Hektoen International

A Journal of Medical Humanities

The scorn of slow stitches

Anthony Gulotta
Bethesda, Maryland, United States

Photo by آرمین on Wikimedia 

As a third-year medical student on my first surgery rotation, I had been standing consecutively for almost three hours. Until now, I had stood silent, watching as the attending surgeon excised a gangrenous gallbladder. Then, my focus was rapidly disrupted. “Over here!” bellowed the surgeon. I was being called to suture for the very first time.

It was a baptism by fire, as I was dropped into the heart of the task with no preparation to speak of. My pre-clinical suturing course, vital for honing basic surgical skills, had been abruptly cancelled because of COVID. Supplied with a do-it-yourself suture kit and online tutorials, I had practiced at the kitchen table. But that controlled environment had not prepared me for the reality of suturing a real patient.  

Each stitch I placed felt like a foray into unknown territory, the needle clumsily dipping into flesh as I attempted to close an incision site. The online instructional videos never prepared me for the nervousness I experienced.  Nor was I ready for the attending’s glare as he scrutinized my every maneuver.

The surgeon, notorious for his icy disdain of medical students, loomed behind me like a caged lion. With each fumble of the needle, I could sense his impatience mounting. To top it all off, complications during another patient’s subtotal colectomy earlier had left him with residual frustration. Now, my meticulous sutures became the unfortunate target of this simmering vexation.

“Faster! I don’t have all day!” His roar shattered the sterile silence. “You’re suturing slower than a turtle with Parkinson’s disease!”

His angry remark only exacerbated my unease. My gloved hands started to tremble. I felt incompetent.

Perhaps, by speaking up for myself, I could soften the blow of his expectations. “Sir,” I replied, my voice surprisingly steady. “I’m sorry if I’m doing this slowly. This is my first-time stitching on a real person.”

Seemingly caught off-guard by my reply, the surgeon’s disposition changed and his body language became less domineering. There was no apology, his pride would not allow that. But the tension eased and he proffered some curt instruction in a gentler tone of voice: “Finish it. And practice. You have potential, if you keep working at it.”

That day I learned some harsh lessons about the importance of adaptability and composure. The medical field was not just about textbook knowledge and technical skill. It was also about resilience and the intricate dance between learning and ego.

Completing medical school and starting residency, a realization dawned on me—in a few short years, I would be an attending physician, likely responsible for the education and training of both medical students and residents. But what kind of preceptor would I be?

As I forge my path in medicine, I hope to nurture future colleagues, not belittle them. And I would like to be the type of attending who understands how a slowly placed stitch, imperfectly sewn, can act as a critical building block in a fledgling doctor’s learning. 

DR. ANTHONY PAUL GULOTTA, a United States Army physician and an alumnus of the Philadelphia College of Osteopathic Medicine, is an Occupational and Environmental Medicine resident at Walter Reed National Military Medical Center, concurrently pursuing a Master of Public Health (MPH) degree at the Uniformed Services University of the Health Sciences.

Disclaimer: The opinions and assertions expressed herein are those of the author(s) and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences or the Department of Defense.

Winter 2024



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