(That's me with my sister and Mom!--- Future Heart & Lung Surgeon, circa 1960!)

I later became a volunteer at Abington Memorial Hospital when I was 15 years old and continued doing volunteer work through high school and college.  In my senior year at Cheltenham High School, I did a year-long work-study project in radiology at Abington Memorial Hospital.

 By the time I went to medical school I already had exposure to almost every part of the hospital, including the operating room, emergency room, radiology and so on  --  and I loved it.

The sciences came easy to me in college and the rest is history!

(That's me as a jock! --- circa 1973!)

When it came to to apply to medical school, I thought I would become a family doctor and so I became interested in the new medical school at Penn State in Hershey, Pennsylvania.  I pictured myself living in the country, marrying a girl named Betty Lou, and being the town doctor. 

However, I (somewhat unexpectedly) got accepted to the University of Pennsylvania and turned down the offer at Penn State.  (Please don't confuse the University of Pennsylvania with Penn State.  Both are wonderful schools, but they have nothing to do with each other.  The University of Pennsylvania is a top Ivy League school and Penn State is an excellent State school.)

It turns out that in 1980, the University of Pennsylvania did not have a family practice training program.  They used to ship the students out to York, Pennsylvania if they wanted family practice experience.  This, of course, was all before Managed Care.  Now most universities have developed strong Family Practice training programs. 

At Penn, I was exposed to many great names in surgery, many of whom became my mentors:  Drs. Jonathan Rhoads, Alden Harken, Clyde Barker, to name a few.  In addition, I found the surgical residents to be brilliant and dynamic (and a lot more fun than the somewhat snobby Penn medical residents).  Most of all, I found surgery to be thrilling and human anatomy to be fascinating.  

At Jefferson, the surgeons and the surgery residents were truly a special group.  We worked incredible hours, often every other night on duty without any sleep.  Everyone really pulled for each other.  There was tremendous teaching, pride, and camaraderie at Jefferson.

I spent 8 wonderful years at Jefferson University Hospital.  There are too many professors, residents, and nurses to thank.  I was blessed to work with mentors like Drs. Francis Rosato, Herbert Cohn, Richard Edie, John Templeton, John Mannion, Fred Armenti, Anne Rosenberg... truly too many names to list here.

It's also where I met my colleague and friend, Dr. Gary Szydlowski.  Gary has perfect surgical judgment and skills.  But he also has another great skill --he's an outstanding assistant in the operating room.  That's also probably why he won the "Teacher of the Year Award" from his days at Allegheny General Hospital in Pittsburgh.  As residents, Gary and I always hoped to work together someday.  When we perform cases together in the operating room it's truly something special.  Jefferson not only trained us well, but having been trained together, we have the same approach to surgery and we know each other's moves as if it were our own.

Before I leave my discussion about Jefferson, I would be remiss not to mention Margaret Gavigan, RN, MSN, MBA.  Margi and I met in 1984 when I was an Intern.  A brilliant and special person who went on to have a magnificent career in healthcare.  She's currently the Senior Vice President and Chief Clinical Officer at Provena Health, a large Catholic health system in Illinois.

After all my surgical training, I still often wonder what it would have been like if I pursued my original dream of becoming a family doctor.  In some ways, I like to think of myself as a surgeon on the outside and a family doctor on the inside.  That's not a bad combination! 

(Part of the great  OR Nursing Team at Lehigh Valley Hospital)

I recently have written an essay about scrub nurses, and in particular, concerning Wendy Petrohoy who is pictured above on the far right.

To see some of my editorials, click here.

The hours however truly are hard.  And, as your practice becomes more successful your hours get worse.  Keep in mind that surgeons don't only do surgery.  We also take care of patients everyday in the hospital who are recovering from their surgery and we see new and follow-up patients in the office every week.  Plus, at any moment we can be called away for an emergency.

Now that I have young children, the long hours have taken on new meaning.  Obviously, I need to find time to be with them.  It isn't easy.  The problem is that when you do a little more each day than everyone expects, soon everyone will expect more!  Fortunately, I have excellent partners who also have great families.  We work hard to help each other out so that we can all enjoy our families.

I joined the Panebianco-Yip Heart Surgeons in 1992 and made partner in 1996.  In 1999, I joined The Heart Care Group along with my partner, Dr. Ted Phillips.   Dr. James Wu joined us in the Heart Care Group in August 2001. Gary Szydlowski joined us in January 2002.  Gary and I trained together at Jefferson and planned many years ago to someday work together.

