Calm Under Pressure- Becoming A Surgical GOAT

©Dr. Aparna Govil Basker
It’s my regular bed time routine to scroll through some Insta reels before I crash for the night. I usually love watching commencement speeches and sometimes some other stuff like stand-up comedy etc. It is good to end the day on a funny note or an inspiring one!
One of the recent commencement speeches I watched was that of Roger Federer. Federer is not only a personal favourite but is also undisputedly one of the greatest tennis players of all times (a GOAT!). He has been admired and celebrated all over the world not only for his impeccable tennis skills but his calm and cool demeanour. I am yet to come across a more graceful personality on the court. Every time I’ve watched him play; I’ve been hugely impressed by his composed demeanour.
Whether he wins or loses, he remains unruffled and tranquil, never showing a trace of excitement or agitation. It has never mattered whether the crowd is cheering him on or being hostile, whether he is being trolled or adored. Federer’s mental strength and fitness shines through. He has maintained the same calm composure in hundreds of matches over two decades. It’s actually quite funny; as bystanders in history, we not only take his greatness for granted but also his remarkable calmness.
What struck me in Federer’s commencement speech was his confession that he wasn’t always this composed. Before his golden era of Grand Slams, Federer was a completely different person— a hyperemotional racquet-breaking brat who couldn’t handle a bad game. This calm and composed demeanour was consciously acquired and cultivated after a deeper self-realization and work with a sports psychologist. It took continuous effort over many years to develop the persona we witnessed on our television screens for so long, both on and off the court. There is no doubt that technical skills and physical prowess played a big part in his success but ultimately what led him to being a GOAT was his ability to create a serene and a resilient mind.
Federer’s journey to mental tranquility and his insights about the importance of mental fitness are highly relevant to a surgeon’s life. Similar to professional sports, the field of surgery demands not only exceptional technical skills but also extraordinary mental resilience and composure. Surgeons operate in high-pressure environments where the stakes are extremely high; a single mistake can have a significant impact on a patient’s health. This responsibility necessitates maintaining a high level of calm, focus, and precision.
In our profession, we confront numerous critical situations at various points. Surgeries can be challenging and intricate, emergencies can arise unexpectedly, equipment malfunctions can occur at critical moments, human errors can happen when least anticipated, and complications are an inherent part of every surgeon’s experience. While it is very easy to express frustration or tension, it is crucial for us to develop our mental resilience to remain composed under pressure.
Many a times surgeons express tension and frustration, especially by directing it towards surgical assistants or operating theatre staff. This creates a stressful environment that affects their performance. This can ultimately impact the overall surgical outcomes negatively. Moreover, such behaviour increases the general stress levels in the operating theatre, which increases the likelihood of mistakes occurring. Surgeons who create a tense and intimidating atmosphere in the operating room disrupt the conducive working environment needed for long-term success. It’s evident that this approach doesn’t lead to achieving any kind of greatness in the field of surgery even if the surgeon is highly skilled technically. I personally feel that they may be successful in creating fear in the short term but fail to get any respect in the long term.
On the other hand, even though it may be difficult, maintaining a professional and calm demeanour not only fosters a more supportive atmosphere for the entire surgical team but also enhances communication and collaboration. This contributes to a smoother operation and better patient care. Surgeons who are conscious about this and prioritize creating a positive and respectful working environment help mitigate stress and optimize the team’s performance, ultimately leading to improved surgical outcomes. Its difficult, but doable!
Federer’s journey has several lessons that are also relevant for surgeons and can be adapted. Just as Federer learned to manage his emotions to avoid being a hyperemotional player, surgeons must learn to regulate their emotions to maintain clarity and focus during surgeries. Emotional outbursts or distractions can impair judgement and affect performance.
Actively working on emotional regulation can help surgeons to remain steady and effective, even under stressful circumstances. Surgeons can benefit from mental preparation strategies, such as visualization of procedures, mindfulness, and stress-relief techniques. These practices can enhance concentration and reduce anxiety, leading to better surgical outcomes. Resilience and the capacity to remain unruffled in the face of complications or unexpected challenges are crucial for successful surgical practice. Ultimately staying calm and composed in the face of adversity can be acquired and cultivated. The first step towards change is to be aware. At the end of the day we all are a work in progress in different stages.
Developing mental toughness and inner calmness is crucial not only in the operating room but also in any high-stakes profession. Surgeons who cultivate these qualities in addition to clinical and technical skills can navigate their responsibilities more effectively, resulting in improved patient care and personal fulfillment. This approach also paves the way for achieving excellence. So if you ask me who is the greatest surgeon I think you already know the answer by now. GOAT in the field of surgery would be someone who would not only be technically skilled but have the highest level of mental fitness and tranquility.
Happy Doctor’s Day!! 🙂