CHAPTER 1

The Life and Views of aSurgical Salesman

An Overview

After graduating from high school, I enrolled at theUniversity of Kansas. I studied journalism and English.In 1971, I graduated with a bachelor of science injournalism. I was ready for the business world andall the exciting opportunities that were soon to bemine. At least, that was my perspective as an immaturecollege graduate.

I will never forget a conversation that I had with myfather at a party after college graduation. During theconversation, he said that there are four kinds of peoplein the business world. There are liars, whores, pimps,and thieves. And that they will do anything for money,power, and sex. He stated that if you are able to find agood, honest businessperson as a mentor, you will bea blessed person and enjoy your work. If not, your lifewill be a living hell. With that, he further emphasizedthat it is more important for whom you work ratherthan where.

As a very young man, I did not really understand thatthose words were pearls of wisdom. I was eager tocapture the world. But I was too naïve to understandthe world that I was about to enter, and how difficultthat world would be. Now, after forty years in thebusiness world, mostly in health care, I realize howbrilliant my father was. I understand how true thosewords of wisdom really are.

Since 1975, I have been employed as an OR surgicalsalesman. During that time, I have worked for severaldifferent surgical companies. Besides the OR, I haveworked in every procedural area in the hospital,including obstetrics, cardiac catheterization lab, GIlab, and the emergency room.

In my sales career, I have sold sterilization productsand sterilizers, antiseptics and disinfectants, surgicalscrub solutions, surgical drapes, surgical gowns,ECG electrodes, wound care dressings, surgicalinstruments, and surgical equipment. I have conductedhundreds of regular product in-services and lecturedhundreds of CEU educational programs for OR nursingstaffs. I have worked in and assisted in thousands ofsurgical procedures. And I have witnessed every kindof operation that can be performed, including an SRS.That is sex reassignment surgery, or a sex changeprocedure.

My ability to gain access into the surgical sales fieldwas a stroke of luck. Years ago, most companies thatmanufactured and sold surgical devices required thatcandidates have prior surgical sales experience beforethey would hire you. I had never worked in the medicalfield. I had no prior surgical sales experience. If youdo not have surgical or even medical sales experienceand cannot be hired, how do you get surgical salesexperience so that you will be hired?

I was employed with one of the larger and moresuccessful consumer product companies in the world.They manufacture and sell a variety of cleaning productsto retail, institutional, and industrial consumers. Iworked as a sales representative in their institutionaldivision. The company wanted to start a surgicaldivision, and I was asked to join. I was one of fivesalespeople, out of over thirty thousand employees,selected to start and operate this new division. Itsounded exciting, and I accepted the offer. Heck, itwas a nice increase in salary. And I believed that itwould be a more prestigious position. Who would notwant to have an increase in pay and advancement inposition in the business world?

I received my first surgical training at a world-renowneduniversity hospital in a large southern state. The trainingwas conducted by the nurse educator for the hospitaloperating room. She was extremely experienced andsavvy. She was very professional and took her nursingresponsibility seriously.

Most OR nurses are very serious about their profession.They are very dedicated to and feel very passionateabout patient care. My nurse educator was an ardentmember of the AORN, or Association of periOperativeRegistered Nurses. The AORN is an association that isvery important to all OR nurses. It is this organizationthat strives to improve patient care in the OR and activelyworks to maintain and improve safety standards.There are chapters in every city or county area acrossthe United States.

My first round of training lasted for three weeks. Therewere many topics and subjects to learn. We were taughtthe proper attire in the OR and how it should be worn;patient privacy issues; OR sterile fields; movement inand out of the OR; conduct in the OR suite; principlesregarding asepsis, infection control, and safety; andfire risks. We were not allowed in any working OR, toactively view any surgical procedures, until after thefirst full week of training. There was a lot to see andabsorb. There would be many more training coursesin the months and years ahead.

My first day working in the operating room and viewingsurgery was quite an overwhelming experience. I didnot become nervous, ill, or feel faint. That is commonfor first-timers in surgery. It was the incredible array ofprocedures that I witnessed. The first procedure that Iobserved was a disarticulation below the right knee. It isalso known as an amputation. It was slightly shocking.The second case that I monitored was an abdominalhysterectomy. Not as riveting as an amputation, butunnerving. It was the third procedure that shocked mebeyond belief!

