Before the First Cut

Every surgery begins long before we pick up the knife.

First comes the qualification, a careful process of determining whether surgery is the right path at all. The indications must be met. The parents and the patient must understand what can be done, how it will be done, and what risks come with it. There is no surgery without risk. There can be bleeding, injury to surrounding tissues or organs. The surgery might not be fully successful. The disease might return. These are not small things. They cannot be undone. And that is precisely why each decision carries such weight.

We carry that weight with us into the operating theatre.

We position the patient carefully, so they remain comfortable for what might be a long time. Sometimes additional examinations are performed once we are already there. And if there is even the slightest concern, the smallest wątpliwość, that Polish word I reach for when "doubt" doesn't feel heavy enough, we pause. We think. If needed, we postpone. We need to be one hundred percent certain that this surgery will bring benefit. Not probable benefit. Not likely benefit. Certain.

Parents often ask me: how long will it take?

It is a harder question than it sounds. We know our statistics, our estimated times. But surgery is not a schedule. If we encounter something unexpected, we do not stop until we are finished. So the most honest answer I can give is: as long as needed, and as short as possible.

I know, while we work, that families are waiting somewhere nearby. Frozen. Holding their breath. I have seen so many faces in my memory, the particular stillness that comes over a parent the moment they see me walking toward them, trying to read my expression before I have even opened my mouth.

I always smile first. My first words are always: we finished, they are alright.

The relief that moves through a person when they hear those words: the exhale, the shoulders dropping, sometimes tears, I never take that moment for granted. There are times, of course, when the news is more complicated. When the surgery was not a failure, but not a complete success either - just one step on a longer road, with hopes still ahead. Those conversations are different, and they require their own kind of care.

Thankfully, in my career so far, I have not had to deliver the worst news. I hope it stays that way.

But I do not forget that the possibility lives with us in that room. It is part of what makes every preparation matter. It is part of the weight.