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Sunday, May 28, 2023



Staff Reporter

The young emergency-room doctor was recalling his days at Harvard Medical School and the distinguished physicians he followed on their rounds and in the operating room.

“One of the surgeons I attended was world famous in his field, orthopedics, and with an ego to match,” the doctor said. “He had written four or five hundred articles in medical journals. And as a diagnostician, he was unsurpassed. He could immediately tell what was wrong with the patient, and how to fix it. But his skills in the operating room were horrendous. You’d walk out of there and think, ‘My God.’ There’s no way I’d let anyone I know anywhere near him. But he was considered the best.”

Doctors with big egos have traditionally been accepted as a given, just like politicians with ambition it comes with the territory. As they have been for centuries, physicians are a repository of arcane knowledge and advanced skills. The training to develop those skills requires a healthy sense of self-confidence combined with a certain detachment from the patients in order to be successful.

“The Greeks had a term for it: hubris,” said Dr. H. Rex Greene, an oncologist who is past president of the L.A. County Medical Association. “It’s not just surgeons, but surgeons in particular define themselves by what they do: I cut, I sew, the patient gets better. In the O.R., they are God. They can throw tools, use insults and grab rear ends, although that part has been tempered over the last 10 years or so.”

For those doctors who are seen as the leading practitioners in their field, what impact does fame have on already sizable egos?

“It’s not as bad as celebrity chefs,” said one leading L.A. internist. “Some doctors cater to high-profile personalities, but it’s the dictates of the doctor’s personality as to whether their egos get out of hand.”

He cites a well-known ophthalmic surgeon “who has an enormous ego, but it doesn’t interfere with his work.”

In many ways, an egotistical doctor is the inevitable by-product of the drive it takes to get through medical school and the years of being an intern. Along with the imparted knowledge is an attitude of almost masochistic sacrifice to the number of hours spent studying and working in hospitals.

“Med school is designed to polish, buff and make a highly trained virtuoso, and that image of physician as virtuoso is powerful,” said Dr. Bruce E. Zawacki, associate professor of surgery emeritus at USC who studies medical ethics. “It’s no accident that we think we’re special because we’re trained to think we’re special.”

“(Ego) is essential to make it through 12 years of boot camp, but at the end you have an army of generals,” concurred Greene. “When I was in medical school, the saying was that the only thing wrong with being on call every other night was that you missed half of the great cases. After a while, it defines you.”

While the combination of supreme skill and accolades has been known to harden some doctors to the actual suffering that patients undergo, that same detached coolness can also be an asset when someone’s life is on the line. Surgeons, it is said, are like fighter pilots: never considering the possibility of failure and never happier than when they are in the driver’s seat. When it is a matter of life or death, those are the doctors you usually want.

And not all doctors are insufferable egomaniacs. There are famous ones who might have every reason to be conceited but aren’t doctors who see their roles as practitioners of the art of medicine and treat their patients as equals.

“One could see if (Hillel) Laks, the head of (cardiothoracic) surgery at UCLA or (Achilles) Demetriou, the head of surgery at Cedars-Sinai, had a God complex, but they don’t,” an internist said.

Los Angeles, however, has at least one area of medicine in which egos are an inherent part of the specialty: plastic surgery.

In a town where surgically shaped noses, tummies and breasts are a sizeable part of the landscape, skillful plastic surgeons can become famous thanks to the celebrities they serve. Along with the notoriety that comes with the being the surgeon who did Cher’s nose, for example, can come an unusual degree of ego gratification, considering the huge population that scrutinizes the surgical handiwork. Some celebrity plastic surgeons go even further in projecting themselves into the spotlight: They hire a publicist.

The resulting public exposure can lead to conceit, but it may not bring with it respect among one’s peers. And it may also bring unintended consequences.

“There is a difference between those who seek out fame and those to whom it occurs,” said Dr. Timothy Miller, a professor of plastic surgery at UCLA’s School of Medicine. “Those who seek it out often do it because they want to get into business. I’m not passing judgement, but I believe that when you start to heavily advertise, then you have entered the business world. If you hire a publicist, it may be more to benefit your ego than your patient.”

Without naming names, Miller acknowledged that there are certain “personalities” in his field in L.A., where achieving notoriety can become so all-consuming that it affects a doctor’s professional judgement. But Miller added that some publicity-seeking plastic surgeons are good doctors nevertheless.

“One guy I know loves the press,” Miller said. “He’d do anything to get a quote (in the papers). He’s a pretty good surgeon, and he has a Queen Mary-sized ego. Does it affect his care? I don’t think so.”

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