Blueprint

The one thing about being a surgeon is that it's never the same thing twice.

The closest analogy is to compare my job to NASCAR racing. We know that a bunch of guys are each going to get in a car and drive around in a circle real fast a bazillion times and one guy will win. Although the same guy can win repeatedly, the events leading up to that finish varies each time, and this is what keeps rednecks glued to the TV. That, and they're hoping to witness a spectacular accident.

The NASCAR driver's goal is to win, and avoid that accident.

An operation is the same thing. I'm going to cut someone open, do something to fix their problem, and then sew them shut. But despite all the testing and preparation I do beforehand, I never know what's really going to be inside a patient's body. This can be a setup for a spectacular accident, and my goal is to finish my job without getting into an accident.

So although I know what I'm trying to do, there's no predicting what's going to happen. There's just nothing routine about my daily routine. And plans change all the time.

At least half of the operations I perform started off with a good plan (and a good backup Plan B just in case) but sometimes by the end of the procedure, I find that I'm on Plan M.


Intern: Well, what do we do now?

Despite multiple attempts and maneuvers, and every conceivable manipulation of my patient's skin and underlying tissue on his leg, there was no way that we were going to be able to bring his incision back together to sew the patient's leg closed. We've spent the past 90 minutes trying every trick in the book. And I had run out of options.

Me: You know... I'm not sure.

You can't just let a man walk around with a big gaping wound in his leg. I had to find a way to close this wound. There is no other option. Unfortunately, there just wasn't enough skin left to do the job.

This patient had a large 6x4 inch skin tumor that had we just excised. That left a good sized gaping wound. It looked like a shark bite. And no matter what I tried, his wound just wouldn't quite come together.

I looked at my intern. He was looking pretty worried. I guess I would be too if I found myself in a similar predicament. Especially if your chief tells you he has no idea what else to do in order to finish the operation.

But what I've learned from watching the best villains and secret agents on the movies is that they always have a way out. Whether it be an escape hatch, a cleverly hidden weapon, a back door, or a suicide pill, these guys always have an answer when they start to get cornered.

Suicide pill being out of the question, I pulled out my hidden weapon and patched up my patient with a skin graft. It left a divot in the leg and wasn't the most esthetically pleasing closure, but at least the wound was finally closed. Definitely not my first choice to use in finishing this operation, but sure beats the alternative.

Intern: Wow... I never thought of that idea.

Me: Yeah. Secret weapon.