Achievements, Regrets and New Year Resolutions!

A brand spanking New year!

As I look back at 2025, I see a lot of things I achieved and a lot of things I am proud of ….at the same time I see lot of things I would have liked to have done differently. I personally feel it’s the same for all of us…….

The truth of the matter is that everything looks simple and straightforward in retrospect and hindsight, but we do not have the luxury of hindsight when we make decisions based on information we have at present, with foresight.

A little detour here – At one part of my life, when I was a junior registrar in Colombo, I was mad about the life of US Neurosurgeon Ben Carson. I watched the movie Gifted Hands, read the book…..I even adopted the same beard style, which I still keep, though I hated Neurosurgery and got hooked with Trauma and Emergency surgery!!. He was a great example of how someone from a disadvantaged background triumphed in life against racism and discrimination through honest hard work and sheer determination – against all odds, he became the first black paediatric neurosurgeon in Johns Hopkins and became world famous for his innovative surgical procedure to separate conjoint twins. I would highly recommend the book and the movie!!

In his book, he mentions a decision matrix which i think, if used, can avoid most of the dilemmas that we have at the end of a year. He describes four key questions to ask at every crucial junction in life –

  1. What’s the best thing that can happen if I do this?
  2. What’s the worst thing that can happen if I do this?
  3. What’s the best thing that can happen if I don’t do it?
  4. What’s the worst thing that can happen if I don’t do it? 

Very simple, infact almost foolishly simple….but surprisingly we don’t use this rational tool to simplify difficult decisions every day. In essence, by doing Ben Carson’s Decision matrix, we eliminate hindsight and convert hindsight into foresight….We visualise our future selves now and use the wisdom to gain insight into our present actions.

So the coming new year I have made a resolution to use Ben Carson’s decision matrix to every decision….infact I used it just now, as I was procrastinating whether to write this blog, which I have done quite a lot lately-….well not anymore!! I decided to put pen to paper [ stylus to my phone!] On a bench waiting to collect my groceries, as Ben Carson’s decision matrix showed me, the benefits far outweigh the risks. Infact, not only that, in the future I am going to use the same matrix to help patients decide on their future care!

That’s me signing off and wishing you a Great year ahead!!

Safe surgery till we meet again!!

LBS

Merry christams and Happy New year…With Santas End of Year Masterclass for Surgeons!

Merry christmas and happy new year to all!

I have been preaching about consistency and Getting things done [GTD] but on the “blog” front I have been a bit of a dissapointment myself I must say. I got caught up on variety of things at work, Deadlines, Covering strikes, Sickness, Kids ect ect and have not taken the pen to write something for a long time…..But as I always say better late than never….and I have made it a new years resolution to write regularly!!

On this christmas I was at Centre parks, witnessing Santa and the Elfs at work and then of course Sanata leaving to the Noth pole with the Elfs, after delivering all the Gifts to the Nice people [Not the Naughty ones!], for a well deserved break. What can we, as surgeons learn from Santa and his Amazing Christams “operation”?

One thing I like about Santa [ And I dont see this from many of my trainnes] is absolute dedication. Rain, Wind , Snow, Cold , even Poor visisbility for Flying ! -Nothing deters Santa. He never dissapoints the millions of children [And adults] who eagerly await his appearance around the world. It is probably very easy for santa to skip a christmas or reschedule a delivery or skip an address – But No, Santa even at his age, never misses a deadline nor does he skip any christmas event citing variety of lame excuses- For all the young and Junior Surgeons [ You may dis⁹agree with the terminology but trust me being the “Junior”surgeon in the room is quite an advantage – when you are senior the buck literally stops with you!} , this is a very good trait to develop early in your careers – be consistent and keep at it – You dont have to feel perfect to get up and come to work! Life does not wait for anyone so get on with it – Just like Sanata has done for years.

Secondly I am yet to hear any child who was dissapointed with Sanatas operation. Its always the same – Same image, Same consistency. You can be rest assured that Santa always gives his best shot at delivering their gifts in an accurate and timely fashion. If you close your eyes just now and Imagine Santa, the image in your head would be remarkably similar to anyone else doing the same thousands of miles away in a different country- It differs very very little with Time , Place and Person. Again an excellent trait for a young surgeon – Be consistent and do your best and leave it, Rest is not up to you. Dont be Mediocre and Slip shod – It does not look good on you or anybody else. Never take things for granted – remember you are building a brand – Just like Santa has a brand that is consistent and universal, you really want your brand to be the best it can be , so dont leave it to chance.

