I attended the WNY vascular surgery symposium this weekend, and something Dr. Bower, chair of vascular surgery at Mayo Clinic said really resonated with me. He told the young surgeons and trainees in the audience to “take what’s given to you”.
Let me give this a little more context. Dr. Bower was talking about the slick open IVC reconstruction that they perform for primary and secondary thrombosis of IVC, and he was saying that one really has to look hard at feeding branches of these big vessels and control them as much as possible to prevent hemorrhage. I believe this notion can be applied to all surgeries, and to life. Not everyone is made the same way, just look at the variants of the aortic arch. Therefore, if life hands you a lemon, or take one away from you, you should be able to take advantage of the situation and change on the fly.
Us medical students spend years learning about basic and clinical science. We learn about pathognomonic findings and evidence based guidelines. These information serve to steer us to the right clinical decision. To be able to adapt, however, we need to master these basic knowledge, go through rigorous training, and collect immense amount of experience. Eventually, when life hands you a lemon (you expose the IVC and find aberrant renal vein), you slice it and put it in a Corona (vessel loop, ligate, re-implant, etc).
Don’t blindly stick to any “rules”. Rules are there to guide you, but not define you. Be able to adapt to the situation, and do what’s best in each individual situation. Take what’s given to you, and milk the heck out of it.