2004 Scholarship Recipient

Daniel R. LeFebvre, MD, 2005

Daniel R. LeFebvre, MD

Daniel R. LeFebvre's Winning Essay

Laying on of the hands has been considered an important aspect of the healing process. Indeed, Surgery is the superlative of the laying on of the hands—going much farther, to the point of actually placing one's hands within the body of the patient. The patient has totally surrendered to the care of the surgeon; the patient is completely vulnerable and paralyzed and the quality of care and the outcome of the intervention depend on the sill of the surgeon and the trust that exists between the patient and the surgeon. Skill comes from hard work and quality training, as well as a certain degree of natural ability. Trust must come from compassion and the highest level of respect for each patient's needs.

My first experience with surgery in which I was the patient involved a form of accidental self-surgery that I performed on myself with a lawnmower on my left great toe when I was sixteen years of age. The second and more meaningful experience immediately followed the first: having my auto-amputation tended to by a general surgeon in Saranac Lake, NY. I remember being extremely frightened and in a great deal of pain. Ironically, I had always wanted to be a surgeon since I was a young child. I had always been fascinated by the human body and by medicine, and I loved working with my hands. At the time of this incident, I felt it was unfortunate that my first experience with surgery had to be under such circumstances. However, as time went on, I realized it was a blessing in disguise.

It would have been easy for my surgeon to trivialize my injury. The truth is, it was embarrassingly minor (amputation of the distal half of the distal phalanx of the left great toe). But he didn't trivialize: he respected my fear and took the time to explain things and made sure to institute good pain management. And he did this with subtle confidence that in turn instilled confidence within me, the patient. I knew that he would take care of me. Now, I am nearing the point at which I will have the opportunity to take care of patients with my hands. I want them to know that I will take care of them.

Seeing cancer, major trauma, etc. can change one's perspective. It is not difficult to see how surgeons may not appreciate what the patient with a "minor" procedure is going through mentally. My job will be to treat all patients as if there are no minor procedures. To the patient, the scariest surgery is the one they must undergo. I am lucky that I know what this feels like, and I will always remember it. I will strive to create a relationship of trust with my patients that is based on empathy and understanding of the patient's needs. This trust will be the foundation on which everything else in the physician-patient relationship will be based.

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