As a surgical resident, I had the opportunity to work with more than 100 surgeons in the operating room over a 7-year period of time. This gave me a wide exposure to varying surgical skill levels, attitudes, and tactical approaches. Not every surgeon is the same. This often comes as a surprise to the public at large. Now, in a perfect world, we can assume that all practicing surgeons have manual dexterity, knowledge and judgment that falls somewhere within 3 standard deviations of the mean. Therefore, through a comprehensive series of checks and balances which are in place, we can expect a strong standard of quality control with regard to surgical outcomes here in The United States. That having been said, just as there is a noticeable difference in ability amongst professional football players – starters, back-up players, etc. – there are similar differences amongst surgeons.
I like to say that, in any job or profession, only 1% of individuals can be in the top 1%. You can’t stuff the 2% in the top 1% no matter how hard you push and shove. They won’t fit. It’s just math. So, I have created in my mind a top 1% club of gifted surgeons with whom I trained.
One of these gifted people was a vascular surgeon with whom I spent a lot of time in my first 5 years of surgical study. The interesting thing I noticed during that period of time was that there were a significant number of surgical trainees who would avoid operating with this man if it was at all possible. Now, this was definitely not because he was abusive in the operating room toward his pupils; but he was certainly a strict task master. He was a perfectionist and always wanted things done only his way. There were to be no exceptions when performing a vascular case under his tutelage. He made it clear that his O.R. was not a place for free-wheeling self-expression. When working with this very serious professional, you were to do as you were told and not stray from his techniques, instrumentation, and maneuvers.
I was completely okay with this. After all, I was there to learn. I was a trainee at that time, not a professor. I was always fascinated by the fact that so many of my co-residents didn’t want to work with this highly capable surgeon. After all, he was doing some of the most challenging technical operations we have in the surgical armamentarium and such experience could only be an asset when we went out into practice for ourselves. Because I was always eager to work with him, in 5-years we ended up spending an enormous amount of time together in the operating room. He became one of my most influential and important mentors. His lessons in many ways have shaped my career.
One day, in my fifth and final year of general surgical training, before going off to do my cardiovascular residency, I was finishing up an aortic aneurysm repair with this fine surgeon. We had completed the critical elements of the operation and were closing the abdomen, a routine part of the procedure which allowed us to chat as we worked. I had a question for my mentor which I had been waiting to ask for years, but hadn’t. Now that I was so close to graduating and because we had developed such a strong personal bond, I felt comfortable asking without fear that I might offend him in some way. “Doctor,” I asked, “why do you think it is that so many of the residents don’t want to work with you in the operating room? I mean, over the past 5 years you have taught me so much. I wouldn’t trade these experiences in the O.R. with you for anything.” “John,” he said, “I recently had dinner in a Chinese restaurant and at the end of the meal I opened my fortune cookie. It said, ‘when the student is ready, the teacher will appear.’ You were ready to work with a teacher like me. I understand that I am a demanding person. It is my responsibility to take care of each patient the best way I know how. This is a serious profession. If my student isn’t willing to do it my way, they might as well stay out of here.”
That was it – a great learning moment. I took something of real value from a fortune cookie, and why not? Knowledge is all around us if we are receptive to it. I think about that moment frequently and use it routinely as a teaching point.
Too often, we avoid situations and circumstances because we are afraid that the bar will be set too high for us to get over. Too often we avoid experiences where we may feel insecure or uncertain. Naturally, we wish to avoid reprimand and criticism because it can hurt. But, unfortunately, it is often in these types of environments that we grow the most and the fastest.
My advice to everyone who will listen is: embrace these opportunities. Find the great mentors and teachers and spend as much time with them as you can. Get close to them and absorb their knowledge and wisdom. Expect to be corrected when you make errors or veer off the narrow path of excellence. It’s not personal. It’s actually very professional. The great educators want you to be the best that you can be. It’s going to be hard sometimes. We can feel humiliated and embarrassed even when no one is intending to make us feel that way. Our ego can get in the way of personal development because it is too fragile and delicate. Good teachers must point out our mistakes and redress them. That goes with the territory. If you wish to excel in anything you do, get around the best people and make their habits and philosophies your own. This is a powerful shortcut to excellence and achievement. It might be difficult at times, but the results are well worth the discomfort in the end.