BLOG: ‘Be quick but don’t hurry’
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The phrase “Be quick but don’t hurry” was coined by venerated basketball coach John Wooden and is applicable to all aspects of life and orthopedic surgery.
John Wooden was arguably the best coach to ever walk the planet, amassing 10 NCAA men’s basketball national championships in a 12-year period as he led the University of California Los Angeles Bruins to unparallelled success. Wooden believed his players should execute with deliberate but quick movements and avoid “rushing.” Wooden preached that hurrying was caused by others forcing one to respond. He further conveyed to his players that quickness was the result of thorough preparation and “failure to prepare is preparing to fail.”
Wooden recognized that most people are naturally hesitant, and his players were encouraged to remove all hesitation from their games. Wooden offered that to remove hesitation one must avoid “maybe,” move on from one’s mistakes and follow one’s instincts. Fear of mistakes was not to impede quickness. In fact, Wooden was noted to state, “the team with the most mistakes wins.”
In the OR
Wooden’s teachings apply well to the OR where efficiency is paramount. After perusing the teachings of this extraordinary coach and his attention to preparation and detail, I wonder how Coach Wooden would approach the practice of orthopedic surgery.
Wooden would surely advocate for surgeons to strive for quick but deliberate movements in their surgeries without “hurry” and attend to the task at hand with laser focus.
Fabled surgeon Robert E. Booth, MD, used to quip that we perform surgery much like an orchestra performs a musical piece. The steps of an operation, much like a symphony, are executed in deliberate and precise fashion. There are no wasted steps, and there is a certain “flow” to the performance.
Imagine the appreciable reduction in anesthesia time and subsequent diminished infection risk if we could incorporate Wooden’s wisdom in our OR.
Perils of ‘hurry’
Wooden emphasized the perils of “hurry,” as it led to commission of mistakes. Wooden labeled hurry as “simply activity.” Wooden would emphasize, “Don’t mistake activity for achievement.”
In fact, Wooden posted on the team bulletin board, “If you do not have time to do it right, when will you have time to do it over?”
How true this applies to surgery. I have “ hurried ” through many a case only to recognize the aftermath – numerous mistakes. As coach would have predicted, I had to subject many patients to a revision or “ do it over .”
Preparation
Wooden was known for absolute and total preparation, especially in fundamentals. He would begin the first practice of every preseason with instruction in how to properly put on socks. Wooden recognized that details matter. Being sloppy in putting on your socks or in doing other small things, predicts that one would not be successful in the big things.
Wooden would preach, “Little things make big things happen.” Coach would spend as much time preparing for practice as conducting it. Surely the good coach would advise surgical preparation to the point of rehearsing all the steps of the case in one’s mind – from the most fundamental aspects to the most sophisticated details.
I bet Wooden would have recommended drawing out the steps for the procedure the evening before so the “first creation” is already completed. In addition, because Wooden took copious notes and graded practices, a Wooden-trained surgeon would keep a record for each case and annotate potential pitfalls as well as self-discovered pearls.
A Wooden-trained surgeon would execute the procedure quickly and deliberately, trusting in one’s instincts and training. Mistakes will occur, but Wooden would advise to not fear mistakes and stick to the gameplan. After a mishap, Wooden would advise to learn and move on.
Outside forces
A Wooden-trained surgeon would be independent of the outside forces converging to induce hurry. Wooden relentlessly maintained that quickness came from within. Some examples of external influences tempting you to respond in hurried fashion may include:
- Your second OR is ready to go.
- You had a delayed start.
- The head nurse does not want to expend “overtime” and asked you to “speed it up.”
- You have been tabbed a “slow surgeon” and wish to prove them wrong.
Wooden would have advocated for maintaining a sharp focus of the task at hand. Wooden always taught focusing on what only you can control.
Importance of character
Lastly, the Wooden-trained surgeon would be dedicated to the singular goal of the well-being of the patient. Wooden’s pupils were not only good players, but became good people, dedicated to honor and selflessness.
For the Wooden-trained surgeon, indications would be sound and the surgeon would tackle cases only in his or her realm of competency. To Wooden, one could do the “most good” in this world by simply being good. The venerated coach knew that ability could indeed help catapult one to success, but it requires character to maintain excellence.
Each day is a masterpiece
When we endeavor to prepare thoroughly, execute quickly, embrace mistakes, practice honorably and focus on what we can control, we are on our way to become our best selves, which for Wooden, was key to a fulfilled life.
“Success is peace of mind, which is a direct result of self-satisfaction in knowing you did your best to become the best you are capable of becoming,” according to Wooden.
References:
Hill A, et al. Be quick but don't hurry: Finding success in the teachings of a lifetime. Simon & Schuster, 2001; 43-45.
Wooden J, et al. Coach Wooden's pyramid of success. ReadHowYouWant.com. Baker Publishing Group, 2010.
https://www.thewoodeneffect.com/motivational-quotes/. Accessed Dec. 11, 2024.
For more information:
John D. Kelly IV, MD, is a professor of orthopedic surgery at the University of Pennsylvania and can be reached at john.kelly@pennmedicine.upenn.edu.
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