medical Center in Columbus, Ohio, and a fellowship in Vascular Surgery at the University of California, San Francisco. He is a Board Certified surgeon in private practice in Indiana. A recipient of numerous regional and national awards for his investigations into the causes and treatments of surgical disease, Dr. Miller has authored many articles and book chapters.

Product Details

• Hardcover: 252 pages
• Publisher: Blue Dolphin Publishing; 1st edition (January 15, 2004)
• Language: English
• ISBN-10: 157733115X
• ISBN-13: 978-1577331155
• Product Dimensions: 9.2 x 6.5 x 1 inches
• Shipping Weight: 15.2 ounces (View shipping rates and policies)
• Average Customer Review: 4.1 out of 5 stars  See all reviews (14 customer reviews)
• Amazon Best Sellers Rank: #1,445,851 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

12 of 12 people found the following review helpful:

4.0 out of 5 stars A Colorful and Interesting Account, June 24, 2006

By 

C. Middleton (Australia) - See all my reviews
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This review is from: The Making of a Surgeon in the 21st Century (Hardcover)

Medical memoirs have become a popular genre. Most are quite revealing as to the virtual hell a four to five year resident must experience to become a qualified practitioner. The resident surgeon's experience has to be the most hellish in terms of the amount of hours worked, (100 hour weeks) the pressure brought to bear from the attending staff, sometimes extremely sadistic, abrasive and demeaning, not to mention the continuos mental strain from lack of sleep and the stress on the residents family, some families, unfortunately, disintegrate at some point along the way. Craig Miller's book clearly expresses all these things, however it is the spirit in which he communicates these experiences that makes his memoir worthwhile reading.

A better word would be a colourful account of his experiences as a resident. He not only explains the program in easy to comprehend prose, it is his anecdotes, describing the many characters that make-up this world that is entertaining as well as intriguing. About halfway through the text, I wondered if he had changed the names of the attending staff, nurses, and fellow surgeons that he profiles, because his characterizations are really, for the most part, quite scathing. In some cases the descriptions bordered on the libellous, smelling a legal suit some time in the future. However I'm sure his editors took this into consideration before publication. I certainly hope so.

The most revealing and educational part of the book was Miller's explanation of the standard step-by-step procedure (the Advanced Trauma Life Support protocols) when working in the ER, the initial steps of trauma management. Interestingly it is broken down simply so that the attending staff do not have to "think", but sequentially run through this procedure of "A is for Airway, B is for Breathing, C is for circulation, D is for Disability and E is for exposure." (P. 207) Miller is extremely annoyed how TV dramas as well as `reality' documentaries give the wrong impression to add to the pathos. In fact the ATLS protocols, following the A, B, C, D, E standard procedure avoids the chaos, ensuring the best for the trauma victim. This section of the text was extremely informative.

By the end of Miller's Chief Residency, he had the confidence and the confidence of his teachers to forge on alone, and realized he had truly become a surgeon. Having read the book in an afternoon, his writing was such that I felt his relief and sense of accomplishment by the end of his five-year residency. This has to be one of the most difficult and gruelling training out of all the professions, physically, intellectually and emotionally. In the Epilogue, Miller expresses his ambivalence about the current residency system in terms of its viciousness and amazing effectiveness in producing top-notch surgeons. The system hasn't changed since the 19th century. The process certainly takes its toll but for a price and is the price worth it?

A recommended read for anyone interested in the education of a surgeon.

8 of 9 people found the following review helpful:

5.0 out of 5 stars A natural follow up to Dr. Nolen's book, October 16, 2005

By 

Julian Guitron (Cincinnati, OH, USA) - See all my reviews
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This review is from: The Making of a Surgeon in the 21st Century (Hardcover)

The world of surgical training has changed tremendously over the past few years. As little as 5 years ago, the rule in surgical residency training was 110-120 hour-work weeks and even some rotations demanded 24 hour in-house coverage for several weeks at a time. This "old school" period is brilliantly narrated by William A. Nolen in "The Making of a Surgeon", but today's reality, significantly different, was captured splendidly by Dr. Miller.

Dr. Miller comes through with what feels like a natural follow-up of Dr. Nolen's work. There are interesting comparisons of several features of our current training as opposed to that of Dr. Nolen's era.

This book was very entertaining, critical and even funny. Suitable for both the non-health system related reader, as well as medical students and residents as a way of comparing our own training. Dr. Miller managed to explain technical terms in a very simple and short fashion that doesn't interrupt his rhythm even for the expert surgical readers.

I highly recommend this book particularly to medical students contemplating a surgical career. If you don't find yourself laughing at Miller's humor, then surgery might not be your most suitable future!

8 of 9 people found the following review helpful:

5.0 out of 5 stars For anyone seeking to better understand the world of surgery, June 12, 2004

By 

Midwest Book Review (Oregon, WI USA) - See all my reviews

This review is from: The Making of a Surgeon in the 21st Century (Hardcover)

The Making Of A Surgeon In The 21st Century is the memoir of medical research award-winning career surgeon Craig A. Miller, M.D., and presents the unvarnished true story of what it is like to train as an extreme specialist. Presenting a world of gruelling 100-hour work weeks, gallows humor, harsh realities, and severe pressure at every turn with human lives literally hanging in the balance, The Making Of A Surgeon In The 21st Century is an absolute "must-read" for anyone seeking to better understand the world of surgery and the people who perform it, as well as a taste advised for those considering this demanding career path - so that they can better know the challenges they will confront.