“He has been doing this operation for more than 30 years,” the nurse anesthetist said to me about the surgeon I was observing that morning. He was performing a triple bypass operation.
He went on enthusiastically.
“Even without knowing the details, I can tell you what his cross clamp and cardiopulmonary bypass time will be for this operation,” he smiled, “well, plus or minus a few minutes.”
I looked over the drape and watched him work.
“The scrub nurse can always tell what he is going to do or ask for next. The surgical assistant knows exactly what he needs to hold or expose.”
The nurse anesthetist was right. The room was quiet. He said very little, but everyone around him knew what was happening. He made small movements, but constantly moved the case along.
An operation that has been optimized over 30 years is a beautiful sight to behold.
As a surgical trainee looking forward to the rest of my career, it is hard not to wonder what my operations will be like in 30 years.
Will I be able to inspire such confidence in my team and my patients? Will 30 years take me from where I am today to this level of excellence?
“Well, maybe one day this will be you. Of course, it all depends on what you make of the next 30 years,” the nurse anesthetist said, as if he could read my mind.
He was right. Even though we were talking about a passage of time, nothing about this process was passive.
What I was seeing before my eyes was the product of 30 years of painstakingly deliberate growth. He had been relentlessly striving to perfect his method that everyone around him could count on, especially his patients.
In fact, I could tell the surgeon was still searching for ways to further optimize his operation, even though no one around him was telling him that he needed to.
As trainees, we all have the same choice to make, every time we make an incision, every time we sew a coronary bypass graft. We must choose what to make of the next 30 years.
In some ways, we can allow our training to become a passive process. Everyone, from time to time, have felt the temptation to simply meet the minimum requirements, and to go through the motions of surgery, allowing the years of training to carry us towards the finish line. We have all at times looked to others to tell us where we need to be, and to set expectations for us.
But as we continue to better understand what it means to be a surgeon, we can choose to make the most of the next 30 years, driven internally by a desire to become better and better.
We can agonize over how to improve even the most minor aspects of the operation, discovering, experimenting, and taking pride in our own methods. Even after we become attending surgeons, when no one will be standing across the table from us to tell us how to improve, we can be the voice inside our own minds.
In watching this surgeon operate that morning, I was awe-struck by what he was able to perfect over the last 30 years.
Simultaneously, I felt a spark of excitement that as trainees we get to begin this process in our own careers today, not knowing just how far the next 30 years will take us.
The opinions expressed in this article are those of the author and do not necessarily reflect the views of The Society of Thoracic Surgeons.