Surgery Secrets with Dr. Jonathan White

Introduction & Quickfire Questions

[00:00] Hello and welcome to Surgery Secrets, where we go behind the scenes to uncover secrets about surgery you won't hear in the classroom. My name is Isabelle Lussier and I'm a design intern for Surgery 101, and today we are sitting down with Dr. Jonathan White. So let's get started.

[00:20] So first off, we'll get started with some quick-fire short answer questions if that's all right. We'll start with some easy ones. So don't worry. Can you tell us your name? Yes, I'm Jonathan White. Perfect. What is your occupation? So I'm a general surgeon. I work here at the Royal Alexandra Hospital in Edmonton.

[00:40] Alberta in Canada. Wonderful and what does your job entail? So I'm a general surgeon so basically that really amounts to being a kind of an abdominal surgeon. So I'll operate between kind of the you know the bottom all the way down to the bottom. I've been described as some

[01:00] I'm going to talk about somebody who does like, bum, bums and guts, because I do a lot of colorectal surgery so I'll see a lot of people with bowel issues or with problems with their bottom or that sort of thing. So I have an elective practice where I see people in clinic and then operate on them. If they need it, I do scopes as well and look into the colon sometimes.

[01:20] You can use your gall as well for emergency things so take out your appendix or your gallbladder or deal with your bile obstruction that sort of thing. It's a kind of a, it's a fairly general practice. Your favourite colour? Blue. Your favourite food? Maybe something Japanese, something like with noodles or ramen, that sort of thing.

Career Influences & Early Inspirations

[01:40] Sounds good. Your favourite superhero? Batman. Your favourite musical artist? Tom. Tom Waits. Your favourite movie? Second movie in the Aliens franchise. So the one by James Cameron. Aliens. Your favourite organ of the body?

[02:00] The rectum, obviously. The last book you read? I read a book called The Dazzle of Day about people who leave Earth and go to settle on another planet. Okay, awesome. You passed the quickfire round. So let's move on to our nitty-gritty questions.

[02:20] Who was your biggest influence? The biggest influence? Probably, I would go back to my biology teacher when I was, I think, 14 or 15, a guy called Jimmy McNally when I was in high school and he was probably my biggest inspiration in terms of

[02:40] inspiring me to do something useful with my life, I guess. And he would have been the guy who first taught me anything to do with the human body or human biology. And I think he's probably the, he wouldn't have thought himself as a great teacher, but I think he was probably the best teacher that I ever had. So I can only imagine how hectic and busy school would have been for a surgical student.

Memorable Moments During Training

[03:00] Can you tell us the most memorable moment of your training? I guess probably if I think about one memorable moment, I remember the first time I took somebody's appendix out on my own and I was really on my own like there was no one there to help me and I phoned my consultant to say I was going to do this and he said,

[03:20] And that's okay, you don't need me and you just put the phone down. And then I phoned my wife and I said, I'm going to have to go and operate on this person and I've never done it before. I've done it with assistance, right, but I've never done it on my own before. And she said, well, just walk me through the whole surgery. So I walked it through with her on the phone all the things that I would do. And she said, well, that sounds okay. And then I went and did it.

[03:40] It was like me and a student nurse who'd never done it before and I was supposed to know what to do and it actually went very well. The patient survived. Can you tell us a recent memorable moment at work? We had somebody who swallowed something recently actually. He swallowed a foreign body.

[04:00] And we thought we could just go down and kind of grab it and pull it out. But then it turned out that it wouldn't come up. And we ended up having to do a little surgery. And when you open somebody up you're trying to figure out well where exactly is this thing and how am I going to, am I going to find it, I'm going to have to kind of search for it and see where it is. But we ended up we made this

[04:20] tiny little cut like that and the piece of the vial that the foreign body was in just popped up into the wound just like it was waiting for us trying to get out. We made this tiny little cut and we just took it out like that and the patient got away with a tiny little incision. We didn't have to search for it at all. I think just it just wanted to come out. Oh my goodness that's crazy.

Recent Memorable Surgical Cases

[04:40] Is there anything that people don't understand about your job because some of the things you do are pretty crazy? I think probably the most common misunderstanding is that all you do is operate, like you're just like you live in the operating room and then they wheel people in and do the surgeries and they wheel them out again.

[05:00] The only people you ever see are asleep. And in fact, the operating is the smallest part of the job. And most of the rest of the time we're spending talking to people and asking what their symptoms are and trying to figure out if they need surgery or not, or if they do need surgery, trying to explain it to them to make sure they're safe.

