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The Color of Surgery

Shin, Alexander Y. MD

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Techniques in Hand & Upper Extremity Surgery: September 2020 - Volume 24 - Issue 3 - p 107
doi: 10.1097/BTH.0000000000000309
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The events of the past several months have been unprecedented in world history. The COVID-19 Pandemic has severely interrupted “normal” life across the globe. Not since the 1918 influenza pandemic, in which estimated at 10 million people died worldwide and over 675,000 died in the United States, has the world seen such a virus spread. The COVID-19 Pandemic will forever change how we interact with each other on a global, national, state, local level. It will also forever change how we, as surgeons, treat our patients—temperature screening, COVID nasal swabbing/antibody testing, N95 masks in the operating rooms during intubation and extubation, and personal protective equipment for outpatient patient encounters, etc.

Recently, the Center for Disease Control (CDC) reported the effect of COVID-19 in racial and ethnic minority groups and stated “long-standing health and social inequities have put some members of racial and ethnic minorities of getting COVID-19 or experiencing severe illness, regardless of age” ( The CDC also reported that as of June 12, 2020, age adjusted hospitalizations are highest among these groups. The role of systemic bias/racism in health care has been raised as a cause of the disproportionate morbidity/mortality.

As we attempt to restore a new normal, an unrelenting, ever-present virus continues to rear its ugly head—racism. Racism is defined as the belief that groups of humans possess different behavioral traits corresponding to physical appearance and can be divided based on the superiority of one race over another. I have read many editorials and commentaries from multiple professional organizations and societies, all condemning racism as well as their plans to have diversity, inclusion and engagement as parts of their strategic plans. The position statements of these organizations are to be commended. The goals to abate and eradicate racism are necessary for the advancement of society and humanity.

We, as surgeons, have a very unique view of humanity. Despite the variations of skin color, behavioral trails, differences in physical appearance, the anatomy and color beneath the skin is the same. The anatomic consistency has allowed surgeons to reproduce and improve surgical techniques in millions of patients over a hundred years. We have the privilege of seeing the colors of surgery: Blood is red, tendons are white, adipose is yellow, muscles are various shades of red, cartilage is white, bone is a pale brownish off-white, arteries are bright red, and veins are dark blue. The colors of surgery are universal and we, as surgeons, have the obligation and responsibility to treat everyone equally.

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