Thursday, June 18, 2009

Less Than Ten: Surgeons With Amputated Fingers

In 1982 Dr. Paul Brown published an article in the Journal of Hand Surgery titled “Less Than 10 – Surgeons With Amputated Fingers”. Over the years Dr. Brown spoke with 140 men and women in surgical scrubs who were practicing their craft with less than ten digits. The severity of their losses ranged from a single missing phalange to an entire hand cut off in a sawmill accident. Astonishingly, only two of the 140 surgeons reported any hindrance resulting from their loss. Perhaps even more astonishing was that some surgeons having lost a finger by accident proceeded to amputate more! This, they said, made their hand smaller and more agile.

This is a picture from Dr. Brown's article showing the hand of Sir Sidney Sunderland, a neurosurgeon. Strikingly, his right hand is missing two phalanges of his index finger! With this hand, Dr. Sunderland apparently performed neurological surgery without noting much of a hindrance.

Dr. Brown’s article provides an interesting approach to questions like “What do you think is the most important factor that makes a good physician?” He describes interviewing surgeons who overwhelmingly thought missing fingers did not affect their performance. Some surgeons were missing several phalanges as a result of a congenital defect – they were born this way. Imagine you were applying to medical school with seven fingers in hopes of becoming an eye surgeon! They must have thought that “perfect ten” is not what makes a great physician. So what was it then?

The thesis of “Less Than Ten” is that surgeons did not hesitate to return to surgery after sustaining severe trauma to their operating hand. They loved their craft and were so dedicated to it that it did not occur to them to quit. Of the two surgeons who no longer practiced, one had lost all innervation to his dominant hand after it was completely amputated. The other surgeon (and I think this is very telling) had thoughts of quitting before he suffered the trauma.

I highly recommend reading this article. I finally got uploaded this article through my domain. Please take a look at it, it's rather fascinating!


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