The Humble Captain

Long before I had language for it, I created an alter ego for myself in the operating room. I call her the Humble Captain. She is still the captain of the ship. The decisions ultimately rest with her. The responsibility belongs to her. 

But she doesn't lead from above. She leads from below.

Lao Tzu wrote, "All streams flow to the sea because it is lower than they are. Humility gives it its power."

I've come to believe the same is true of operating rooms. When I make it psychologically safe to be around me, everyone else becomes braver. The scrub tech recommends an instrument. The circulating nurse asks the question she's been wondering if she should ask. The CRNA notices a subtle change in the patient. The anesthesiologist offers a suggestion without worrying about stepping on my toes. Information flows freely because no one is spending energy managing my ego.

Ironically, the more authority I give away, the more effective my leadership becomes. The buck still stops with me. But the operation isn't about proving I'm the most powerful person in the room. It's about creating the conditions where ideas and solutions can come from anywhere.

People sometimes mistake our laughter and banter during difficult cases for a lack of seriousness. It's the opposite. Playfulness allows our nervous systems to feel safe enough to think critically. A brain trapped in urgency loses access to curiosity, creativity, and intuition. A regulated brain observes, solves problems, and notices the tiniest details others miss.

Biologists have long recognized that play isn't frivolous. Young mammals play because it develops the very skills they'll need to survive: coordination, adaptability, emotional regulation, and social cooperation. The animals that play are preparing themselves for the moments that matter most.

I think operating rooms work the same way. When the atmosphere is calm enough for people to smile, tease one another, and think out loud, we've created the conditions where everyone's brain performs at its best. It's black-and-white thinking to assume we must choose between showing up super serious or careless. There's a middle place, where lightness gives us access to observational awareness and surgical intuition. That middle place is the safest way to approach a high-stakes situation.

The culture many of us inherited in surgery was built on intimidation. The surgeon barked orders, and it was everyone's job to comply. Respect flowed upward. I've spent my career trying to build the opposite. I'm not people-pleasing or ingratiating myself for favors. I'm connecting with my team from a place of humility and lightness.

Because in my experience, that's the safest way to navigate the precarious, unpredictable nature of the operating room.