In October of 2004, we formed a new practice known as the Lehigh Valley Heart and Lung Surgeons.  Dr. Michael Szwerc joined our team in 2005 and Dr. Mehta joined our team in 2007.  In October 2011, Dr. Tim Misselbeck joined our team.  Dr. Misselbeck completed his training at the Texas Heart Institute and had the privilege of working under Dr. Denton Cooley.

Now, seven surgeons strong, we are the largest and most experienced cardiothoracic surgery group in the region.

You’re Never Alone in the Operating Room

Raymond L. Singer, MD

The operating room can be a scary place –and I don’t mean just for the patient.  For the past 20 years and after completing 5,500 operations, I walk into this hallowed sanctuary each day, scalpel in hand, knowing the tremendous responsibility I bear to care for another human being.  The night prior, I fall asleep going over the planned operation in my head, like a quarterback reviewing the game plan before stepping onto the playing field.  Only this is not a game and failure is not an option.

I remember the first time I held a beating heart in my hand.  I was a surgical intern at Thomas Jefferson University Hospital and had the privilege of working under Dr. John Y. Templeton, III.  Dr. Templeton was one of the pioneers of open-heart surgery. He had assisted Dr. John H. Gibbon, Jr. during the first open-heart procedure using their new invention –the heart lung machine—on May 6, 1953, also at Jefferson.

Dr. Templeton asked me to open his patient’s chest and expose the heart.  Every surgeon remembers his or her first day in the operating room.  I recall just standing there, praying not to make a mistake.  Of course, Dr. Templeton had seen hundreds of new surgeons in training, long before he met me. He knew I was hesitating and so he looked up at me with his surgical headlight blinding my eyes and said very loudly, “Young Dr. Singer, will you please just cut something? There isn’t anything in the human body you can break that I can’t fix!”

By now, I wasn’t breathing.  Dr. Templeton smiled and looked back down at the surgical field.  I realized at that moment, my indoctrination to the operating room had begun.  Out of the corner of my eye, I noticed the scrub nurse shaking her head, as she too had seen many young surgeons in training freeze under pressure.  I finally brought the scalpel slowly down onto the patient’s skin, my first cut barely scratching the surface –then deeper, then the sternum, until it was time to expose the heart.

With the sweat beading up on my forehead and my eyes wide open, I made a small cut into the pericardial sac holding the heart.  Slowly I opened the cavity like a child carefully unwrapping a gift.  All at once it lay before me –God’s magnificent creation—the human heart.  A glistening red muscle, the heart has an amazingly complex design, yet absolute in its efficiency.  It almost seems to churn all of its many diverse parts in different directions all at once, heartbeat after heartbeat, in an elaborate dance of life.  I was awestruck… and 3 decades later, each day and each time I hold the human heart in my hand, the emotion evoked within me remains the same.

Through it all, I never felt alone in the operating room.  In addition to the wonderful nurses, anesthesia team members, and all of the quiet heroes behind the masks, I’ve always had the calming sense that God was with me, too.  In a very real way, it’s hard to imagine doing what I do each day without a spiritual connection –without prayers, conversations, or guidance from God –and sometimes for forgiveness when my best is not good enough.  And although thankfully rare, patients whose life was lost by my hands remain with me –their faces, their families, and their goodbyes.

At the end of each week, I try to make it to Shabbat evening services.  As the Sabbath approaches, I find myself looking forward to my leaving the sanctuary of the operating room and joining my family and friends in the sanctuary of the synagogue.  By week’s end, I’m usually exhausted –both mentally and physically.  My fellow congregants know that I always sit in the last seat of the last row at synagogue because, as much I may wish to rest, I must remain on call for my patients.  Heart surgery is like no other field of medicine.  There are few handoffs.  If you operate on a patient’s heart that day, you’re on call that night for that patient.  It’s the way it’s always been done and it’s the safest.  No one knows what you did in the operating room that day better than you.

 When I sit in the synagogue on Friday nights, I mostly close my eyes and listen to the prayers and reflect.  Indeed, my favorite part of the service is the silent prayer.  I always hold my hand over my face as I immerse myself in deep thought, asking God to watch over my beautiful wife and daughters during the countless hours that I’m away from them, and to grant me the strength to continue my life’s work.  During the Mi Shebeirach, I will often provide the names of one or two of my sick patients for the congregation to join in prayer.  And during the Mourner’s Kaddish, I read aloud both for the memory of my father and for all who I could not save.

Most of all, going to synagogue gives me peace.  I’m at one with God and the universe, and with all who have come before me.  It is the realization that the universe is unfolding for all of us as it is meant to be –that we should be humbled by all of God’s work and appreciative for all of His gifts.  And even as I watch the Sabbath candles dwindle before my eyes, my own inner candle is restored once more –my strength, my love, and my faith renewed.  Amen.