Kern Singh, MD, of Midwest Orthopaedics at Rush, and J. Brian Gill, MD, MBA, of Nebraska Spine + Pain Center, share challenges they have faced in their careers.
Dr. Singh: I would say that in my brief 10 years as a spine surgeon I have had multiple major challenges. The one that is the most significant, however, is a challenge that
most surgeons deal with on a daily basis. Balancing research and academic commitments, a busy spine practice and a family are something I struggle with every day.
When I first started my career, I was single and could provide all my energy towards building my practice and research. As time has gone by, six years to be precise, I have since married and have two beautiful children. My wife has helped provide balance in an otherwise imbalanced lifestyle. I am now very selective about which meetings I attend, present or am involved in. Weekends with my wife and family take priority. I have cut back on my practice to make sure I am home in time to see my two children almost every night.
I try to carve out a few hours every night with my wife to catch up on the day and life in general. Fortunately, sleep is not something I need much of. My father once told me the only people who remember you in the end are your family — words I try to live by today. Amazingly, when you pause from the rigors of operating, clinical practice and academics you realize there is a world outside of all those stresses that continues with or without you. I have just chosen to be more involved in that other world and to be like my father who was always there for me when I was growing up. I still struggle with being available for my wife, but that's an evolution she has been helping me through.
Dr. Gill: This is a very challenging question in which I do not think that I have completely answered and still struggle with at times. I have had and will continue to have 
challenges in my career. I think that one of the hardest things to figure out as a spine surgeon is who to perform an operation on and who to treat from a nonsurgical standpoint. This is the art of medicine.
Someone told me in residency that as surgeon, you will figure out how to do the operations quickly, but deciding on whom to operate on will be a lifelong challenge. The other obstacle that I face is when I have to confront a patient and their family when nothing can be done from a surgical or nonsurgical standpoint to alleviate the pain that they are experiencing.
As a physician, we want to help others and, in particular, spine surgeons want to treat pain, deformities, and/or neurologic dysfunction. However, the treatment can sometimes be worse than the actual problem or potentially cause more harm than good.