09/20/2025
Just read this courageous post highlighting the incongruous duality of fragility and strength that defines so many surgeons. It really spoke to me. What would it take for more of us to live our humanity? Are we only able to acknowledge and respond to our vulnerability after our destruction?
Below is the opinion piece by Paul Fedak entitled “A Heavy Heart” featured in the Globe and Mail:
As a cardiac surgeon, I chased excellence and saved lives. But what began as commitment to a noble pursuit eventually became toxic.
At first, the back pain was manageable.
It started as whispers from my spine. But then came the feeling that my brain was on fire. I couldn’t sleep. I couldn’t focus. The pain was starting to take control.
I started cancelling the heart surgeries I had been scheduled to perform. No one knew why. I kept my pain hidden. I just kept going.
But one day, while holding a beating human heart, my gloved hand seized. My right hand, the one I trusted, stopped communicating with my brain.
The scans showed what I feared: years of damage from the work I loved. Cervical spine degeneration, they said. Now the surgeon needed surgery.
I cried alone in my car after every doctor appointment – not because of the pain, but because I knew what it meant. I wasn’t a surgeon anymore. I felt eviscerated. Hollow.
It wasn’t the unrelenting pain emanating from my spine that broke me. It was the unceremonious ending of the career I had loved and worked so hard for. I lost my surgical career in silence. A surgeon friend had taken his own life not long before; the thought crossed my mind that I didn’t want him to be alone.
Doctors know suffering – at least, we know the kind of pain we witness in our patients. But what happens when the doctor becomes the one who suffers – and worse, when they have to suffer in silence? This is the part we don’t talk about, especially in the medical community. The grief of losing what defined you. The loneliness of pretending you’re okay.
I’ve never shared my story publicly until now. But I think it’s maybe time we started telling the truth about our profession, and speaking from the heart. David Whyte, poet and author, says the courageous conversation is the one you don’t want to have. For me, that conversation begins now. It’s time to speak the truth – from the heart.
As kids, my best friend and I loved riding our BMX bikes in the local ravine. My best friend was always the bravest one there. Jump! The group of boys would yell at him, before he’d propel his bike down a long, treacherous slope and take flight at the top of a hill. We rode side by side, heading home only when the sky turned pink. Safe inside, we’d pass the one game controller we had back and forth, rescuing the damsel-in-distress from the angry gorilla hurling barrels.
I was part of a group of kids that spent a lot of time on their own, with parents more focused on their careers and social lives.
I was especially independent. My mother, a beautiful French teacher, got sad after I was born. She packed up and left before I could ride a bike. I asked why she went, and the response usually involved something about her having to leave to find her joy. Her joy wasn’t me.
My dad, trying to fill the void, snuck me into R-rated action movies, with stories that taught me how to be a man: be a brave hero, never quit, carry your pain in silence. When I caught my dad staring into the distance, I wondered if he had dreams he’d buried. He never said much. Maybe he hoped I’d dream even bigger than he ever did. I couldn’t let him down.
Cars replaced the BMX bikes when we hit our teens. My best friend’s new ride reminded me of his childhood cruiser: fat tires and a hunger for speed. We were joyriding, windows down, the radio blaring: “… and she’s buying a stairway to heaven."
Everything went dark in an instant.
When I opened my eyes, I saw the night sky. Faces hovered over me, concerned, in a fog of smoke. I remember seeing the car crumpled like an accordion, its frame bent.
Later, I woke in a hospital bed, disoriented. I asked the nurse where my friend was and said I needed to see him. I was met with silence. I asked again and again, to anyone who would stop long enough to listen, but they kept moving, looking away. My father told me bluntly – man to man – it had been a head-on collision. My best friend had died in the crash.
The sum of my early losses drove me toward a single, unshakable goal: excellence – unmistakable and invulnerable. People came and went. But this career – this one thing couldn’t be taken from me. It was mine alone. So I chased it relentlessly, through undergrad, medical school, and the long crucible of surgical training. I became a heart surgeon. To me, cardiac surgeons were superhuman.
For years, I chased perfection and caught excellence. I flew to conferences. Lectured in packed halls. Sipped wine with the Prince of Monaco. I had arrived. And yet, the applause felt distant and hollow. It was never enough.
Heart surgery is intoxicating. The focus. The precision. The privilege of holding a life in your hands, and giving it back. But the thing that intoxicates you can also become toxic. I gave my career everything: my time, my family, even my body.
My kids waited for me to come home to open presents on Christmas morning. Vacations were rushed. I often left early. I felt increasingly uncomfortable the further away I was from the hospital. I missed birthdays, and I never knew when a long weekend was coming.
