This question was originally posted on Quora, and below is a selection of the best relevant answers. What's It Like To Perform Surgery For The Very First Time? Sure you'll know what you're doing and have 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? Answers: 1- Robert Gluck, Hand Surgeon, The Healthy Hands Center -- Long Island, NY Country Doctor Photo by Eugene Smith, Life 1948 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! 2- 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) 3- Ajeesh Sankaran, Orthopedics My first surgery was on the forearm, involving fixing a fracture with a plate. I remember every detail of that surgery, past midnight in cold Delhi winter. I had, of course, seen and assisted in the very same procedure many times. I had read up all I could find about the fracture, the fixation and the approach. Yet as the time to place the incision came I remember being scared witless. I took my time to mark the incision, while the scrub nurse rolled her eyes. After the initial hesitation, I was caught up in the excitement of surgery itself, the very reason I chose the field.That surgery went well however and the patient made an uneventful recovery to full activity. I cannot express how that boosted my confidence for future procedures! 4- Ed Averbukh, Trying to do my best The first surgery I performed was extremely traumatic for me, as well as for my supervising surgeon and definitely for the patient who was under local anesthesia. The fact that I continued operating after my first experience may be attributed only to my excessive optimism. My skills improved greatly over time, but now, more than 20 years later, I still remember my first surgery. Edit: My answer was not detailed enough, so here are some details: I was extremly tense before the surgery and the old professor who was supposed to assist me and to supervise the surgery was not good enough to deal with any complication. He probably knew that and did not induce any confidence in me. So I injected the local anesthesia with my shaking hands and probably caused some internal bleeding. From there on things went downhill. After few moments I wasn't able to procede and the professor who was assisting me wasn't able to help as well. The head of the department was called in and gave me some adivice. Few minutes later it was decided to abort the surgery and to continue on other occasion. I actually don't remember who and how finished this case. Anyhow, my other surgeries during the residency were much better. 4- Jeffrey Wint, Hand Surgeon, MD There are several levels of first time surgery. SO really there is no first time. Medicine and Surgery is a very careful and long apprenticeship. Medical school is 4 years. Internship is one and Residency after that is variable but most surgeons spend 3-7 years after internship. Think oabout how many of us learn about tools and appliances in the home or learn to drive. You just dont hand over the devices or keys and say go for it. As a medical student you may be allowed to suture under direct supervison. Perhaps you are allowed to do " something": in surgery. This progresses through training. AS far as that "fear" its never really gone. Perhaps there is less but as a surgeon there is never a non chalant or detached moment. Surgeons have lots of little things they mull over and things that keep them up at night even for seemingly minor things. You are always thinking about how you do things and how to avoid problems or improve things. The level may have been different the "first" time but its an often repeated feeling so truthfully it all runs together. Still I remember my first case in private practice. It felt good to do it and a healthy does of fear was there ( as always.) but it did not feel like a first case due to training. 5- JehanZaib Shah, Works in Orthopedic Surgery It was like driving the car for the first time. I was excited,petrified an scared shitless. When i gave an incision. it felt like all the cars are coming my way and sooner or later i am going to crash. Everything became magnified like if i was myself standing inside the abdomen. My hands were shaking and sweating severely. Though it was winters,outside it was freeezing but i was sweating profusely. I forgot everyhting. My bills to pay, my wife was pregnant with my first child and had to deliver that week, totally forgot i had a fight with my mother and my damaged car in the workshop . I forgot everything And what was the surgery. Appendicectomy A playground for the new surgeons. In next 2 years i did 70 Appendicectomies. I dont remember any of them except 1 or 2 but this 1st one will stick with me for all my life. 6- Mohd Habba, Born African, raised in Asia, worked and studied in Europe and now back to Sudan Think of a surgery just as a video game... would you ever go play advanced level from the first day you got it.. Sure no! you are going to play the easy mode first and after a few round intermediate level and in a couple of weeks you are playing the crazy hard modes well, it' almost the same but in a longer timeframe... in the first years after school we were doing dressing and minor procedure so you get familiar with equipments and stuff.. then, bit by bit you are introduced to bigger problems to solve and when it come for the day you go solo.... You wont really notice becuase you'll be godamn tired at the end of a night shift waiting for the morning to come... Source
