Ron Hekier🚢 Profile picture
Feb 3 14 tweets 3 min read
The fastest surgeon I have ever known moved his hands slowly.

A two-time Olympic medalist rower coached me to slow down.

The most effective managers are often the ones who speak the least.

Let's learn what it means to say
"Slow is smooth. Smooth is fast." #ship30for30
When I was starting my surgical training in 1997, I already knew of the biggest tour-de-force for a general surgeon.

It's a Whipple procedure, an extensive and difficult surgery typically performed for cancer of the pancreas.

It’s a massive procedure which few surgeons perform.
The surgery is fraught with many areas where a mis-step can cause fatal bleeding.

For those that do this extensive surgery, it often takes 4 - 6 hours under ideal circumstances.

But one of our surgeons in my training program routinely performed this surgery in about 3 hours.
This kind of surgical speed is hard to put into context.

Imagine a runner finishing a 26 mile marathon while the rest of the pack has yet to cross the 20 mile mar..

This surgeon was faster than any I had ever seen, and on one of the most complex and dangerous procedures we do.
One day I asked him. “How are you so fast?”

His reply:
“I do the same surgery as everyone else. I might even sew slower than some. But in the end I am faster than most other people because my hands don’t perform any unnecessary movement like most do.”
His speed also ironically made him safer.

In this specific surgery which has many chances for getting into life threatening bleeding, being smooth reduced the risk of damaging fragile blood vessels.

Slow is smooth and not only fast, it's also safe!
I came across similar advice about 13 years ago while training for an indoor rowing competition.

I set up remote coaching by Xeno Muller, 2x time Olympic medalist whose gold medal win in 1996 set an Olympic record which stood for 16 years.

Xeno knows speed.
One of the most challenging parts of his training program were the workouts with a seemingly absurdly low stroke rate.

My form broke down when rowing slowly. I literally couldn’t do it!

I was upset. I was paying him to make me a faster rower and he was having me row slowly!
I asked Xeno to skip those practice sessions which had me to row slowly.

I reminded him I was on a deadline with the competition fast approaching. (Which he of course knew.)

But he kept the slow training sessions, telling me
“You never go fast if you can’t go slow.”
By rowing at a very slow pace my coach could easily see the inefficiencies in my technique.

The slower I rowed, the more pronounced and awkward those inefficient movements would feel.

Then we could eliminate them.

To be fast, I had to be smooth, which meant I had to be slow!
The same principle, "Slow is smooth, smooth is fast," exists in areas which that aren't physical but are more cognitive and cerebral in nature.

The most effective managers and supervisors who are the top of their field often seem to say little.
All of us have been impressed by someone at a meeting or lecture or debate who doesn't seem to say much, but when they speak they have a solution.

We all inherently respect a team leader who is deliberate and thinks before they speak and thinks before they act.
The most effective executives are often those who in a crisis will first slow down to listen and absorb facts and only after contemplation call for action.

Bezos, Cook, Nadella, the CEOs of Amazon, Apple, and Microsoft, are never seen as being brash nor impertinent.
tl;dr

•Slick surgeons, top athletes, and effective managers move slowly.
•Control and precision reduces chances for errors.
•Smooth and deliberate action brings inefficiency to light.
•Contemplation and clarity make for a great team leader.

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More from @ronhekier

Aug 7, 2022
About 15 years ago I performed a routine surgery which harmed my patient. The problem manifested later, they required additional surgery, and I was sued for hundreds of thousands of dollars.

Instead of being scared of performing that same surgery, I relish it.
I recently learned that this viewpoint is similar to the mindset evaluated by a Stanford psychologist and her colleagues who studied Navy SEAL candidates.

Their findings are completely opposite of the conventional wisdom towards stressful events.
We are typically taught to avoid stressful situations for optimal outcomes.

We are taught that stress is bad.
But what if it isn’t?

Let’s see how Navy SEAL candidates respond to stress and how it affects their success:
Read 12 tweets
May 22, 2022
In 1997, I was poorly prepared for the transition from med school to surgery residency.

I fell back upon a primitive approach of command and control in order to get my tasks done.

Here are tips from an FBI hostage negotiator which would have saved me years of pain.
1) FBI hostage negotiator Chris Voss says: “Life is negotiation” because
most interactions at work and home boil down to :

“I want.”

It was probably a decade or two until I realized that the approach I was using, "my way or the highway," was counterproductive and destructive.
As a surgeon, I wanted a lot of things.

“I want:”

That lab value immediately.

The doc I'm consulting to see my patient ASAP.

The OR staff to be ready for my next case.
Administration to understand how hard surgeons work and pay us more.
Read 13 tweets
Feb 13, 2022
In 1913, a Harvard Med physiologist had a hunch. Later, he would go on to invent the terms “Fight or flight response” and “hemostasis.”

And on the WWI battlefields in Europe he pioneered the treatment of shock.



But first he studied the urine of football players.
👇
So on this SuperBowl weekend, instead of sitting glued to our televisions, let’s look back to 1913.

There were many football matches played, but that year as in each year, only one was known as The Game.

Harvard-Yale
In 1913, W.B. Cannon was Chief of Physiology at Harvard Med. As a med student, his pioneering use of X-Ray showed that agitated animals exhibited changes in their digestion.

He set out to find if sensations such as pain, hunger, and fear caused bodily changes in humans.
Read 18 tweets
Feb 11, 2022
When I was in my 5 year surgery residency training, my Chairman shared with me the “Three A’s for success.”

Initially I was surprised with the sequence of the first A and the last A, but I eventually came to learn those qualities transcend all professions. #ship30for30
The 3 A’s needed for success in surgery are also the keys to succeed as a human being.



In order to achieve professional success, you're going to need to be available, affable, and able.
If all of us followed this list of The Three A’s for Success our careers and even our interpersonal relationships with loved ones would improve.
Read 17 tweets

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