The thing about being in a procedure-oriented specialty is that you can’t gloss over mistakes or failures. Either you can do it, or you can’t. And when you can’t, it’s out there in the open for everyone to see. The only way I can find to cope with this is to be even harder on myself about failures (eg, apparently total inability to find vessels of even the largest magnitude with any needle) than anyone else will verbalize. They don’t say anything, but I know what they must be thinking: surgery intern can’t seem even to tell which is the business end of the needle, let alone what to do next with it. . . especially during a code, which made it harder for me, but all the more pointed that I failed. . .

This is a minor example, although major enough for me the last few nights, but I know it’s true for all of surgery. Your actions are big and permanent, and everyone can see what you did. You have to be your own worst critic, because there’s nowhere to hide. Every time you touch a patient, you leave evidence for everyone to evaluate; you are constantly being judged on that basis. In practice, everyone knows which surgeon struggles with which procedures; and in residency, we all know who had a hard time with the lap chole yesterday, who can intubate patients without blinking, whose postops are most likely to have complications, or who you can always call for help with a difficult line.

Advertisements