1086: Do you get nervous or anxious?

I will be the first person to tell you that performing ocular surgery is stressful and not easy. We are working in such a small volume of space, less than 1 milliliter, with delicate ocular tissues and no margin for error. While so many US medical schools have changed from grades to simply pass/fail, that is not reflective of the reality that you will face in the future. Every patient wants a perfect score, 100%, from the surgery that you perform on their eyes. I have never met a patient who asked for a passable job.

While the USLME step 1 is now pass/fail without a score or percentile rank, ask yourself if you want the surgeon who operates on your eyes in the future to have just barely passed the exam. And for those keeping score, remember that essentially every resident will graduate from their program and become a practicing ophthalmologist, even if their surgical skill level is far below the mean. This means that the onus is on you, the surgeon, to maximize your learning and to hone your surgical skills. You are an expert at reading a book and acquiring knowledge and you can do that for the rest of your life. But you have a very finite time in which to be directly proctored to learn ocular surgery. Once you finish training, you are on your own. There will be no attending surgeon or professor to bail you out.

A resident said that operating with me attending them made them nervous. I can understand that, but it should be just the opposite. With me sitting next to you, I can save any case, help with any tricky maneuver, and recover from just about any complication. I am also absorbing the vast majority of the liability for the case since the attending surgeon is responsible for everything. You should rest assured that with your attending surgeon seated next to you in the surgery, you have a much wider margin of safety.

Is this your heart rate during a tough surgery? No, this is my heart rate during a weight lifting session!

If you want stress, imagine operating on the mother and father of a fellow ophthalmologist, while he watches live right there in your operating room. This is what I did and I wore my heart tracker during the process to show you that I did not experience a single episode of tachycardia. Clips from those surgeries are shown in this video so that you can see calm, steady hands, a great incision, a pretty capsulorhexis, and a smooth controlled surgery. And these were not easy cataract cases. I have done cataract surgery on more than 50 fellow ophthalmologists and I offer them a video of their surgery afterwards. In the future, one of my CataractCoach fans will end up doing cataract surgery on my eyes and I want you to be calm and collected!

Even more stress is performing live surgery at large meetings like the AAO (American Academy of Ophthalmology) and the ASCRS (American Society of Cataract & Refractive Surgery) — something that I have done many times and around the world. Imagine a few thousand fellow ophthalmologists watching you operate live while you have a moderator in one ear piece asking your questions and a video director in the other eye telling you to adjust your hands to get a better external camera angle. And this is going on while you are doing the surgery. And yet, in this situation I am able to control the stress and avoid nervousness, tachycardia, and anxiety. I am not that special — you can learn this too. It is mind over body.

click to learn from this video where I explain how I can limit stress in the operating room:

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