What motivated me to aim to be a heart surgeon was a word of a surgeon.
"Cardiac surgery offers no money, no free time, and no status, full of unavailability. You cannot expect something good to happen if you become a heart surgeon."
It is the word of a chief of cardiac surgery staff back then at a certain university where I visited as a student about 25 years ago. Normally, you will get weak-kneed to hear the word. However, I was a man of rebellious spirit at that time, and thought "This person must be hiding something. I’m sure a lot of good things are waiting for me," then decided to become a heart surgeon. (It didn’t take so long until I realize that the person was right.)
For good or for evil, at Ehime University, my alma mater, we had only 1 or 2 cardiac surgeries annually with a focus on pediatric open-heart surgery in those days. With the goal of achieving career in adult cardiac surgery, I didn’t have any other choice but to leave the alma mater. Therefore, I joined the "Department of Thoracic Surgery at Hyogo College of Medicine" through introduction of Dr. Takeuchi, a professor of urology and my close friend back then.
This was my first step as a heart surgeon.
Then, I was transferred to Kansai Rosai Hospital, where my mentor Dr. Shimizu served as a director of the department of cardiovascular surgery. This was the first transfer for me. Since then, to get an opportunity to experience more cases has been a top priority for transfer, which remains to be my policy until now. As a result, repeated transfers that defy the boundaries of the medical office has led me from east to west and the other way around thus far.
"Right treatment" can be achieved only by collaboration between physician and surgeon.
Recently, we often find lectures titled like "How to become a leading heart surgeon".
To obtain a position as a top heart surgeon, knowledge, skills and ripe judgement are essential. But I think it is more important to have a good mentor.
In general, the word “mentor” may indicate more like "master" or "teacher", which are different in nuances from what I mean. The ideal mentor for me, is someone who comes up to your mind spontaneously when you are confused or in trouble and makes you think “What would he or she do."
At the same time, mingling with leading cardiologists is critical to succeeding in a career of heart surgeon.
"Surgery is what the surgeon performs." I suppose that many doctors think in that way. On the other hand, the patients would hope that there is nothing but an optimal treatment. However, in fact, both of the cardiologist and the cardiac surgeon individually provide their own treatment for heart disease. I don’t think the patients can imagine that they need to make a choice between the two.
Cardiologists are responsible not only for preoperative diagnosis but also for postoperative care. Cardiologists who trust and value you will introduce patients as well as the up-to-date information in the area of cardiology. This is highly significant for us as we are the specialists in cardiology first, the surgeons second.
When performing coronary artery bypass surgery, I often think "If I were an interventionist (a cardiologist who specializes in catheter treatment), in what order, and to what extent the branch (the blood vessel) should be widen". This process is very important for determination of what I can do or should do for the patient as a surgeon.
Today, with the rapid progress in catheter/robotic treatment, new techniques blurring traditional distinction between cardiovascular surgery and cardiology will be required. That's why the relationships between the cardiologist and the cardiac surgeon is so important when choosing an optimal treatment for the patient. Gathering and sharing knowledge of each other to gain mutual understanding, without such communication, it is difficult to say that the disease has been appropriately treated, and the disadvantage for the patient must be significant in my view.
In addition, the cardiologist who values you must be one of the best. Because it will lead to your good reputation among other cardiologists who support him. Establishing your trust is key to become a leading figure in your own area of expertise.
To continue on your course as a heart surgeon who can offer reliable treatment
If you have been a doctor for a long time, you may sometimes waver over making another choice in life.
Looking back on my past, I have received a number of excellent offers that could have led to drop out. Nonetheless, for what reason do I continue my career as a heart surgeon? It is extremely simple. What it comes down to is that “I just like this organ, the heart”.
If you get interested in the heart, you want to know more about it. The more you know, the further interest you will find out, which will enable you to do better surgery. Initially it might have been a little feeling. However, by cherishing “the bud” of feeling, I could keep myself motivated to stay on as a heart surgeon.
I am not coordinated at all. So, day by day, facing the heart in front of me, I do my best to operate in more satisfactory manner compared to yesterday or the previous one. As a consequence of focusing on that point only, I could establish a position as a heart surgeon with the greatest number of cases in Japan.
You don’t have to play your cards right. You would rather be so clumsy as to get left behind from others. I belatedly understand that pushing yourself more by blocking your escape route is important for a heart surgeon. While minimally invasive procedures including catheter treatment advance, number of cardiac surgeries is decreasing annually. We cannot deny the possibility that the department of cardiac surgery itself will be eliminated in the near future. I realize that I have to refine my skill all the more to survive to the end.
Surgery provides patients with a solution to their problem.
Surgery gives a surgeon an opportunity to express yourself as an artist does through his or her work. I would be more than happy if I can convey my way of life through my surgery, and if young doctors can take advantage of my knowledge and experiences.