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As an active surgeon and former department chairman, Dr. Paul A. Ruggieri has seen the good, the bad, and the ugly of his profession. In Confessions of a Surgeon, he pushes open the doors of the O.R. and reveals the inscrutable place where lives are improved, saved, and sometimes lost. He shares the successes, failures, remarkable advances, and camaraderie that make it exciting. He uncovers the truth about the abusive, exhaustive training and the arduous devotion of his old-school education. He explores the twenty-four-hour challenges that come from patients and their loved ones; the ethics of saving the lives of repugnant criminals; the hot-button issues of healthcare, lawsuits, and reimbursements; and the true cost of running a private practice. And he explains the influence of the "white coat code of silence" and why patients may never know what really transpires during surgery. Ultimately, Dr. Ruggieri lays bare an occupation that to most is as mysterious and unfamiliar as it is misunderstood. His account is passionate, illuminating, and often shocking-an eye-opening, never- before-seen look at real life, and death, in the O.R.
- Sales Rank: #57798 in Books
- Published on: 2012-01-03
- Released on: 2012-01-03
- Original language: English
- Number of items: 1
- Dimensions: 8.20" h x .70" w x 5.40" l, .50 pounds
- Binding: Paperback
- 272 pages
From Booklist
The life of a general surgeon is more guts than glamour. Often sleep-deprived and standing on his feet for hours, this physician-author navigates anatomical intricacies and deals with unexpected bleeding. Not to mention the pressure of a full bladder midway through an operation or worrying about a potential malpractice lawsuit. The job requirements of his profession include good judgment, an ability to think and act quickly, self-reliance, and a fondness for using one’s hands. The job description sounds stringent: “Show me where the problem is so I can fix it, remove it, rearrange it, drain it, or pass you on to someone else.” Yet in a series of sentimental clinical vignettes, the doctor divulges a wide range of feelings: pride, guilt, humility, regrets, failure, and, ultimately, burnout. His patients teach him many lessons. Trust makes the physician-patient relationship work. Detachment can be difficult. Imperfection is inevitable. Survival (of patients as well as the doctor) is the bottom line. Honest and angry, this cutting memoir by a midcareer surgeon feels like an act of penitence. --Tony Miksanek
Review
"An honest and open look into the surgical profession." ---Library Journal
About the Author
Paul A. Ruggieri, M.D., is a practicing board-certified general/laparoscopic surgeon who has been operating for over 20 years. Dr. Ruggieri performed his surgical training at the world-renowned Washington University School of Medicine, Barnes Hospital, in St. Louis. He then spent three years as an active duty general surgeon in the U.S. Army. Currently, he is former chief of the department of surgery at a large community hospital in Fall River, Massachusetts, the very hospital he helped build as an ironworker before attending medical school nearly 30 years ago. Dr. Ruggieri has written several books for patients. He lives in Rhode Island with his wife and three stepsons. Visit his website at www.paulruggieri.com.
Most helpful customer reviews
3 of 3 people found the following review helpful.
Sharp as a scalpel describing the demands required to be a surgeon and the sacrifices made
By Steven F. Wolfe
As a fellow physician I can really feel what you are writing. Though I am a dermatologist, I can relate to your experiences as a surgeon. I think few outside of the medical profession could understand this as well. Some may criticize your discontent with the system--they obviously know little about what physicians have to deal with daily. Making statements about being paid for your services is correct. Quite simply, you busted your ass to get to where you are, you truly do deal with life or death daily, and you have to deal with regulations that are time consuming and heinous, made by people who have no understanding what someone like yourself has to do. You have every right to be angry about it. I applaud you for sharing true stories about patients who you saved, who you didn't, and who you wanted to but couldn't. I understand your questioning yourself about the decisions you make. Though my field is so much less intense both in hours worked and severity, you vividly portray the true sacrifice you made to become a surgeon and to practice as one. I don't know how anyone could really understand and appreciate it unless they have worked 100 hour weeks taking care of patients. Though I don't do that now, I did in the past, and it is all the more reason I feel everything you are writing. The public should pay attention to your comments about the number of surgeons retiring in their 50's and 60's the shortage of surgeons to come, and the difference in training of the current generation. If it were up to me, you'd be paid multiples of what you currently earn. There is almost no amount of compensation that would not be justified for the sacrifices you incurred, the difficult life you lead, and the demands of your profession. When you write about the 7 hours throughout the night you spent assisting your colleague trying to find an ovary through dense scar tissue, and note that a plumber is paid more, you are not exaggerating, you are telling a fact. It is truly bullcrap that our society allows this blatant disregard for your skills. How much does a pilot make flying a plane 7 hours? An investment banker on wall street? Yet they do not face the potential of death and lawsuits. I hold you in high regard for writing what you did.
