Sunday, October 19, 2008

Soft Eyes

The title of this post is another reference to "The Wire"; this time from season four. I know, I just used a clip from "The Wire" last month. I acknowledge that. I'm a repetitive son of a bitch. But it's the best thing this country has produced in terms of the visual arts (TV, movies) in a long time. Anyway, there is an episode in season four where Greggs, a rookie female homicide detective, gets stuck with a seemingly unsolvable case; dead drug dealer turned informant on some back alley with no witnesses. Greggs pieces it together by going to the scene and picking up on the little details. Her senior partner sees the perpetrator in the interview room and he's dumbfounded. How'd you do it? he asks. Soft eyes, she says.

You have to look at things from different perspectives. It's those hard eyes that get you in trouble. An inability to see things beyond the clouded distortion of past experiences. Surgery, in a way, is quite similar to breaking down a crime scene. We're taught a technique. We know the anatomy. We have xrays and ultrasounds and other data to use going into an operation. But you can never anticipate the contingencies. Unfortunately, we don't all look exactly alike on the inside and it's the subtle variations that can sabotage an operation. If you go into an operation thinking it's going to be just like the other hundred you've done before, you're going to get someone hurt.

The laparoscopic cholecystectomy affords plenty of opportunities for surprise. Aberrant ducts. Posterior branches of the cystic artery. And all the adventures associated with acute inflammation. More than any other operation, the lap chole requires your utmost vigilance. You can't go through the motions. You can't flip on the autopilot switch like you can for say, an inguinal hernia or a lipoma excision. You better keep those eyes as soft as you can.....

1 comment:

Bianca Castafiore said...

"Soft eyes" see so much, so well. Interesting how the concept holds true in so many professions and it makes sense it would work as you gaze at your surgical field...

We made it last as long as we could, and watched the last episode of the final season last week. Truly a great show.