I took up forging knives right before the COVID-19 Pandemic. I am thankful for all of the lessons that life has provided me, but I am excited about the lessons my hobbies present.
Forging a blade is an involved process like medicine. The technical, emotional, and tactile elements of both forging and medicine mirror each other well. Though a given process can be generalized to simple steps, it doesn’t fully encompass the practice.
Today’s story is one of a Ka-Bar forge project for a dear friend and colleague who followed me throughout my military career. My friend is lovingly referred to as “Shotgun Schillaci” for his exploits while deployed. His time with the 82nd Airborne left him with a love a specific blade. When he heard that I had taken up forging blades, he told me that I owed him a Ka-Bar.
The history of a Ka-Bar was actually one of Marine origin for a versatile combat knife which was adopted in WWII. The Army and Navy followed thereafter.
To forge a blade from a billet of steel, you have to heat the blade to a critical temperature and strike that hot metal with hammers. In Medicine, we forge our medical students by pouring knowledge into an empty vessel until they form a billet of basic knowledge. We heat things up by putting them in front of patients. The pressure and stress progressively heats them up to the point of glowing. The attending or resident then begins to hit them with questions, stressing and shaping their minds. As we hit them over and over, they begin to take shape. Some material, fractures from the stress, some material thrives. We continue to work with the student until they can pass their boards and graduate medical school.
The cruible of medical school and residency match is followed by a rapid cooling at the graduation ceremony. In forging, this is the quench. The controlled cooling of the blade in oil is not as fast as oil as to ease the metal into a specific pattern. If the cooling is too fast, the blade will be brittle and break easily. Looking back to my graduation ceremony, we were given a heavy dose of anxiety while we celebrated as the keynote speaker warned that “we were the future of medicine” and “our patients’ lives are in our hands.”
Having the rough shape, we test for hardness through intern year. A new level of stress where a resident tests whether they took the quench well. Did they cool too quickly and become brittle? Or did they listen to the warnings and prepared to be tested against the cold file of residency? The Ka-Bar was hard. The file skated off of the edge, the grind sparks were bright, the quench was successful.
Refining the blade, grinding the blade, and sharpening the blade is accomplished by a grinder. The grind begins coarse and gets finer with time. This is similar to medical residency. The first year is a coarse grind. The resident finds humility through difficult experiences and gets refined through experiences. Despite sleep deprivation, they are expected to maintain the highest levels of professionalism, craft, and knowledge. Over a year or so of refinement, they begin to shine or they get so thin that they can no longer be considered a blade. These thin blades are disgarded or dismissed from residency.
The Ka-Bar refined to a point of shine as well as rugged appearance. Unique to this blade as a resident physician is unique as a result of their individual exposure and experiences.
After forging, shaping, quenching, and refining, it is time to finish the blade. A blade is not complete without a handle, edge, and tempering. Handles need to be comfortable to the wielder. In the case of a physician, this is measured by the patient experience. It is difficult to create a handle that is universally comfortable. What works in North Carolina may not work in California. As such, we do our best and make the handle as pretty as possible. Diversity, inclusion, and emotional intelligence training can help residents fit more patients and community. Dressing the part is the equivalent to the pretty component of a blade.
The quality of a blade is the sharpness and durability. As residency training progresses, a resident is applied to tense situations, cooled, and applied to stress again. This is similar to tempering a blade or heat treating. This improves the flexibility and durability of a knife. It bends but does not break. Generally steel goes through hot and cold cycling to improve the durability of the blade. The last piece of training a resident is refining the edge. This is accomplished through board exams, skill evaluation, and procedural scrutiny. At the end, the resident is strong, flexible, and sharp like my Ka-Bar gift.
The blade is unique. The resident is unique. There are basic qualities that all of their type share, but each blade is their own blade.
A message to resident physicians – Your attending physicians will hit you when you are hot with anger and frustration. They will grind, shape, and refine you over time. Your time with them will be hot and cold. If you listen and take the lessons as they come, you will be prepared to a razor edge. Good luck on the match!
Revolutionary Healthcare PLLC 