STANDING ROOM ONLY Dr. Kelly works a crowded OR at a hospital in Mumbai, India.

There's a lot to complain about these days: insurers, budget restraints, legal issues and the omnipresent compliance shackles. A recent teaching/service trip to Mumbai, India, gave me a real infusion of gratitude for my life and surgical practice in America.

The international arthroscopy conference I was invited to was held at a reasonably comfortable hotel, but security was always on hyperalert. I went through more metal detectors than the butler at the White House. After delivering a lecture, I was asked to perform a live knee surgery in order to convey contemporary surgical techniques to an audience of surgeons. Not on a cadaver, but a real patient. I wasn't even fully apprised of the diagnosis.

Feeling uneasy about operating on someone I'd never met, I reasoned that I could perhaps help this uninsured soul with a technique not available to her in her native country. I was escorted to a state hospital that was hot, steamy and extremely limited in equipment. I examined the anesthetized patient and discovered that her very unstable knee would need a posterior cruciate reconstruction.

The equipment we take for granted in America was not present. No drill guides, thermal ablation or cannulas. Several Hail Mary's and MacGyver Moments later, I was able to successfully complete the surgery in a room that was as humid as the steam room at the YMCA. I emerged from that case a changed man: My respect for my Indian surgical colleagues rose meteorically. More importantly, my appreciation for my surgical life will never be the same. Lessons learned:

1. Stop complaining. When I have a bad hair day at my surgicenter, I now pause and reflect on how blessed I am to be in a hyper-efficient, air-conditioned and squeaky-clean facility. If the latest newfangled suture passer breaks, I will remember that I just asked for a second version of an instrument that my Indian colleagues will likely never behold.

2. Stay positive. If a case seems challenging, I remember that my Indian brethren are faced with similar pathology, but without the support staff, hypotensive anesthesia, thermal ablation and 'Nano passing' instruments. If my Indian colleagues can find a way to get the job done, so can I.

3. Give back. My new friends from Mumbai would give anything to spend time in America to learn. We waste equipment daily that would be revered in underdeveloped countries.

4. Count your blessings. When OR delays, equipment issues or scheduling conflicts ensue, remember on your drive home to your suburban, garage laden, carpeted, well watered and manicured dwelling, that we live in the most endowed country in the world.

We've got it good
Whenever I get a case bumped, an insurance denial, a delayed start or even a subpoena, I toast my Indian brothers and sisters with a glass of non-bottled water. Life is good here.