I'm Dr. Tom Krummel, a pediatric surgeon by trade and chair of the department of surgery
at Stanford. Like with most things preparation is everything
and so if you arrive ill prepared and ignorant of what's going on you'll get very little
out of it. If they arrive understanding what the problem is, understanding what the plan
is whether it's in the office or the operating room or anyplace in between, then you'll get
the most out of it. These days it's easily possible to find many videos available on
the web for all kinds of things so the prep ahead of time will make you a good observer
rather than a naïve observer. information is ubiquitous and so if someone
hasn't read up on gallstones and is coming in to watch a cholecystectomy, I get the sense
that they're apparently not that interested .
it's not like it is portrayed on TV. Forget it. It is not emotional outbursts. It is not
drama. Rather it's day in day out people trying to solve other people's problems.
In the operating room there's frequently a concern that you're gonna faint or it's gonna
be horrible or ugly and I always tell our students coming in that actually it's like
watching the most beautiful sunrise you've ever seen in your world; absolutely spectacular
privilege. I think that's something that we really need to focus and emphasize to our
trainees is that it is a remarkable privilege to watch healthcare happening and so it needs
to be treated as such. The patients are generous in their exposing
themselves and their medical problems to observers and that always needs to be remembered. Again
there is a certain expectation of not just decorum but behavior and an attitude of respect
that I think if that underpins the interaction things will go well.
if it looks like there's trouble it's not a time to start asking questions but to sorta
pull back and wait for the right moment. And usually we try to have a chaperone in for
starters just to get people in the groove and better to ask questions later rather than
when it looks like we're in the middle of something that appears difficult. And usually
that's not that hard to tell. The other people in the room can also be incredibly
helpful so while there's often a tendency to focus on the docs the nurses are there,
are incredibly helpful to us. The scrub techs, the anesthesiologists, the other trainees
that may be students or residents are great sources of information.
seeing the same case with a different surgeon, seeing the same surgeon do the same case can
be very helpful. You know sometimes the insight because you don't really know what you're
looking at, is missed. ride in the back of an ambulance, spend a
Saturday night in the emergency room, you know go to labor and delivery, watch how the
attendants park the cars. Again it gives you a deeper appreciation for the workflow and
you'd be surprised what an open mind will do.
The unique opportunity is to watch not only what is done and what is said but what isn't
said. If it looks like something is difficult, the surgeon may not say it is but that's an
important observation about maybe there's a better or an easier way.
Make it really good quality time and by that I mean you know there are a million distractions
and we all got iPhones and things to mess around with or to be distracted by. But you
know if you bring a real prepared mind, I know what's gonna happen, I'm watching what's
happening, couple of key questions at the beginning and at the end will make the most
out of the time.