"Give me a break and I'll fix it!"
Break
verb: break; past tense: broke
1. Sustain an injury
"The patient's arm broke" or, orthopaedically speaking, "the patient had sustained a midshaft humerus fracture, endangering the radial nerve."
Quite literally, a day in the life of an orthopod revolves around the surgical management of musculoskeletal injuries — a broken bone requiring a fix, an osteosarcoma requiring a fix or a torn ACL requiring a fix. Skill and a high degree of manual dexterity can help the orthopod fix countless breaks - but is it enough to fix the instrumentalised patriarchal beliefs that limit orthopaedic surgery to a mere boy's club?
2. Crush the emotional strength and spirit
"The junior resident's self-confidence broke as they battled through the sleepless nights, emotional exhaustion and harassment."
The rate of burnout among orthopaedic surgeons is higher-than-average at 50-60%1, with a greater prevalence noted among junior residents. Undoubtedly, the rising competition to get into the specialty, nights on-call, long hours, and sleep deprivation only catalyse this until an orthopod finally suffocates under the gravity of expectations they face.
Emotional exhaustion. Depersonalisation. Loss of personal accomplishment3. The three phrases that have shadowed us since the day we embarked on our journey in medicine and will always linger. Afterall, medical professionals, as we know, can fix any medical
condition if they aren't the ones impacted by it.
Drained, they say, denying its very existence.
"I broke. I give up. I surrender. I am handing back my dream of becoming a surgeon3."
Burnout doesn't differentiate between sex, ethnicity, or race — all victims could potentially hit their unfixable states. However, the misconceptions towards orthopaedics — the sheer brute force, inherent misogyny, and gym bro's club — work as granulomas, walling off not only the female population from being attracted to the very intricacies of this specialty but also suppress the ones that do partake in it from thriving. Because God forbid, she contests or challenges the substantial workload. She decided to pursue this. She asked for it. They told her she couldn't do it. It is these bigoted attitudes that need to be fixed. It is a break from these that she deeply longs for and deserves.
Say, one does muster up the courage to admit to being broken, was it a brave move or a sabotage that will break them further? The concerns about speaking out - being blacklisted, looked down upon, ruined 'good references', and ultimately broken dreams of getting onto the training program. All these factors cloud the forefront of the mind wanting to seek help, wanting to speak up, wanting to be fixed. However, the fear of sabotaging their dreams and reputation hinders them and suffocates them until they physically and physiologically break. It is this toxic culture that needs to be fixed.
noun: break
1. A pause in work or activity
"Give me a break and I'll fix it!"
This culture can be fixed. It is what is necessary for the progression in not only the field of orthopaedics, but surgery as a whole. Burnout plagues countless surgeons with unfaltering potential and drive. They deserve to be recognised for their hard work. They deserve a break.
Whether it be a day off, safe working hours, or even a simple check-in with a colleague, a culture of supportiveness and healthy work environment must be built. This change needs to occur at a systemic level to continue supporting budding surgeons as they navigate through their long and undoubtedly difficult journey. While manifesting significant mental and physical tolls for the person going through it, burnout is also associated with increased intraoperative irritability2. Despite being far from optimal, it is hardly something under the control of someone who is completely worn out, exhausted, broken.
This danse macabre needs to be fixed with empathy, not pitiful remarks of "maybe this isn't for you." The entrenched beliefs in the system long for a shift. Mentorship plays an essential role in this as guidance from a senior who has battled these hardships paves a
tunnel of hope - one that will not dim the surgeon's light as they walk through it but mould them into resilient and empathetic heroes.
They need a break to develop their passion towards orthopaedic surgery. To build positive relationships with their colleagues. To have time off work to pursue their hobbies. To enjoy and cherish what they do.
To fix the broken.