The Role of the Surgeon’s Physiology and the State of Mind in the Surgical Decision-Making Process: An Update

The surgeon is the captain of a complex ship that often travels and navigates through some rough waters, often between life and death. Just like with any other leadership position, such as those associated with a business organization, flying an aircraft, a military unit or squadron, or even a sports team, a lot depends on this one person. The direction in which he or she will steer this ship, called the operating theater, may have major consequences, as it often goes through dangerous and sometimes uncharted seas. Each decision made will have substantial effects on everyone involved in the voyage, primarily the patient and the outcome of the operation, the family and the loved ones, but also the entire team of anesthesia and nursing. The difference between the realities of an operating theater and the wrecked ship metaphor is, if things go wrong, the only one who is lost and never returns home is the patient. To ensure the best possible outcome for the patient, it is imperative that the surgeon, like any good captain, maintains the clearest state of mind to steer this journey towards a safe harbor. In the event of a mishap, unlike any shipwreck, the patient is the one who suffers the ultimate loss.