Teaching Surgery

Teaching Surgery

(This is an excerpt from my new book, “Heart, Guts & Steel: The Making of an Indian Surgeon“)

I was assisting my Junior Resident with her first hernia repair. And it was moving along at a snail’s pace.

From time to time, I was tempted to urge her to hurry up. “If you stick with this, we’ll be here until dinner time!”

But I left the words unspoken.

Better surgeons than I had been patient with me while I learned to operate. Now it was my turn to return the favor. So in a quiet tone, with no trace of the irritation within, I asked her: “What are you worried about?”

She looked up from the table. “I can’t see the spermatic cord clearly.”

After doing over one hundred hernia repairs, I knew that the critical structures of the cord were miles away, figuratively speaking. But then, to a beginner surgeon, it was natural to worry because everything was crammed into a space barely 7 to 10 millimeters wide.

“Listen,” I said. “Hold up the hernia sac with your fingers. Spread it out.”

“Like this?”

“Perfect. Now, look at it against the light.”

She tilted her head and bent down, the bright glow of the operating lamp shining through the translucent structures and clearly defining the border of a hernial sac.

“Wow! I can see it so nicely.”

I felt a thrill of satisfaction. It’s the feeling every teacher experiences while conveying a precious lesson to his student. Be it a minor tip or a life-saving trick, the transfer of knowledge is exciting.

“Okay. So you know where to dissect. Let’s go.”

In just a few minutes, she had isolated the sac and was ready to begin the repair.

While she deftly inserted the stitches that would support the abdomen wall and prevent a recurrence of the hernia, my mind skipped back to the dozen repairs I had suffered through before a co-resident taught me this neat trick.

In surgery, you don’t have to reinvent the wheel – if you have teachers who will show you how to operate. But if you’re unlucky and have to figure things out on your own, it can be a long, painful haul.

Thirty minutes later, the repair was nearly finished. For a first-timer, she hadn’t done too badly. There would be dozens of refinements to her technique and skill. But that came later. For now, there was the warm glow of content from an operation well done.

“Good work. It’s a nice repair.” I smiled.

Her face beamed under the mask that covered everything but her bright, shining eyes.

“Thank you. You made it happen.”

I did? I wonder. But then, maybe, in some small way, I did.

My eyes, too, shone.

 

(This is an excerpt from my new book, “Heart, Guts & Steel: The Making of an Indian Surgeon.“ You can read another section of it in this post, ‘Crisis’.)

Heart, Guts & Steel - The Making of an Indian Surgeon

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