Embracing Later Career Challenges
As I entered my sixties—an age when many physicians contemplate retirement—I found myself facing new professional challenges with undiminished enthusiasm. The 1990s brought dramatic transformations to China's healthcare system, with new technologies, changing administrative structures, and evolving patient expectations. Rather than viewing these changes as a reason to step back, I embraced them as opportunities for continued growth and contribution.
In 1996, at age 62, I accepted the position of Chief Surgeon at China Railway Wuhu Hospital, a role that would define the final chapter of my formal hospital career. This appointment came with significant responsibilities at a time of transition for China's railway hospital system, which was modernizing its facilities and practices while maintaining its special focus on railway workers and their families.
The hospital administration specifically recruited me to lead the surgical modernization program, a task requiring both technical expertise and change management skills. Many of the surgical staff were excellent practitioners but had limited exposure to newer surgical techniques becoming standard elsewhere. Similarly, the hospital's equipment and protocols had fallen somewhat behind contemporary standards despite adequate basic resources.
With the energy of a much younger physician, I threw myself into this revitalization project. My approach balanced respect for the institution's established practices with gentle but persistent pressure for advancement. Rather than imposing changes by administrative fiat, I relied primarily on demonstration and education—showing colleagues the benefits of updated approaches through my own practice.
A particularly successful initiative involved the introduction of modified early ambulation protocols following abdominal surgery. Against considerable initial resistance, I demonstrated that carefully structured early mobilization reduced complication rates and shortened hospital stays without increasing surgical risk. After implementing these protocols in my own patients with documented success, other surgeons gradually adopted similar approaches, eventually transforming post-operative care throughout the department.
Technological Adaptation in Late Career
The most visible aspect of my late-career evolution involved adaptation to new surgical technologies. Throughout my professional life, I had witnessed—and embraced—successive waves of surgical innovation, from the introduction of modern anesthesia techniques in the 1960s to increasingly sophisticated imaging modalities in the 1970s and 1980s. But the technological acceleration of the 1990s presented challenges of a different magnitude.
The arrival of laparoscopic surgery at our hospital in 1997 exemplifies this dynamic. At age 63, I undertook training in these minimally invasive techniques, beginning with basic procedures like laparoscopic cholecystectomy and gradually advancing to more complex interventions. Learning these skills required not only manual dexterity but adaptation to an entirely different surgical visualization paradigm—operating while watching a monitor rather than looking directly at the surgical field.
Many colleagues my age declined to learn these new techniques, content to continue with traditional open surgery until retirement. I understood their reluctance but couldn't imagine practicing surgery without offering patients the benefits of these advancing technologies. The learning process was humbling—my early laparoscopic procedures took significantly longer than the equivalent open operations—but perseverance eventually yielded proficiency.
By 1999, I had performed over 120 laparoscopic procedures and began training younger surgeons in these techniques. My experience demonstrated that age need not be a barrier to technological adaptation, a message I emphasized when encouraging other senior physicians to expand their skills. Several colleagues who had initially resisted eventually followed this path, creating a surgical department unusually balanced between experienced senior surgeons and technically innovative younger practitioners.
Similar adaptation occurred in my embrace of computerized medical records and digital imaging technologies that transformed hospital operations during this period. Having begun my career maintaining handwritten surgical logs and film-based radiographs, I now enthusiastically adopted digital documentation systems that enhanced record-keeping accuracy and accessibility. While the transition required considerable effort, the resulting improvements in patient care coordination made the investment worthwhile.
Teaching and Mentorship in the Sunset Years
Throughout my later career, teaching assumed increasing prominence. With decades of experience across an unusually broad surgical spectrum, I offered younger colleagues something increasingly rare in an era of subspecialization—a perspective that integrated surgical knowledge across traditional specialty boundaries.
My teaching during this period addressed not only technical skills but the cognitive and ethical dimensions of surgical practice. Regular case conferences I instituted focused particularly on surgical decision-making: when to operate, when to wait, when to refer, and how to manage complications. These sessions drew participants from throughout the hospital and occasionally from other institutions, creating a valuable forum for continuing medical education.
Between 1996 and 2012, I formally mentored 23 surgeons, many of whom have gone on to leadership positions throughout Anhui Province and beyond. My mentoring approach emphasized autonomy within a structured framework—giving trainees increasing responsibility while maintaining appropriate supervision. This progressive independence model proved particularly valuable in developing surgeons capable of practicing effectively in various settings, from modern urban hospitals to more resource-limited rural facilities.
Perhaps the most meaningful teaching of my later career occurred through the "return to basics" seminars I developed for younger surgeons. While enthusiastically embracing new technologies myself, I recognized that excessive reliance on sophisticated equipment could atrophy fundamental surgical skills. These seminars focused on techniques that remain essential when technology fails or is unavailable: physical diagnosis without imaging, surgery without specialized instruments, and management of complications with limited resources.
These sessions drew on my experiences during the resource-constrained early decades of my career, reminding younger surgeons that technology supplements but cannot replace surgical judgment and fundamental skills. The popularity of these seminars among residents and young attendings suggested a genuine hunger for this historical perspective alongside their technological training.
The Rewards of Persistence
The extended duration of my surgical practice has provided unique personal and professional satisfactions. Unlike colleagues who retired in their sixties, I've witnessed the long-term outcomes of surgical interventions performed decades earlier. Patients return years—sometimes decades—after their operations, often bringing their children or even grandchildren to meet the surgeon who had such an impact on their lives.
One particularly memorable case involved a young woman on whom I had performed emergency surgery for a ruptured ectopic pregnancy in 1973. The operation saved her life but required removal of one fallopian tube, raising concerns about her future fertility. Twenty-five years later, in 1998, she visited me at Railway Hospital, bringing her 24-year-old daughter and infant grandson. Three generations stood before me—living testimony to the far-reaching impact of a single successful operation and the body's remarkable compensatory capacity.
