The normal person thinks that because the last 20 people survived, the next patient is very likely to die.
The mathematician considers that the probability of success for each surgery is independent, so in the mathematician’s eyes the next patient has a 50% chance of survival.
The scientist thinks that the statistic is probably gathered across a large number of different hospitals. They see that this particular surgeon has an unusually high success rate, so they conclude that their own surgery has a >50% chance of success.
Yes, that’s the conclusion that the scientist has come to. The chance of getting 20 in a row is so extraordinarily unlikely that it’s reasonable to conclude that the chance is not 50/50 for that particular surgeon.