[05:20] they understand what's going to happen and what the risks are and what all the different things that could happen. So we spend, I spend a lot of time talking to people who don't need to have surgery and we just chat to them and say well this is what surgery might offer but you might want to go somewhere else and maybe have an answer.

[05:40] So I think the thing that people don't understand is there's a lot of talking and communicating and working with patients in surgery and it's not just all about operating all the time. Would you say patient interactions are your favorite part of the job or do you prefer surgery or what's your favorite part of the job?

Misconceptions About Being a Surgeon

[06:00] I think I like talking to people. I like really interesting discussions, like really difficult things where we're going well. Sometimes you obviously shouldn't operate and that's easy and then sometimes you obviously should operate and that's easy as well. But there are cases like a colleague just sent me a patient to see yesterday.

[06:20] where no one knows the right answer, right? And you're trying to figure out and you really have to listen to what the patient wants and what's really going on. And you really have to be able to explain things very clearly to the patient to say, well, I'll often say, you know, there's three options, right? You can do this, or you can do that, or you can do that. And the patient’s the one who’s the boss here, they’re the one who has to decide.

[06:40] So I think that to me that complicated conversation where you're kind of building understanding and getting to the same point as the patient and trying to really hear what it is they want is an interesting bit. The other pieces actually I actually like the intricacy of the operating; I like doing a difficult thing.

[07:00] And doing it well. And actually, I get a lot of satisfaction out of the results like when a patient gets better and goes home again. That's like high five like we did this difficult thing and it worked right. Or, I mean one of the most difficult operations I do is when somebody's got a rectal cancer and we're taking the rectum out to get rid of this tumor.

[07:20] And then we join everything up again afterwards and the patient goes home, and then the pathologist gives you the report and in the report it basically tells you whether you're any good or not. Like did you get the tumor out properly? Did you treat it properly? Is there anything left behind? All this kind of stuff, right? And I like that. I like the use in your

Best & Worst Parts of Surgery

[07:40] hands to get fiddly things done, but I also like that sense of satisfaction saying, yeah, that was a good result. Yeah, I can only imagine how good it feels to help someone's life. So that would be amazing. I guess on the other side of it, what would you say is the worst part of your job? I sometimes find the hardest part

[08:00] is trying to explain to a patient that they don't need surgery. Some people come saying, well, they're absolutely sure they want an operation. And then you're trying to say to them, well, it's not really going to help. I was thinking about somebody recently who came in with some vague symptoms and it turned out they had a very advanced cancer.

[08:20] And in fact, we kept them under my care for several days, even though it was clear that they were not going to ever have surgery and the surgery wouldn't be the best thing for them. But it needed us to do a whole bunch of different tests to kind of figure out, well, if you're not going to have surgery, what's the best thing for us to do instead of that? And in those cases, I really I'm really allowed to do surgery.

[08:40] surgery and be able to offer somebody a cure, but sometimes it's really not the best thing. So that's the hardest thing when the patient says to you, but when you're not just operating on me and take this thing out and I'm like, well, I'm afraid that that wouldn't help at this stage. So that's probably the hardest thing. In terms of surgery, I can only imagine how kind of

Unexpected & Unusual Surgical Cases

[09:00] It can get sometimes. I mean I've watched Grey's Anatomy but I'm sure it's not exactly like that in real life. Can you tell us about like the weirdest or messiest or grossest thing that's happened to you at work? I remember years ago I operated on a guy who had a bile obstruction. We thought he had a tumor or something and we took out this piece of the bile.

[09:20] And in the piece of the bile was a pencil, like a full length pencil and it was sharp at one end like it wasn't blend or anything. And he had swallowed the thing and it had gone down all the way through his bile and got stuck in part of his colon. And we thought it was a cancer but in fact it was just a reaction to this, this perforating pencil.

[09:40] And apparently the reason why he'd eaten the pencil was he'd been at some kind of stress management course, I think. And they'd given him a pencil to record, like to do journaling. And on the side of the pencil, they said, address your stress. So the way he decided to address the stress was to eat his stress pencil.

