Tuesday, April 10, 2007

Surgeon Hangman

My love for Atul Gawande is fairly irrational. Sure it has something to do with his saving lives and winning a MacArthur and being brown and a Rhodes Scholar, but actually--really--it’s mostly because his name is a version of li’l A’s name…

So I was thrilled when Charles McGrath’s almost hagiographic essay about Gawande in the Times made it to the top-ten e-mailed list. Except that when I read it, the article described him playing Hangman on the patient’s surgical drapes and that made me really sad and very indignant.

Forget for a moment that the game itself reprehensibly requires a rather barbaric pictographic accompaniment. Just the fact that he would indulge in any diversionary game on the body of a patient--a patient who most likely thinks of his surgeon as a human savior, a patient who is anaesthetized and can convey neither consent nor acquiescence for the act, a patient i.e. another human being--suggests a level of disrespect for the human body that's disappointing.

Surgeons have to draw on humans and give orders for their hair to be shaved off and palpate female breasts when necessary. If they do it simply because the person in question happens to be drugged and because they can, then someone will have to explain to me how they’re ethically different from some sickening mass of frat boys.



Anonymous said...

Welcome back. I missed you :-) I thought the whole game thing was weird and not sure if it was real or the author was trying to be funny or if Gawande thought it was funny but it was definitely WEIRD!

maya said...

Thanks, JOAT :*)

Big A says that dehumanizing the patient could well be a "coping mechanism" for those working in the medical industry; i say, "hmmff."

Anonymous said...

it wasn't on tne patient, it was on the a surgical drape.

Anonymous said...

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maya said...


Check out the picture gallery--the patient is covered with surgical drapes and Gawande and crew are indeed drawing *on* her/him. Perhaps your point is that they aren’t drawing on the skin of the patient?

But we quibble. And i suspect that this is standard surgeon’s arrogance/garden variety American insensitivity/some combination or variation of the above, and that it is my fault for being overly sensitive and fastidious.

But I do know that when I take student papers and portfolios home to correct, I write comments/directions where relevant but I would never irrelevantly (irreverently) doodle on something fundamentally not mine.


Thanks for the link.

Anonymous said...

It's been a while and I may be wrong, but I do believe I wrote the anonymous comment above, embarrasing typos and all. :-)

Yeah, that was indeed the point: I seem to remember checking the photograph in the Times after reading your entry, and confirming that the good doctor had indeed not been scribbling away on the patient himself (i.e., on his skin) but rather on the drapes.

Interesting how that seems to make a difference to us! I'm an MD, too (trained where Gawande did, actually, although I don't know him), and this seems an instance of doctors forgetting how quirky our "world" sometimes really is. There is a certain culture in the OR that all medical folk gradually imbibe during their years training - what you can touch and can't, what you can do and can't, etc. Drawing a Hangman on a patient's skin would be very inappropriate; scribling on the surgical drapes (not viewed as "belonging" to the patient, but rather a temporary cover in the OR that helps define and protect the sterile field) conversely is usually viewed as quite innocuous. I haven't noticed that this is a particularly American surgical tendency - we're just as nutty elsewhere. :-)

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