Introduction: The Stoic Surgeon

It was in the early morning hours of a crisp fall evening when it happened. I was in the operating room trying to understand why my patient was in such profound shock with the life leaving her body. A mother of two small children and the wife to a devoted husband did not choose to be here with me. Fate brought us together. Her abdomen was open and while there was bleeding there – it did not explain why she was dying. As the anesthesiologist tried to catch up with what blood loss there was, it struck me. The sac that surrounds the heart (the pericardial sac) is full of blood compressing the heart and keeping it from filling. I need to open her chest and repair the injury to the heart. Sure enough – she had a large amount of blood in the pericardial sac that was coming from a hole in the right atrial appendage. As we sewed the hole closed, a large amount of air entered the heart. She died. My thoughts went immediately to her children and her husband. Now, I have to go tell them the news that will change the trajectory of their lives.

It is in the clarity that these moments bring that the principles of Stoic philosophy find new breath. My journey into Stoicism wasn’t academic; it was born out of the immediacy of moments like these. In this world, Stoicism’s ancient wisdom offers a pragmatic guide. It teaches the finite nature of our lives, resilience, focus, and the importance of inner equilibrium in the face of external chaos. This is my story, a surgeon’s story, where Stoicism is not just philosophy but a daily practice.

History: Stoicism’s Enduring Path

Stoicism, rooted in the bustling ancient markets of Athens, evolved under the scrutiny of thinkers like Zeno of Citium, and flourished on the streets of Rome. Figures such as Marcus Aurelius, Seneca, and Epictetus didn’t just study Stoic principles; they lived them amidst the complexities of their times. Stoicism taught them, as it teaches us, to discern between what is within our control and what is beyond it, urging a life of virtue in the face of life’s unpredictabilities.

This philosophy’s journey through history is a testament to its adaptability and enduring relevance. It has guided leaders, thinkers, and everyday individuals through the millennia, offering a compass for ethical living and mental resilience. In the high-stakes world of trauma surgery, where decisions are fraught with tension and the need for clarity is paramount, Stoicism provides a foundation. It emphasizes courage, temperance, justice, and wisdom—virtues that inform not just an approach to being a surgeon, but also in research and in leadership.

Core Tenets of Stoicism

Courage in Stoicism isn’t about the absence of fear. It’s about confronting fear—facing it head-on, whether in the quiet moments before surgery or in the decisive actions that follow. In the trauma bay, courage translates into making tough calls under pressure, a lived practice of Stoicism’s call to bravery.

Temperance is balance. It’s the surgeon’s steady hand, the calm in the storm. It’s about moderation in all things, from the confidence in one’s skills to the humility in acknowledging the limits of your own skill and knowledge. Temperance in surgery is a delicate dance between doing everything and knowing when to step back.

Justice speaks to the ethical heart of medicine. Stoicism teaches us that justice isn’t just about fairness but about doing right by our patients, colleagues, and ourselves. It’s in the choices we make, the respect we show, and the care we provide, striving always to balance the scales.

Wisdom is the culmination of experience, the insight gained from each challenge faced. It’s the application of knowledge, the understanding that every action has its time and place.

Stoicism and Emotion: Embracing Rather Than Rejecting

Stoicism is often misunderstood as a call to suppress emotion. That person is stoic – look how they are able to endure pain. Yet, it’s quite the opposite. Stoicism teaches us to lean into our emotions, to understand them, and to use them as a guide towards growth. In surgery, the weight of emotion—fear, hope, grief—is a constant companion. Stoicism doesn’t ask us to ignore these feelings but to recognize them, to learn from them, and to let them inform, not dictate, our actions.

The Role of Suffering and Adversity

Adversity is not a barrier to growth but a pathway. Stoicism shows us that suffering and difficulty can make you stronger than you were before. Each challenge in the operating room, or in life is an opportunity to apply Stoic principles, to grow stronger in the face of adversity. The concept of “amor fati,” or love of one’s fate, teaches us to embrace every moment, not with resignation but with vigor, finding in each challenge a chance to advance.

Applying Stoic Philosophy in Modern Life

The Stoic principles of courage, temperance, justice, and wisdom are not relics of the past but guides for the present. They offer a blueprint for living with purpose and integrity, whether in the high-stakes environment of trauma surgery or the daily trials of life. Embracing Stoicism means striving for excellence, not through grand gestures but through the quiet dignity of doing one’s best, every day, in every way.

Stoicism, with its focus on virtue, control, and the pursuit of wisdom, provides a timeless framework for navigating the complexities of life and the challenges of modern medicine. It teaches us that, even in the face of the unpredictable, there is always room for growth, for courage, and for compassion. As we move forward, we will let Stoicism’s light guide us, illuminating the path to a life well-lived.