04 September 2011

Macho Surgeons

Gabriel Weston in Direct Red* mentions, obliquely, the ‘macho’ culture in operating theatres. I doubt if there are any surgeons who routinely throw scalpels around these days — they would soon get a well-deserved bollocking from the theatre sister if they did. It’s all health and safety now. But it was once common, ordinary. Why?
I think it’s a memory from the ‘golden days’ of surgery, from the start of the 20th century to early post World War II times. Physicians then had almost no medications that actually did much for the patient; they relied on nostrums, fancy diets and authority. But surgeons could treat and cure some conditions by operations. If you had, for example, a stomach ulcer, no amount of diets, stomach bottles or whatever would do you any lasting good; only an operation would. And in those days, the success of an operation was measured by whether you survived it. There weren’t any antibiotics to ‘clear up’ any residues, no intensive care units for the patient’s optimised recovery,the surgeon had to be accurate, decisive, neat and quick.
So, there was a lot of pressure on surgeons to perform. And this stress was externalised through aggression and nit-picking. If the scalpels were blunt, the surgeon felt that the success of the operation was jeopardised, perhaps with some justification. So he — only men then — threw the scalpel away in disgust. And, as with physicians, surgeons then were authority figures; you didn’t dare question what was said or done.
Surgeons learnt by apprenticeship; you watched, listened, helped and learned. Not just how the operation was done, you learned how it was expected that you would behave in theatre. And the traditions of scalpel throwing were passed down through the generations, unthinkingly, unquestioningly. 

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