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Principle one

 

 Leitgedanken

"As a Head Chef, I set the highest standards for my cuisine, my dishes, and my wine. The centre of the art of my cuisine is my guest. I set the same high standards for my surgeon: for his knowledge, his ability and above all, for a deep personal understanding of me and my illness. He has fulfilled my expectations. I would put myself in no one else's hands. He has changed my life for the better."

Jacky Donatz,
Head Chef,
Restaurant Sonnenberg, Zurich

 

As a surgeon, I am a physician. As such, I do not operate simply on a hernia or something more threatening. I always operate on a person. People are unique. They are part of a family, whose members cherish them.

Families, their living together and the interactions of the different members, the various cultures of the world, social differences, and professional strengths, understanding of medical connections or lack of understanding for the physician – how different and fascinating are the personalities us physicians encounter daily. We must deal with completely different life situations: young people who have their whole life ahead of them, who suffer from a malignant tumour, react differently to a large operation than older people, who already have a large part of their lives behind them and are also often winding up their lives.

To meet all of the expectations of every single person, to understand them and to try to grasp their situation, with all their fears, concerns and hopes – now imagine how demandingthe task of surgery is, how difficult it is to understand that there are also people who reject our knowledge and art and do not wish to undergo an operation.

Scientific knowledge, technical ability, appropriate indications – everything is important; without these arts, there is no medical activity. But all this beside the trial to understand the person which is sitting opposite of you. It is important to understand not only a suffering, help-seeking patient, but an entire human being with all their rights and integrity as a patient. The physician must not only sit across from his patient; he must stand by their side. With this, comes the physician's medical obligation not to impose his own value system on those who are seeking advice ("What would you decide in my situation if it were your wife?"). Today, it is completely frowned upon to exercise a certain medical power, which relies on additional knowledge, preventing the patient from freely arriving at his own decision, but to try to impose one’s own will and one’s own value system onto the patient. These factors become particularly important in malignant diseases which suddenly become more important than the rest of the medical art. The questions as to why: "Why me? Why now? Where does the disease come from?" fade very quickly compared to the much more burning questions which concern us deeply in the long run: "How long will I live? How will I die and where does my path lead to?" Questions as to the sense of life, the sense of our birth and death suddenly become more important than anything else. In these uncanny questions, neither the scientist, nor the technician, nor the good surgeon with clear indications is called upon, but the physician in his entire humanistic view caring for the patient in his most basic function. In these circumstances, one looks for the healer, the shaman and poses questions within the area of transcendence.

Here, the challenge for the surgeon and physician is almost too big. The topics become difficult; they affect our most ancient darkest fears. In this situation, discrete, compassionate answers must be given to provide hope. In the long run, the most important art of the physician and surgeon is to be truly humanistic. Therefore, it is also true today that the physician's profession should be a true mission.

In 20 years as an active surgeon, I have performed abdominal surgery on over 5000 patients, advised and treated even more, I try to reflect today on my activities and to propose a basis of generally accepted principles. I have learned these principles in the course of my professional activities while working with my surgical teachers, and I have further developed them on my own. They are the focus of my professional and life experiences. They govern my activities and my understanding for humans, who entrust themselves to me as patients. They form the foundation of my activities and assure the optimal operative treatment of injured, sick or even seriously ill patients.



In my practice, I treat both men and women with equal attention and respect. To simplify the readability of the text, I have used the masculine form in the text.



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