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.

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But as much as I admire these advances, and I truly do, I’ve also come to believe something else: innovation means nothing if the systems around it remain broken.

A machine can sustain a body. But it can’t fix a healthcare system that treats people like numbers. It can’t repair the trust eroded by injustice, corruption, or indifference. It can’t substitute for empathy. And it certainly can’t carry the weight of moral failure.

The Myth of the Fix

In medicine, and in politics, business, and education—we’ve bought into a seductive idea: that if we just find the right tool, the right platform, the right procedure, we can fix anything.

It’s not entirely wrong. Sometimes a new technique or piece of equipment does change lives. But more often, we mistake tools for transformation. We expect machines to compensate for what only people and culture can build: trust, integrity, compassion, accountability.

I’ve seen hospitals with the latest surgical robots but no time for follow-up care. I’ve seen patients given high-tech implants but discharged into lives where they can’t afford medication or a healthy meal. These aren’t tech failures, they’re system failures. And no device can solve a problem it wasn’t designed to understand.

High-Tech, Low-Touch

There’s a term we use sometimes: high-tech, low-touch. It refers to care that is full of machines and procedures but light on human connection. It’s not always intentional. Sometimes the pace of the system makes it inevitable.

But I worry when we celebrate a new wearable or AI diagnostic tool without asking: Who is this helping? What problem is it solving? And what deeper issues might it be distracting us from?

The most advanced technology in the world can’t replace what a patient really wants to know: Do you see me? Do you hear me? Do you care what happens next?

That requires presence, not just processing power.

The Heart Can Be Replaced, But the System Can’t

I once worked on a case involving a young man who received a mechanical heart—his only option while waiting for a transplant. The device worked perfectly. But around him, everything else was fragile. He didn’t have stable housing. He struggled to get transportation to follow-up appointments. The system gave him a second chance physically, but not structurally.

This is the reality for so many people: high-level interventions in low-functioning systems. We save a life and then return it to the same stress, neglect, and inequality that contributed to the crisis in the first place.

We need to ask harder questions:

• Can our systems support the solutions we offer?
  
• Are we addressing root causes, or just symptoms?
  
• What is the human cost of innovation without equity?
  

Political Systems Are No Different

It’s not just medicine. The same pattern shows up in government. We build voting apps but ignore voter suppression. We invest in cybersecurity while trust in institutions crumbles. We automate services while people can’t get a human being on the phone when they need help.

Technology can make things easier. But it can’t make things fair. That requires ethics, policy, and leadership that sees beyond the dashboard.

Like in medicine, the political “patient” may have shiny new equipment, but if the diagnosis is ignored or the treatment plan is unjust, the whole system remains sick.

Innovation Without Trust Is Empty

Trust isn’t glamorous. You can’t patent it or pitch it in a TED Talk. But in every field I’ve worked in, it’s the most valuable infrastructure we have.

When patients trust their providers, they’re more likely to follow treatment plans. When citizens trust their institutions, they participate in democracy. When teams trust each other, they innovate better and faster.

Without trust, even the best tools fall flat. You can’t design your way around doubt.

So we have to build trust into the system itself—through transparency, consistency, humility, and care. It takes longer than writing code or ordering new equipment. But it lasts longer, too.

What I Hope We Don’t Forget

I’ll always believe in the power of technology. I’ve seen it save lives, restore hope, and do things I once thought were impossible.

But I’ve also seen what happens when we treat tech as a substitute for compassion, and innovation as a way to avoid harder work. We can replace a heart, yes. But we can’t replace the relational tissue that holds people, systems, and societies together.

That’s not something you can plug in. It’s something you build—slowly, intentionally, and together.

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I never set out to become a collector. At least, not in the traditional sense. I don’t have rare coins or antique stamps. What I do have is a growing collection of everyday objects from a country that no longer exists: Yugoslavia. Old matchboxes, detergent labels, chocolate wrappers, soda bottles, notebooks, and factory pins, items once taken for granted, now almost forgotten.

Each piece I collect is a small act of preservation. Not just of packaging or design, but of memory. Of an economy that functioned in its own way. Of a time when industry meant more than GDP it meant identity, pride, and a shared future, however flawed or fragile.

