Abstract
Mohamed Khadra was, until recently, Foundation Professor of Surgery at the Australian National University Medical School. Prior to that he had been Pro-Vice Chancellor at the University of Canberra and preceding that, Professor of Surgery and Head of the School of Rural Health, University of New South Wales, at Wagga Wagga. Professor Khadra, a medical graduate of Newcastle, also held degrees in education, computing science, a PhD in urology, as well as his FRACS. He impresses as a polymath with an intellectual restlessness seen not uncommonly in our most talented colleagues.
His professional autobiography consists of anecdotes of his surgical training, early consultant days and teaching as a clinical academic. At times poignant, at others confronting, his book is no-holds-barred, including a sobering interlude involving his struggle with cancer as a young consultant. Professor Khadra's recollections are fictionalized to protect confidentiality, but lose none of their narrative and rhetorical power. Among other topics he ranges over: the hard-headed brutality of surgical training; the exigencies of private surgical practice versus best clinical practice; interactions with changes in nursing education and care; as well as struggles with health administration.
Perhaps most poignant is his self-described burgeoning empathy, developed from his experience as a cancer patient and the broader perspective of teaching and public health. He describes this type of empathy, verging on sympathy, as disabling for a surgeon, who in his view needs to maintain a certain empathic distance from patients in order to perform surgery.
In reflecting upon my practice as a psychiatrist, it is ironic that the same empathy needed to support my patients through the travails of their mental illnesses becomes a deepening wound for a brilliant and dedicated surgeon such as Professor Khadra. For psychiatrists, maintaining empathy is a delicate balancing act, assisted by the requirement for formal peer review and support processes. Such processes may need to be further developed in medical practice in general, including surgery.
We should be mindful of the saying inscribed on a sundial referring to the hours: ‘All of them wound, the last one kills.’ [1]. Thus it may be with empathy for physicians, and is a counterpoint to the recent simplistic calls for ‘more empathy’ from doctors; because empathy must be balanced against a certain objective distance for clarity of thought and action in medical practice.
Professor Khadra finally depicts his quiet departure from medical practice following this journey, at my estimate around the early age of 45, for a career in provision of distance education in the developing world and more. Making the cut is a gripping, incisive and poignant autobiography of the meteoric career of a talented surgical professor, now sadly lost to medicine.