To Be Or Not To Be

November 24, 2013   

To be or not to be, that is the question!

We all know that confidence and competence go hand in hand. The more competent you are, the more confident you will be in doing something. Also, The more confident you are, the more competent you will look at doing something. However, this is completely different when it comes to surgery.

The stereotypical surgeon is “decisive, well organized, no-nonsense, hard working, but also cantankerous, dominant, arrogant, hostile, impersonal, egocentric, and a poor communicator.” Their military style of leadership in the Operating Room (OR) – degradation, humiliation, and rigid chain of command – is quite frustrating for a lot of students and residents during their training. This is of course necessary for the OR to function properly since a meek and timid surgeon may be unable to command the nurses, and this could lead to mistakes that could turn into a disaster.

When I go to the operating room, all I do is watch the operation. Most of the time, I review the case with the attending before we come into OR, the anesthesiologist walks us through the anesthetic process, the attending doctor talks us through what they will be doing – Incision, anatomic structure identification, the goal of the surgery (e.g. Removal of tumor), what could go wrong and the amount of time the operation will take. Then after that, all students are left to their own devices, we just stand there and watch the whole spectacle. At first, this seems a good thing since we learn how things work in the OR, increase our knowledge and core competence. But after a few months, you get bored, frustration sets in, the operations get more technical and you are left wondering if you will ever be a good surgeon. In the process, your confidence suffers. If you ask the teachers if you can take part now that you look the part, the answer comes no. The teacher doesn’t want to face a frivolous lawsuit from a disgruntled patient. Even some teachers are as afraid as not to allow us to watch the operations at all.

Now the questions come, do you stay at the in-patient department and take part in wound dressings and attend to patients with different sets of clinical problems and have marked confidence or go into the OR to spectate? Do you participate or spectate? Do you play for a team that guarantees you a starting place or go sit on the bench for a bigger team? More confidence or more competence?

Well, I think it’s good to have confidence but competence is more important in our line of work. No doctor wants to face the prospect of telling a patient “Sorry, I don’t know.” For that reason, I prefer standing 12 hours watching operations than taking part in treating patients. I just hope and wish to take part in them too.

PS: Last two weeks have been tough, The winter has come, Changchun had the biggest snow in 50 years, we felt the after effect of this earthquake, stayed at thyroid and breast surgery department and was allowed to take part (well, watch) in only one surgery. The Good; I have decided to move my website to a VPS host and joined a gym. May be, I will write a post about both the gym and the hosting when time allows me.

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