Born from Disappearance

I was born in Yugoslavia, a nation that disappeared during my lifetime. That’s an odd sentence to say aloud. One day, we were living in a unified socialist republic; the next, our maps, currencies, and institutions were all being redrawn. The war took much. But so did the quiet erasure that came after, the shift to privatization, foreign imports, and a new vocabulary of consumption.

What disappeared along with the country were the brands that filled our homes and kitchens. Varteks jackets, Cockta cola, Plavi Radnik notebooks, Radenska water, and Gorenje appliances (some of which still survive in new forms). For years, I saw these names vanish from store shelves, replaced by Western labels that felt foreign and sterile.

That’s when the collecting started. Not out of nostalgia, exactly but out of a need to remember what the world once looked like through a Yugoslav lens.

Packaging as Memory

I keep most of my collection in boxes and folders, stored carefully like a strange kind of archive. There’s something moving about the packaging design of that era. It was often bold, minimalist, and functional with sharp typography and strong colors. There was pride in the aesthetic of the everyday.

A bottle cap from Pipi orange soda isn’t just aluminum. It’s a memory of childhood summers. A cardboard sleeve from a Yugoslav record label isn’t just decoration. It’s a glimpse into what people danced to, dreamed of, or gifted to each other.

Design mattered, even in planned economies. Maybe especially in planned economies, where scarcity gave every item more symbolic weight. You didn’t just throw things away. You saved tins and jars, you repaired appliances, you sewed patches on your Varteks trousers. And when something new appeared in your pantry, it felt like a small event.

Factories and Futures

My collection also includes industrial catalogs, employee badges, and factory postcards. These are perhaps the most haunting. They speak not just of consumer goods, but of an entire philosophy: that industry could build a future for the people. Factories were more than workplaces; they were community centers, symbols of progress, and even sources of local pride.

In Yugoslavia, it wasn’t uncommon for people to take photos in front of their workplaces, proudly posing with their coworkers. You don’t see that today. Partly because work has become more precarious. But also because that sense of collective belonging has frayed.

When I look through a catalog from a now-closed textile factory in Slovenia or Serbia, I don’t just see products. I see dreams. I see the belief that a domestic economy could support dignity, not just demand efficiency.

Between Nostalgia and Critique

I’m aware that collecting these items can be seen as romanticizing a system that was far from perfect. There were shortages, inefficiencies, and political repression. My archive doesn’t ignore that. But it offers a more textured view, one that honors the complexity of what was lost.

Nostalgia isn’t about pretending things were ideal. It’s about acknowledging that something meaningful once existed. That people found beauty and pride even within a system that eventually collapsed. And that the disappearance of everyday objects tells us just as much as the disappearance of flags or leaders.

Why It Matters Today

In today’s world of digital everything, fast fashion, and disposable design, there’s something grounding about holding a 1980s Yugoslav notebook in your hand. It’s real. It’s physical. It has weight, texture and story.

My collection is a counterpoint to the algorithm. It resists forgetting. It reminds me and I hope others that identity isn’t just in grand narratives or history books. It’s in what we ate, wore, and built together. It’s in the brand of soap our grandparents used. The wrapping paper of a birthday gift. The label on a glass of mineral water.

There is value in remembering these small things. They tell us who we were and maybe, who we still are.

Preserving a Disappearing World

I often imagine what future historians will make of my collection. Will they see it as quaint? Political? Melancholy? Maybe all three.

But for me, it’s personal. It’s how I make peace with the past. How I stay connected to a country that shaped me—even as it was being dismantled. How I carry forward not just the facts of history, but its textures, flavors, and colors.

In archiving a lost economy, I’m not trying to rebuild Yugoslavia. I’m simply trying to remember it honestly, tenderly, and with the respect that ordinary things deserve.

Sometimes, that’s enough.

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There’s something strange, almost contradictory, about reading Russian literature during a surgical rotation. One minute, I’m closing an incision with practiced precision; the next, I’m in the staff lounge, nose buried in The Brothers Karamazov, pondering the meaning of free will. People often ask me how I unwind after long days in the operating room. My answer tends to surprise them: I read Dostoevsky.

