Trusting Your Own Hands: Lessons from the OR

By: Dr. Wissam Benhami, MD, General surgeon

Affiliations: Université des Sciences de la Santé (Youcef El Khatib) – Algiers, Algeria and Clinique Rahmouni Djilali (formerly Les Orangers), Chikh El Bachir El Ibrahimi, El Mouradia, Algiers

Every surgeon faces moments when they feel like even though their hands know the truth, doubt pushes them to look outward for guidance. I often remember this playing out in two operations linked by the same thread. My hesitation was replaced by reassurance from someone who had not lived through the case from the beginning.

The first case was an emergency colectomy in an unstable patient. The resection was complete, and the question was a familiar one. Should I restore continuity or divert the patient? The tissues were distressed and the patient’s physiology was fragile. My colleague also hesitated. It was not ignorance in either of us. Instead, it was the quiet calculations surgeons make when risk feels more dangerous than it should. 

A surgeon from the neighbouring theatre stepped in, glanced at the field, and said, “It looks good. You can do an anastomosis.” The comment was light and felt almost casual and yet it miraculously shifted the balance. We completed the anastomosis but with unfortunate consequences- a leak. The patient survived, but only after sepsis, reinterventions, and a prolonged recovery.

The second case involved a patient with Crohn’s disease. The bowel was inflamed and although perfusion was not perfect, bowel viability did not seem to be compromised. A stoma had been planned but once again,  a colleague entered and questioned this decision. “Why do a stoma? This will do fine.” This reassurance again tipped the scale. We performed another anastomosis which was complicated by another leak.

These cases are not examples of incompetence or arrogance. They expose something subtler: the authority we assign to the “fresh set of eyes.”

Surgeons are trained to call for help. It is rightly framed as a safeguard against overconfidence. Many complications have been avoided because someone spoke up. But we rarely examine the opposite risk of external reassurance overriding well-founded hesitation and sound decision making.

A surgeon entering mid-case sees a snapshot. The operating team has lived through the entire film — the difficult dissection, marginal perfusion, creeping instability, accumulating fatigue. Context is embodied knowledge. It includes tactile feedback, tension in the tissues, and a sense of when conditions are borderline. These things are all difficult to articulate but play a central role in judgment.

Objectivity from outside does not automatically mean deeper insight. It simply means objective distance. This distance can create clarity, but it can also create oversimplification. Confidence delivered from the doorway may feel authoritative precisely because it is unburdened by immersion.The problem is not the act of seeking advice, it is mistaking perspective for decision. When reassurance arrives at the moment of vulnerability, it can subtly convert hesitation into compliance.

I still believe in teamwork. I still ask for help. But, I have learned to recognise that my hesitation is not weakness, it is data. When something feels marginal, that feeling often reflects accumulated information that is invisible to a late observer. Help should inform judgment, not replace it. A colleague’s opinion is valuable, but responsibility remains with the surgeon who has lived through the case minute by minute, from beginning to end.The question is not whether we should call for help, but how we can integrate advice without surrendering the quiet knowledge formed by our own hands.

Wissam Benhami, MD, is a general surgeon recently graduated from Université d’Alger, currently working at Clinique Les Orangers, an oncologic surgery clinic in Algiers. She dreams of specializing one day in hepato-biliary and pancreatic surgery. In her free time, Wissam enjoys working out, practicing Pilates, reading romance novels or self-development books, playing with her cat Olivia, and cooking indulgent meals for her husband, her love language.