There’s No Crying In Surgery

By: B. Aviva Preminger, MD, MPH, FACS

Not long ago, one of my daughters came home upset after a biology exam. She had studied so hard. She thought that she understood the material, but when the test was in front of her, everything suddenly felt harder than it had the night before. By the time she finished telling me about it, she was in tears, mostly from frustration.

I listened for a while, because sometimes what our children need most is simply to feel heard. But at a certain point, I found myself saying something that sounded harsher out loud than it had in my head, “There’s no crying in biology.”

She looked at me, surprised, and a little offended. She had expected me to indulge her feelings more. Instead, I took the opportunity to teach her something.

Anyone who has seen the movie A League of Their Own remembers the famous scene where Tom Hanks, playing the manager of a women’s baseball team, shouts at one of the players who starts crying on the field: “There’s no crying in baseball!”

In surgery, there’s no crying either.

That doesn’t mean surgeons don’t feel stress, or worry, or even fear. Anyone who tells you that they never feel those things in the operating room is not being honest. Every surgeon has cases that are more difficult than expected, moments when anatomy is not exactly what the textbook showed, or when a procedure takes longer than planned. In those moments, you are very aware of the responsibility you carry. A patient is asleep on the table, trusting that your hands will do exactly what they are supposed to do.

Early in my career, I remember finishing a particularly challenging case and feeling shaken afterward. Nothing catastrophic had happened, but it had not gone as smoothly as I wanted, and I kept replaying every step in my mind. I spoke to a senior surgeon whom I respected very much and admitted how unsettled I felt. His response was unexpected. He listened, nodded, and then said something I have never forgotten, “There’s no crying in surgery.” He explained that it was my job to learn from the experience, build on the lessons, and do better next time. That is what I owe my patients and that is how I would grow and mature as a surgeon.

At the time, the comment sounded almost cold, but over the years, I have grown to understand exactly what he meant. The operating room is not the place to fall apart because the patient needs you to be steady. There is time to worry later, but in the moment, your job is to stay focused and keep going.

That was what I was trying, perhaps imperfectly, to explain to my daughter that night. When you are in the middle of the exam, you don’t cry. You take a breath, you read the question again, you give your best answer, and you move onto the next question. You can feel disappointed afterward. You can be frustrated. But, if you get stuck on one question and melt down, you simply will not finish the exam. You need to keep it together and stay in the game. Later, you can learn from your mistakes and figure out how to do better next time. Furthermore, there are things in life to cry over, but a biology exam isn’t one of them (even if it seems that way when you are a freshman in high school).

As a mother, this is not an easy lesson to teach. Every instinct is to comfort, to say that everything will be fine, that the grade doesn’t matter, that she tried her best. And of course, those things are true and I said them as well. But I also know, from lots of test-taking and from years in medicine and from life in general, that confidence is not built when everything goes perfectly. It is built when things are difficult and you push through them and learn from the experience.

In surgery, we don’t have the option of stepping away when something becomes stressful. We pause, we refocus, we adjust, and we continue, because someone else is depending on us to do exactly that. Over time, that discipline becomes part of who you are, and without even realizing it, you start to build resilience.

Of course, our children are not surgeons, and a biology exam is not an operation. They should be allowed to feel upset, and they should know that home is the place where those feelings are safe and that sometimes it is totally ok to have a good cry. But part of growing up, and part of parenting, is learning that strength is the ability to hold yourself together when the moment requires it, and to let yourself feel everything later.

That night, after the biology exam tears stopped, we went back over the material together. The questions didn’t seem quite as impossible the second time. The frustration softened, replaced by the quiet determination that I have seen so many times in the operating room—the decision to try again, to do better next time, to not let one difficult moment define the outcome. 

At Preminger Plastic Surgery, we are committed to educating our patients and providing personalized care tailored to their unique needs. For those considering plastic surgery, we offer guidance every step of the way to help you achieve your aesthetic and wellness goals. Dr. Preminger is a board-certified plastic surgeon with degrees from Harvard, Cornell, and Columbia. For more information or to schedule a consultation, please visit premingermd.com or call 212-706-1900. Follow us on Instagram @premingerplasticsurgery.