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What’s Important: Being Present

Krueger, Chad A. MD1,a

doi: 10.2106/JBJS.16.01254
The Orthopaedic Forum

1Womack Army Medical Center, Fort Bragg, North Carolina

aE-mail address:

“How was deployment?” As a military orthopaedist, this is a question I got frequently from family, friends, and colleagues after recently returning from overseas. Many curious orthopaedic colleagues wanted to know what type of cases I had completed, whether I thought service overseas made me a better surgeon, or what it was like to be “over there helping all those injured service-members.”

When I answer, I’m a little embarrassed to admit that I was not deployed to an area that is recognized as a “combat zone.” The closest I got to trauma while deployed were a couple of ankle fractures. I saw plenty of clinic patients and walk-ins with various aches and pains, but it was not a very busy orthopaedic practice. This relatively slow pace left me with a lot of time to think.

I thought mostly about my family. While I was fortunate enough to have access to technology that made keeping in touch with them pretty easy from where I was stationed, the bottom line is that I was thousands of miles and multiple time zones away from the people I love most. Amid this longing to be with my family, I realized that it was not so much that I wanted to talk to them. I simply missed their presence. And that is when I started to wonder—how much of my presence does my family really get when I’m actually home with them?

Like many of us, I struggle with maintaining equilibrium between home and work. I love what I do for work, but I know that all too often I prioritize work at the expense of family. I am always trying to be better at my profession, and there is always another patient to care for or a professional goal to accomplish. But while I was deployed, I began to wonder whether some of those strivings came at the expense of my personal relationships. I had time to recognize that I frequently half-listen to conversations as I think about an upcoming case, type on my computer as my son plays by himself, or stress about an upcoming project instead of enjoying a family dinner. In short, even when I am physically home, I am often mentally and emotionally absent.

I have known this about myself for a while, and I have often tried to convince my wife (and myself) that I have changed. But while overseas, I admitted that I hadn’t. I was, for the most part, following my dream of being an orthopaedic surgeon. My life was largely fulfilled. But what about my family’s life? We chose where we live based on my job; scheduled activities around my meetings, clinics, and surgeries; and occasionally “didn’t bother dad” so I could do what I “needed” to at home. I began to wonder whether this was the life that my wife envisioned for us when we got married. It took being deployed to finally and fully recognize that the answer was probably “no.”

So I took more than 3 weeks of leave when I returned home from deployment. I can honestly say that it was the best 3 weeks of my life. Like many of you, I had not had 3 weeks off from work since before I started residency, and much of the time I had taken off since then typically included attending an orthopaedic meeting. Even during vacations from work, I usually brought along something that I needed to complete for work. Not this time. We took some trips, we spent a few lazy days at home, and, more than anything, we were a family. And this time, I was present.

What do I think this means for me as an orthopaedic surgeon? I love caring for patients, being involved in research, and being fully invested in my work. Also, as a young orthopaedic surgeon, I feel it is vital to my development to be as busy clinically as I can be in order to hone the skills and knowledge that I gained as a resident. This, for better or worse, means that many of the other facets of my life get put on the back burner from time to time. I recognize that, and I am blessed to have a family that supports me as much as they do.

However, I also know that I can be more fully engaged with my family—be present—when I am not engrossed in work. Just as what I do now clinically as an orthopaedic surgeon will shape my career path, what I do now as a husband and father will also shape my future personal life. With a commitment to be present, I can delay a research project by a day or 2 in order to play with my son, and the project won’t rot. I can put down the journal I’m reading to actually pay complete attention to my wife as she talks to me, and the printed words will still be there when I pick it up again. I can be fully committed to my patients as an orthopaedic surgeon but also be fully committed to my family.

Most importantly, my deployment was a reminder that I take my family, and the very fortunate life we live, for granted all too easily. I’ve come to realize that every day they choose to spend their lives with me is a gift and, at any time, that could change. I need to do a better job of showing my family and close friends how important they are to me by actively taking part in the minutiae of everyday life—even when it conflicts with my profession. To paraphrase 1 of my mentors, the patients I treat and the research publications I produce will not show up at my funeral, but I sure hope my own family members will.

So, how was deployment? It was great. I don’t know how much better I am as a surgeon or even as an officer in the military, but I know for a fact that I’m a better husband and father because of it. And at the end of the day, that’s really what’s important.

Disclosure: No external funding was received for this study. The Disclosure of Potential Conflicts of Interest form is provided with the online version of the article.

Disclaimer: The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Copyright © 2017 by The Journal of Bone and Joint Surgery, Incorporated