The year was 1984. I was a chief resident in general surgery at the US Naval Hospital, Oakland, CA. I and my two co-residents were finishing the last of five years of training in general surgery. By now, we were functioning as nearly independent surgeons, operating on our own patients and helping train the residents behind us. We were allowed to operate without an attending surgeon present most of the time, but were expected to request assistance if we needed it on complex or difficult cases. By this time, we had enough knowledge and surgical experience to feel fairly confident in our capabilities.

Surgery is a strange amalgam of confidence coupled with humility. Confidence is a must in a profession where you are cutting people open as a matter of routine. Humility is equally important. People and the human body are simply too complex to be approached without some trepidation and with great respect. There has to be a balance, however. The over-confident surgeon is just as dangerous as the overly-timid one.

One of the traditions of our program, indeed, of most surgical training programs, was to send off the graduating residents with a banquet. It was attended by all of the residents and attending surgeons and their spouses. The graduates were toasted and roasted in equal measure in funny and, sometimes, embarrassing ways. For that evening, the general surgery service at the hospital was covered for emergencies by one of the other surgery services so that we all could attend and the day’s surgery schedule was shortened as well. For the graduating residents, it marked the transition from resident to attending surgeon and was highly anticipated.