Revisiting the stereotype of the surgeon in the 21st century

Surgeons have to stay compassionate while maintaining a work ethic that optimises patient safety with empathy and skill

- Sanjay Govil

For surgeons of my generation, the "surgical personality" is a clearly identifiable trait. We could fairly accurately recognise which medical student would specialise in a medical versus a surgical discipline. Dr Kathy Hughes in her blog Behind the Mask says novelist Richard Gordon's popular creation, Sir Lancelot Spratt, epitomises the stereotypical surgeon, usually male with a "testosterone-induced swagger, confident, brash, charismatic and commanding to the point of arrogance".

"He is volatile, even bullying and abusive. Cuts first, asks questions later, because to cut is to cure, and the best cure is cold, hard steel. Sometimes wrong, but never in doubt. Good with his hands, but has no time to explain. Compassion and communication are for sissies." He is also decisive, well-organised and hard-working.

A 1991 study by Schwartz and others, analysing the personality of medical students found that those who were competitive, aggressive and highly confident became surgeons. Kevin Dutton in his book The Wisdom of Psychopaths (2012) found that surgeons are No.5 on the list of professions with the highest number of psychopaths. It is cold comfort to know that CEOs and lawyers score ahead of us.

There are some kinder descriptions of surgeons as well. The familiar adage that surgeons must have "the eyes of an eagle, the heart of a lion and the fingers of a lady" is attributed to Aristotle. Another good one is that "a surgeon should have a temperate and moderate disposition. He should have well-formed hands, long slender fingers, a strong body, not inclined to tremble and with all his members trained to the capable fulfilment of the wishes of his mind" (from Chirurgia Magna, written in 1296, by Guido Lanfranchi). Not surprisingly, both these quotes are from surgeons themselves.