Surgical Precision
TIL that “surgical precision” is nothing more than a myth.
Context:
I'm working at an aircraft startup and one of my colleagues is a retired surgeon. I had wondered in my first week at the company at his “quick and dirty” style of work.
Some cuts he made were curvy as hell and I was sure that I could have made the same cuts with much higher precision.
While on my first day I had taken a flight with him to Oslo, today joining him in his Renault Zoe on his way to Oslo I got a real chance to talk with him for the first time.
Another fun thing that I had learned about him during the day was that because of his disapproval of Christmas, last year he decided to dress as Karl Marx instead of Santa. His wife dressed as Rosa Luxemburg.
And instead of Christmas Songs they were singing “The Internationale”.
Now enough of the context:
What he taught me was that surgeons are not at all trying to work as precise or as good as possible. They are trying to work as precise as necessary.
But the number one priority is to get the job done. So this is mostly a game against time because every minute that a patient is lying on the table with his chest open is not a good minute for his body.
So trying to be as precise as possible is not doing the patient any service.
Quite on the contrary: being as precise as necessary and working as fast as possible is what saves the patients live. And in the end, the patient will judge the surgeons skill by how he closed the wound. So this for the surgeon the moment when the job is done, when he's closing it all up, so this is where he's starting to take his time because he knows exactly by what the patient will judge his work.
He was also telling me about his time in the municipal hospital in New York some decades ago (he's 75 now) while we were sitting in a Café waiting for his Renault to charge.
On the worst day he got seven patients with bullet wounds at the same moment. One had been shot in the heart so there was no time to open the chest in the usual way, so he simply made a diagonal cut and pulled apart the ribs to stop the bleeding of the heart. In the meantime several doctors were opening both his arms to get blood back into his body.
I realized that in such a moment, there is basically nothing you can do wrong. You either act fast and risk making a mistake, or you do not act and all and the patient dies as well.