The Promised Lands: A Heart Surgeons Journey Through Narcissism

By Brian Hummel M.D.

An honest and frequently humorous description of becoming a heart surgeon while confronting an ego of narcissism.

• Language: English
• Publisher: Xlibris US
• Release date: Mar 16, 2023
• ISBN: 9781669869917

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Copyright © 2023 by Brian Hummel, M.D.

All rights reserved. No part of this book may be reproduced or transmitted

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Rev. date: 03/16/2023

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CONTENTS

NOTE FROM THE AUTHOR

FOREWORD

(1) First Impressions, Self-Doubt

(2) Med School

(3) First Day

(4) Blind Leading the Blind

(5) Chief’s Conference

(6) Finances

(7) To Be Known

(8) It Was a Joke!

(9) The Mentors

(10)

(11) Life Lived on the Periphery or in the Cocoon of Narcissism

(12) There Are No Unnecessary Operations; However, Some Are More Necessary than Others

(13)

(14)

(15)

(16)

(17)

This book is dedicated to my wife, Kristin, my living example of strength, goodness, hope, and love. To Christian, Stephen, Maggie, Sydney, and Jordan, you continue to amaze me and daily make me proud. To Allison, Krissy, and Jon, you have added to us all. To Asher, Kipling, Teddie, Amary, Garrett, Hannah, Sam, and Kathryn, you bring light to every room.

To my patients, for those where my intellect and skill were not enough, I am profoundly sorry. To those who trusted me and made me feel needed, I thank you.

To my fellow residents, you all made the lands extraordinary. especially to Will Ryan, Dan Raess, and Lee Bourland, you enouraged me to be better.

To my parents who did their best and my siblings, Brad, Becky, and Barb, you make the family real.

And to my friends (Randy and Wendy White, Tom and Sally Petcoff, Cliff and Georgeanne Williams, Darryl Pottorf and Mark Pace, and the late Robert Rauschenburg), what a ride!

NOTE FROM THE AUTHOR

The origin of this book is rooted to multiple conversations over the years with many of my fellow residents, the universally held perception that while our residency was in some ways like many others across the country, we had been a part of that transition in medical/surgical education from old school to a more controlled supervised model that dominates the programs today. We were witness to a unique collection of individuals with widely regarded skills and a solidified place in U.S. history as well as in the writings and teachings of surgery. The confidence and ability to care for the sickest and most damaged of our fellow beings brought outsized pride and hubris to those of us so susceptible. Perhaps we bought into the idea of everything in Texas was bigger and better. Perhaps our socialization and its echo chamber reinforcements of our beliefs took many of us down a distorted path. I know for me, the self-aggrandizement worked its slow inexorable way to my belief in who and what I was. It is a story I now know while not necessarily unique to surgeons (we are a susceptible lot) is found in every walk of life and in every socioeconomic class. The rediscovery or perhaps first-time discovery of who you want to be is within all of us. I hope this personal story will offer a glimmer of change being possible.

Brian Hummel, MD

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The Promised Lands

A Heart Surgeon’s Journey through Narcissism

FOREWORD

I hope the following account of my professional progress and my stunted personal growth will be of interest. My goal is to describe how it is possible to move from a dark personal hole to a place of peace and tranquility. I will not pretend to have expertise on personalities, their strengths, or their weaknesses. I will simply be honest. With that honesty, I have changed some names in an effort to prevent my memories from conflicting with those who recall differently and whom I respect immensely.

I offer my unending thanks to those who have walked the halls of the lands and been pivotal in training some of the finest surgeons I have ever encountered. It must also be stated that surgical training has evolved significantly since I was a resident as well as the technology afforded the generations of surgeons that have followed. Some of the events will raise questions; they are not intended as a condemnation or an endorsement of the actions of some individuals but rather a recollection of those friends and colleagues who made the lands legendary, the hallways, clinics, operating rooms, and environs of Parkland Memorial Hospital.

