The Test

So, who views this situation as a difficult time - the patient or the surgeon?  It has been my experience with surgeons that they have trained for years for surgery and look forward to using their skills to solve a problem for the patient........so........is the problem the burden of the patient in this situation?  I don't think I was thinking of a shoulder implant here to match the illustration, however; I think I equated the quote with developing courage. 

How does someone develop courage without facing a challenge, burden, or problem of some type?  I suppose the burden is the test to know the level of courage you have......then what?