In 1977, Dr Wilfred (Bill) Bigelow, the father of cardiac surgery in Canada, noted, "There is not a hospital or centre in the world that has contributed as much to the development of the whole field of cardiovascular surgery than the Toronto General Hospital." 1 There are two ways to look at the early days of cardiac surgery. One, as envisioned by cardiac surgeon Dwight McGoon at the Mayo Clinic, is lyrical. "Cardiac surgery represents a challenge in surgical technic [sic] comparable to that of

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... the music of Liszt to the pianist, the Olympics to the athlete or Mount Everest to the climber. The reward of the surgeon is not only the thrill of accomplishment, as it might be to the musician or athlete or climber, but is also the health and happiness of many of his patients." 2 The other is realistic. Cardiac surgery is a difficult, demanding profession. It demands technical expertise and an ability to lead an integrated team through often complex, high-risk operations and unexpected emergencies in the operating room, the intensive care unit, and the ward. Of the surgeon, it requires personal qualities of determination, physical durability, courage, curiosity, optimism, flexibility, patience, humility, resilience, and compassionate support of patients' families and other team members when patients die. When a patient does die in the face of best efforts, a cardiac surgeon must not take this personally but must learn from the experience and move on. Today it is recognized that the frequency of "burnout," depression, substance abuse, and suicide within the medical profession is significantly higher than in society generally. It is estimated that for every one hundred promising young medical students and resident doctors who aspire to be cardiac surgeons, one succeeds.