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The Surgeon |  |
| We're in an intensive care ward. There's a peaceful atmosphere of carefully monitored bodies.
There's an occasional beeping sound. Relaxing after a three hour heart operation is a coronary surgeon
(who must remain anonymous). Click the highlighted speech to hear a sample of voice.) |
K: Tell me, in that operation, that you were just conducting, you mentioned something at the end when the final stitches were being applied about how important they were, can you repeat that?
I: Yeah, it's just the skin suturing, the closing of the wound is the first thing patient knows about the operation and notices constantly. I've noticed over the years that it's very important psychologically for them to feel pleased with the operation and they feel pleased if wound looks good, and they assume because the exterior wound looks good that the rest of the operation has been done with meticulous care and attention, without actually having known that. And so, almost as a signature you want the wound to look perfect, straight, neat, clean and well sutured.
K: Well what kinds of traits does it require of you?
I: I think there are a lot of nonspecific things like control of the emotion. And to treat the operation as a technical procedure without emotion and therefore maintain control of the physical space and the systems with which you're working. I think if you become emotional, you tend to lose that impartiality and don't perform technically as well as you should. So that's a very important aspect. There other aspects such as spatial conception and being able to visualise something in three dimensions and being able to estimate size and spatial relationship in three dimensions without a physical presence. Then there are the physical skills of basic cutting and sewing and the skill of judgment, of judgment of size, and placement of sutures, etc.
K: Do anything else with your hands that's similar to surgery?
I: Yes, I think there are a lot, I seek satisfaction in other areas of craft, I guess. Leadlighting, woodworking, painting, aspects of house renovation.
K: And how do they compare to performing an operation?
I: There's a lot of similarity. You can draw parallels between say lead lighting, where there's a conceptual element of design and colour, and then there's a physical performance of task, which has to be accurate and has to be translating a concept into a physical presence. And there's the 3 dimensional aspect to that. As well you can conceptualise something in three dimensions. And then I think the accuracy with which work is done to satisfy the aesthetics of. And that's part of surgery. The satisfaction of the aesthetic is a very important element in performing an operation well. If you look at an operation and you feel pleased with what you've done, and it pleases you aesthetically, then that's my judgment of whether the operation has been successful.
K: And what do you look to particularly to judge the aesthetics of an operation?
I: You ask difficult questions. In coronary surgery, for instance, the line and the length of the grafts. The matching of targets with preordained preoperative plan. The intellectual fulfilment of matching particular grafts to particular arterties. All of those have an aesthetic element which then translates probably just to me as an individual performing that operation. To me they are aesthetically pleasing. And the obvious is the physical appearance of the heart following coronary surgery when the grafts just look right and there's not other way of describing them they look right and the operation feels right and in that circumstance it's your aesthetic satisfaction is rarely wrong.
K: What are the major differences between the sort of operations you do in surgery and the sort of procedures that you would do at home with leadlighting and woodwork?
I: I guess a major difference is that you can be perhaps more venturesome, and perhaps a little faster with craft work, because you have the potential of going back and redoing it. So if your cuts aren't perfectly accurate the first time, you can afford to go back and recut a piece of glass or another piece of wood. Whereas you often don't have that opportunity surgically, it has to be right first time. It leads to perhaps a little more freedom freedom artistically in a practical sense. In the craft application. You develop new techniques and new skills faster because of that ability to able to experiment and to be able to perhaps abandon a failed experiment and move on. Whereas surgically that's much more difficult to achieve. Because you have a responsibility to the patient and the profession not to do anything that would compromise the result.
K: So do you look for hobbies or pasttimes which give you the opportunity for experimentation?
I: Yes, I do. I enjoy cooking without recipes. And I enjoy exploring new fields that I don't have prior knowledge of.
K: And so you find there are certain habits which you've acquired in the operating theatre which are difficult to break and inappropriate when renovating a house?
I: Perhaps obsession would be the most difficult. And being able to accept something that is not perfect.
K: Can you give an example of where that's happened?
I: Yes, I was painting a room in the front of the house, and I painted it three times and I still wasn't happy, so I got interior decorator to come and advise about colours and the final decoration. And then having told us once what she thought was appropriate, we went to the shop and were about to purchase everything, and I got cold feet and called her and said I wasn't sure we were doing the right thing, and so she kindly came over and we went through it again. And following that, we did as instructed and it turned out perfectly.
K: I'm sure you don't get bubbles in the wallpaper.
I: How do you avoid them?
Frêre Jacques, Dormez-Vous? The Pleasures of Contemporary Surgery and Woodcraft