He was a very old surgeon by the time I met him. His hands were swollen from years of arthritis, his back bent from decades of standing in the operating room. He moved slowly, with effort. But his mind was sharp as a tack.
Though he no longer operated, he came into the hospital every single day. Not to cut or suture, but to teach. He spent hours walking young physicians through the fundamentals of surgery — lessons that had very little to do with how to actually hold a scalpel.
One of those lessons still sharpens me today.
The One Minute Rule
When you numb the skin before a procedure, you inject lidocaine into the epidermis — that narrow layer beneath the skin where the nerve receptors live. It works beautifully. But it takes time.
In a busy, hurried environment, that time is easy to forget. Too often the sequence goes: inject, incise, move forward — leaving the patient wincing through the first cut.
My mentor was adamant. After every injection, he insisted we stop. He would stare at the clock, and we would wait one full minute before making the incision. No exceptions.
That minute was his gift to the patient. And his lesson to us.
Reflections
I think about that pause almost every day. Not just in procedures, but in medicine as a whole.
How often do we rush from one step to the next — lab to prescription, question to answer, visit to discharge — without waiting long enough for the last step to truly take effect?
That old surgeon taught me that the pause itself is part of the medicine. The minute isn’t wasted; it’s the moment where care becomes humane.
About Stories from Beyond the Chart
Stories from Beyond the Chart is an ongoing series from Iatria General Medicine, where medicine meets humanity. Written from the perspective of a practicing physician, each piece explores the moments, lessons, and conversations that go deeper than the data in a patient’s chart. These reflections highlight how care is about people, not just problems — and how medicine, when done with attention and heart, becomes a shared journey.
Learn more at www.iatria.com
Traditional Medicine, Modern Philosophy