Developed new found respect for my old attendings today. Our new partner is learning robotic surgery. She was doing laparoscopic surgery prior to joining us but we are trying to get her up to speed on robotic assisted laparoscopy. Kind of tough for her to catch up since Hector and I have done over 350 cases. Was letting her do a case on one of my patients today while I sat and guided her through the surgery. Its one thing to have patience and teach someone on a patient you don't know (I instruct and proctor on other physicians learning robotic surgery) but an entirely different thing when it is your patient. The hardest thing is I feel like I made a commitment to the patient that they would get the best care- they came to me because I am an expert in robotic surgery. Its not that Robyn is a bad surgeon- far from it. Its just that she is nowhere near as fast or good as Hector and I are. I still can't believe how my former attendings could stand there and let us fellows and residents do those cases and make the mistakes we had to make to learn along the way. For those not in the medical field, this sounds scary but that is the way every physician learns- there is no substitute for hands on practice. Have two more similar cases tomorrow that Hector wants me to let her do. I think I'll have to do half of them myself just to keep the case going, plus maybe she can learn something by watching the way I do it. I know she feels frustrated as well, she says she can do the surgery in half the time with traditional laparoscopic surgery and she probably can. I said the same things when I started. However, once you get really good at robotics there isn't anything you can't tackle and you don't get any better without practice.

On a different note- had a 19yo patient the other day that has a rare tumor. How do you convince her and her family to go along with your recommended plan when you aren't even convinced? They want survival percentages and chances that things will work- there just aren't any good randomized trials with tumors this rare that one can point to and say "this is what you need to do". The best I can do is offer by best opinion (guess) and hope for the best.