Observations on the Physics of the Surgical Residency

OBSERVATIONS ON THE PHYSICS OF THE SURGICAL RESIDENCY VIC VEEANOVICH* I. The Motivation to Study the Dynamics of the Surgical Residency My interest in physics began as an undergraduate. I was fascinated with the power of being able to understand and predict the world around us with a few elegant equations. I was also struck by the philosophical discord among the comforting determinism of classical physics, the uneasy contortion of relativity, and the "Katie-Bar-the-Door" indeterminism of quantum mechanics. So even though I eventually went into medicine and became a surgeon, I naturally maintained my interest in the study of dynamical systems. It did not take very long for me to recognize as a surgical resident that the process oftraining surgeons was a dynamical process shrouded in much mystery and myth. However, with a Galilean faith in the power of observation and reason, I felt that the workings ofthis system could be made understandable , if not predictable, to those not a member of the high surgical rabbinate. I must make the disclaimer that much of this work may seem disjointed. Paralleling the humbling difficulties that high-energy physicists have had in unifying the four forces of nature (they're down to three now, and if they roll the dice right, they may get down to two), I have also been unable to totally unify the observations reported here into one grand theory. However , as with classical physics, where mechanics, optics, and electromagnetism were not seamlessly woven into one theory but nonetheless useful individually , so each topic developed here will apply only to its own individual corner or tassel of the surgical residency magic carpet. The opinions expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the United States Government. *General Surgery Service, Ireland Army Community Hospital, Fort Knox, Kentucky. Address correspondence to: MAJ Vic Velanovich, MC; General Surgery Service, Attn: MCXM-SSC-S; 851 Ireland Loop, Fort Knox, KY 40121-5520.© 1996 by The University of Chicago. All rights reserved. 0031-5990/96/3903-0950$01 .00 500 Vic Velanovich ¦ The Physics of Surgical Residencies II. Heisenberg's Uncertainty Principle and the Surgical Teaching Staff Surgical teaching staff are a uniquely unpredictable lot. I had many months offrustrating attempts to understand and anticipate their behavior, especially, though not exclusively, to determine when a tirade or castigation would be directed at me. I attempted many experiments to identify those sets of conditions which would elicit these most unpleasant responses. I soon realized that this was much like determining whether the new species of shark you discovered is a maneater without being eaten yourself. Therefore , I must confess that most of my observations were done after setting up these experimental conditions on some other resident. At first, I thought that the lack of a predictable pattern of outcomes based on the initial conditions were due to this indirect data-gathering technique. However , after prolonged bafflement, it dawned upon me that these qualities were inherently unpredictable. Hence, I developed the Heisenberg Uncertainty Principle for the Surgical Teaching Staff: One cannot tell with any arbitrary degree ofcertainty both the position and momentum ofa surgical teaching staff at any arbitrary time t. This important principle requires further explanation. First, let us define the problem this principle hopes to explain. The problem is not only anticipating the behavior of the teaching staff, but also knowing "where they're coming from" and "how hard they're coming." The first statement will be defined as their position, p. p is not only the corporal location of a particular staff's body in space-time, but also their psychological construction at time t. The second statement will be defined as their momentum, m. m consists of both the size and velocity of a particular staff's corpus through spacetime and the size and velocity of his or her emotional/intellectual flow. Therefore, the level of a resident's uncertainty, UR, is proportional to these factors over space-time, such that UR« a~p—m dt dt The constant a is a correction factor for each particular staff depending...