Innovation

The ability of someone to change old ideas, to modify well-established principles, and to challenge the ordinary.

Peter F. Drucker (b. 1909), the talented Austrian-born writer, judicious observer, and teacher of management techniques, extensively reviewed the principles of innovation in Innovation and Entrepreneurship, published in 1985 [[1]]. In this book, he emphasizes and analyzes knowledge-based innovation, and expands on the key ideas of advancement of knowledge and application of technology. In as much as he believes in the “unsuccessful attempts to identify the personal traits, behavior, or habits that make for a successful innovator” [[1]], he proposes simplicity and focused-oriented activities as essential principles associated with effective innovation [[1], [2]]. We follow these ideas and search for better means to teach innovation as a way to maximize our ability to transform the ordinary in the surgical sciences into the extraordinary.

One of our advanced and thoughtful senior surgical residents had finished his daily rounds and was chatting with Dr. Mackey, his surgical career mentor. The young trainee had recently attended a national surgical congress where he incredulously witnessed the emphasis placed on the necessity of being a practical and common ground surgeon rather than an innovator. Even though it was clear to him that practicality and innovation were not antagonistic in principle, he sought the perspective of his admired mentor, surgeon Mackey. After hearing of this experience, Mackey deliberately turned to the resident with surprised eyes and exclaimed, “Innovation is everything! Let me explain what I mean. Not infrequently, you will hear that surgeons need to concentrate on what we do well and eliminate thoughts of grandiose, innovative ideas. What an incongruent, irrational, irritating thought! On the contrary, I believe surgeons need to think and practice innovation whenever possible. Innovation should be part of our daily activities; innovation is everything!” The smart resident whole-heartedly agreed, finding his mentor's confirmation both reassuring and uplifting!

Now, the difficult task—how to teach innovation to surgical residents and faculty, how to exalt its virtues and how to proceed in the effective practice of innovation? The great enthusiasm of surgeon Mackey, admittedly a fictional character, should be contagious and worth imitating [[3]]. In the past, creative and innovative surgeons have been a frequent source of our writings. Indeed, we can refer to many inspiring examples, in particular to the Nobel Laureate Surgeons [[4], [5], [6]]. This dedicated group of individuals demonstrates a whole range of innovative abilities and exemplify a life of innovation.

For a brief moment, consider the unique qualities of these Nobel surgeons. Certainly, innovation is one of them together with commitment, determination, and focus [[5]]. These qualities, each important on its own, require the others to reach the potential climax of success so evidenced by these accomplished surgeons. Charles Huggins, one of the nine Nobel surgeons, would remind his students daily of the importance of discovery by asking, “What did you discover today?” [[7]]

From a practical point of view, what is the most effective way to teach innovation so everyone participates in the experience? How do we excel through innovation? How do we improve our professional practice by using innovative principles? There are no simple answers, but being part of the experiment justifies the effort. First, an annual course of theoretical lectures dealing with innovation should be instituted. Second, a series of books and papers about innovation, obtained from the business literature, should be included in the curriculum. Third, during rounds, in conferences, and in the operating room, innovation should be a topic of frequent discussion. Finally, residents should be required to write a paper or present a lecture dealing with innovation. If these suggestions were incorporated into residency programs, our residents would be better prepared to serve as the innovative surgeons of tomorrow. It is feasible that our residents would develop habits of change and improvement. It is feasible that our residents would be agents for enhanced operative techniques and surgical management.

Before concluding, we could receive some lessons from the greatest innovator of all time, Leonardo da Vinci (1452–1519). Can da Vinci teach us some practical and applicable lessons? Was he seeking innovation continually? Did he cultivate some principles that allowed him to innovate effectively? The most plausible answer is yes for each of these questions. Yes, da Vinci qualifies as a competent teacher of innovation, in as much as he pursued it throughout his lifetime. Yes, he cultivated solid principles to reach heights of excellence in innovation and pure knowledge.

Da Vinci was his own man, unafraid to challenge authority. He questioned old and new principles that did not conform to his expectations. His continual quest was to reach the truth. He was a consummate experimenter with wide-ranging curiosities. He acted based on knowledge and experience [[8], [9], [10]]. According to one of the great students of da Vinci, Michael Gelb, the master considered himself a discepolo della esperienza (disciple of experience) [[10]]. Though da Vinci was not a scholar or academician, he occupied himself in gathering knowledge and actively searching for answers to critical questions. His guiding principles were independence, curiosity, originality, quest for knowledge, and determination. Da Vinci's life and virtues demonstrate how we can improve our innovative skills in daily professional practice.

Thomas Alva Edison (1847–1931) embodies the classical example of American innovation [[11], [12], [13], [14]]. He and another distinguished American, Benjamin Franklin (1706–1790), were the most notable heroes of innovation on the American continent. Both of them produced many works of great significance. For this writing, I concentrate on the good deeds of “The Wizard of Menlo Park,” as Edison was known in New Jersey where he lived [[11], [12], [13], [14]]. Starting with the telegraph, the phonograph, the dictaphone, and the electrical lamp (incandescent light bulb), he completed 1093 successful patents in his lifetime, an unmatched record. Edison was an innovator's innovator all his life. He lived and breathed innovation. He was a practical man who saw needs and took advantage of the opportunities to fill them. His virtues were those of perseverance, full commitment, dedication, focused planning, and the desire to succeed at all cost. These significantly special characteristics distinguished Edison as “the innovator of the millennium” [[12]].

As a way to continue the extraordinary legacy of Thomas Edison, the Edison Preservation Foundation organizes the annual Edison Innovation Conference, where the Edison Innovation Awards are given to those especially gifted individuals who have pursued and demonstrated “Edison's legacy of entrepreneurship and innovation” [[11], [12], [13], [14]]. Given Edison's unique life and superb accomplishments, it is not hard to admire the man who is considered to be the “inventor of the 20th century” and the “father of modern invention” [[12]]. Without doubt “his genius paved the way for the development of the computer, cell phone, and compact disk” [[12], [13]]. His brilliant example capitalizes on the best virtues a person can possess as a dedicated innovator [[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16]].

Like surgeon Mackey and the interested resident, we can ponder the potential benefits of this especially important and infrequently cultivated virtue of innovation. We, like they, attempt to define and characterize innovation as it differs from creation and discovery. One way to separate the three qualities of innovation, creation, and discovery is to consider innovation as an agent of change, creation as an agent of developing something new, and discovery as a mechanism to encounter something that was not known to exist before. In this form, you can be an innovator, creator, and discoverer simultaneously, or you can be an innovator and not necessarily a creator or discoverer. Each one, I believe, has its special characteristics and well-defined boundaries. Today, we are talking about the possibilities of incorporating only innovation into professional activities. Surgeon Mackey would claim there is much more to discuss. Still, he and his younger colleague could depart having explored new and enhanced possibilities for integrating innovation into surgical practice.