Thirdly , Appearance matters. I am yet to come across a situation santa was caught in dishevelled mess – He is always neat , tidy ,same unique red coat , neat and pressed , with his christmas hat on, even on extreme busy christmas period where he is doing “rounds”. Similarly you should always think about your appearance – It matters. If you appear tired, untidy and unkepmpt , and then you are discussing an emergency operation with your patient which you are about to embark on, which indeed has the potential to alter your patients whole life, how does it look ? You will certianly not be inspiring much confidence in your patients mind and instead of calming them , you may be aggrevating the mental suffering. Remember Santa – however “Crazy” his delivery rounds are he always appears neat,tidy and Professional- We should make the effort to do so too!

Last but not least , Plan ahead, Just like Santa. Its not easy Logistically to do a Operations of such magnitude like santa and achieve efficiencey like he does, with Zero tolerance for errors or delays. Never has he delivered the wrong gift to the wrong household. How does he achieve it – He plans every thing carefully for months. He has a team of elfs who he delegates responsibilities. He has checklists – Sleigh, raindeer and gifts carefully labelled and packed. He risk stratifies with Naughty and Nice lists. He plans his acess and exit carefully [ Chimneys] and has contigency plans for unexpected findings [ What if there is no chimney ?]. He makes sure his team gets cared for [ Carrot and Mince pies for the Raindeer!]. He keeps the Morale high despite extreme work pressures[ Ho Ho Ho!]. All of this are excellent traits for a young surgeons to master – Plan ahead for all contigencies, Be organised, and above all be nice to your staff- They will look after you.

Finally despite all this planing , Shit happens! – Occasionaly even Santa gets stuck in Chimneys and has to be rescued!! Things will go wrong whatever you do and one needs to expect that. But by paying meticulous attention to details and mastering his craft , Santa is able to run a grand “operation” with remarakable accuracy and efficiency. We should learn from him too!!

Thats me signing off for today!

Merry Chistmas and Happy New year ahead! Safe surgery till we meet again!!

LBS

Teachers day……

Taking up the blog after a long time I must say! Once again I have only myself to blame- I cant make the lame excuse that i didnt have time, As everone else in this world I had 24 hours but i chose to prioratise other things !!

I am writing this on october 5th – so called word teachers day. Now i dont agree to this western concept of dedicating one specific day for something important and dear to us….they should be commemorated all days of the year, but in a way its good to have atleast one day to remind ourselves of what matters in life!!

I must say I have been fortunate in many ways to have had great teachers throughout my life and career. When I started my training in Sri lanka I had excellent surgeons to learn from. Things changed a bit for the worse when I moved over to residency somewhere  else. There were many mediocre teachhers that took no interset in teaching me, though once again due to I got lucky and stuck gold. I did not have many great teachers but few I had were absolutely outstanding!! Suffice it to say with their generous help and guidance I did well!!

Good teachers are like candles, in my opinion. If you use a single candle to light thousand more , the original candle will not loose any brightness!! Similarly the lighted candles would also pick up the flame and light many more !! If you look at it its amazing isnt it ?

Similarly the great teachers and trainers [ albeit few] whom i was fortunate to associated with, were like bright candles….they not only ignited the passion for  surgery but they also showed me the correct way forward with their guiding light…..I was truly fortunate and blessed to have them in my life indeed!!!

Fast forward many years, I am now in a pisition that I can pay back the next generation, which is a truly remarkable feeling!

Everytime i teach something to somebody , I feel I am also igniting the passion to learn and develop, and in turn they will also pass the flame onwards….onwards and upwards!!

Hence I will take the opportunity to thank all my teachers past , present and future!! Mr Ronnie Matthew, Mr John Wang, Prof Soo Khee Chee to name a few, amongst many more – Thank you for your generosity and kindness!! I will pay it forward!!!!

Happy Teachers day!!

Safe surgery till we meet again!!

LBS

Fairness…..Do people always get what they deserve ?

I am taking up writing this blog after a long time….I can’t give any excuses, though. I did not practice what I preached – consistency. Too bad. However, as with many other things, it is important not to let failures dominate and dictate terms, so I am determined to start today to write this blog regularly. It helps that I am down with a terrible fever and laryngitis and just recovering my voice- I am off clinical work for the last few days, so I have time on my hands, which is indeed a rare commodity.