A teenage man was brought into the OR to have backsurgery. It was a trauma case. He was involved in a caraccident and arrived at the hospital by ambulance. Hewas immediately brought to the OR from the emergencyroom. The OR team took him from the ER stretcher,placed him on the surgical table, and began preppinghim for surgery. Within minutes, he went into cardiacarrest. Immediately, the OR team began CPR and wentfor the crash cart. The mood in the OR quickly changedfrom relaxed and congenial to emergency mode. Loudvoices, direct mandates, and quick actions prevailed.The circulating nurse told me to immediately leave theroom. I quickly responded to her mandate and went tothe OR nurses' lounge.

Approximately one hour later, she came to the loungeand told me that the young man had expired. Shecould see that I was quite shaken. She was very kindas she explained to me why I had to leave the OR andthe appropriate protocol under those circumstances.She also taught me a valuable lesson that day. Shesaid not to take anything that you see or hear in the ORpersonally. She said that the yelling and shouting thattranspires during any OR situation is not personal—itis situational.

I went back to my hotel room that night emotionallydrained and physically exhausted. I wondered if thiswas a job that I wanted to continue. I made a promise tomyself to stick it out. I did not want to quit and wonderlater if I had made a mistake. And I remembered theadvice that was given to me by that OR circulatingnurse. It helped to lessen my anxiety. I have neverforgotten that advice or my first day in the OR.

I held a sales position with my first surgical companyfor four years. It was quite a learning experience andprovided me entrance into an amazing selling society.However, I was ready to move on to another company. Idid not enjoy the management by intimidation and fearphilosophy that the company practiced. I hoped to finda company that subscribed to a different philosophyand stay in the surgical field. I loved the medicalenvironment and working in surgery.

I quickly found another job through a recruiting firm.It was with a company in the surgical field. And, as Iwould learn, that management team treated employeeswith respect and integrity. I also found the businessmentor that my father discussed with me years before.For the next twenty years, my business life would bea wonderful learning and growing experience with mymentor.

I enjoyed my new employer and my new sales position.The company was well established in its surgical niche,and it manufactured the highest quality products. Itwas the world leader in its field in the surgical industry.My business success was more than I could ever haveenvisioned. I relished waking up every morning andgoing to work.

David, the gentleman who hired me, was just that. Hewas a gentleman. I never heard David say a negativeword about anyone. He treated everyone with a uniquesense of respect and dignity. He led by example withevery conversation, presentation, and interaction thathe performed. For me, a young man finding his wayin the business world, David was the perfect person toemulate. I could learn the proper and ethical way thatbusiness should be conducted.

More than once David proved to me that he was a manof genuine character. I remember a sales promotionthat he was conducting with the sales force. Mostcompanies do these promotions to make selling funand allow the salespeople to earn some extra cash.There also are bragging rights associated with winningthese promotions. Salespeople are very competitive.Don't let anyone convince you otherwise.

I won the sales promotion by making a huge sale toone of my university hospitals. The order was so largethat it could not be filled by my company. And to makethe problem even worse, the entire line of product thatI sold was placed on a recall. No product to sell orship, with any company, means no commissions forthe salesperson.

I received a phone call from David. He congratulatedme on the large sale and winning the promotion. Hesaid that he had some bad news and some good news.He wanted to know which I wanted to hear first. I saidthe bad news. He said that the company would notbe able to pay me any commissions because of theproduct recall. I said that I was disappointed; however,I understood. I asked him the good news. He saidthat the good news was that he would pay me thecommissions.

I almost fell over. He was going to pay me severalthousand dollars in commissions out of his own pocket.I told him that he did not have to do that. He said thathe did. He said that when he hired me, I became partof his business family. He said that the product recalland the company's inability to fill the order was notmy fault. He emphasized that I made the sale and thatI deserved to be paid. After that act of kindness andgenerosity, I would do anything for him.

David and I successfully worked for that companyfor ten years. Sadly, the business world changesperiodically. David saw that his time was up with ourcompany and that it was time for him to move ahead.When he announced that he was leaving, I told himthat I wanted to go with him. He said not to worry; hewould call me. In fact, out of fifty salespeople in ourdivision, all fifty wanted to go with him. No one knewwhere that would be, but it did not matter. We wouldhave followed him anywhere.

David was not out of work for any length of time. Heaccepted a position as national sales manager with asmall but growing surgical company. He called oneday to offer me a sales position. I said yes withouthesitation. That quickly, the world was right again.

Joining a new company and selling different types ofsurgical products meant more surgical and producttraining. The next series of training was not conductedin the OR. It was held in classrooms with a surgicaltraining company. This training session was titled,"Codes of Conduct and Safety in Patient Care Settings."

