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Thorac Cardiovasc Surg 2023; 71(08): 595
DOI: 10.1055/s-0043-1776774
Editorial

When the Going Gets Tough,…

Markus K. Heinemann
1   The Thoracic and Cardiovascular Surgeon, Universitätsmedizin Mainz, Mainz, Germany
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…the Tough Get Going. This old proverb could have been the motto of the Strong German Hearts project initiated by Torsten Doenst and the German Society for Thoracic and Cardiovascular Surgery (DGTHG) in January 2023. Together with coaches from the Special Forces of the German Federal Police, experienced cardiac surgeons submitted 14 carefully selected trainees to a 36-hour nonstop training program in Berlin. Besides manual tasks, concentration exercises and intellectual challenges such as abstract writing, coaching sessions teaching how to cope under extreme stress had to be taken. You can read all about it in two special reports in this issue.[1] [2]

Suffice it to say that it was an incredible experience for all who participated, whatever their role, yours truly included. The Editor of this venerable journal had the task to introduce the trainees to the art of abstract writing. They were then confronted with a made-up dataset in the afternoon of day 1 and given 90 minutes to compose an abstract in randomly assigned groups of two. The same task was to be repeated with a different dataset 24 hours later, sleep deprived and exhausted. Both abstracts were ranked according to a standardized evaluation sheet. Not surprisingly, performance was lower on day 2, but not very much so (score: 22.4 ± 1.5 and 19.7 ± 2.5; p = 0.037). One group even surpassed itself by scoring 2 points more and achieving the overall top score of 25 (of 31 possible points) on day 2.

In the introduction round, I reminisced that this kind of setup was routine for residents back in the 1980s. When I left home, say, on Monday morning at 7 a.m. and was on call that night, I was bound to return around 7 p.m. on Tuesday. Later on, when my children had grown up more, “You weren't there!” became a household phrase whenever stories of school events and the like were told. Definitely nothing to be proud of, but those were the days. You could bet that when you tried to sneak out red-eyed in the afternoon you ran into a senior surgeon who immediately kidnapped you because of that bloody abstract that absolutely had to be finished that very day. In this respect, our Berlin program setup was, indeed, very realistic 80s.

Another memory, this one coming from the United States, was the reply to the question: “What is the problem with being on call every other night?” Correct answer: “You miss half the good cases.” Case load and exposure to surgery are still very important determinants for the duration of surgical training. But even 40 years ago, it took longer than you had ever imagined.

The most impressive result of our program was the discovery that the trainees, who had probably expected to enter some kind of challenge for individuals, were fused together by the tasks and experienced that the only sensible way to get through all this was by turning it into a group effort. Including the trainers, I hasten to add. When we finally headed out into the Berlin night after 36 hours of incessant challenges, we all felt a comfortable sense of unity: the young are able to do it, and the old still persist, so much so that we stumbled into a club that had just opened at 10:30 p.m. and danced our rocks off to music of the 1980s. My memory fails me, but it may even have included crooner Billy Ocean's “When the Going Gets Tough, the Tough Get Going,” the theme song of the film “The Jewel of the Nile.” To get into that 1980s groove, watch the video, also featuring the movie stars Kathleen Turner, Michael Douglas, and the inimitable Danny DeVito. “Tough! Tough! Huh, huh, huh!”[3]



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Artikel online veröffentlicht:
04. Dezember 2023

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