During a decade-long career in general surgery, I have often come to the conclusion that life is not fair at all. I have, with my own hands, operated on patients who do not deserve to be shot at and suffer serious injuries, to have their limbs mangled and apmutated due to land mines, or to lose their lives due to diseases that no one knows or understands or due to selfish and reckless acts by other fellows in human society. I have seen kids who lose parents and get orphaned- I clearly recall the young people who died of a variety of illnesses, when they were just starting to blossom and enjoy life. No one seems to be immune to the unfairness of life – It is just how it is…..

As medical professionals and Surgeons, we have mastered the art of detaching ourselves from the sad reality and moving on…..We can’t dwell on the patient who lost their limbs or died – our services are needed for the next patient who is gasping for breath or fighting for life. The show must go on at all costs. Therefore, we put on a brave face and the mask of “no emotion” and carry on….. A lesson we all learn very early in our careers is that we can’t win all battles. Most of the time, we are fighting a losing battle.

That’s all and good for the professional aspects of medical and surgical lives, but how about real life?

The events that happened or are happening over this weekend have really got me thinking of this also. I notice that the same rules apply to real life, too. People behave in bizarre ways that we can’t predict or analyse. There is no logic or reasoning at times. At times, you are left wandering – How on earth did they come up with the decisions they have? Some things are obvious, but people decide to ignore them and make decisions based on surmise and conjecture….Are they correct decisions, based on past experience? They are probably not, but then again, we can’t predict the future, so only time will tell…..

So, how should we circumvent this irrationality of human decision-making? How do we avoid the heartbreak that comes with this? I can only turn to Buddhist philosophy here – Arguably, Buddaah was the greatest philosopher known to human civilisation- He preached a philosophy, not a religion……

In simplistic terms, Buddha said, “Give all to everything you do but expect nothing in return…..Absolutely Nothing”. Expect nothing from people you help, people you serve…..Be neutral and detached. That way, you won’t be guaranteed you will get what you deserve, but you have the guarantee that you will not have resentments. In other words, you can’t control what other people say or do and how it affects you, but you can control your reaction to that and your inner peace of mind. In Buddha’s own words, ‘ One who conquers one’s own mind will conquer the world.”

So in this coming week, try to do good and serve people…. but expect nothing in return, Try to conquer our minds to achieve inner peace and tranquility…..Life is neither fair nor predictable, and people make irrational decisions. At times, we can do nothing about it, other than conquer our minds and reactions to these

Safe surgery and Hope to see you soon!

LBS

It Pays to be Humble…

A Story from 15 Years ago

Early years of 2010s – Cant recall exact year

I was a General surgical registrar and was attending College of Surgeons Sri Lanka sessions and there was session on Hepatobilliary surgery.

At the end a Shiek gentleman from the back row politely introduced himslef and asked some questions from the visiting “expert” and thanked him for his replies. Nothing out of the ordinary – May be a Visiting consultant from a peripheral unit in India I thought…

Next day I was surprised to see the same man doing a Plenary lecture – Aravind Singh Soin …great talk, to the point. Not only till I googled him later that I relaised this polite unassuming man has performed more than 3500 living donor liver transplants in India which is the highest in the country, and the second-highest in the world! Probabaly more than whole of the liver surgeons in that room , including the visiting expert, combined !!

Moral of the story is it pays to be Humble…..

PS – What prompted me to write this is I was teaching in course recently and , while most of the partcipants were great, one trainee , an ST4 from Wales, really stood out.For those not familiar with uk training system ST stands for Speciality Trainee and starts from ST 3 to ST 8…so he was a very very junior trainee starting his surgical career.

He had his own opinion on everything we taught, He was so experieneced that he probably had nothing to learn, probabaly could teach next time. Little lunch time chat, as I happened to sit at his table at lunch, was illuminating for me – He talked ill of training in the rest of the world, including Pakistan where he was originally from, and in his own opinion , there would be nothing that he could not do after CCT and he would be far superior to his colleagues doing FCPS back home. Suffice it to say it was even more illuminating when the course director discussed each candidates experience and future golas at the end of the course…He had done less than 60 appendicectomies….Femoral hernias were less than the number of fingers of one of his hands ;)These are the most basic General surgical operations, not Liver transplants…and I leave it to your judgement about the descrepancy between his judgement of his own ability and experience and reality. If this is his arrogance now, I cant imagine his arrogance when he finishes training.

What can i say….My mind immmediately went back to Aravind Singh Soin 🙂 I recal the saying ” Empty Vessels Make most noise” , exactly the case here.

