Sitting Bull

Master the use of this 

When I was a general surgical trainee, learning the ropes, one of the most technically accomplished consultants was a urologist. He'd actually trained as a thoracic surgeon, and unlike a lot - not all I should add - of the current general surgeons, he was completely unfazed cracking open a chest, say for trauma, even if he'd not done it for 5 years.

He gave me two excellent pieces of advice. Firstly, avoid cutting with scissors, use them sparingly, the best surgeons use a knife as much as they can. I still recommend this, although I occasionally permit myself a bit of blunt dissection with scissors - isolating the sciatic nerve for example. I saw him do a nephrectomy very quickly and deftly, without using the scissors once, as far as I can recall. The second piece of wisdom is probably the reason why he switched to urology: always sit down, "as you never know when you'll next get the chance". When he asked me what I wanted to do, and I said probably orthopaedics, he advised me to subspecialise in hand surgery, as "they seem to sit down a lot". He had a point.

We brings me back to Leon Wiltse, who also advised sitting down - primarily to be better at humanising the inevitably hierarchical doctor/patient relationship. A hero of this blog, Leo Gordon, said something very similar, in his usual way, "the most basic of surgical actions":