Dear Editor,
I read with a sense of déjà vu your editorial on SOS=Save our Surgeons (from succumbing to stress).[1] Just last month, I had an expulsive hemorrhage during an elective extracapsular cataract extraction for a brown cataract in a one-eyed patient. I remember my heartbeat thumping aloud, mouth drying, and my hands shivering, while I tried to rapidly suture the wound and salvage the case.
I have become aware that as we age the stress is high during complex surgeries, since we have to deliver results. However, experience helps us to preempt complications, as the surgery progresses, by using our dexterity and tricks learnt over years and astute observation skills. All ophthalmic surgery, is a signature of the surgeon in the eye visible for a lifetime, so the pressures are very high to deliver every-time.
My 1-year vitreoretinal fellowship in Japan introduced me to Zen and zazen. The term Zen is the transliteration of Sanskrit dhyana -meditation, which leads to prajna which is the highest form of intuition we humans possess. Zen is a body and mind discipline, concerned with here and now, with the aim of seeing things as they are, in their true nature. This constant awareness and being in the moment, aids in calming the surgeon to face challenging realities during ophthalmic surgery. The very essence of Zen is the destruction of dualistic distinction, leading to growing concentration and compassion which forms the crux of medicine.
Zen frees us of stress and anxieties through zazen and gives us equanimity to address difficult situations and complications encountered in life and during surgery. In this Buddha nature of calm and serenity, the patient and the “ I” become one, so stress disappears.
D.T. Suzuki[2,3] introduced Zen to the west, emphasizing the value of meditation and intuition. Ophthalmic surgery, in itself is a delicate performance art and is more mental than physical. To be the best, one needs to control his mind and use it as a tool. Zen meditation can give us an insight into Wabi-, meaning spare, simple, functional means of transcending the Self, which gives us a deeper understanding of surgery. That is, when the archer becomes the arrow[4] and the surgeon the knife. So, going beyond your mind gives a deeper and different understanding of a certain equanimity to doing the surgery well and opens our inner eye for a stress-free sustenance.
If one really wishes to be master of an art (surgery), technical knowledge of it is not enough. One has to transcend technique so that the art becomes an “artless art” growing out of the unconsciousness.
D.T. SUZUKI
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Conflicts of interest
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References
- 1.Honavar SG. SOS =Save our surgeons (from succumbing to stress)! Indian J Ophthalmol. 2021;69:2245–6. doi: 10.4103/ijo.IJO_2164_21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Suzuki DT. Essaysin Zen Buddhism;Grove publisher - New York, Series 1,2,3 London, 1950,1953,1953 [Google Scholar]
- 3.Suzuki DT. Introduction to Zen Buddhism. New York and London: Grove publisher -New York; 1949. [Google Scholar]
- 4.Herrigel E. Zen in the Art of Archery. New York and London: Penguin publisher-UK; 1953. [Google Scholar]