Going to medical school in Silicon Valley, I’ve had the opportunity to be housemates with more than a few good entrepreneurial start-up types. One of the mantras of those guys is “fail early and fail often”. What it’s supposed to mean (or at least what I think it’s supposed to mean) is that by making mistakes early in your career you get them out of the way when it doesn’t matter, and you take away important lessons that will help you to succeed when it matters later on.
With that in mind I thought I’d share one of my early medical school failures in the anatomy labs. At Stanford, we are lucky to have two classical and gifted anatomy instructors. I felt lucky to be perhaps one of the last students learning muscles, nerves, and bones with a coloring pencil and paper, a learning style I’m sure will soon be replaced with digital animations and iPads and who knows what else. I took the course seriously realizing this was some of my best preparation for surgical clerkships as well as for better understanding the internal organs as part of the physical exam.
Myself and three other students shared one body, and as the semester progressed we learned to work as a team and enjoy each other’s company. We had developed a camaraderie between the four of us, and we would debate decisions and forge ahead together. Was this the nerve we had been looking for or just another piece of fascia? We would take a quick vote and then cut or dissect.
The day arrived when it was time to quarter the body (yes, we actually cut the body into 4 pieces). To gain access to the anatomy inside the pelvis, we were to cut the body horizontally at the spine (transverse plane), and then cut vertically (sagittal plane) to separate each leg from the other. With saws grating, this was difficult to watch and to hear. I volunteered to do the sawing. We did our best to tie off the portion of bowel we would cut through, as failure to do so would lead to leaking bowel contents. I began sawing away through the bone of the pelvis.
As soon as I cut through and felt the legs fall away from each other, I knew there was a problem. I could smell it, and as I looked down I could see it as well; I had cut straight through a huge full cross-section of bowel, and bowel contents were now all over our cadaver. I was horrified. Many people felt queasy from disgust, but the thing that most horrified me was that I had ruined the gift of someone’s body as a cadaver. I felt a strong degree of gratitude to the person who donated their body, and I felt I let her down, I felt I let my teammates down, and I felt I let my instructors down. Along with the instructor, we spent the rest of the session trying to clean off the bowel contents from relevant anatomy (all of it basically).
I actually couldn’t bring myself to go to anatomy lab for a full week. I made an appointment with the instructor. I wanted to fully apologize for being so cavalier in dissection. I had a whole mini-speech/apology prepared. He said something to the effect of: “don’t worry, it happens to everyone.” He was right, mistakes happen.
Everyone learns something different from a failure. For me, here, it was that in any surgery or any intervention there are risks and benefits. Every physician needs to carefully weigh each before going forward, and he or she needs to be prepared for when bad outcomes happen, because no matter how good you are, they will happen. For me, it was fortunate to learn this on a cadaver.