Seminar topics included: patient rights and safety(HIPPA), role definition/codes of conduct, pathogensand blood-borne viruses, infection prevention, standardprecautions, principles of asepsis, hazard protection,and fire safety.

For another ten years I prospered, learned, and grewfrom David's example. Unfortunately, he had to retireearly for medical reasons. Suddenly, the man whotaught me a lifetime of ethical business professionalismwould no longer be there.

I could never thank David enough for the lessons thatI learned from him—and not just from a businessperspective. He taught me life lessons. He taught meto be honest and humble in everything that I do inlife. The last time that I spoke with him, I said thankyou and good-bye. It was a wonderful conversation,although it was one of the sadder days of my life. I havenot spoken with him for several years. I hope that heis doing well.

I stayed with that company for another thirteen years.There were several management changes during thattime. The managers came, failed, took their options,and left. It happened repeatedly. The company wasfloundering and doing nothing to improve the workingenvironment. Business was not fun anymore. The sameold management philosophy of intimidation and fearkept appearing. I realized that the greatest obstaclethat I had in performing my job and being successfulwas my own company. That was a sad awakening.

The one constant that kept me interested in work wasthe operating room. It was like an addictive drug. Withthe operating room came excitement and fascination. Itmade you feel that you were participating in somethingmeaningful. It required continuous training. I wasconstantly studying and learning about new surgicalproducts, anatomy involved in specific procedures, andthe step-by-step performance of the surgeon duringthose procedures. I was tested on products, technicalspecifications, and how and why instruments wereused. It was never-ending. I loved it. It helped keepme going.

The operating room is a world unto itself. It is a worldbehind double doors. You will easily recognize wherethe operating room is. There is usually a sign that says,Stop! Do Not Enter, OR Personnel Only. It is a secretiveand cloistered world that most people enter only whenthey have a surgical procedure performed. Most peopleknow or understand very little about that world.

The secretive nature of the OR is intentional. The peoplewho work in the OR follow a strict code of silence.You are not supposed to speak about procedures orpatients outside of the OR suite. There is never tobe conversation relating to any surgical procedure inelevators, hallways, waiting rooms, or dining areas.There could be a relative or friend of a surgical patientwithin ear range. Overheard conversations aboutpatients may be a violation of their privacy rights andcould be fuel for a lawsuit.

This manner of conduct is understood by every hospitalemployee from the housekeeping staff to nurses andmedical students. During my first week of surgicaltraining, I was in the cafeteria eating lunch. Sitting atthe table next to me was a group of first-year medicalstudents. They were talking and laughing about someof their patient cases. One of the head nurses fromthe OR happened to be walking by and heard theirconversation. She instructed them to follow her. Tenminutes later the group returned. There was not asmile on any of their faces. Not one of them said aword. I can only imagine what was said to them inprivate.

I believe that the majority of people who are goingto have surgery do very little research about theirsituation. They know very few facts about their hospital,the OR suite, the OR nursing staff, anesthesia, or theirrecommended surgical procedure. But most astoundingto me, they know nothing about the attending surgeonwho is about to invade their body! I cannot imaginecommitting yourself to surgery without doing extensiveresearch on everything and everyone involved in theprocess. If you do no research as a patient, you willassume the worst and anxiously await your doom.

No one looks forward to being admitted to the hospital.And the thought of having to undergo a surgicalprocedure conjures up the worst fears and anxiety.Those fears and anxiety are understandable. It isnatural to have a fear of anything that is unknown.We have heard horror stories of mistakes that occurin surgery, and we can visualize one happening to us.However, if you take the time to research and educateyourself about the surgical world, you will lessen yourworries and fears. An educated patient is a confidentand relaxed patient.

There is no average day in the OR. Each day is a dayof miracles and tragedies, joy and sadness, successand failure. Many thousands of surgical procedures areperformed every day in the United States and acrossthe world. The procedural specialty fields includegeneral, neurosurgery, orthopedic, vascular, urology,gynecology, plastics, thoracic, and obstetrics. Withineach specialty comes new advanced techniques andinstrumentation.

The rate of technique change in the surgical fieldoccurs at a staggering rate. What was the standardpractice six months ago is now outdated and passé.New instrumentation and modified technique are theconstant norms.

The vast majority of surgical procedures performedrun smoothly and have successful outcomes. Andthe reason for the high success rate is due to theknowledge, training, expertise, and professionalism ofthe OR team. Each member has spent years in trainingto achieve a license or certification in a specialty field.And each member spends many hours in continuingeducation courses, in-services, and seminars. This isa requirement to maintain a valid and current licenseor registration certificate.