toughen up

during the old days of training, the prof believed in toughening us up. looking back i still wonder whether it was necessary.

there is a lot said these days on some blogs about the 80 hour work week. in those days we hadn't even heard of such a thing. there was no such thing as time off post call. any day of the week you had to be available for your patients. there was no such thing as handing a patient over to someone else because you were tired or upset or whatever. i remember being on call on friday night, working through the night. working through the next day to work off the leftovers and only getting home at about 9 the next night. then being on call the next day and night and doing a full day's theater list the day after on monday. after the list you operate the leftovers and the comebacks from the call. by tuesday you struggle to remember your name.

but i digress, as usual. this story comes from much later on in my training. i was the senior, the number one dog. i was in the toughest firm, the rounding off. after call, the prof would take us on academic rounds. as a junior i always struggled to stay awake during these rounds, having often only had one or two hours sleep the previous night, but somehow as the senior registrar in this particular firm the tension on the round was always enough to keep me wide awake.

without fail, on these rounds, the prof would tell us to take one patient back to theater for some or other reason. we used to bet about which one he'd chose. we were usually unpleasantly surprised. at a certain patient, usually towards the end of the rounds, the prof would look at me and with a wry smile say, 'you need to take this patient to theater.'

'yes prof.' i always replied and smiled back. in front of that prof it was important to show no weakness. he was like a pack of wild dogs. if he sensed fear he would tear you apart. he would then volunteer to join me if it happened before home time. this would never happen. by the time we booked the patient on the emergency list after the rounds, the list would be so full that we usually operated late at night.

this sort of behaviour is, of course, questionable. one wonders if it really was necessary to operate the patients. the answer is mostly yes, but not necessarily immediately. it wasn't so much about the patients but about training surgeons who would have the ability to put their own needs (even physiological needs) on hold if need be in order to be able to do what is needed for the patients, be they only future patients.
i'm not presenting answers to these questions. i'm only stating things that happened.

however recently i have had the dubious pleasure of operating quite a number of patients with very complicated gallbladder disease. interestingly enough, although the surgeries were complex and challenging, at no stage was i even slightly phased. i realised this had a lot to do with many complicated gallbladders that i operated post call at the prof's beck and whim so many years ago.
so one can't help wondering at the method in his madness.