For me, literature, especially the dense, philosophical kind isn’t a break from medicine. It’s an essential part of staying balanced within it. Where surgery is sharp, efficient, and tightly bound by protocol, novels are messy, human, and unresolved. They remind me that the world is not only made up of clinical facts and procedures but also of emotions, contradictions, and stories.

Why Dostoevsky?

I came to Dostoevsky during a particularly intense part of my training. I was exhausted physically from the long shifts, emotionally from witnessing trauma, and mentally from the pressure to always be exact. A colleague handed me a worn copy of Notes from Underground, saying only, “This is weird, but you’ll get it.”

They were right. I did get it. I saw in Dostoevsky’s tormented narrators a mirror to the psychological toll that high-stakes work can take. His characters aren’t polished heroes; they’re conflicted, obsessive, burdened by their thoughts. It was comforting, in a strange way. I didn’t need my books to give me an escape. I needed them to show me I wasn’t alone in feeling the weight of uncertainty and responsibility.

Surgery and Storytelling

Surgery, like literature, is about narrative, just a different kind. Every procedure has a beginning, a middle, and an end. There’s anticipation, a moment of crisis (usually the unexpected twist), and hopefully, a resolution. When I open a body, I read it like a text. The anatomy tells a story sometimes straightforward, sometimes full of complications.

Reading Dostoevsky between procedures doesn’t just give my mind a chance to recalibrate. It also sharpens my empathy. In medicine, it’s easy to see patients as cases. Literature insists I see them as characters, with fears, histories, and contradictions. That shift from case to character is essential if I want to be more than just technically competent.

The Stillness Between Chaos

The operating room is a place of motion: buzzing monitors, clinking instruments, fast decisions. Reading, by contrast, is still. It slows me down in the best possible way. I often steal a few minutes between cases, coffee in hand, to read a few pages. It’s not just an act of relaxation, it’s an act of survival.

In Crime and Punishment, Raskolnikov spirals between guilt and rationalization, asking whether a person can ever act with pure motives. That question resonates in medicine more than one might expect. Every day, we make choices that affect people’s lives. We weigh risks and benefits. We decide when to intervene and when to hold back. Literature gives me a framework to reflect on those decisions, not as a doctor, but as a human being.

Shared Humanity

One of the most profound realizations I’ve had, whether while assisting in trauma surgery or reading The Idiot, is that we are all deeply fragile. Dostoevsky’s characters are broken in beautifully honest ways. They want to be good, but they often fail. They struggle with pride, faith, jealousy, and love. So do we, beneath the masks and the scrubs.

That’s why reading helps me show up for my patients with greater presence. I don’t pretend to have all the answers, and I don’t view suffering as something I can always fix. But literature has taught me to sit with it, to be a witness to it. Sometimes that’s all a person needs: someone willing to truly see them.

Carrying Both Worlds

It’s not always easy to live in two worlds: the precise world of anatomy and the messy world of literature. But I think the tension between them is what keeps me grounded. Surgery is about control. Literature is about surrender. In one, I hold the knife; in the other, I let go and let the story carry me.

There are days when I come home too tired to even cook dinner. But I’ll still read a few pages before bed. It’s a ritual. A way of saying: I am more than what I do. I am still thinking, still feeling, still becoming.

What We Carry

At the end of the day, I don’t think reading Dostoevsky makes me a better surgeon in a technical sense. But it makes me a better listener, a better thinker, and maybe, hopefully, a more compassionate human being. And that matters.

In the sterile corridors of the hospital, it’s easy to lose sight of the deeper questions. Why are we here? What does it mean to suffer? To heal? To be good? Dostoevsky doesn’t give answers, but he gives language to the questions. And for me, that’s enough.

So yes, I read Dostoevsky between procedures. It keeps me sane. It keeps me human. And in a profession that walks so closely alongside life and death, that is no small thing.

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I remember one night in particular—48 hours with barely any sleep, scrubbing in and out of emergency surgeries, the hospital lights growing dim in my mind even as they stayed bright overhead. The shift was so long, I started to lose track of time. My body ached, my eyes burned, and I could feel my patience thinning, even though I tried to stay calm. It was one of those stretches that every surgeon eventually faces: the kind that tests not just your skill, but your stamina, your values, and your sense of self.

