“Ballet is not just movement, not simply abstract. It’s something beautiful. Sometimes there’s this feeling in the movement that makes me want to cry.”
—Nina Ananiashvili, prominent twentieth- and 21st–century ballerina
Watching my 14-year-old daughter perform as the Sugar Plum Fairy in The Nutcracker in December of 2015 ranks as one of my proudest moments as a father, although not because her countless hours of grueling work had resulted in the lead role in the classic ballet. It was much more than that. She had just started the long, solo dance—it was truly enchanting choreography—when a technical glitch caused the music to abruptly stop.
My wife and I watched in stunned horror, totally flabbergasted, in the quiet auditorium. And then something truly amazing began to happen. With no music playing, my daughter simply continued the dance.
In complete silence, she remained elegant and flawless, never missing a beat or a move. Only the sound of her feet touching the stage and baited-breath from the audience. For the next 6 minutes, it was as if the silence itself had been muted as our daughter performed her ballet perfectly, as if a full symphony orchestra conducted by Tchaikovsky himself had been playing the entire time.
I was not the only one in the audience amazed by my daughter’s grace and determination. She received a standing ovation that seemed to last as long as her dance. Our pride as parents was beyond words, but after the ballet I could not wait to ask her what went through her mind during the entire period of dancing without music. I had to know how she never missed a beat.
Her answer was as stunning as her performance. She told me that it didn’t bother her at all because she could still hear the music in her head. To her, it was fine—no big deal.
As a parent, all I could think was, “Wow—how could that be?” But after some reflection, I realized that my daughter’s reaction was the sign of a truly focused expert, much like what we do each day as surgeons when we are focused on getting an excellent result for our patients. This type of focus is both instinctive and learned behavior, but I believe it is more innate than something that can be taught. The eye only sees and the ear only hears what the mind knows, and so it was in this case with my daughter hearing the music in a silent auditorium as she danced her solo ballet.
Each of us has, at times in our lives, found ourselves in a situation when the music stops and we must go on—perhaps not as flawlessly as my daughter, but nevertheless, your work goes on, your family goes on, your life goes on. The unexpected is a reliable part of each and every day, which is why we must prepare for all that life brings us, from the lessons we learn as children to how we are trained as doctors and plastic surgeons. It is our coping mechanism, and although it is sometimes more difficult to cope than others, one of my goals in life is to be prepared—and to prepare my children—to live each day to its fullest; if you live each day as if it is your last, you will never regret it.
The better prepared you are for the unexpected, the better off you, your family, and your patients will be. It is a lesson I learned early in life on our family ranch in North Dakota, where the unexpected was normal. For instance, a long drought meant no income for the family, so we had to do the best we could with what we had—and it was always just fine, even if it meant you did not get the best clothes or new shoes. We learned quickly that nothing mattered as much as being united as a family with common goals. My parents taught me early on to do more with less—but to do it better than anyone else—and that work ethic has never left me for a single day. And it has certainly served me well during the times in my life when the music stopped. It is vital to survival and success in this competitive world where the music often stops and starts up again just as rapidly.
I have hoped and prayed that I have been able to actively instill some of these same traits in my children over the years. So it was truly awe inspiring to see this echo of my parents’ work ethic appear, on stage in front of hundreds of people, in my daughter’s brave action (Fig. 1).
This all comes down to how you mentally prepare by means of practice and repetition for all you do in life, and it is especially important to how we train as surgeons. We must be prepared for unexpected events daily and, for the sake of our patients’ safety, we must deal with them with no margin for error.
So each day, as I tell the residents to put on their game faces and be prepared to know the anatomy, variants, and pitfalls, they too will navigate the forks in the surgical road that can often lead to “no music” while the dance must flawlessly continue. That is the definition of not a good but a great doctor—and vital to the making of a plastic surgeon. Each day in plastic surgery is indeed a dance or ballet—especially face lift and rhinoplasty—as one must plan and perform each part carefully, meticulously, and error-free, as each step predicates how well the next one will go.
If you should find yourself heading down an unprepared path with no music, your preparation will predict how well you perform a new operation for the first time—you are very focused, concise, somewhat anxious (in a good way), yet cautious as well to do the right thing. This holds true in plastic surgery and in life.
If there is one thing that I have learned in my career as a physician, surgeon, editor, teacher, husband, and parent is that life is always full of surprises and adventures. And no matter how well you plan, the music most definitely will stop playing from time to time. Trust in your preparation, and keep dancing.
“Do not brood. It makes the moment you are living in unavailable for learning and life.”
—Suzanne Farrell, prominent 20th-century ballerina
The author would like to thank Mike Stokes, American Society of Plastic Surgeons Director of Publications, and Aaron Weinstein, Managing Editor of Plastic and Reconstructive Surgery, for assistance copyediting this Editorial.