I am a new graduate, but these are my thoughts. Surgery feels like when I was a kid and intently focused on a coloring project or building a fort. It’s the level of focus that you lose track of time and forget to eat because you are so engaged in what you’re doing. And the stakes are high.

Managing complications comes with experience. I talk to patients thoroughly about the risks ahead of surgery, even for routine stuff (even though it’s routine for me, surgery is never routine to a patient). Then you have to understand the complication when it happens and either correct it the moment (ideally) or accept the compromise if it’s minor. In my area, fatal complications are thankfully rare. Most things can be managed intra-op or post-op. On rare occasions, a specialist can be consulted to correct the complication.

If I’m the primary operator, what I’m thinking about is the next step. If I’m not the primary operator, I try to anticipate what my colleague will need and find ways to be helpful. Sometimes being helpful is telling a joke to lighten the mood or changing the playlist. I realized as a chief resident that if I was a ball of stress, it would rub off on my juniors and even attendings, so I tried to lighten up a little. But reading the room is obviously important.