I can hear my uncle’s valve ‘tick’ from across the room. When there is a lull in dinner table conversation, this mechanical sound serves to remind our family of the part that surgery plays in our lives. My grandmother passed away prematurely from mitral valve disease, and the hearts of my uncle, my mother, and I are affected to varying degrees. Each knot that secured my uncle’s valve represents thousands of hours of practice, countless knots and, perhaps most importantly, my uncle’s trust in his surgeons.
My mother is reviewed annually and we know a valve replacement will be needed, just not when. I often ask myself what I expect from the surgeon who will operate on my mother. I want them to be as experienced as possible, to have performed this procedure hundreds of times. I want them to have practiced every skill so frequently that what my mother and I find so utterly petrifying is, to them, routine. If this is what I expect from the surgeon who will operate on my mother, then it stands to reason that this is what I must expect from myself as I work towards a career in surgery.
With my own experiences in mind, I have tried to practice my skills as often as I can. Every patient is a relative to someone and deserves the care I would expect for my own mother. When we use our skills in a real operation, we owe it to our patients to have practiced as much as possible beforehand, as we would expect nothing less for our own relatives. During my General Surgery foundation job, I was assisting my consultant during a complex laparotomy. He asked me to insert and secure the drain (under his supervision) and described this drain as the patient’s ‘lifeline’. 5 days later I removed her drain and the patient and her children thanked me for my team’s work. The knots I tied during her operation were certainly not as critical as those tied by my uncle’s surgeon to secure his metallic mitral valve. Nor were they done without oversight, with my consultant looking over my shoulder. But they were tied by me, they fulfilled their role, and they contributed, in some small way, to this patient leaving the hospital to return to her family.
So when we practice our surgical skills, however simple they may be, we must not lose sight of their eventual use, nor of the trust that our future patients and their families will place in us. When we are at home, with our suture pads or lap boxes, we are tight rope walkers training a few feet from the ground, identifying simple errors, and stepping back onto the rope after every fall. We must practice and practice until we are confident that we are not making errors near the ground, and only then can we gradually raise our tight rope and walk where the consequences will be felt.
About the Author
Chad Brooker-Thompson - SUTURE UK June Blog Competition Winner
Chad is a FY2 in Barts Health & soon to be general surgery education fellow there, interested in General & Vascular Surgery.