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The day I decided surgery was for me…man is sometimes unexpectedly mortal.

Authors: Suha Ugur; Post Foundation Fellow; Aintree University Hospital; Liverpool, United Kingdom; @suhaugur2

“Yes, man is mortal, but that would be only half the trouble. The worst of it is that he’s sometimes unexpectedly mortal—there’s the trick!”

Mikhail Bulgakov, Russian novelist and a physician himself, delivered this statement. He highlights the uncertainty within medicine and our desire to exert control over it. I believe this is where surgeons thrive as they are continuously wrestling with unknowns and the unpredictable, making decisions within moments.

My experiences shadowing surgeons working in Van, a city in Turkey reeling from the effects of a devastating earthquake, solidified my desire to pursue surgery. Particularly, witnessing an example of the split-second decision making and how experience impacts on this. Whilst observing a para-aortic lymph node dissection, the renal vein was inadvertently lacerated, and significant haemorrhage ensued. I was fascinated by the reactions of the two surgeons, one senior and the other junior. The junior surgeon reacted immediately with sharp orders and requests, fervently working to stem the bleeding. In contrast, the experienced surgeon used a brief moment to compose himself and proceeded to control the haemorrhage successfully. The idea that an accumulation of skill and experience can help manage such unpredictable moments with a calm confidence excited and inspired me. The rest of the operation was completed without further complication and the patient was discharged home safely.

When reflecting on this with my colleagues, one statement really resonated with me: “sometimes surgery is more art than science”. For me, this highlighted another reason why surgery was for me. The need to combine a robust knowledge of anatomy and physiology with the knowledge derived from experience and the need to improvise when you have the odds stacked against you. Ultimately, the skill of a surgeon amounts to the challenges faced along the way.

The day I decided surgery was for me, I understood the capability of surgery to rationalise and tackle the endless complexities of human pathology.


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