To all surgical trainees , and for that matter, to all Surgeons,  I would highly recommend being Humble….Dont make the stupid mistake of thinking you are the best of the best or no one is better than you. There are, and there will always be, people better than you. People who have gone very far and achieved great heights, like Aravind Singh Soin, are often unassuming and humble…

Save yourself the embarassment of being Arrogant and having to “eat humble pie” once you are proven wrong! Be humble….it pays to do so!!

Safe surgery till we meet again 🙂

LBS

Island Mentality….At its best !

Sundays I tend to catch up on the News from certain “Islands” that I spent a significant portion of my working life. There are Two of them…And, To say the least, it is certainly entertaining to review their handiwork.

A certain tiny island that I used to work in was unique in the sense that “brilliant people” who used to live there always used to look down upon anyone that is not from their “tiny community”….Tiny in more than one sense of the word. Anyone “outside” of their community was inferior…either a Liar or an Imposter. They were absolutely so full of themselves that, a suitable comparison was Hitlers Nazi philososphy. “We are the best [ Aaryans] and no other nation was anywhere near us” was their motto….And if there was a scandal…It is always the lesser Nantionalities….Never one of their own. It was “unthinkable” to even imagine that they would get involved in a scandal.

So I was reading the news yesterday….And I read that Ministry of Health in this particular island has suspended a consultant surgeon in Private sector who has commited fraud of more than 100K by using 6 TOSP codes for a procedure that takes only 2. Oh well …I thought, may be one of those “pesky fradulent foregners” , certainly not the ” brilliant honest natives who had exemplary careers” No way….Well needless to say, I was ofcourse wrong.

I am sure they will come up with some plausible explanation….”honest mistake” , “Blinded to the error” , “overlooked the details” …Or may be even the coding nurses fault…who was probabaly one of those “dishonest lazy immigrants”

On the other hand…what more can you expect from a culture that worships money as a religion ? Have no family or social values other than money ? I came across one “joker” that proudly asvertised ” taking blood from Migrant worker dormotries in a Covid 19 pandemic” as a prime qulaification for practicing colorectal surgery in private sector. This lunatic even displayed photos of such individuals on the website ….No consent or  PDPR …Nothing. This particular individual would sell his mother even without blinking an eyelid for money! A first class beggar for sure!!

Therfore the “Island mentality” of looking down upon anyone or anything that one does not understand is not surprising in this cohort of individuals….It is a defence mechanism. It is a way of justifying the delusional state of affairs that exist in this tiny island and its inhabitants….

In hindsight …..I never belonged there. I had values that went beyond ” Money”. Neither did many of my colleagues who left this place. They also had values and Moral principles they lived their lives by…And hoarding money by even selling ones parents was not among their values nor mine!

Our values were not for sale…

On that note I will end the post here. One final note though….You can run but You cant hide, Karma will invariably catch up with you. If you are a liar and a fraud – Enjoy while it lasts!!

Safe surgery!

LBS

The 3 “P”- The Professor, PEG, and the Phone call

I was a local surgical trainee in South Asia more than a decade ago and then left for East Asia for Residency training before I moved to the West, where I reside at the moment. Hence Sundays are always fun days- certainly for me, as I catch up on news from elsewhere.

To give a little bit of background , I had no plans of leaving South Asia initially where I was a surgical trainee, and I must say I did quite well in all my surgical exams – I was an exceptional student so to speak of – How ever my ambitions to join academia to University that I used to study medicine did not bear through. As with many “other” things in South Asia , appointments – academic or otherwise , rarely go to people who deserve them – ” apple polishing’ and ‘sucking up’ to others was not things I was good at – These are Indeed an essential skill if you are to survive there. So to cut a long story short soon after a rather disappointed me left South Asia and for east Asia – We will revisit this point a bit later.

This particular piece of news from the country where I used to train in South Asia caught my eye this week – Apparently a ” Professor” had made a “royal mess” of removing a PEG tube [ Gastrostomy tube used for feeding] and reinserting a new PEG [ Likley for a buried bumper], and the patients family was unhappy. So the patients father had attempted to call the “professors” via phone – It is a cardinal sin or a “sacrilege” for the “mortal patients” in this particular country question their doctors, let alone call them. Annoyed the “professor” had “threatened” the family to discharge the patient from his care without any explanation , which he had done – the family were left hanging in a limbo, Patient got seriously unwell and then went to private sector to get the mess sorted. But they were not keeping quite about it hence I heard the news.

