The Zen of Surgery

Calm, happy patients make calmer, happier surgeons.

It adds up to better outcomes. Though it’s hard to prove, the more the patient helps the surgeon relax, the better the surgeon perceives the patient and the job ahead. I know, having been both the surgeon and the patient. 

As a surgeon, I see every patient as a unique challenge and every problem as an opportunity for improving my surgical technique and their outcome. An anxious patient—or worse, a distrustful patient—biases the decision-making process in surgery.   

For example, a patient whose ligament is at least partially torn. Based on the patient’s history, exam, and MRI, the surgeon decides whether to perform a primary repair (which has a higher chance of failing, but a better outcome if it works) or a full reconstruction (where the ligament is replaced by a new ligament, either from the patient’s own knee or from a donor). This decision is based on a number of factors. Is the repair possible and likely to work? Is the patient willing to restrict their activities while the ligament heals? Did the patient understand the risks well enough before surgery, and will they be okay if it fails and requires another surgery? 

While each of these decisions seems clear, there’s another factor to consider. How patients present themselves in the pre-op holding room just before the surgery actually affects how the surgeon makes his or her decision. If a patient meets the surgeon with confidence and calm, it creates a certain mindset. If a patient says, “Just do what you think is best,” their smile and grace instill in the surgeon the confidence to do for the patient what they would do for themselves and approach the procedure with boldness and creativity.   

If the patient is tense, wary, or unfriendly—or even if their family member or friend attending them is—the surgeon retreats to the safe zone of doing what is most likely to work, rather than what might be a novel and potentially better approach. 

As a patient who is also a surgeon, I understand that I probably induce a bit of over-caution in both the operating surgeon and the OR team. The natural intimidation of operating on one of your peers, and knowing that your procedures will be reviewed by informed eyes, makes the procedure that much more difficult. How to deal with this?  

The answer—whether one is besides the operating table or upon it—lies in the zen of surgery. If both parties appear calm, display confidence and competence, have a smile, and show a personal touch, the experience and outcome are far more likely to be successful. As I tell my patients, “I can fix almost any complication, as long as your head is in a good space.” When a patient has a positive attitude, and approaches the procedure with the attitude of “Let’s do this together,” complications seem to occur less often.   

So, the next time you find yourself heading into surgery, smile. Infuse the world around you with your grace. The whole operating room team will bestow their competence and creativity upon you.