YOU HAVE TO LOSE TO WIN

Dr. Geeta Sundar

I have often been asked this question, by friends, colleagues, acquaintances – “Why Surgery?”

Hmm. Where do I begin? With what words do I explain the meaning of Surgery in my life? From where do I elucidate the essence of Surgery? How do I communicate the significance of what this professional choice means to me?

Surgery has been in more ways that I can mention, a saviour, a salvation, a balm, a sweet poison, a nectar, an escape from all that is peril. Surgery swooped in at the right moment in my life and represented everything that shone, sparkled and shimmered and gave me a chance to hide under the covers of its wide umbrella and get lost in a world full of its wonder.

My introduction to Surgery was late in my teens, during the undergraduate years, but the moment I met Surgery, I knew, like just knew, deep within my bones, deep in my system, from the very roots of me to the very tips of my fingers, in my every breath, in my every vision of a future, or thoughts of a distant destiny, that Surgery would be something I would fight for, would grasp, lug and tug to my side. I couldn’t fathom doing anything but Surgery!

Surgery fascinated every energetic mitochondria in my body. Every piece of me knew this was it. I had met my match, my twin flame, my companion. I understood that I’d rather master Surgery than wish for anything else, that my soulmate was Surgery in the end and that I had forged an unbreakable bond with Surgery.

But, my journey to reach Surgery wasn’t an easy one. It isn’t enough to love Surgery and wish to be with it, for it takes time, effort, hard work, energy, positive thoughts, self-belief, persistence, determination to create that environment to attract and inherit Surgery. And even if Surgery entered your life, and stayed for a while, each second with Surgery generated stress, pain, exhaustion, grief, wistful thoughts, yearning, and an uncanny ache and distress in the heart, mind and body and one that’s hard to come out of. Little did I know what the world I was choosing would do to me, but to be honest, I had done my homework and researched about Surgery, and from what I had heard, despite all the bad press and the harsh discouragements, my mind was made up. I was going to make space for Surgery. All or none. I was standing behind my decision voluntarily. I chose this. I wanted this.

And the people that advocated Surgery, the pioneers of Surgery, the seniors in this field, only had horrible days in store for me. They bullied, branded, brandished, intimidated me. Why? You’d ask. “It’s the system. It’s what was done to us. We are going to hand out what we experienced. And you are first year – learn the way of the world. Obey. Bow down. Be our slave. No other way.” Every minute was painful, laborious, rigid. Every day turned bleak, each hour brutal, each task torture. Words abusive, rude and unkind. Stringent and unrelenting duties. Non-stop. No peace, no mindfulness, no food, no rest. No pause. Losing weight. Failing health. And it wasn’t just the people I worked with, it was also thankless families and ignorant relatives who put undue pressure on an already breaking front.

I was hopelessly caving it. Catering to those oppressors. Falling abysmally into a vortex of self-hate, mangled negative thoughts and burdened with responsibility of the patients, pleasing the tyrants, and going against that I stood for, my principles and what I believed in. My love for Surgery was questioned. My passion and pledge to Surgery judged. Surgery stolen away from me for the work I couldn’t do due to red tapes and a thousand reasons, masquerading as excuses. Surgery punished onto me for all the tasks that fell into ‘lacunae’ as they put it. I was told I was a nothing, a nobody, I had no capacity to continue this further, I was in no position to even be a doctor; that I was a mere human wasting my time and money. And the fact that I was a woman, trying to learn the man’s skill, made it all worse; feminism was never in the horizon. And the more I resisted their comments, the more defiant I got, the more I tried to stand up against the tyranny, the harsher the climate got.

I forgot what I was made of. I forgot the strength my upbringing had given me. I forgot who I was. What I had been. Where I had once thought Surgery was bright and glimmered. The glamour it had promised. I was suffocating. I was not in my senses. There was no life line. This was no saviour. How had I made this profound mistake? How had I assumed I knew what a relationship with Surgery would be like? How had I imagined a good, sunny, satisfied life with Surgery, if I couldn’t even get through my training years?

All the old naysayers, their sentiments echoed to me from the past. Hounding me, reverberating, on repeat over and over again, like a hallucination, chasing me, their words in my ears, in my mind, shaking my already broken self-esteem. I was going to fail. I wasn’t good enough for Surgery. I was nothing. Surgery deserved better. And it was not meant to be. I was the weaker sex. There was no silver lining here…

“We have two options medically and emotionally: give up or fight like hell – Lance Armstrong”

 For days I cried and questioned myself. Tried to delve in deep. Find myself from the chaos and the agony. But came up empty. So lost, confused and headless, with no sensible company, I hung onto the only thing I knew. Me. My love for Surgery. My passion for Surgery…and there in made a discovery. That my love for Surgery defined me. That adoration still throbbed inside me and it would always. I had come way too far for Surgery to just give up. I had given up so much and sacrificed so many things to be here. And I wouldn’t let it just go away that easily, in wain. I was made of much tougher stuff. I was strong. My parents had brought me up in a liberal and bold manner. I just had to channel that boldness onto Surgery and hold on through whatever storm life would bring.

And I did just that.

The hours are very long. Yes. The duties are sometimes the worst and exhaustive to the point one might break. Yes. The people who work with you might want to hurt you, but can only do so much harm if you don’t let them. The words they use might be callous and vengeful, but they are just words and if you can filter the noise out, you can actually learn and progress. Yes. You will be mentally tired, physically beaten and will still have to assist in Surgery, skipping sleep, food and family. Yes. Nothing about Surgery is easy. It’s a life style. It’s a behavior. It’s a code. It’s a habit. It’s routine. It’s a dictum, it’s a rule. No way around it, no way to escape it. The good comes with the bad, the bad comes with the ugly and it will crash land on you, and the faster one recognizes it, accepts it and embraces it, the sooner that conduct becomes easier to sail through.

