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Surgery is a fast-paced, high stress job. Surgeons undergo years of meticulous training to do what they do, and the pressure can be intense. For some, this pressure can manifest in a tremor, a phenomenon about which there is still a huge amount of stigma.

Tremor is an unconscious, uncontrolled movement, often in the hands, which can affect the fine motor skills required to do the intricate work of surgery. The causes are multifactorial, and are not the same for everyone. One cause can be psychological, related to anxiety and compounded by stress.

But in the busy, competitive world of surgery, there is limited time or opportunity for optimising personal performance, and those who develop a tremor can feel isolated, and that they’re not performing to the best of their ability.

When surgeon Lilli Cooper developed a tremor herself she asked around for support, but guidance to manage it was scarce. In this programme, Lilli explores the tremor; where it comes from, what causes it, and what’s the best course of action.

Some surprising answers are to be found in the field of ‘performance science’. Tremor can be linked to performance anxiety, which is common in other fields with high pressure and high expectation; performing musicians and actors, sportsmen and women, even fighter pilots know the tell-tale signs well. But in fields like music and sports, the psychology is well understood, and the stigma has been broken down over many years. There is a deep understanding of the necessary rituals: the prep beforehand, careful management of focus during, and the post-performance wind-down.

In the operating ‘theatre’, could surgeons like Lilli take a lesson or two from the high-pressure world of performance?