The Power of a Stitch

Reflections from the Association of Women Surgeons' Booth @ the 3rd USA Science & Engineering Festival

By: Shannon F. Rosati, MD

As a surgical resident, I have spent countless hours arduously laboring on my craft – in my intern year, it was knot tying and holding perfectly still in the OR to maintain exact retraction; in my second year, it was central line placement and the art of the sub-cuticular skin closure; now in my third year, it is operating, fascial closure and having a team of junior residents looking to me to help them learn.

It was with these lessons in mind that I spent the weekend volunteering at the 3^rd USA Science and Engineering Festival. Amongst hundreds of booths, led by teams from NASA, the NIH, the EPA and the National Science Foundation, to name a few, I went to represent the Association of Women Surgeons. Our booth was not flashy- there were no robots, no gravity defying experiments, no inflatable cadaver lungs. We sat with few simple tools: needle drivers, Adson pickups, scissors, foam boards, and suture.

As the first child approached, a young girl no older than seven, I looked around, nervous – what did I have to offer that could compare with the amazing experiments and innovations that surrounded me? There was a ROBOT one row over after all! The child asked, “ What does your booth do?” And so I answered her with a question of my own- “ do you want to learn how to place a stitch?” Immediately, her eyes lit up, eagerly nodding her head “yes”, after looking to her mother, who said, “This lady is a doctor. She can teach you.”

I demonstrated for her what I have come to take for granted over the past several years – load your needle, place it perpendicular to the skin, turn your wrist and drive it through to the other side of the incision. Next the tie (here we did instrument ties) – place the needle driver in between the two ends of the suture, loop one end around, and pull through. After loading the needle for her (not one child stuck themselves, respecting my instruction on the sharpness of the needles), and painstaking concentration, she was able to place one suture, with one knot.  “See?” I told her. “You’re ready to be a surgeon!” The look on her face and her excitement at having completed the task was echoed throughout the weekend – more and more children, all immediately engrossed in the placement of one single, interrupted stitch, all smiles and excitement when their task was accomplished.

Who knows if any of the several hundred children I encountered this past weekend will have a future in the medical field. What I do know is that this experience for me not only reaffirmed my desire to teach others, but also, and more importantly, reminded me of how much I can learn from the simplest of tasks. We owe it to our patients to remember that each and every stitch is important, that everything we do can make a difference and has an impact on those for whom we are charged with caring.

As I journeyed home from Washington, DC, more exhausted from my weekend of suturing with these children than from my last 80 hour workweek, the words of one of my “junior surgeons” resonated in my mind. This young boy, having finished his stitch, surveyed his slightly less than perfect knot quizzically, while his mother asked him “what would you tell your patient?” He stated simply: “I would say that I did my best.” And therein lies what I will continue to strive for, as a resident, a future fellow, and attending – to do my best, at each and every stitch, for each and every patient.

Shannon F. Rosati, MD is a General Surgery Resident at the Medical College of Virginia (Virginia Commonwealth University).