I told myself it was commitment. That it was noble. But I was being pulled apart, and it was lonely. Was this really excellence?
I came across a kindred spirit – a thoracic surgeon and care leader who’d been asking the same questions as me – by chance, while I was leading cardiac care for several hospitals in Calgary.
He became a close companion, helping me carry the emotional weight we bore, torn between the system we longed to create and the rigid, sometimes dehumanizing one we worked in. We’d drop our masks in the hallway and whisper stories of doubt and defeat. Over lunch, we talked about cycling, side by side, like kids, escaping obligation.
My friend resisted a system designed to silence the soul, and while the rest of us followed orders, he spoke out – not to provoke, but to protect the spirit of why we are doctors.
One day, his name appeared in the subject line of an e-mail. Another accolade, I assumed. He deserved it. He stood at the pinnacle of his career.
Instead, it was his obituary. My friend had taken his own life.
His death gutted me. I kept thinking about him and what he carried. The burden of speaking truth while being strong for everyone else. The silence behind his eyes. I knew that silence. It was inside me.
In medicine, stoicism still masquerades as strength, and excellence hides suffering. I waited for an institutional response. There had been others before him. Instead, the usual boxes were ticked. Protocols were followed. The system moved on. My grief deepened, fed by the empty way we bury our colleagues.
Soon after, an old stabbing pain behind my shoulder blade reignited like a three-alarm fire, spreading into my brain. I couldn’t sleep. The pain took over, swallowing me whole. It all culminated in that one terrible incident – my hand seizing while conducting open-heart surgery.
Just like that, my career – that untouchable thing that I thought could never be taken from me – was over.
Open this photo in gallery:
In the surgeon’s world, you don’t talk about your pain. You don’t risk the patient’s trust, or the confidence of your team. So, you push through – even when your body says, enough.
We don’t talk about this part of practising medicine – the pain and the silence. Many of us suffer through it alone. Some medicate. Some detach. Most, like me, keep going until they can’t.
I wore the mask. I called it professionalism. But it was fear. Afraid that if I stopped, I might disappear.
It ended without ceremony. There was no big goodbye or celebration – just a slow fade. I didn’t know how to grieve the loss of the life I had built.
I broke down, physically and mentally. I drifted around, ghost-like, mourning the life I once lived. Yet I didn’t reach out. I didn’t know how to stop pretending I was okay. The superhero disguise fit too tightly to ask for help.
But I couldn’t stop thinking about my friend.
I didn’t want him to be alone.
Whispers chanted: Jump.
The numbers are staggering. One in seven surgeons in the U.S. struggles with suicidal thoughts. The majority never seek help – afraid of what it might cost them. Physicians die by su***de at twice the rate of the general population. Ask any doctor, and they’re worried about someone: a colleague, a friend – sometimes, themselves. Many carry what I carried: talent as armour, pain buried deep, eyes at the edge of tears.
Silence doesn’t just harm doctors. It harms patients. We stop properly listening to the people we are treating. Stories become symptoms. People become pathologies. I grieved for the patients I had unintentionally silenced with efficiency. Now I was one of them, reaching back to remember who I’d been, aching to be heard.
I once believed that healing could be given by a surgeon’s blade. My perspective has changed. Surgeons cut to cure the body, but it takes a collective spirit to heal a wounded soul. Healing begins not in doing, but in just being – through relationships, storytelling, and compassion. When we surrender to being, we receive grace. Achievement fades. Our true purpose – to be in community with others – becomes clear.
We are taught to be resilient – to endure, to numb ourselves, to withstand the pressure. But what if resistance is the problem? What if true strength is allowing the moment to be fully felt, and letting its truth transform us?
I used to hold hearts in my hand, fixing their physical infrastructure. Now, I speak from the heart, and I recognize its greater function.
We can only carry our pain in silence for so long. If we’re lucky, we get the chance not to dull the pain, but to lance it. To release the pressure: the truth, the grief, all the parts we’ve hidden.
Only when exposed can a wound start to heal.
Being a surgeon is about being brave. But speaking up – especially against a culture of shame and blame – takes a different kind of bravery. Not everyone will speak. But someone has to go first.
The poet David Whyte also said: “Sometimes you need to lose everything you thought you were to find out who you really are.” I found something inside me – something soft. It’s not brilliance, or resilience, or even excellence. It’s warm. Ancient. A knowing without words.
We are not born to do. We are born to be.
This is how I came back to life. This is when I began to heal – when I remembered myself.
