2023 | Volume 24 | Issue 2

The alter egos of surgeons


Author: Dr Imad Jaboury

Surgeons are not barbers anymore; consider they may be more like these people.

A pianist – it is essential that surgeons naturally have or are able to develop hand dexterity.

A detective – surgeons must keep an open mind and consider all possibilities when making a diagnosis.

A judge – surgeons must make independent judgments. To operate or not, when to operate, and which operation; all the while remaining uninfluenced by external pressure.

A pilot – surgeons must be in the right plane during dissection to avoid becoming lost. The most dangerous parts of a flight are the takeoff and landing, and the most dangerous parts of a laparotomy are the start and closure.

An army leader – casualties are part of war, just as complications are part of surgery. A surgeon must minimise the number of casualties and complications they have and manage them when they occur. Winning the war is to save lives, reduce pain, and minimise suffering.

A plumber – they close off the main supply before fixing a leaking pipe, just as a surgeon clamps the artery proximally before fixing an injury. Plumbers also often use a basket passed distally through a distal manhole to relieve a proximal blockage. Surgeons use the same principle during endoscopic retrograde cholangiopancreatography and in transurethral ureteric stone extraction.

A tailor – aside from the obvious, a tailor will repair a torn new dress by sewing the edges together, whereas in older garments they stitch a patch of new fabric to the defect instead. A hernia defect in a child or patient with strong musculature can be repaired by primary repair, but in older people with weak muscles a mesh must be applied to the hernia defect.

A gardener – a gardener preferentially chooses a healthy seed, planted in fertile ground. Similarly, a graft must be healthy, and the recipient area must be well vascularised for it to be successful.

A reporter – surgeons must document and report findings instantly and accurately. Too many medical mishaps are secondary to poor documentation and communication.

A parent – parents must respond to their crying babies when awoken in the middle of the night; likewise, surgeons must review their patients with severe pain at any time.

A priest – surgeons must always stay focused on the patient while operating. The theatre is their temple, the table their altar and surgery their prayers.

A goal scorer – even Messi would struggle if he played with an unsporting team. In the theatre and on the ward, teamwork is quintessential.

A spider-man – like a spider, surgeons need eyes at the front to see the operation, on the side to teach their assisting juniors, and on the back of their heads as peers are watching. Spider nets protect them and help them move quickly from place to place. Surgeons similarly need a support network of friends, senior colleagues, and lawyers to help them throughout their career and protect them against adversaries.

A politician – there is a lot of politics in surgery, and one must be political to survive.

The alter egos of surgeons