Again I am not sure about the exact detail nor can I comment on the technicality of the problem, though from what was said, as an experienced General surgeon, it did seem pretty clear to me what had happened. Hence let us leave the technical bits aside [Although if you are the “professor” one would expect one to know how to deal with a PEG complication – A competent registrar should be able to]

What is glaringly obvious is the ” Lack of communication and complete Arrogance of the Professor -Mistakes happen even to the best of Surgeons [ Obviously the said “professor” does not belong to this group…] but it is ultimately the doctor patient relationship and the Rapport with the patient and family that decides the outcome. You can do the most complex operation and do an exceptional job at that [ Not the case in this particular case I am sure as I have seen this “professor” at work] but if you do not explain what you do/did to the patient and expect to Patients to accept your word as “gospel” truth – and get “Annoyed” when a patient requests clarification or calls you – I have one advise for the ” Professor”- Find another Job. You may survive in this particular country in “South asia” for some time , as patients do treat ” doctors” like Gods, but even then, Look what happened …….Did not go well did it ?

Coming back to the personal bit for the story- This particular “Professor” was one of the “Apple polishers” that was appointed for an academic position apparently I wasn’t deemed suitable – I had the “pleasure” of knowing him for some time and this is certainly not the first time he demonstrated these traits , not to mention his surgical incompetancy, which was glaringly obvious – But he was a world class ” apple polisher” so I presume in South Asia you climb the up the ladder fast :). I am sure he sets an exceptional example for the medical students and juniors also. Once again “perils” of Appointing the wrong person for the wrong Job – This particular country is a prime example of this, not only healthcare but In every imaginable field. The end result is country is nearly Bankrupt now ……

So the moral of the story is – Accept mistakes, acknowledge them, communicate honestly, manage patients expectations- Above all do not get annoyed when the patients seeks clarification – Leave your Ego aside. As the famous saying goes “You can run but you cant hide”

One cannot promise success all the time, but one can promise to do ones best -and Most patients would appreciate your truthfulness and honesty even when things go wrong !

Safe surgery till we meet again !!

LBS

ABC: Always Be Closing – A Guiding Principle for Success

I am back after a long time – Under the most celebration-worthy circumstances. As I write this blog post today I have just turned 40 years!

In Hindsight I have been an extremely lucky man. I have enjoyed reasonably good health, and success in my life so far. I have had my fair share of ups and downs in life but have been lucky enough not only to survive, but thrive, to some degree atleast!

It was not plain sailing all along though. I had to go through incredibly tough times and survive horrendous hardships to get to this point. It is a long, hard, and arduous obstacle course to become a general surgeon even in one’s own country, in familiar settings. I uprooted myself from the familiar circumstances and moved to one of the most unfriendly countries in the whole world to complete my residency training. I did not speak the local language. I knew nothing about the local culture. Obviously, I was the subject of incredible amount of jealousy and hatred as supposedly I took a “training number” reserved for the Locals , so to speak of .

However I survived – Not only did I survive , I did well. I completed residency training and graduated. It was not easy at all , there were certainly times I wondered I should continue or not – But one principle kept me going. When people around me were shouting me to quit, this principle kept ringing in my ears – I will share that with you today!

Some time back I came across the american you tuber Casey Neistat and watched one of his videos themed “Losers and closers”, in which he talks about ” A B C – Always Be Closing”. I think it was based on a movie clip with the same name though I have ot come across the movie. This clip fascinated me- Casey Neistat was a rebel, an absolute rebel and he nailed it in this video – His dedication and attitude to work and nay sayers was incredible. He even had “Always Be Closing” tattooed into his arm!! I will post a link to that video down below for you to enjoy it also.

So For the next 5 long years where Life was difficult and challenging I always lived by this philosophy ” A B C – Always Be Closing”. If you start something, you need to finish it – it is a non-negotiable rule. Whenever I was thinking of quitting I reminded myself about ” A B C”. I wanted to be a “Closer” not a ” Loser”. Needless to say, I thrived amongst adversity. While some of my colleagues succumbed I carried on! I was a “closer”

Fast forward many years I still live by this principle. If I start something, may it be writing a blog post, writing a paper, writing a book I always try to ” close”. I see a lot of trainees fail to follow this rule – They start things that they do not follow through. They do not finish what they start- hence they automatically qualify to become “losers”

I will put the link to the original Casey Neistat video below. It was a life-changing video for me – Maybe it will be for you too!

Remember “Always Be Closing”

Until we meet again – Safe surgery!

LBS

Link to video -Casey Neistat – https://www.youtube.com/watch?v=z_ESakf05PQ

First ever book review – My Own!

I am coming back to the blog after such a long time – my apologies about it! I have been keeping busy with numerous projects and one stands out!- which I am going to share with you!

