Wednesday, April 25, 2007
Plumbing the Depths
Our shower has been acting up lately. It's happened before, but this behavior was different. Not wishing to hijack my own post, suffice it to say I came up with a clever solution. These little domestic victories, when they occur, find parallels in my mind with surgery. Finding solutions to unusual problems is very often what it's all about. Every once in a while I allow myself an inward smile, and tell myself I have a brain with certain kinds of software -- and feel surprise that I found my way to being a surgeon. It was, in the subject sense at least (and in others, not so much), a good fit. I'm able to figure certain kinds of things out with efficiency, and I think it's a talent not given to everyone. Not even every surgeon.
It's not unique, of course, and I'm truly not trying to boast. It's just that I'm sometimes amazed at having wandered into surgery from a series of serendipitous situations, discovering after the fact that I can actually do it, that my thought processes are suited to it. Given the body's amazing ability to heal itself and to withstand various insults, I'd say most people who don't faint at the sight of blood could be taught to do a large portion of what surgeons do. Nor is the talent, or whatever it is, to which I refer unique to people who do surgery. Artisans of all sorts surely have it. What I'm trying to describe is the ability to find ways out of unfamiliar situations. You can be taught how to use certain tools, how to accomplish a particular job. It's when encountering problems for which there's no road map that a certain (probably indefinable) way of looking at things is a great help. The body continually surprises; or, as I used to say, there's a lizard under every rock.
"We're bogging down, boys," was a thing I frequently uttered during a difficult operation. When working through a tough bit of anatomy, distorted by scar tissue or tumors or infection, if I sensed progress wasn't swift enough, I'd find a different avenue. That's in no way unique, of course. But it's critical that you get that vibe before crossing a line into tiger country. Likewise, there's some sort of spatial sense that allows some people to look at a surgical field and see what the perfect tool is; or to be able to position a needle in a needle-holder at exactly the best angle in a deep hole before trying it another way and having to change. Letting the scrub nurse know what you'll next be using, especially if it's not going to be something typical, far enough ahead that she'll be able to get it ready, is something not everyone does easily. When assisting, it frequently happened that I'd see where the surgeon was headed and assume a certain approach would ensue, a particular instrument would be called for, only to be surprised. And often, after watching futile diddling, finally see (or suggest) that other approach.
Only so much can be taught; only so much can be assimilated later. To some degree, it's about pre-existing wiring. I hope the reader will accept that when I say I think I had it, it's not for self-tooting. It's in abject amazement, because I had no reason to suspect it before I chose to be a surgeon, or even while I was in the early stages of learning. It's a "who knew?" sort of thing. (While in training, I first heard the quote from an unknown [to me] author, describing the necessary attributes of a surgeon: The eye of an eagle, the heart of a lion, the hands of a woman. I used to describe myself has having the eye of a needle, the heart of an artichoke, and the hands of a clock.)
For the life of me, I can't paint or draw anything that looks like something. I couldn't sculpt my way out of a canvas bag. Building a glob of clay into a recognizable work is a talent entirely out of my ken. Even more mysterious is the ability to hack a chunk of marble until it's the Pieta. (Who was it that said "I just cut away everything that doesn't look like a duck" -- or something similar? Might have been big Mike himself.) Given the choice, I'd absolutely, in a heartbeat! opt for that kind of art -- which is truly a gift -- over some sort of ability (real or imagined) to smooth out some surgical rough patches. But there have been times when I was glad to settle.
Update: the shower is acting up again.