Every job in this world relies on a certain amount of trust between the seller and the buyer. Let it be a teacher, coffee shop owner, elected representative of legislature or police officer, the person seeking their service trusts them. Though several mechanisms exist to ascertain the efficiency and reliability of the seller, it all boils down to trust when the final transaction happens. Among all these, the highest level of trust is bestowed when a patient offers his or her body to a surgeon to cut open, repair organs and return their bodies in a better shape when they come out of anaesthesia. In a normal state, no one would imagine, even in their wildest dreams, that someone can rip through their chest wall and handle their heart and lungs. But it routinely happens in a cardiothoracic theatre during heart bypass surgeries.
When such an amount of faith is bestowed upon a surgeon, it becomes his paramount responsibility to deliver his best every time. There are no specific qualities of a good surgeon. Rather, how one can define a good surgeon is also nebulous. For the common man, a famous surgeon is a good surgeon. A surgeon with fewer failures and who handles those failures deftly is seen through medical society’s lens as a good surgeon.
Theoretical knowledge of the subject is the bedrock on which a good surgeon’s career is built. It makes a surgeon fundamentally strong. But executing the intended action through one’s hands is a natural skill. Just like there are born artists, natural dancers, and gifted singers, some surgeons perform surgical steps naturally. Their ability to observe, imagine and replicate things comes naturally. But this would be a small percentage. The rest of the surgeons use their cleverness, hard work, assimilating things, and most important, practise repetitively to become good surgeons. There is no shortcut for this majority group. They have to go through the grinding apprenticeship. That is why many surgical specialists mature “surgically” around 40 years. By then, they understand their skills, strengths and limitations, and work accordingly.
Every art (I presume surgery is also an art form) is mastered in three stages: Shu, the learning stage, Ha, the innovation stage and Ri, the creative stage. In the Shu stage, the student learns the art by strictly imitating the master. He does not pose questions regarding his learning. When he is able to replicate his master’s actions effortlessly, he moves to the Ha stage, where he understands the reason behind every action. He expands his theoretical knowledge and seeks help from other masters to comprehend the nuances of the art. In the Ri stage, he becomes a master by himself, liberated from the previous stages. Now he becomes a creator introducing newer versions and manifestations of the art. All good surgeons go through these stages and the best surgeons attain newer versions of Ri. Those who try to bypass the Shu-Ha stages hardly reach the Ri, unless otherwise they are exceptional. For surgeons to respect and repay the trust reposed on them by the patients, they need to be honest, theoretically robust and be masters of the Shu Ha Ri.
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