The physical edifice of the lands is irrefutable. The emotional and, to some extent, mystical lands through which we journey is the variable in all of us, the places some see as promised, the ultimate end point of endeavor and success. It is toward these lands we walk through life. A journey never in a straight line but one buffeted by stumbles, storms, and distortion. Those who retain clarity may find their promised lands. That is the faith we keep.

This is a story of my own journey of which the lands, physical and emotional, had a profound and indelible impact. It is this personal voyage replete with flawed emotions, behavior, and growth I am writing. I came to understand later in my life how much of a narcissist I was. The emotional baggage I ultimately unpacked was both frightening and liberating. (The firm and determined independence my wife displayed caused me to focus on the me buried for all those years.) It is not a story of celebration, although I do celebrate it, as much as it is a story of hope and love frequently unexpressed or not reciprocated. It is perhaps the story of many of us who live in a dark place but know they want the sunlight.

It takes five years to learn when to operate and twenty years to learn when not to. It can take a lifetime to separate the surgeon from his soul, to remove the shroud that obscures the real from the perceived, the fearful from the honest. Unfortunately, the shroud is removed too infrequently to salvage the many lives that could be filled to a meaningful one of gratitude and self-actualization. I am lucky I can now stand in front of a mirror and know that what I see is real. I want to talk about how that came to be not because I am a psychological genius or a trained psychologist but because I am a cardiac surgeon who finally awoke to the fact I was not who I thought I was and discovered I could be someone better!

(1)

First Impressions, Self-Doubt

The forty individuals gathered at a cocktail party/welcome mixer the last week of June 1977 provided my first insight as to the recurring voice in my head, that repetitive refrain that I was mistakenly included in this group and unworthy of participating in the five-year training program that was being introduced that evening. The imposter syndrome, as I listened, was going full bore in my head. We were informed there were nearly one thousand applicants for these slots, and of the forty assembled, the intent was to finish ten chief residents at the conclusion of our five-year training. That was our first lesson in esprit de corps, a lesson and ethos that would serve us in both a positive manner and prove detrimental to many of us in our actions and interactions with family, friends, professional colleagues, and patients. It magnified the personal and emotional struggles in many of us and began the long road to dysfunction in more than a handful.

We were reassured that this was not a pyramid program and that all who truly wanted would complete the training; but additional time may be required for some, i.e., a year or two in the lab or at other institutions. There seemed no reason to doubt this information, but the reality was that pyramid programs were not only active among surgical training sites but common and rather ruthlessly manipulated to create competition between residents. Nothing like being told after three to four years that your work was not good enough to allow you to complete the training and be eligible to sit for the written and oral boards of the specialty. The anxiety of not being adequate only made the situation more fearful. The manifestation of the inferiority complexes that came as unseen renters in the brains of those interns and others more senior than our class as well as some that followed proved to be expressed in myriad ways. We were now residing in the perfect petri dish for discordant behaviors and flaws that became apparent in the coming years. We all wanted to believe we belonged; we were the select few. We were indeed special. The new chief had chosen us as his first class; we had to be special, right? To those of us so inclined, it was the fuel to latent narcissism. We were better; we were a privileged group.

I was internally conflicted. I was chosen and thus special, but I was convinced otherwise (my heart rate and hyperhidrosis readily reminded me I was woefully inferior to the individuals I was meeting). In addition to those who seemed and acted more comfortable and mature than this small-town Iowa kid, there were a couple of them whose looks and mannerisms seemed very familiar. It turns out that these individuals were each nephews to well-known television personalities. The first and ultimately one of the true characters of the group was the nephew of Dan Blocker, who played the character Hoss Cartwright on the long-running television show Bonanza. They looked very much the same, and frankly, the TV personality of the uncle was embedded in his nephew, a gregarious stout young man with a mischievous smile that as the years passed presaged the reality of his interactions with his coresidents and those around him. A sidenote to our classmate was that his father was the chancellor at UT Galveston, a bit of good political fortune that perhaps influenced or saved the career of his son at