As you would know by now, I have been blessed with the good fortune to work in multiple different countries and settings – some in the so-called “developing countries” and some so-called “developed world”. The differences I encountered were blinding and stark at times 🙂

I was a trainee in a certain “East Asian” country for almost 7 years. Apart from their “Island mentality” [Dont believe me ? Its an actual entity , read all about it in my previous Blog] what surprised me the most was the fact that some of the “surgeons” over there could not even do a simple operation properly……but the ease they had access to international qualifications such as fellowship…..Just by virtue of “being born” in a certain country. This left me ” disgusted”

On the otherhand my time in Southeast Asia as a trainee was incredible and rewarding . Surgeons, there were competent and skillful…they obviously knew what they were doing. They had excellent hand skills. They could complete a complex operation, skin to skin, without any problems – however. just by virtue of where they were , they did not have access to higher qualifications such as Fellowhip examinations – they had the skills but did not have the know how to obtain international qualifications !!

This made me angry ….why is there such a discrepancy and why could not deserving surgeons from disadvantaged settings who had all the necessary skills could not obtain the specialist qualifications they richly deserve?

I had only one answer to my question – there was no guidance for them to show the path to obtaining international qualifications. Therefore I decided to take matters into my own hands - I compiled a book to guide the general surgical trainees from the dis advantaged settings to obtain fellowship examinations in general surgery!

Certainly was not easy to do this …I spent many sleepless nights and sacrificed the time I should be spending with my Kids and Wife to make this project a success. But having said that I have absolutely no regrets at all, I had plenty of motivation …..

Most of the material in this book was taught to me by my excellent teachers [ I did not have many , but the few genuine teachers I had were exceptional – Ronnie Matthew , John Wang, Jhonny Ong, Alex Chung, Chok Aik Yong, Koh Yexin to mention a few ]. I took pride in the fact that I was paying it forward to helping the younger generations ….Afterall our noble profession is all about giving back and paying it forward !!

What can you do today to give back and pay it forward ? 

TC and Safe surgery till I see you again !!

LBS

Consistency ….Key to sucess!

No excuses this time around…I was Lazy and missed writing this blog a few weeks :(. However, that conveniently brings me to this week’s topic – Consistency!

I have many trainees who work with me, and often I get this question – How does one become good at what one does…This applies not only to surgery but to any other aspect of life, whatever you do! The answer is simple enough but the advice is not easy to adhere to …..Be consistent !!

Consistency is the key to success undoubtedly. Doing something again and again leads to mastery and understanding – we do not have to be a genius to figure that out -It holds true for any skill we practice. For example, when was the last time you drove to work – do you remember anything about the drive at all? The answer is No…While you were thinking of the rising cost of living , raging wars around the world or the case in theatre to do today , your subconscious mind neatly managed the potential hazards and navigated you safely to work !! That is because you have taken that journey hundreds of times in the past ….there is nothing to think !!

Lets change the scenario though- assume you have never driven a car before , or just passed your driving test. You are not experienced , You are not familiar with the roads. You will recall every single stop of the journey! That is because if you don’t concentrate every inch of the way you will likely do a mistake that will end in a disastrous manner !!

So in essence by practicing a certain skill over and over again you become so fluent in that skill that you do not have to consciously think about performing that skill. This holds true for any profession – A sandwihch maker at Subway has made thousands of subs that he or she does not have to think! The same way a pilot with thousands of flying hours under his/her bellt or a surgeon with thousands of operations under their belt would perform seamlessly without the need to stop and think about each step on the way.

How ever achieving consistency is not easy. The enemy of consistency is perfectionism. Infact this is one of those rare instances in life that quantity is more important than quality. If you are a potter it is better to put out one pot a day for thirty days than spend thirty days making one ideal pot…. Ultimately by making pots again and again your pots will get better with time, hence doing it consistently is way more important than getting bogged down by attention to minute details!

The other enemy of consistency is Laziness, Lack of motivation and drive. Then again most of us feel that lack of motivation is what is preventing us for putting out work. How ever that is not always true. We need to change our mindset to shift the focus from external factors motivating us to internal factors motivating us …For example as a professional I will need to go and do my Theatre list even though I do not feel 100% – At times you just need to get on with life , how ever you feel about it !!

So Lets remember that consietncy matters and as professionals weshould not depend on external motivation for us to work! Needless to say I will also try to practice what I preach and cosnstently out out at least a weekly Blog!

Safe surgery till next time!!

LBS