Growing as an Orthopaedic Surgeon: from Economy to Business Class

You all remember your first Dynamic Hip Screw (DHS)
surgery, how you felt exhilarated and proud of yourself,
sharing your achievement with friends and family. What a
great feeling when you do an operation for the first time.
It is an integral part of life to be driven to achieve new
things and bigger steps.

But do you remember your 15th DHS? Probably not. After a
while it becomes routine, the thrill is gone, and you just
come out satisfied you have performed a good surgery but
shortly afterwards forget all about it. Instead, you are
probably thinking of when you will be doing the next
bigger surgery…

This is adaptation, a normal fact of life. It is what makes us
seek progress and improvement to satisfy our desires. Of
course we should set long-term goals and aims in life but
usually we go through them one step at a time.

As a young surgeon, you may remember when you
travelled to a scientific meeting, and you saw your senior
surgeons going left to business class, while you went right
to economy. What did you think then? How amazing it
would be to be flying in business class instead of these
cramped economy seats. The bigger screens, nicer meals,
even bigger smiles from the flight attendants, and, to
make things even worse, you probably paid for your ticket,
while the senior surgeon was sponsored!!!

…but there are a few things you should know…
Firstly, the physical changes: as a young surgeon you can
easily work all through the night and may need to
continue during the morning hours (if the work regulations
allow it), but, as you get older, your body is less tolerable
to these unaccustomed stresses, as can be seen by the
back pain most senior surgeons have or even
osteoarthritis of the knees. Therefore, the economy seats
are more of a torture for them than for you.

Secondly, the senior surgeons travel a lot more often as
they are invited to many meetings when they become
famous and renowned, thus it is more likely that they
would be sponsored. Moreover, physically it becomes

even harder to go through all this travelling in economy
class.

Adaptation also plays a role. It is like upgrading your small
manual car to a bigger more comfortable automatic car
with air conditioning. You get used to the new one and
you would have difficulty enjoying your older car as
before, often wondering how you travelled for hours in it.
Similarly, after you start flying business, it becomes more
difficult and inconvenient to fly economy.

It is this adaptation which makes us buy a bigger car or
seek to perform bigger and more complex surgeries,
leaving the simpler ones to others. This is a necessary fact
of life that makes room for younger surgeons.

On the other hand, you are probably enjoying the
economy trip more and watching all the movies, plus
making new friends who are by default ‘invading your
space’… but in business class, the senior surgeon is busy
preparing all his last-minute lectures and not enjoying the
larger screens as much. Plus, no one makes friends in
business class, since everyone is separate, busy and not
interested. At that level, business class becomes a
necessity rather than a delicacy. Many may have to land
and start work or give lectures shortly after, while you may
have two to three days before or after the meeting to rest
and enjoy the new place.

So, the message here is that you should enjoy ‘life in
economy class’, which is reflected in the physically
challenging working hours, the smaller car, and the lower
pay, just as much as you enjoy your early surgeries,

because each step in life has its own kind of enjoyments
and requirements.