By Marc A. Neff, MD, FACS
On May 25, 1977, George Lucas introduced us to his “Star Wars” universe. Since then, the films alone have grossed more than $4.49 billion. The franchise has grown to encompass six movies, a TV series, books, comics and radio, and has inspired the hearts and minds of an entire generation of would-be Jedis. The saga has become the myth of our time. Recently, Disney purchased Lucasfilm for $4.05 billion.
This saga is the classic embodiment of all aspects of a myth. It involves a hero who falls from grace. He learns he has special powers and goes on a spectacular journey. Along the way, the hero will meet a wise mentor, have several brushes with death and acquire several unique companions. finally, there is an ultimate challenge that is overcome despite unbeatable odds. The hero then returns from his trial, successful, and makes the world forever a little bit better.
In the first movie, Luke, a forgotten farm boy, learns he has a special heritage. He is taught to believe in his potential by his mentor, Obi-Wan Kenobi. His magical power is The Force. His companions include droids, Wookies, a smuggler and a princess. He faces insurmountable odds in challenging Lord Vader and the Death Star, but in the end, he is victorious.
I would suggest that surgical residents everywhere are reenacting this myth every day. They start medical school lost in the drudgery of the lecture hall. They spend hours toiling in the library and in books at home. They are much like that poor, forgotten farm boy—or girl, given current residency statistics.
After a time, the medical student progresses to the knowledge that they want to be a surgeon. They commit to the training and begin the application process to a surgical residency. They commit to a life of surgery, or in the Star Wars realm, they would now be considered a Youngling, starting to select a Jedi Academy at which to train. The Youngling starts to recognize that they have some special abilities. Perhaps it surfaces in anatomy lab, or maybe when learning their first procedures such as placing IVs, or finding veins. They recognize that they are not like other medical students. They have a special talent, dexterity, a mental concept of anatomy that not all possess. They recognize that they are, like Jedis, Force-sensitive.
Then, they leave home and embark on a residency. They often travel to a far-off place or world (a residency program, or in this analogy, a Jedi Academy). There, they meet strange people who will help them in their training. The different residents in emergency medicine, family practice, OB/GYN and the nurses with whom they become friendly are like the different characters in the “Star Wars” saga, the droids, Wookies, smuggler and princess. And although there are many Jedi academies spread across the country, with different Jedi knights and masters, all Padawans study the same techniques from the same tomes of knowledge. They battle the same dark foes (appendicitis, cholecystitis, colon cancer, etc.) and learn to use the same lightsabers (scalpels, laparoscopic instruments, retractors, etc.). All Jedi academies produce Jedis.
But it is the attending surgeon who is the surgical residents’ Obi-Wan Kenobi—their mentor and guide in this strange new world. The attending surgeon often is considered all-knowing, with an ability to know labs and x-ray results with the precognition of a Jedi. They often can influence people with a look or a stare, like the Jedi can with a wave of the hand. They can reach their hand deep into the pelvis and use some unknown power or Force to free up a stuck piece of bowel in an adhesion, or mobilize a splenic flexure high up by the diaphragm. Of course, there is a hierarchy among surgical attendings (like the hierarchy of the Youngling, Padawan, Jedi, Jedi knight, Jedi master and Jedi grandmaster), where some have more knowledge in lightsaber combat techniques than others. And there is a Jedi Council that decides the fate of the young trainees (the Mortality and Morbidity Conference). At these Jedi academies, there are even evil surgical attendings that often are considered Dark Sith lords, and I suspect some really can shoot Force lightning from their fingertips if they get mad enough. But I digress.
The point of this analogy is that residents are our modern-day Jedis in training. They have to have a singular dedication to their path. As Yoda said in episode I and episode V, “A Jedi must have the deepest commitment, the most serious mind.” They will have several obstacles in their way, many times seemingly impossible to overcome, before they complete their training and can call themselves attendings (Jedi). They will battle with balancing their career and their social relationships. They will be tempted to take short cuts (not check that x-ray after line placement, but sign it out to someone else, or assign that H+P to a younger level resident) and give in to anger, hate and the allure of the dark side of surgery (of the Force). They will have to face the Jedi Council several times. They will be apprenticed to several masters before their training is complete. And, in the end, they will have to face numerous tests of their ability (ABSITE exams), before they ultimately face the Death Star (the board exam). But, like Luke, most will re-enact this modern-day mythos and become a true surgical attending (a Jedi)—a powerful hero for good who wields a scalpel (or a lightsaber) in remarkable, unimaginable ways, a superhero who stands against evil in our world (surgical pathology and insurance companies).
If you believe any of what I have written here, then, to the young Jedi in training, I say that even when you are tired, hungry, embarrassed, overwhelmed, mentally exhausted and ready to quit (which happens at least once every six months), remember not to give in to the Dark Side. Remember that it took three movies before Luke could be considered a Jedi. When you are about to give up preparing a five-minute summary on a 200-page chart for the Mortality and Morbidity Conference, remember what Yoda said to Luke in the swamp on planet Dagobah about lifting an X-wing out of the swamp with the Force, “Do or do not, there is no try.” And, when you feel like a dark-side surgical attending has just cut off your hand like Vader did to Luke, or that you will be unable to destroy the Emperor’s new moon-sized battle station, remember what Obi-Wan said to Luke “The Force will be with you … always.”
Dr. Neff is medical director of the Kennedy University Hospital Bariatric Surgery Program, Cherry Hill, N.J.