27/10/2025
David B. Granet MD MHCM FACS 3rd+
Endowed Professor, Vice Chair, Surgeon & Television Host, at UC San Diego
For thousands of years, surgery was about the hands. Steady hands. Skilled hands. Hands that could cut and sew, hands that carried both precision and courage.
Watch a surgeon work, and it’s easy to think the magic lives in the hands.
The scalpel. The steady movements. The elegant choreography of tissue and steel. That’s the part people can see. Yet surgery has always been about more than mechanics.
Here’s the quiet truth: surgery is a cognitive task, implemented through the hands.
The real surgery starts long before the incision. It’s about judgment. It’s about knowing when to intervene, how much to risk, when to stop. It’s about blending science with artistry, precision with restraint. It lives in the decision-making; the choice of how to approach, when to pivot, and when to not operate at all.
It lives in the judgment that can’t be taught by an algorithm, and the responsibility that can’t be delegated to a machine.
A surgeon doesn’t just cut. A surgeon thinks and then acts.
That distinction matters more now than ever. Because if you listen to the buzz around the future of surgery, it’s filled with talk of technology.
Sharper robots. Smaller incisions. More precise instruments. AI that can map, predict, assist, and maybe someday… replace.
Robots don’t decide what matters.
AI doesn’t hold the weight of telling a family why surgery is, or isn’t, the right path.
Technology may shape the tools, but judgment will always shape the outcome.
Surgery is a deeply human act; not just because it’s done to human bodies, but because it’s guided by human minds.
What will define great surgeons in the decades to come won’t be how fast they can suture or how flawlessly they can operate a robot. It will be how clearly they can think. How wisely they can decide when to or not to operate at all.
This shift has consequences. If surgery is fundamentally cognitive, then training can’t just be about time in the OR.
It must teach clinical reasoning. Pattern recognition. Anticipation. Restraint.
It must teach how to be accountable for decisions that no machine can own.
Yes, the tools will evolve.
Yes, technology will take us places we couldn’t have dreamed of a generation ago.
But the core of surgery is not the tool. It’s the surgeon.
And if we lose sight of that, we risk building a future of surgery that’s efficient but hollow. Precise but soulless. Technically perfect but devoid of judgment.
The future of surgery isn’t in steadier hands.
It’s in sharper minds.
*Because in the end, robots can hold a scalpel.*
*Only a surgeon can hold responsibility.*
Collected..
Really worth reading and sharing