Similar encounters occur with surprising frequency, creating a tapestry of human connections spanning decades. Former patients stop me on the street, approach me in restaurants, or make special visits to the hospital simply to share updates on their lives and express continued gratitude. These interactions provide a profound sense of fulfillment that transcends professional accomplishment, connecting surgical practice to the broader human community it serves.
Beyond these personal connections, continued practice has allowed me to witness the evolution of surgical outcomes over time. Operations considered risky experimental procedures in my early career have become routine, with dramatically improved success rates. Conditions once considered fatal or permanently disabling are now managed effectively, often on an outpatient basis. Having participated in this transformation—first adapting to it and then helping to advance it—provides a professional satisfaction few other careers could match.
Remaining active has also preserved my connection to younger generations of medical professionals, preventing the isolation that often accompanies retirement. I continue to learn from younger colleagues even as I teach them, creating a mutually beneficial exchange that keeps my practice contemporary while preserving valuable historical perspectives that might otherwise be lost.
Facing Mortality with Professional Insight
At an age when many contemporaries have passed away, my lifetime in medicine has given me a uniquely informed perspective on mortality. Having witnessed countless deaths throughout my career—some peaceful, others difficult—I approach my own inevitable end with neither excessive fear nor artificial detachment. The surgeon's intimate familiarity with human frailty fosters a certain clear-eyed acceptance.
This perspective has shaped my approach to aging and health. I maintain realistic expectations about physical capabilities while refusing to surrender to unnecessary limitations. I follow the preventive health measures I've advocated to patients for decades, not with the desperate hope of immortality but with the rational goal of maintaining function and independence as long as possible.
My surgical background has made me an informed patient during my own inevitable health challenges. When I developed hypertension in my seventies, I approached treatment decisions with the same evidence-based methodology I applied in surgical practice. Similarly, when arthritis began affecting my hands—a particularly concerning development for a surgeon—I sought appropriate interventions while adapting my techniques to accommodate changing capabilities.
Perhaps most importantly, this professional familiarity with mortality has focused my attention on purposeful living in whatever time remains. Having seen how suddenly life can end through accident or illness, I appreciate each day of continued health and activity as the gift it truly is. The privilege of continuing meaningful work into advanced age—still helping patients, teaching colleagues, and contributing to my profession—represents a form of immortality more satisfying than any desperate grasp at extended biological existence.
Legacy Considerations
As I approach the end of an unusually long surgical career, questions of legacy naturally arise. What remains after 67 years of medical practice? What endures beyond the thousands of operations performed, most of which will eventually be forgotten as patients themselves pass away?
The most tangible legacy exists in the surgeons I have trained, who now practice throughout China and in some cases internationally. Their work extends and multiplies my own, often in ways that surpass my contributions. When former students introduce innovations or achieve academic recognition beyond what I accomplished, I feel a paternal pride that rivals any satisfaction from personal achievement.
Another significant legacy lies in the systems and protocols I helped establish at three successive hospitals. Standardized approaches to common surgical emergencies, quality assurance mechanisms, and training programs continue to function long after their origins are forgotten. The surgical department at Railway Hospital, in particular, developed under my guidance into a regional center of excellence that continues to serve patients effectively today.
My academic contributions, while modest by the standards of university professors, represent another aspect of professional legacy. The papers and presentations I produced over decades have been cited in subsequent literature and incorporated into surgical training materials. Several of the modified techniques I developed for resource-limited settings continue to be taught to surgeons working in similar environments.
Perhaps the least tangible but most meaningful legacy exists in the changed trajectory of thousands of lives impacted by successful surgical interventions. Patients who would have died or remained disabled without surgery went on to live productive lives, raise families, and contribute to their communities. This ripple effect extends far beyond what can be measured or counted, representing surgery's profound social impact across generations.
Reflections at Dusk
As the sun sets on my surgical career, I find myself reflecting on the extraordinary privilege it has been to practice this profession across seven decades of tumultuous Chinese history. From the early years of the People's Republic through the Cultural Revolution, from the reform and opening period to today's modern China, I have witnessed my country's transformation while participating in the parallel revolution in surgical care.
When I began practice in 1956, surgical outcomes that would be considered catastrophic by today's standards were accepted as inevitable limitations of medical science. Infant mortality, maternal death during childbirth, and fatalities from common conditions like appendicitis or gallbladder disease were regular occurrences. Today, these outcomes have become so rare that each instance prompts intensive review and corrective action.
This transformation occurred not through any single breakthrough but through countless incremental improvements in understanding, technique, technology, and systems—each building upon what came before. Having participated in this process for over 67 years provides a perspective few contemporary surgeons can match, a living connection to historical developments that younger colleagues know only from textbooks.
The sunset years of a long career bring their own satisfactions. The ambition and competition that drive younger surgeons has mellowed into a deeper appreciation for the art of medicine itself. Free from the need to prove myself or advance professionally, I can focus entirely on patient needs and the cultivation of the next generation of surgical leaders.
If asked what wisdom I would share from this long journey, it would be the enduring importance of balance: between technical skill and compassionate care, between embracing innovation and preserving fundamental principles, between professional dedication and recognition of our common humanity. This balance, more than any specific technique or accomplishment, represents the true art of surgery as I have come to understand it over a lifetime of practice.
As I continue to practice even now, well into my ninth decade, I recognize each operation might be my last. Rather than creating anxiety, this awareness brings a profound appreciation for the continued opportunity to serve. The sunset glow of a surgical career illuminates not only accomplishments past but the ongoing privilege of meaningful work in the present moment—a gift I continue to treasure each day I enter the operating room.
