Losing sight of the shore

After earning a medical degree, completing two years of supervised clinical training known as housemanship, and obtaining my medical license, I made what many considered an unusual decision.

I left Accra, Ghana’s capital city and the place where I grew up, received my medical training, and called home, and moved nearly 250 miles away to work at a hospital in an underserved community. 

My reason was simple: Widespread reports in the media and public discourse in Ghana consistently highlighted the uneven distribution of healthcare services and medical personnel across the country, particularly in rural and underserved communities. I believed that I could help.

I had discussed with the hospital leadership that I would join the department of internal medicine, but on my very first day, I was surprised when the medical director said, “Francis, you are going to the department of surgery. That is where we need additional hands."

I remember thinking, Why did I even come here? Surgery was never what I imagined myself doing. Part of me wanted to return to Accra immediately. But turning my back would also mean turning away from the very people I had come to serve.

So, I stayed. But deep down, I was scared.

I had little experience managing surgical patients on my own. What if I made a mistake? What if I harmed someone?

Over the next three months, this became my routine: Whenever there was a surgical emergency, I would be called. I would assess the patient, review test results, discuss the case with my consulting surgeon, obtain informed consent and anaesthesia clearance, and head to the operating room.

Inside the operating room, I always stood on the left side of the operating table, the assistant’s position, while the consulting surgeon stood on the right, the side of leadership and responsibility.

Over those three months, I spent hours assisting my consulting surgeon, closely observing how he approached general surgery cases, made decisions, handled complications, and led the operating team.

But I never gathered the courage to stand on the right side of the table.

Then, during my fourth month, I was called again to the emergency unit.

A man in his 40s presented with severe abdominal pain. He reported a history of recurring upper abdominal discomfort that had never been investigated, a possible symptom of a stomach ulcer. His abdomen was distended, rigid, and extremely tender. The severity of his presentation suggested a life-threatening abdominal emergency requiring urgent surgical attention.

I strongly suspected a gastric perforation. Emergency investigations pointed to it, but I could not confirm the diagnosis with certainty until surgery. A gastric perforation is a life-threatening complication in which a stomach ulcer burns a hole through the stomach wall, allowing food and digestive juices to spill into the abdominal cavity.

I assessed the patient and called my consultant.

After listening quietly, he replied, “Francis, I had to step out of the hospital for an assignment. Even if I rush back, it would take me nearly two hours. This patient cannot wait. I think I can count on you today."

I froze. What?

For a moment, I considered referring the patient to another hospital. But the nearest facility was hours away, and he might not survive the trip. If I did nothing, he would die.

So, I made a decision. After obtaining informed consent and anaesthesia clearance, I had the patient prepared for surgery and wheeled into the operating room.

And for the very first time, I stood on the right side of the table as the lead surgeon. 

I asked my junior colleague and a visiting doctor from Europe, who had been observing and learning with us, to assist me during the operation.

Then I said a silent prayer and made my first incision.

My hands were shaking. I was sweating. But I steadied myself, and step by step, we opened the abdomen. After suctioning out the leaked gastric contents and carefully examining the area, we saw a perforation on the anterior wall of the stomach. It was about half a centimeter wide. Small to the eye, but large enough to take a life.

I took a deep breath. Using a technique I had read about and spent months observing my consultant perform, I repaired the perforation.

The surgery was successful and the patient was eventually discharged. He returned for his follow-up visits looking like a completely different man from the one I met in the emergency unit. 

After that experience, I went on to perform surgeries more independently, averaging about three procedures per week for nearly two years. I also played a central role in planning, coordinating, and implementing two surgical outreach programs in collaboration with Ghanaian and European surgeons. Together, we provided surgical care for more than 200 patients at little to no cost.

At the end of my first year of service, I was named Best Medical Officer at the hospital in recognition of my performance, hard work, and dedication to patient care. It was a proud moment for me, but I cared far more about the lesson I had learned.

I realized I was capable of much more than I had believed, but it took a moment that demanded more of me to recognize it. 

William Faulkner once said, “You cannot swim for new horizons until you have courage to lose sight of the shore.” For me, that shore was the left side of the operating table.

We all have one.

A place that feels safe and familiar, and does not demand more from us than we are certain we can give. But sometimes life presents us with a challenge that calls us forward with urgency, purpose, and the weight of something larger than ourselves. It is the moment when a higher purpose, like saving a life, eclipses our fear, and the person we are meant to become is ready to step up.

When that moment arrives, I hope you will banish fear, uncertainty, and self-doubt and choose to step forward. Because that step will lead you to growth, meaning, a version of yourself you are yet to meet, and an opportunity to make a profound impact.

Courage is not the absence of fear. It is the decision to act in spite of one’s fear.

Lose sight of the shore.

Francis Opoku Twene (2025 cohort) is a medical doctor pursuing a master’s degree in epidemiology and clinical research at Stanford School of Medicine. As a first-generation college student, Francis is passionate about mentorship and capacity-building and inspiring future health care professionals.

Knight-Hennessy scholars represent a vast array of cultures, perspectives, and experiences. While we as an organization are committed to elevating their voices, the views expressed are those of the scholars, and not necessarily those of KHS.