It's well past 2 a.m., Toronto time. Starting work on this website felt like finally facing a piece of homework I'd been putting off — and with it came an unfamiliar flutter of excitement, and memories of the residency years when I first set foot in urology.
Looking back, my training schedule was borderline murderous, and I was never a warm or gentle doctor to my patients through it. I got through my first year on one resolve alone: if I lacked skill, I'd make up for it with sheer effort, so as not to burden my patients. I remember pushing the dressing cart through the ward at 4 a.m., and elderly patients well into their seventies pressing crumpled bills into the pocket of my worn white coat. It was a common enough scene back then, but the quiet guilt that pressed on my chest every one of those mornings has never quite left me.
The reason I applied for a pediatric urology fellowship after residency was just as clear: the sheer urgency of "I have to learn more." Training conditions were rougher back then, and the fear that I might do irreversible harm to a patient while practicing under-prepared, under a specialist's title, weighed on me heavily. I chose pediatric urology, resolving to learn a little longer under a mentor I'd long admired from my residency years — Professor Sang-won Han.
The life of a fellow turned out to be no easier. As resident numbers shrank, ER call duty fell to fellows; nights on call bled into full days in the OR, which bled into late nights writing papers, which bled into obligatory dinners with no room to decline. It was a harsher schedule than residency itself, but I got through it on the satisfaction of having research recognized at conferences and watching my own hands grow more capable, one technique at a time. Once I was appointed as university hospital faculty, I first grew anxious about building up a patient base — and once the clinic did fill up, I found myself wrestling with the limits of my own stamina instead, wondering how I could properly care for so many patients at once.
Watching countless surgeons over twenty-some years at a university hospital, I've come to believe a good doctor needs exactly two things. First: a doctor without skill can never be a good doctor. No amount of warm empathy or sweet reassurance at the bedside changes the fact that incompetence translates directly into physical harm. Second is something a visiting fellow from Uzbekistan — Savar — once left me with. A few years ago, I asked him half-jokingly what he thought mattered most in becoming a good surgeon. Among the answers, one word stayed with me: "Humanity." I've watched surgeons with brilliant hands, surgeons with vast experience, surgeons who simply refuse to quit — each with a strength of their own. But the one non-negotiable quality that separates a "good surgeon" from a "great surgeon" is a genuine regard for the patient. Without that foundation, a doctor reflects on nothing, feels no responsibility for their own shortcomings, and can never carry full responsibility for a patient.
I believed that even without much warmth to offer, holding real care for patients deep down and refusing to compromise on skill would be enough to make me a good doctor. But the world changed, quickly. In an era when access to medical information is incomparably easier than it once was, I began to feel the limits of my own approach — one that, if I'm honest, still resembled the outpatient clinic patterns I first observed as a student twenty years ago.
The real problem facing outpatient clinics today isn't an imbalance of information. It's the absence of any process to refine the overwhelming amount of it.
Over 90% of the parents who walk through a clinic door have already searched the internet exhaustively, and 20–30% have already been seen at another major hospital. When that fragmented internet knowledge, or a hazy memory of a previous explanation, conflicts with the actual diagnosis, parents show real confusion and distress. But the outpatient system simply doesn't allow the time it would take to fully talk them through it.
There has always been a quiet thirst in me for a refined archive — something to substitute for the explanation the clinic's physical constraints never leave room for, something to keep parents from losing their way in an ocean of information. Alongside it sat the frustration I've felt teaching students and residents with textbooks that never quite matched the reality of practice, and a personal wish, held since I was a student, to write and to keep a record.
The fellowship I was fortunate enough to receive in Canada became the chance to finally act on that long-held thirst. And so this space, The PedsUrologist, begins. I hope it becomes a steady standard for parents unsettled by unrefined information, and a living clinical foothold beyond the textbook for students and residents working through sleepless nights. And I hope, too, that it becomes an honest place to share the small reflections of one surgeon along the way.