In surgery we have a lot of sayings and mottoes: "The rules of surgery: 1. eat when you can 2. sleep when you 3. pee when you can and 4. don't mess with the pancreas", "Better lucky than good", "All bleeding stops eventually" "The enemy of good is better". My personal favorite is "Often wrong, never in doubt" and this was told to me when I was a first year med student and first exposed to the favorite surgical pastime: "pimping". It has a terrible name, and if you've never gone to medical school or don't work with surgeons, when you hear the phrase "pimping" you likely think of hookers and their employers. I assure you, surgical pimping has nothing to do with either. Being "pimped" means having one of your seniors, be it a resident or attending, ask you questions. This generally happens in the OR and will often pertain to the case, such as "what is this structure?" "what's the blood supply to this organ?" "what's the indication for this procedure?". It also occurs commonly during rounds and is generally considered an educational exercise. I can assure you, the questions I have gotten wrong over the years have been the answers that I have not forgotten. In my third year surgery rotation, there was a vascular surgeon that loved to teach, but in the form of pimping, meaning you would be assaulted with questions and scenarios until you finally said "Uncle!" aka "I don't know". He would then teach you about whatever it was for the next 20 minutes, it was great, but very intense. One day I was going to scrub with him on a temporal artery biopsy, so I studied everything about the anatomy, the indications, the complications, I thought I knew it all and could field any question he would throw at me. Well, as soon as we prepped and draped the patient and was about to inject lidocaine, the local anesthetic, he asks me, "what is the toxic dose of lidocaine and what is the first sign of its toxicity?'. Of course I had no idea, I should have been better prepared, knowing his penchant to ask about ANYTHING pertaining to the case, but I didn't know then. I do know now and I will never forget it.
That being said, one can imagine pimping can sometimes be a little malignant and a way of clearly establishing superiority, but rarely in my experience. Surgeons also tend to be people who like to know everything about things that interest them, fans of minutiae and trivia. I have been pimped on the difference between diamond carats and gold karats, what kind of plane is it in the last scene of Casablanca, how many surgeons have won the Nobel prize, etc. Obviously, not pertinent to the case or patient per se, but clearly of interest to the surgeon.
As I said, the first time I was pimped I was a first year medical student and shadowing my mentor who is a plastic surgeon. I was observing a facelift and he asked me to identify the thin muscle in the neck he was pointing to and tell him the innervation. I responded with a slight lilt in my voice, making my answer sound less like an answer and more like a question. He responded, "The most important thing you need to know about being a surgeon is that you may be wrong but you are never in doubt."
I luckily grew up with an excellent role model for this. My father is king of convincing you whatever he says is right, no matter how ridiculous it may sound and how much your mind may try and rebel his explanation. It's all in the delivery, and it will make you doubt whatever opposing knowledge you have, just ask my mom, she has been the victim of many less-than-fact explanations that she may have repeated trusting my dad's "knowledge". In order for this to work, you actually need to be quite intelligent and have a broad base of knowledge, so that the explanation provided will be assumed to based in fact. I, luckily inherited my dad's ability to confidently provide possibly false explanations on the fly, and clearly it serves me well in surgery. The best is when my father and I disagree on some "fact" and then it turns into an actual research expedition. In fact, everyone in my family has some form of this "disorder", so for a while we actually kept a record of these wagers and tallied who was right most often (I believe I won for the last recorded year, 2009, but then again, the record-keeper may have had some selection bias). So once again, my family has provided me with an incredible foundation for my surgical education.
