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First day at work as a lead surgeon

Abraham Eisenstein, M.D. ▼ | June 3, 2017
When time comes for a surgeon to do the first surgery on your own, this is both a scary feeling and excitement above anything else.
Lead surgeon
Surgeons   Fear and excitement of lead surgeon's first day
In every walk of life there is time when you must do the job on your own, without help from your professors and senior staff.

The same is true for surgeons - by most considered as the highest point in a medical career you can reach - with one difference: Someone's life is at stake. So, how do surgeons feel when they are "on their own" for the first time?

Good news is there is no first time.

Medicine, and especially surgery, is a very long apprenticeship. First, there is a school, four of five years, and there are internship is one and residency, all in all up to seven years or so.

So, there really isn't "OK, now you're on your own" situation.

During learning and work, a young doctor and surgeon will spend endless hours under supervision, starting with very simple procedures, gradually going toward more complex ones.

This is progress through training and the young surgeon in never allowed to perform a procedure if the senior staff think she's not up to the task.

When you through all of that, and when your first day comes, it is always scary. Other people call you "doctor" - with a reason. Hospital staff expects guidance, and your patients expect the solution to their problems.

The first day is always hectic because you will usually start as a doctor in a new hospital or practice. You have a lot of duties, you are new and must learn fast, from simple stuff like where' the toilette to history of your patients.

You must think fast and react fast, and job is piling up like there's no end. Nurses are running around, bombarding you with more data than Google, every single case is different, then something unexpected hits you, you have no time for lunch... And your first surgery is waiting!

And there you are standing in the operating room, looking at the patient, trying to remember what the heck is appendix and what to do with that sharp object in your hand.

Remind you: that's happening after you survived all kinds of situation while being a resident, 28-hour shifts, almost dictatorship from your supervisor, being pushed for years to be the best you can be. And still... What the heck is appendix?

Different people prepare for their first surgery in different ways. Some are reading all books on medicine they have all night long, some are studying the procedure they must perform tomorrow, some go to sleep...

But they never sleep. Feelings are just too strong, adrenaline is high, and above all there's fear that you will make a mistake.

And this is normal. When the moment comes to make the first cut, although a senior doctor is looking at you, ready to jump in, you know that that's it: Now it's your responsibility.

One surgeon will take a deep breath and start, another is waiting before another doctors say "So, shall we?" but they are all scared until the procedure starts.

And along the way you are praying that there's no complications. But if there is, your brain starts to think very quickly. If you are positive you know what to do, you jump onto it. If you are not sure, you present your solution to other doctors and ask them for an advice.

This is the moment when you really feel what it means to be a surgeon and deal with unexpected.

After that, the practice kicks in. You are focused, your knowledge erupts with the first cut and your fear magically disappears. Time stops, you are working, and when you are done, the eruption of excitement and pride happens. Jumping around the hospital while nurses are smiling? Yes, that can be seen too.

How to make your start as a surgeon easier? First, perform as many simpler procedures as you can. That will make you more confident and less prone to faint when you see blood and flesh.

Then, respect nurses. Nurses are the power that keeps every hospital going. They are taking care of patients, fight with their diseases and fears, and preparing the patient for your surgery. They are of immense help in any situation. And they are willing to help young doctors.

And third, respect primary care doctors. Being a surgeon, your task is easy: cut, remove, close. There are differences between procedures, but that's basically it. However, it's on a primary care doctor to examine the patient and come up with a right diagnosis. And that's hard thing to do.

As you might be happy that you are now official a surgeon, your educations doesn't end here. Depending on a career path you choose, you may learn for another 8 or 10 years, or even more, before you become capable of leading your team through most complicated surgeries.

But you will never forget your first day full of fear and excitement that marked the start of a great career.