[10:00] going to say you must come home and have so many crazy stories to tell your wife. Can you tell us a bit more about your support system and kind of what they mean to you? So I would say my main support system is family. Although, I mean, we've got a small circle of friends here and I actually feel

[10:20] Very well supported among my colleagues. So there's 14 of us now here, Royal Alexandra, who do general surgery and it's a fairly small team. We're fairly close-knit. And I think we sort of operate like we're family almost. Like I'll put my patients in the hands of my

Support System & Work-Life Balance

[10:40] colleagues and they put their patients in my hands as well. So there's a lot of trust and support in that. And certainly if I get into trouble, I'll just say, hey, go to the next operating room and say, hey, can you come in and look over my shoulder for me and see what you think? And I'll do that for some of my colleagues as well. So I think I get a lot of support from my colleagues.

[11:00] My wife and I are on our own here. We don't have any kids. So really my main support system with family is my wife who's right here in Edmonton. And then I also am very close to my family back home. So I would speak to my mum and dad on the webcam back in Northern Ireland pretty much every Sunday.

[11:20] when we're in town. And then I've got two brothers and a sister that I communicate with as well. So really those are the main support systems that I have and I think that's actually super, super important because it's difficult work that we do and I think we need to have somewhere where you can kind of go and share some of these stories.

[11:40] decompress and take off some of the weight. And did your family see you as becoming a surgeon when you were older or was it kind of a surprise to them when you decided this career path? I think it was a surprise to me actually. I think it was definitely a surprise to them as well. I mean I'm the first

[12:00] person in the family to not just go to medical school but to go to university, and I think I'd always been interested in sort of science with my biology teacher and everything, and then I kind of thought, well, my father’s very practical, and he said, well, you know

Career Expectations vs. Reality

[12:20] what are you going to do with this? You're not just going to be the eternal student. You're going to have to do something that helps people. So I kind of thought, well, medicine sounds kind of okay. And then when I was in medical school, I kind of thought, oh, I could never do surgery. They're just horrible people. They're just nasty. I don't want to work with any surgeons. And then I thought it was going to be a family doctor. I got

[12:40] I got out of medical school and the first thing that I was assigned to was a surgery ward, and I was there for four months. First thing out of medical school. And I just got blown away by the impact of the thing, like people would come in sick, and you do something yourself, like with your actual plans, and they would get better and go home again.

[13:00] I went from that to doing four months of surgery, and then I did four months of geriatrics. The contrast between the impact of surgery and the kind of immediately getting better thing the next day to going to geriatrics and seeing how things move so much more slowly there.

[13:20] That's what made me think, well, surgery sounds pretty good. So I applied to get on the surgery training scheme and away we went. And my wife and I ran into one of our old friends from school in Vancouver a couple of years ago. We hadn't seen each other for like 20 years and she said, you know,

[13:40] I knew that you heard you went to medical school I kind of lost track of you after that. But she said now I've heard you're a surgeon, like she said, I never thought you'd go and do the most difficult thing. Like you actually went and did the most difficult thing in the whole medical thing and she was like, I never actually imagined, imagined you would do this I'm like well

Advice for Aspiring Surgeons & Final Thoughts

[14:00] It was a surprise to me as well. So if you weren't doing your current job, what career would you most like to do? Do I probably do something more creative, I think? Maybe something with writing? If I could go back and do it all again, I might actually.

[14:20] do something even more along the lines of music. I'm learning Clawhammer Banjo at the moment. So I think I'd quite like to go back and kind of do some more stuff around music theory and some of the history of music actually. So it would be something creative writing or music. If you could go back

[14:40] What advice would you give your younger self or someone considering your career? That's a good question. So I would say keep an open mind and prepare to be surprised because if you said you're going to end up

[15:00] doing surgery, I would have said you're nuts. If I said you're going to end up living in Canada for the last 15 years, I would have said you're nuts. Sometimes opportunities come up and you have to just take them and run with them and see where they go to. And the idea of

[15:20] life that you might have when you're younger may not necessarily be the thing that you end up with later on because the thing you end up with is going to be better I think. So I would say keep an open mind and never say never. I'm sure at some point in the past I said oh I'm never going to live in Canada and they

[15:40] And here we are, you know, that's some great advice so thank you so much Dr. Dykstra for joining us today and reminding us that no matter our most embarrassing moment we're all the same when we work. So, join us next time for another exclusive look into surgery today. Follow us on LinkedIn for new surgery.

[16:00] Secrets episodes and check us out on Facebook, Instagram, and Twitter for more information on Surgery 101. Head to our website, surgery101.org as well. Thanks again and we'll see you next time.