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Are we surgeons finding it all too much? Dealing with the pressures of our profession
  1. C Niek van Dijk
  1. Correspondence to Professor C Niek van Dijk, Academic Medical Center, Amsterdam 1105AZ, The Netherlands; C.NiekvanDijk{at}

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We all agree that a review of the literature should be systematic and not selective. There is one field in which - I must admit - I have always allowed myself a selective read and that is on the positive effect of red wine on health. I love those steps down to my wine cellar to choose my daily ‘medication’. But now there is no way to ignore it. A proper analysis of 599.912 current drinkers, published in the April issue of the Lancet, has demonstrated that there is no protective effect of alcohol on cardiovascular disease.1 In fact, modern DNA techniques demonstrate that alcohol contributes to poorer health from the first pint! The outcome of the Lancet study provides a basis for further reduction of the health advice for alcohol to a maximum of 100 grams per week for men. Current recommendations are much higher in many countries; for example, in the US, the directive sets a ceiling of 196 grams per week for men.

How does this affect our profession? It has been shown that there are more heavy drinkers among physicians than among the general population.2 This reminded me of a situation early in my career -back in the eightees- when I was invited for a live surgical demo. There I was, far away from home. The operating room and instrumentation seemed antique, and the nurses were chatting an unknown language. Twenty orthopods were standing around the OR waiting for me to demonstrate an ankle arthroscopy. In talking with the anesthesiologist, I noticed a heavy smell of alcohol. It was 2PM. What was I to do? I took my host aside, but he reassured me that he ‘works better after a few beers, it’s normal’. I accepted and performed my demo. My public was happy …

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