Burnout doesn’t always hit like a thunderclap. Sometimes, it creeps in quietly, masked by adrenaline and purpose. In surgical life, we often push through without recognizing what we’re really feeling. We wear our endurance like armor, even when it’s cracking.

The Unspoken Weight

People imagine surgeons as high-functioning heroes—calm under pressure, in control, precise. And yes, sometimes we are. But underneath the surface is a real human being. One who sometimes doubts. One who worries. One who’s running on empty.

There’s a cost to carrying that kind of responsibility for so long. The pager never truly sleeps. Even when you’re off-call, you’re not really off. You think about the patient you operated on hours ago, wonder if the bleeding has stopped, if the graft is holding. You wake up in the middle of the night replaying steps, questioning decisions. It’s not just physical exhaustion—it’s emotional and mental wear.

During the hardest years of my training, I often felt like I was living on a razor’s edge. A few wrong steps—forgotten meals, skipped sleep, isolation from friends and family—and the weight of it all would start to pull me under. But I kept going. We all did. Because the work mattered. Because the people mattered. And because walking away never really felt like an option.

When the Mission Keeps You Moving

Despite the long hours and endless demands, what saved me time and again was my connection to the why. Why I became a surgeon. Why I chose this life, knowing it would be hard.

For me, surgery has always been about service. About being useful in someone’s darkest hour. There is something incredibly grounding about helping someone survive the unthinkable—about stitching them back together, literally and figuratively. That purpose, that mission, gives the long nights and missed holidays some kind of meaning.

I once operated on a young man after a car accident, and when he returned to thank me six months later—walking, smiling, alive—I realized that those brutal shifts had given him a second chance. That helped me hang on. It still does.

Mentors Who Made the Difference

I wouldn’t have made it through those years without mentorship. Not the kind that just teaches you how to hold a scalpel, but the kind that reminds you how to hold onto yourself.

There was one senior surgeon I looked up to immensely. He had this quiet way of checking in, always knowing when I needed a break—even before I realized it myself. One night, after a particularly tough case, he found me sitting alone in the locker room. I was drained. He didn’t say much—just sat down beside me and handed me a cup of tea. After a few minutes, he said, “You did good work today. Get some sleep. I’ve got the next one.” That moment stuck with me.

The best mentors teach you not just how to survive in surgery, but how to endure it with your humanity intact. They lead by example—showing vulnerability, taking care of themselves, drawing boundaries. I’ve tried to pass that forward with younger colleagues. Even a small gesture—a shared story, a check-in, a quiet moment—can make a world of difference.

Learning to Refill the Tank

Burnout isn’t something you can outrun forever. Eventually, the cracks start to show. I’ve had to learn to recognize the signs in myself. Irritability, brain fog, lack of joy in the work—those are red flags. I’ve also learned, the hard way, that self-care isn’t selfish. It’s survival.

Now, I make space for recovery. I disconnect when I’m off duty. I spend time with my family. I go for long walks, I write, I cook. I’ve reconnected with the things that remind me who I am outside of surgery. And that’s not weakness—that’s wisdom.

It took me years to understand that being a good surgeon doesn’t mean being invincible. It means being resilient, honest, and humble enough to ask for help when you need it.

A Bravery Beyond the Knife

When people think of bravery in surgery, they picture life-or-death decisions in the OR. And yes, those moments exist. But some of the bravest acts I’ve witnessed are quieter: A resident admitting they’re overwhelmed. A colleague taking time off to recover. A nurse speaking up when something doesn’t feel right.

Bravery is staying in this profession and continuing to care, even after hard losses. It’s showing up again and again, even when you’re tired, because you believe in the mission. It’s finding meaning amid the chaos. That kind of courage deserves just as much recognition as any technical feat in the operating room.

Still Standing, Still Grateful

Today, I look back on those long shifts not just with fatigue, but with a kind of quiet pride. I made it through them, yes—but more importantly, I learned from them. I learned that rest is not a reward; it’s a requirement. I learned that connection and mentorship are lifelines. And I learned that bravery in this field comes in many forms.

