I once flew ten hours across three time zones, landed just after midnight, napped for an hour in a quiet call room, and scrubbed into a liver transplant before sunrise. The patient was prepped. The team was waiting. The donor organ had a narrow window before it would no longer be viable.

That kind of scenario sounds dramatic, and it is, but it’s also normal in the world of global transplant surgery.

Medicine has always been demanding. But transplant surgery across borders introduces a new kind of intensity; where time, geography, and biology collide. Organs don’t wait. They don’t care what time it is, where you are, how long you’ve been awake, or what your circadian rhythm has to say about peak performance.

And yet, the expectation is the same: zero mistakes.

When Distance Meets Urgency

Global medicine is a gift. It allows for collaboration across countries, shared donor registries, and expanded access to life-saving procedures. I’ve worked in operating rooms on four continents. Each one has taught me something valuable. But there’s a hidden cost to this international web of care: the toll it takes on the people who do the work.

You can’t perform a transplant on Zoom. These are not procedures that can wait until Monday morning, or be safely delayed by a surgeon’s need for sleep. Every organ has a finite window for transplantation, sometimes just a few hours.

So we chase time. We fly through it. We manipulate it. And we pay for it.

Jet Lag Doesn’t Show Up on the Monitor

There’s no readout for jet lag in the OR. You won’t see it on the patient’s chart. But ask any surgeon who’s done this long enough, and they’ll tell you—it’s real, and it matters.

Jet lag isn’t just about being tired. It’s about disrupted body chemistry. Cognitive fog. Delayed reaction time. Mood swings. Even small impairments in attention or decision-making can have big consequences when you’re clamping an artery or sewing a bile duct.

We’ve gotten good at managing it. We adjust our sleep schedules, bring blackout curtains, swallow melatonin like candy. But no matter how well you prepare, your body still knows it’s not supposed to be operating on someone else’s liver at 3 a.m. local time.

The challenge is: you can’t let it show.

Rituals That Keep Me Grounded

I’ve learned to develop my own system, a set of rituals and rules that help me stay focused when my brain and body are screaming for rest.

• Hydration before caffeine. Dehydration worsens jet lag and fog. I drink water obsessively before I reach for coffee.
  
• Silent minutes before the OR. I find a quiet space, no phone, no conversation for 5 minutes before scrubbing in. Just breathe. Just focus.
  
• No second-guessing once we start. The time for doubt is during prep. Once the first incision is made, the mental noise has to shut off.
  
• Always debrief. After every international case, I write notes, not just clinical ones, but personal. What worked, what didn’t. Where fatigue crept in. What I’ll do differently next time.
  

These habits don’t erase the strain. But they anchor me. They help me stay present—even when my internal clock is twelve hours behind.

The Myth of Superhuman Surgeons

There’s a quiet mythology around transplant surgeons. That we’re tireless. That we thrive on adrenaline. That we don’t need rest like everyone else.

I get it. When you’re literally holding someone’s life in your hands, you don’t want to admit to being human.

But we are.

We make mistakes when we’re overworked. We suffer when sleep is chronically disrupted. We feel the emotional drag of bouncing between countries, cultures, and crises.

The solution isn’t to pretend we’re invincible. It’s to build systems that respect the human limits of the people doing the healing. Better scheduling, more backup coverage, realistic expectations for recovery after travel. This isn’t about coddling, it’s about safety.

What It’s All For

Despite all of this, I still believe deeply in global medicine. I believe in saying yes when the call comes. I believe in racing the clock when the patient on the other end of the flight has no other option.

I believe it’s worth the jet lag.
But I also believe we can do better: for the surgeons, nurses, pilots, and coordinators who make this work possible.

We need to talk more openly about the hidden costs of this profession. Not to complain, but to evolve. To protect the people who protect others.

Because ultimately, trust—not just skill is what holds a surgical system together. Trust between team members. Trust in your own judgment. Trust that when the next case comes, you’ll be ready.

That trust is built not by denying the strain, but by facing it honestly and adapting accordingly.

Time Is a Scarce Resource

Time zones and flight schedules are just logistics. But time itself: restorative, reflective, and real, is a resource we too often ignore in medicine. We celebrate productivity, speed, and endurance. But none of that matters if it comes at the cost of clarity, presence, or care.

A transplant is a race against time. But the people running that race deserve space to breathe, recover, and prepare for the next one.

We can’t control the urgency of medicine. But we can build systems that make it more humane, for everyone involved.