YES, MASTER!

Have you seen those Kung Fu movies, where an enthusiastic student searches for the ultimate master of a Kung Fu style, so that he can fight the bad guys who’ve wronged him? Learning surgery is exactly like that. The master is often very different from what the student expects. He might be a hard-ass, who makes the student hate him, only till the end, when the student actually realizes how much he has learnt and changed. True masters are rare in surgery. True teachers are rarer.

The face of the surgical unit that I am part of is changing drastically. From the first of January, I will be the only one left in my unit, who was there originally when we started in May. The exit and entry of new teachers made me wonder about how surgery is taught and learnt in our hospitals.

In the beginning it takes a while to just get used to the body that’s deeper than skin. Just holding instruments and internalizing them takes months. Soon, the hand starts to work subconsciously. You look at the problem, and that’s all you look at, for the instruments are just extensions of your fingers.  And that’s when you start to understand the difference between those who teach you.

Some surgeons are fast in their manner. They go through the procedures in surgery like darts. Other’s are slow and meticulous, taking their time with every step of the process. Don’t get the wrong idea here. Both kinds are excellent surgeons. I believe speed is a matter of practice yes, but after a point it’s more a matter of character.

There are standard textbooks of course, but no other branch in medical science provides as much independence and ambiguity as surgery. Once you perform a procedure, it is yours. It is your imprint on that person for the rest of that person’s life. Did you use two sutures or one? Did you give a subcutaneous stitch, a mattress suture or just a simple knot? Did you cauterize the tissue or did you dissect it with the scissors, or even with your fingers? Did you skeletonize the structures? Did you clamp them together? The variations that are possible with every single part of every single procedure seem endless. And the more the masters that teach you, the more the variation, the more the styles.  But just like that, subconsciously and before you can put your finger on it, you have a character of your own.

One of my master’s once asked me when I thought I’d become a surgeon. Would a degree, a Masters in Surgery, make me a surgeon? Or adequate practice in a certain procedure? No matter how many procedures a student learns, there are more that he hasn’t, and there are more ways of doing one than he can learn. I believe, that you call yourself a surgeon when you are comfortable with providing the solution. When you don’t stand limply in front of a suffering patient, when something surgical from your side can save him. Even, if all you can do, is make constant calls for help.

You become a master, when you can do this, calmly, swiftly and precisely.

So here’s to the masters that have taught me, and those that I look forward to. May I prove a worthy disciple, and come out a master in my own right someday.