Surgical life is intense, demanding, and often unforgiving. But it’s also beautiful. Because in the midst of all the struggle, we get to be part of something truly meaningful. And that, more than anything, is what keeps me going.

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As a surgeon, I’ve had the unique privilege of stepping into operating rooms on nearly every continent. Each time I put on scrubs and wash my hands at the sink, I’m reminded that medicine, and especially surgery, is one of the few professions where the rituals, the ethics, and the language are strikingly similar no matter where you are in the world.

There’s something deeply comforting about that. I may not speak the local language fluently. The OR might look different—sometimes a high-tech facility in Germany, other times a modest rural clinic in East Africa. But once the patient is prepped and the team is assembled, we all fall into the same rhythm. The scalpel, the sutures, the shared focus—they speak a language of their own.

The Rituals That Bind Us

One of the first things you notice when walking into an operating room anywhere in the world is how ritualized the environment is. There’s the same careful choreography: handwashing, gowning up, glove snapping into place, the time-out to confirm the patient and procedure. These steps are not just protocol—they’re sacred. They mark the transition from the everyday to something more precise, more intentional, and deeply human.

I’ve seen this ritual followed with near-religious reverence in Tokyo, and with equal seriousness in a mobile tent hospital in the aftermath of a natural disaster. It’s as though the OR becomes a kind of sanctuary, where the outside world falls away and all that matters is the human life on the table. Regardless of where we are, we take a collective breath and begin. That sense of focus is shared—and it’s powerful.

Speaking Through Our Hands

Communication in surgery is unique. We rely on short, sharp commands and a lot of nonverbal cues. A nod, a glance, the way a hand reaches out—these are all deeply understood in the OR. It’s a language you learn not from textbooks but through repetition, observation, and immersion.

Once, during a medical mission in South America, I worked with a local team whose English was limited and my Spanish was even more so. But we barely needed to speak. I asked for instruments with gestures, and they responded with quiet efficiency. When things got tense, our eyes met and we adjusted course without a word. That kind of communication is built on trust, professionalism, and a shared goal: doing right by the patient.

Ethics Without Translation

Perhaps the most powerful example of our universality is the ethical compass that guides us. The Hippocratic Oath, or some version of it, resonates in every place I’ve practiced. Whether I’m working alongside colleagues in Scandinavia, Southeast Asia, or Sub-Saharan Africa, the core values remain the same: respect for life, a commitment to do no harm, and the duty to care for each person equally.

I remember a case in a war zone where supplies were limited and triage decisions were incredibly difficult. The local doctors and I had differing cultural backgrounds and medical training, but our values aligned perfectly. We debated hard, we made tough calls—but always with the patient’s well-being front and center. That kind of alignment transcends borders and speaks to something fundamental in all of us who choose this work.

Lessons From Every Culture

Traveling and working internationally has taught me that no one system or approach has all the answers. In some countries, I’ve learned about resourcefulness—how to do more with less. In others, I’ve seen incredible innovation and the seamless integration of technology. I’ve watched surgeons in rural clinics improvise with tools we might throw away, and I’ve seen robotic-assisted surgeries in gleaming hospitals that feel more like spaceships than ORs.

Each time, I take something home with me. Sometimes it’s a new technique, other times it’s a new way of thinking about patient care or team dynamics. The best surgeons are perpetual students, and working across cultures has made me more humble and more open-minded. It also reinforced a deep sense of gratitude—for my own training, for my colleagues worldwide, and for the opportunity to serve.

More Than Just Medicine

In the end, surgery is about healing. But it’s also about humanity. What unites us in the operating room is not just our skill, but our shared purpose. Whether it’s stitching up a wound or removing a tumor, we are part of a global brotherhood and sisterhood that operates beyond politics, borders, or beliefs.

I’ve come to believe that surgery—done right—is one of the purest expressions of empathy and solidarity. You place your hands, your knowledge, and your heart at the service of another human being, often one you’ve only just met. And you do it not because of nationality or language, but because of a quiet promise we all made when we chose this path: to help, to heal, and to never stop learning.

So yes, surgery has its own language. But more importantly, it has a soul. And that soul speaks fluently, wherever you are in the world.

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