TEXT

    A famous surgeon tells about the importance of self-confidence from his own experience.

    The Making of a Surgeon

    How does a doctor recognize the point in time when he is finally a "surgeon"？ As my year as chief resident drew to a close I asked myself this question on more than one occasion.

    The answer， I concluded， was self-confidence. When you can say to yourself， "There is no surgical patient I cannot treat competently， treat just as well as or better than any other surgeon" - then， and not until then， you are indeed a surgeon. I was nearing that point.

    Take， for example， the emergency situations that we encountered almost every night. The first few months of the year I had dreaded the ringing of the telephone. I knew it meant another critical decision to be made. Often， after I had told Walt or Larry what to do in a particular situation， I'd have trouble getting back to sleep. I'd review all the facts of the case and， not infrequently， wonder if I hadn't made a poor decision. More than once at two or three in the morning， after lying awake for an hour， I'd get out of bed， dress and drive to the hospital to see the patient myself. It was the only way I could find the peace of mind I needed to relax.

    Now， in the last month of my residency， sleeping was no longer a problem. There were still situations in which I couldn't be certain my decision had been the right one， but I had learned to accept this as a constant problem for a surgeon， one that could never be completely resolved - and I could live with it. So， once I had made a considered decision， I no longer dwelt on it. Reviewing it wasn't going to help and I knew that with my knowledge and experience， any decision I'd made was bound to be a sound one. It was a nice feeling.

    In the operating room I was equally confident. I knew I had the knowledge， the skill， the experience to handle any surgical situation I'd ever encounter in practice. There were no more butterflies in my stomach when I opened up an abdomen or a chest. I knew that even if the case was one in which it was impossible to anticipate the problem in advance， I could handle whatever l found. I'd sweated through my share of stab wounds of the belly， of punctured lungs， of compound fractures. I had sweated over them for five years. I didn't need to sweat any more.

    Nor was I afraid of making mistakes. I knew that when I was out in practice I would inevitably err at one time or another and operate on someone who didn't need surgery or sit on someone who did. Five years earlier - even one year earlier - I wouldn't have been able to live with myself if I had had to take sole responsibility for a mistake in judgment. Now I could. I still dreaded errors - would do my best to avoid them —— but I knew they were part of a surgeon's life. I could accept this fact with calmness because I knew that if I wasn't able to avoid a mistake， chances were that no other surgeon could have， either.

    This all sounds conceited and I guess it is - but a surgeon needs conceit. He needs it to encourage him in trying moments when he's bothered by the doubts and uncertainties that are part of the practice of medicine. He has to feel that he's as good as and probably better than any other surgeon in the world. Call it conceit - call it self-confidence； whatever it was， I had it.