“Fight each round, take it on the chin, and never never give in – Olivia-Newton John”

However, knowing all this, why did I still commit? Why then do I still struggle and try to maintain this relationship with Surgery?

I ask myself these questions daily, and every day, I am only left with the same profound love for Surgery. The bad situations, the fights, the discomfort, the rawness, the appalling masks are all forgotten, hell, even forgiven sometimes and what remains is the will, the power to continue, to move on, to squash all the awful and shimmy them up somewhere, and face each day as a new challenge to fall in love a bit more. Politics, like in all aspects of life exist here too. Muddled waters, logistics, favoritism prevail and act as hindrances to achieve the best. And more so in a country like ours, where excuses absolve and rationalize politics, where ‘adjustment’ is the word of the hour, even if you try, the ‘system’ won’t let you get to the prize.

“You may encounter many defeats, but you must not be defeated – Maya Angelou”

Surgery brings with it, a tirade of blizzards.

Some navigate and cruise through with love, determination and hard work, whilst others chose resilience, fame, glamour, nepotism and acrimony to prove a point. It doesn’t matter what your relation with Surgery starts off as, but you need to understand the big picture, perpetrate and invest every ounce of dedication to Surgery, because it is that demanding. Real life in Surgery is far from what all the sitcoms depict – there are no off hours in the duty room to make out, no severe upheaval of emotional outbursts, it’s not every day you fall in love with your patients, the cases are not that straightforward nor are they so complicated, each patient is important, each case is a learning, each scenario is a teaching forward, and each nuance of patient care is learnt on the job. Experience is a grim guru, but portrays what no book can ever show you.

With great power comes great responsibility. True that. But they forgot to add that with great responsibility, also comes, pain, mistakes, triumph and guilt. When you represent the decision maker for the people, it pinches, it makes you understand how crucial your job is, and how important it is to fully understand your relation with Surgery. Surgery that occurs in the Operating Theatre/Room is only a mere two percent of Surgery. Those skills come with time. Those skills come with practice. Nobody knows how to hold a scalpel or cut or even suture on day one. It’s an art that’s learnt and harnessed with repetition. The rest of Surgery in peri-operative care is where the obstacles lie. As one of my professors put it explicitly – “Even the peon boy knows when to operate seeing a scan…but it is a surgeon who knows when not to operate.” And therein lies the stark difference. That person who understands Surgery well in all its intricacies, its manifestations, expressions, forges a tougher connection in establishing good decisions and outcomes.

And even if you do your best, and you know in your heart you have done everything you possibly could for the patient, the outcomes are determined by fate, and often times you lose a fellow human despite all ‘reasonable’ measures. And with that realization, comes profound understanding of humility, helplessness and vulnerability. You understand that you are just a mediator of means, and there are so many things that you have no control of. Mortality is a branch of Surgery you accept with a heavy heart; and hope that each leaving soul can teach you how to save similar in the future. But, it is the aspect of owning that mortality in front of the patient kin that causes the most distress, remorse and denial – denial for both you and the people you face. You can see the emotions spiraling in their eyes, their face and you know how much it would hurt to be them; and it is then that you also understand morality and dignity.  

And then there is the fun. The happy. The joy. The jokes you create and laugh off in the OR. The friends you make for life, for advice, for aid. The people you leave lasting impressions on and those who render you impressed. The entangles of a good working team, of leading, or choosing wisely, of small battles won, of diagnoses worked out, of understanding physiology and body healing, of gossiping away in the cafeteria, of partying with buddies on a rare night off, of studying books that weigh heavier than your arms, of loving every minute of the OR when you do more than just assist a case, of running around in the emergency room being the force of trauma care, of tears that form when a patient kisses your hand, of tumors that you annihilate with a scalpel to the joy when a patient poops after rigorous anastomosis, to so much more and beyond. It’s all in there, hidden, in silent moments, in quiet surrenders, at end of sleepless nights…just a quiver here, or there, just a few sparks or shines and its up to you to catch it and relish it…

What then, do I offer to those who wish to love and adore Surgery like me? I tell you nothing but the truth. I tell you the facts as they display themselves. Chose it wisely. Weigh your options well. Do not regret. Move on. Let go of baggage. Learn to be the bigger person. Be the nicer person. Be positive. Never lose your calm. Know that there is a day in the future when things will be better. Learn to work as a team, learn to be a leader. Know how to stand by your decisions. Learn how to stand up for yourself. Know your limitations, ask for help when you are out of your depth. Never lose sight of your self-esteem. Make friends. Give your 100 percent to everything – your work should speak for itself. Study hard. Work harder. Make mistakes now, in your training years, and learn to set them right. Rest when you can. Sleep when you can. Eat when you can. If anyone offers you food or water, never refuse. Say thank you more often than sorry. Own your mistakes. Never lie to your seniors or patients. Love your patients. Love your job – nothing beats that job satisfaction.

It doesn’t end here though, rather it’s just the tip of a long drawn haul. There is surgical research, telescopic super specialties, and so much more to dip into. And from my small sojourn into Surgery, I can tell you this much, it’s all about balance, priorities but most of all, self-care, self-esteem, self-help, and self-love.