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there came up and said, "You're missing an H and that H is heart." He was right. Empathy and compassion are also essential. So basically, there are 5 H’s: hard work, honesty, humility, humor and heart; if you are equipped with those attributes, you will not only make a great resident, but you will most certainly become an absolutely great urologist.
F.N.: Does working closely with residents, fellows and students inspire creativity and innovation?
Prof. Ralph V. Clayman: Absolutely! That's the fun of it. It is about being able to share in other people's creativity. Everybody comes into Urology with a different perspective, a different background, different experiences. The idea that all of these individuals with diverse backgrounds and experiences can get together and focus on a problem and then together using their collective intelligence, develop a creative and at times innovative solution is just such a wonderful thing in which to participate. One of the best experiences is to challenge an intelligent and committed group of individuals with a problem who have the drive and humility to freely bounce ideas off of each other. In essence, this is what I call "mental Jazz" where each individual is using their mind as an instrument and the entire group is riffing off on another. When all those notes come together, something beautiful occurs. In jazz, it's a hit record. In science, it's a ground-breaking innovation.
T.S.: What does research mean to you? How do you feel when you go to the lab?
Prof. Ralph V. Clayman: Academia is a perfect place for me, because I love the laboratory and what it allows us to do. For me, the enemy is the status quo. If at the end of the day, things are exactly the same as they were at the beginning of the day, then we've wasted a day. We haven't pushed anything forward. From a more existential view, why are we here? I believe we're here to make this a better world for all of the people who are experiencing this life with us in the present, and if we are lucky, for many of the people who follow us after we are gone. How do we do that? In Urology we push things forward through good science and proven innovation. You need the clinical realm, because there you're going to run into problems: the patient who had a complication or the case in which the equipment was lacking. Those problems that you face clinically serve as a stimulus for you to go into the laboratory and solve them.
When you are fortunate enough to eventually answer or solve those problems in the laboratory, you then have the opportunity to take that solution out of the laboratory and, via a clinical trial, bring it to the bedside, to the benefit of the community.
In academia in order to innovate, you need both the clinical realm and the laboratory. To have a creative mind and to be in the clinical realm without a laboratory is a curse; but, to be creative and have a laboratory but no clinical involvement is also a curse. You need both.
F.N.: In your opinion, what character traits make a good surgeon?
Prof. Ralph V. Clayman: That simply is again the 5 H’s: heart, humility, humor, hard work and honesty. If you're not willing to work hard for your patient, if you're not going to be honest with your patient, if you're not humble with your skills, if you're not able to introduce a sense of humor so people have the ability to laugh a bit, and if you don't have the empathy, then it’s hopeless. The worst thing in the world is a surgeon who has no humility and who will tell you that they’ve never made a mistake. You know that's not possible. What you also know is that this is an individual you would not want as your surgeon. Surgical hubris kills. If you don't have the humility to be able to admit that you've made a mistake, you're going to hurt a lot of people and you will never become a better surgeon because you are incapable of learning from your mistakes. If you're not honest with people, that's a disaster. If you are not treating people who come to you with their problems the same way you would treat your family, that's a moral and ethical dilemma. If you're doing a procedure because you benefit more financially from that procedure than from another procedure, but the other procedure is really better for your patient, that's also a moral and ethical dilemma. The money you get from doing the wrong things to other people, does not bring happiness. It's going to pay for the sorrows that may deservedly befall you.
T.S.: Back in the 90s you performed the first laparoscopic radical nephrectomy procedure. Could you briefly describe us the story behind the first case? How did your technique evolve through the years?
Prof. Ralph V. Clayman: It all began when the laparoscopic craze hit in the late 1980s, with the first laparoscopic cholecystectomy. That became wildly
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