The surgical football

Representation pic

I must confess that I'm not a big football fan, but I jump onto the bandwagon once every four years and watch the last few matches of the FIFA World Cup. And what an eclectic final we witnessed, probably one of the greatest matches ever played. Every conceivable emotion that humans are capable of experiencing came alive in a span of three hours across the globe. Joy, sorrow, hope, fear, and passion were not just simmering, but boiling in the same pan. The certainty of Argentina's success was transformed almost irrevocably in a matter of minutes by the French. However, the exuberance of Mbappe's youth was eventually silenced by the resilience and wisdom of Messi's old age.

The morning after the dust had settled, I couldn't help but think about the similarities between soccer and surgery. It's a different thing that when soccer players end their careers, surgeons start theirs but every surgery performed on the brain (if not spine) is like a football match - if not always a final, at least always a knockout. It's you versus the tumour. Only one can win.

You need to know when to attack and when to defend. You need to find the correct corridor and get to the tumour without conceding a foul to a neighbouring blood vessel. Unlike in football, in neurosurgery there are no yellow cards. Only red ones. One mistake and you're out of the game. There's no referee to argue with. An operation is indeed akin to a football match. Several minutes of boredom and a few moments of terror. For most of the game you're passing (instruments) and occasionally, you're dribbling since some of the instruments have a foot control. It's only those moments of terror that test your grit and grace.

Also read: Of Messi and other messes

Younger surgeons (the Mbappes), having just learned all the skills in the game are often more aggressive. They walk into the operating room with their chest popping out, they have the brashness of a footballer and attack a tumour destroying everything that comes in their way. This pugnacious attitude often works and in fact is needed in the right dose, but overdoing it might harm both the player and the team.

The tempered surgeons (the Messis) know when to pick their battle. They're gentler with tissue, they take their time to dissect and attack in short bursts when time and space is on their side. This makes them surer and more efficient, even though it may seem like it takes longer to complete the task. They know how to get themselves out of trouble and that comes only with the wisdom of experience. As the famous surgeon and writer Atul Gawande says, "The differece between triumph and defeat you'll find isn't about the willingness to take risks, it's about mastery of rescue." Good doctors and hospitals don't fail less. They rescue more. Argentina was able to rescue themselves from where they were. There was a certain cockiness about France when they thought they had made it in the end.

Taking a penalty is like removing the last bit of tumour stuck to an important artery or nerve. At that given instant, everything you've trained all your life for becomes important to the solution of the problem. You can't do it later. You can't scroll down on your phone for help. You have to have the exact precision, speed and timing for that one move. Your heart is racing beyond measure and yet your hands have to be still as a star. Everyone is watching what you're doing on giant monitors in the operating room amidst the deafening silence of beeping monitors. Either you score or you are annihilated.

And both those things can happen in the span of one operation. The emotions we witnessed in the World Cup final, surgeons experience regularly, but thankfully it's not broadcast live on world television.

Oftentimes we score, but sometimes we stand defeated. And when we lose we too cry like grown up footballers, but it happens in the isolation of our closed spaces. We don't have people telling us, it's going to be okay. Like the famous surgeon Leriche (it's not a coincidence that he was French) said "that every surgeon carries within himself a small cemetery where from time to time he goes to pray - a place of bitterness and regret. Where he must look for an explanation for his failures."

Every footballer probably does the same for every penalty they miss. Every sportsperson does that for all the chances they lost. Michael Jordan said, "I missed more than 9,000 shots in my career. 26 times I was trusted to take the game winning shot and I missed. I've failed over and over again in my life and that is why I succeed." And that is what Messi showed the word on that fateful Sunday. That is what surgeons across the world do when they go out each morning like gladiator sinto the battle field. "Neurosurgery is a contact sport," the famous aneurysm surgeon Juha Hernesneimi once told me.

As we draw closer to the end of another glorious year, most of us sit back and reflect on our hits and misses. On our wins and losses. On our triumphs and disasters. We deliberate on where we went wrong and what we need to do to course correct. We forgive those who hurt us and seek forgiveness from whom we have harmed. We strive to take the next step in the right direction. We hope that in the coming year we will be better, stronger, gentler and kinder versions of ourselves.

We wish that that each of us will have a story to tell, because, as Gawande says, "Life is meaningful because it's a story and in stories, endings matter." Just like it did for Argentina and Messi. Hoping the end of 2022 allows you to start a new beginning.

Wishing you all a merry Christmas and a happy new year.

The writer is practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals.