What’s it like to perform surgery for the very first time?

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Sure you’ll know what you’re doing and had plenty of practice on things that aren’t people. Sure you’ve watched others doing it. But what’s it like the very first time you cut somebody open to make them healthy? Is there extra fear of messing it up? Were you fairly confident?

(This question was originally posted on Quora, and below is a selection of the best relevant answers.)

Answers:

Robert Gluck

You’re one year old and taking your first steps. Your mom holds your hand as you waddle along with your little padded tush and she let’s go. You’re walking! Yeah! It’s all heavily scripted but what do you know? Mom makes sure that you’re well protected. No stairs. No sharp corners. You fall, you get up.

Training as a surgeon, the first few times you think you’re flying on your own…hopefully you’re not. But, what about that very first time when you’re really flying solo? On the other side of the blade, the scalpel, the lancet, the knife…on the receiving end of your services, is someone you were talking to a bit earlier. Or maybe it was their family. Or maybe not. Maybe it’s an emergency and you’ve never even met! One way or another, on the other side of the knife is someone who feels, who dreams, who lives a life. Someone with a past, a present, and a future that you will help shape…or un-shape. Someone who trusts. You.

They trust you. To get it right. To do your best. And maybe your mom’s not around. Or…you are the mom. And there’s no one else to ask. The buck stops here? So, through your exhilaration, your apprehension, your fear, you need to focus…your life depends on it. Well, as it so happens, not your life. Their life! Their pleasure, their pain, their existence. You deal. You are the house. Focus. Plan. Stay a step or two ahead. Biological systems are complex. Shit happens. Shit like unexpected bleeding. Like weird anatomy. Like infection. And later…Scarring. Recurrence. Metasteses. Wet and dirty bandages. Bandages that fall off. Are too tight. Patients who don’t listen. Patients who are scared and in pain. Your first surgery doesn’t begin and end in the OR. But for now…stay focused…cut sharp and think sharp!

Laszlo B. Tamas, Neurosurgeon with ties to the Bay area and Silicon Valley.

Memory is a filter, and I think mine is more of a filter than most. Frankly, I don’t remember my first surgery as an event. I remember trepidation, clumsiness, slowness, having to think about every step, and sometimes impatience and even hostility from the supervising surgeon.

And since then, a slow, steady growth in ability, understanding, of conscious movement becoming subconscious, of befriending margins without passing them to normal brain, of having an intuitive “feel” for the brain, gray and white matter (subtle), arteries, veins, arterialized veins, and now no longer having any anxiety about cases except for the most unusual and risky. And, looking back at the “surgeon” of 20 years ago, recognizing what a dolt I was! (and maybe not being so hard on the other young dolts I come across). Read all the answers here.

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