Fear is your superpower

Lessons from the operating room on anxiety, fear, and falling in love with failure

My hands look steady. They place each suture where it’s supposed to go. They thankfully don’t betray me when the scrub nurse puts scissors in them.

Inside, my chest is crushed in a vice. My breathing is shallow. And my brain roils worse than a ship in the Bay of Biscay.

“What if you can’t do this?” my brain asks me, the patient’s face literally wide open in front of me. “You know what, never mind. You know you can’t do this. Your repair is just going to break down, your reconstruction is bound to fail, and then what? You’re screwed. He’s screwed.

“You shouldn’t be here.”

I know that voice. I know this feeling. I’ve written a lot about the fact that I live with anxiety, my jagged traveling companion. And this—the racing heart, the shallow breathing, the catastrophic thinking? He’s back.

And worse. He’s got a point.

Let’s back up.

A few years ago, I met Sebastian (not his real name). He had a tumor on his jaw that I had taken out. I’d replaced the diseased mandible with a metal plate, rotated some muscle over it, and closed everything up. I’ve done this operation hundreds and hundreds of times. And Sebastian looked great, just like his predecessors.

He looked great, that is, until he didn’t. Two weeks after the original operation, Sebastian’s face broke down.

Every single incision pulled apart, leaving gaps wide enough that you could see his tongue through his neck. His spit bathed his chest.

It was, to use the technical word for it, real bad.

It’s hard to describe the sinking feeling you get as a surgeon when one of your wounds opens up. We all know that complications happen—the only surgeon who doesn’t face complications is the one who doesn’t operate—but still. Even a small dehiscence can make you question your competence, to say nothing of a total and complete wound breakdown like Sebastian had.