I got interested in flying as a teenager, but money and subsequently life got in the way. It was not until November 2008 that I flew my first solo flight. Since then, I’ve logged well more than 2,000 hours as pilot in command. I’ve worked hard since then to be a capable and safe pilot. I’ve flown my parents, children, grandchildren and friends all over, including a recently completed 13th trip to the Bahamas.

Beyond my initial training, I continue to study and have recurrent training to ensure both my safety and that of my precious cargo. At the end of the day, one careless mistake could end in tragedy.

Recently I read something that applied to aviation: “If you do something dangerous and you do it repeatedly, you’d better be very good at it.” And I thought about us as eye surgeons.

FOCUS LESSENS ERRORS

I love flying my plane. Even the most stressful part of flying, the landing, is exhilarating.

The same goes with surgery. I take pride in completing one perfect case after another. But as with flying, I cannot make mistakes.

Sure, we all make small mistakes that, if dealt with properly, can be corrected with little to no harm. But the big ones? We know those can end in permanent blindness to our patients.

How do we avoid complications? I still do not have all the answers, but I’ll give you what I think is the most important one: intense focus on the task at hand. Especially early in your career and again with anything unusual or new. Think about nothing else.

Some of my dumbest mistakes have been on a medium cataract with a well dilated pupil and great red reflex in a very cooperative patient. It is a perfect setup to be lulled into a sense of complacency with this “easy case,” and that’s when you inadvertently grab and tear that posterior capsule.

ONLY GOOD EYE

We have an acronym in our practice: OGE. It stands for “only good eye.” The other eye has severe visual loss, and today’s operation is the patient’s only shot at any hope of seeing for the rest of their life. On average, I have one of these every surgery day.

In large letters on the patient’s data sheet at the end of the bed, we write “OGE.” When I start to make my capsulorhexis, my surgical coordinator will gently say, “OGE.” She will again remind me as I begin the phacoemulsification. In my entire career, with several tens of thousands of cases under my belt, I’ve never had an incident of any kind with an “OGE” case. Why? I think it is because I’m hyperfocused during these cases.

What does this intense focus not mean? It does not mean being stressed or tense. Whether I’m flying my plane or performing eye surgery, I’m generally relaxed and enjoying what I’m doing. Being anxious doesn’t help anyone, including you and the patient.

RELIEVE ALL PRESSURE

One more thing — little planes don’t have bathrooms. The last critical thing I do before every flight is empty my bladder. Consider the same before you enter the operating room. You never know what complications you will encounter, and the more pressures you can relieve, the better. OM

Larry E. Patterson, MD, is an instrument-rated private pilot. He is also the chief medical editor of Ophthalmology Management. On the side, he is the founding partner of Eye Centers of Tennessee. His e-mail is larryp@ecotn.com.