79 of 83 people found the following review helpful.
Not always right but never in doubt
By BrianB
Surgeons are full of courage. To cut into another human being, slicing through the living, bleeding skin, exposing the interior organs, removing, rearranging or remodeling them, requires outrageous conceit. An elective surgery, performed on a patient who is healthy, who freely requests such injury in pursuit of a greater good, is daring enough. But surgeons are often confronted with a desperate person, one who teeters on the brink of death, desiring only life. Surgery in such circumstances may save them, or it may hasten their departure to the land from which none return. The final arbiter of that hasty decision may be a judge and jury, and the final disposition financial and social ruin for the intrepid doctor. Who would choose such a job in a time of shrinking pay and waxing quality reviews?
Fortunately for all of us, there are plenty of individuals who would. The old axiom that surgeons are born, not made, holds true. Regardless of the rewards or penalties exacted upon their persons, surgeons can be nothing else but surgeons. So they tell us. And Dr. Ruggieri tells us plenty. In Confessions of a Surgeon, we read about his emotions, his late night thoughts, his shortcomings and misgivings, his resentments towards his patients, in short, his all too human traits. He writes about his mistakes, how they affect him, and how they affect his patients. Most patients don't like to think of their surgeon as a human being, but surgeons have all the limitations that the human condition entails. Star Trek Voyager may have the perfectly unflappable android doc, but you and I were born too soon for that. Some readers want the unvarnished truth, and here they will get it. If you prefer your surgeons on a pedestal, don't read this book.
Dr. Ruggieri is not a professional writer, and Confessions is more like a conversation than a polished narrative. There are clichés, repetitions, and meandering paragraphs, but it does not detract from the story. This is highly readable, informative and entertaining. He allows you to walk into surgery with him, belly up to the table, and get your hands bloody. If you really want to know what happens in an operating room, or what a surgeon thinks about while you complain about your belly ache, it is all here in living color.
I am an anesthesiologist, so I spend my days and nights working with surgeons, helping them, accepting their help, joking with them, and fighting with them. I have made a close study of the surgical personality, and Dr. Ruggieri is an outstanding specimen. He writes about the enormous complexities of human physiology, yet he is compelled to fast decisions and faster action. He writes about being humbled by his profession, and in the next paragraph he compares surgeons to gods. That is the mind of a surgeon. When he says humble, he means as humble as a god can be. I'm having some fun here, but considering what they do every day, you have to give them enormous respect. You have to respect his writing too. This book is a winner.
17 of 17 people found the following review helpful.
Very insightful
By Patricia
I originally bought this book in the Kindle version but then wanted to give it as a gift to a doctor friend so I bought this hard-cover version for him. The author, a successful surgeon, is remarkably forthright in his descriptions of the life of a surgeon, covering his days in medical school to his early practice and later as a more experienced and respected practitioner. It is his openness about his mistakes that makes the book so interesting. I certainly admire him. He is not happy with the way the practice of medicine is moving today and spends a lot of time refuting it. That part can seem a bit preachy but the book is well worth it.
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