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E.O.E Newsletter | www.huanet.gr
go on a flight simulator to show that they're still able to fly every year. They take a technical test. We only take cognitive tests. We are a specialty with cognitive and technical skills, who are allowed to do technical things because of our skills on a cognitive test. That's insane. So, if I had my druthers, there would be both technical and cognitive boards as well as technical and cognitive recertification. Also on a daily basis, you would not go in to do a laparoscopic or robotic surgery, until you spent 10 minutes warming up, because we know that a warm up makes you better. That warm up doesn't have to be the surgery you're going to do. It can be as simple as laparoscopically or robotically throwing sutures and tying knots, forehand, backhand, left hand, right hand. I would like to see hospitals where they guarantee the skills of their surgeons on a daily basis.
If I were CEO of a hospital I would mandate a “warm- up”. Before you're allowed into the operating room on any given day, you've taken your 5 or 10 minute warm up on the simulator console and the console has come back and said: "Dr. Spinos is operating within his standard deviation on his warm-up exercises, and he's good to go". But let's say, because we're all human: “Dr. Spinos has the flu, he is feeling horrible or he went to a party the night before and they were serving a 1982 Bordeaux and he had three glasses of wine, instead of one”. On this test, after 10 minutes, the console says: " You are two standard deviations off your norm". You take it again and you're still two standard deviations off your norm. You get locked out of the OR for the day, no harm, no foul. I don't care and don't want to know if you're impaired because of the flu or, heaven forbid, a family tragedy, or because you had too much to drink. I don't want to know the reason. All I want to know is that, on that day, you're not on your game and the hospital is not going to let you play. Remember every time we do something as a surgeon, we never suffer the consequences of our actions, only the patient and the family do. I do not believe that there is a surgeon on the face of the planet who, given the opportunity to take back one or two days that they had in the OR, would not do it in a heartbeat. That's what I would like to see. I would like to know that the technical ability of the surgeon is guaranteed, on the day that he or she is going into the operating room, and my life is on the line.
T.S.: Through your career you met and closely cooperated with the father of Endourology, Dr. Arthur D. Smith. Could you tell us a few words about your cooperation with Dr. Arthur D. Smith?
Prof. Ralph V. Clayman: Arthur is a legend and deservedly so. I was incredibly fortunate to get to know him when I was a resident, and then to become his friend. Arthur Smith has an uncanny ability to draw people in, to open the doors of his academic house to anybody who wants to cross the threshold. Arthur Smith has the ability to believe that you're going to succeed, and because of his belief in you, you believe you're going to succeed also and you do. He created the Endourological Society. He co-created the Journal of Endourology. He made Endourology welcoming to anybody who was interested. When shockwave lithotripsy came up, and all of a sudden there were the SWL meetings and the Endourology meetings, Arthur chose not to compete but instead to collaborate. The end result was the Endourology & SWL Annual World Congress. Great! When focal therapy came out, Arthur embraced it and brought it into the Society. When robotics came out, he embraced that and brought it into the Society. There was room for everybody in Arthur’s tent. Everybody was made to feel welcome. That's the lasting legacy of Arthur Smith. He changed the specialty, leave no doubt. He changed it for the better. Because Arthur was never concerned about Arthur. He was concerned about everyone around him. That's fabulous and rare. I count my lucky stars that he came to the United States and came to the University of Minnesota while I was a resident. Astounding that he and his family would leave the beautiful climate of South Africa and elect to emigrate to the United States and choose a state with the worst winters, the coldest days and the most snow that you could possibly find. But we are all thankful that they did. We've all benefited from Arthur Smith.
F.N.: Have you ever visited Greece? Could you name your favorite place?
Prof. Ralph V. Clayman: I love Greece. I have visited Greece. We had a World Congress of Endourology on the island of Rhodes, which was fabulous. I got to also visit the place of Hippocrates on the Island of Kos. I also had the good fortune to visit Athens. Actually, while there I had the wonderful experience of running a lap on the initial Olympic Stadium. Also, I love the food and I love the people. Greece is just beautiful. I am going to go back in August. My wife and I are taking a cruise from the east coast of Greece to the west, through the canals and the waterway there. We both enjoy the history as well as the art. To be sure, Greece is such a special and beautiful country and we are very much looking forward to returning.
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