If there is God, why have the surgeon?

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Scrubbing in' is the act of cleaning your hands and arms with antiseptic prior to a surgical procedure. A neurosurgeon, whose career typically spans 30 years, and performs 300 surgeries annually, scrubs in for 10 minutes before every surgery, making it a grand total of 1,500 hours in front of a scrub sink. That, inarguably gives the surgeon the cleanest set of hands in the family, but it also offers him space and time for introspection as he stares at himself in the mirror, literally and metaphorically wearing a mask.

When you are a resident doctor, responsible for ensuring that there are no glitches, scrubbing in gives you the time to ponder over whether you have all the answers to questions about the patient's history that the chief surgeon might put to you during the operation: what does he do; is he a smoker; does he drink; does the name on the MRI match the patient who is inside the room; is he as old as the scan mentions he is; details of his symptoms. The answers may sometimes alter decision-making on the operating table.

I'd always remember to check with the anaesthesiologist if blood was available for the procedure, if antibiotics had been administered, and if the appropriate medication had gone in before the start of the case. Those 10 minutes of scrubbing in allowed me to run through a mental checklist to ensure the chief surgeon didn't have to worry about the little things.

As I evolved into an independent surgeon, the scrubbing in thoughts altered. I now run through the steps of the surgical procedure in my head; visualise the length, breadth and height of the surgical corridor; which blood vessel or nerves I need to be careful about. And, I always have a Plan B in place. Sometimes, Plan B fails too. Now, I routinely draft up to a Plan D. In the final one minute, as I let the warm water trickle down my elbows, my palms held high, the one thing I do is pray: first, for the patient who is about to undergo the knife and then for the guy using it. While I may not be rigorously religious or even superficially spiritual, I do believe in a force that guides, and might even offer direction to our actions. In the operating room, at least for me, there is an unseen power that connects the patient and surgeon, offering us both reassurance and confidence. On occasion, when there is uncontrolled bleeding during surgery, the 3 Ps that have stood the test of time - pressure, patience and prayer - come to work. A little music in the background doesn't hurt.

When I trained at the Christian Medical College, Vellore, before each patient was wheeled into the OT, the nurses would hold each other's hands and whisper a prayer. I happened to be walking by during one such routine and heard them say, "Take care of our patient, Mazda. Give him courage and strength. Help him recover fast. For this, we thank you, our lord, our Mazda. Amen."

I did not know whether I was temporarily flattered or permanently embarrassed when I clarified the doubt. It was 'master' they were referring to, the lord above, which, in their accent, sounded just like my name.

Some modernists argue that religion should play no role in science. But medicine is not an exact science; it is ambiguous. At the same time, we know of excellent surgeons who are atheists. For them, their work and skill is their religion. Once, while we both scrubbed in on a case together, I asked one such eminent surgeon, if he believed in God. "What's the difference between God and neurosurgeon?" he asked. Knowing he was trying to mess with me, I looked at him amused, gathered my thoughts, and said, "God doesn't think he's a neurosurgeon."

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