Urology Pearls

Experience of others can teach us much

By Shahar Madjar, MD, Journal columnist

The other day, when I was watching “Newshour,” a TV news show on PBS, I realized that I am not alone in trying to answer the question, “What can we learn from each other?”

In a segment called ‘what can orchestras teach executives about business,’ residents, doctors, surgeons, and executives from the New York-Presbyterian Hospital were paying a visit to an orchestra conducted by Roger Nierenberg.

Some of the musicians in the orchestra had never played music with each other, and yet, when they gathered under the baton of Mr. Nierenberg they played Hayden’s symphony number 4, and they played it flawlessly. ‘What can you steal from the orchestra and transplant into your own life, bringing greater success to your organization?” Nierenberg asked the audience.

One surgeon in the audience was wondering how he could adapt the same kind of team work to his own environment, the operating room.

“They sound like one instrument,” he said, adding, “If I am doing an operation with a team I have never worked with before, it is invariably chaos.”

Listening to Nierenberg would make you wonder how you hadn’t applied orchestral solutions to your own work.

“The first things orchestras do,” the conductor explained, “is to tune up.” In a similar manner, the take-home message was, the surgical team — surgeons, anesthesiologists, nurses, and surgical technicians — should gather before surgery and just talk about how they are going to perform the operation.

The ideas floating in the room were simple, yet appealing: teamwork! communication! collaboration! When the oboes, horns and bassoons play a quarter of a tone lower than they should, the orchestra sounds like a high school orchestra, Mr. Nierenberg said. In a similar way, a resident from the cardiothoracic surgery department admitted, “when the ICU is not on the same page as the cardiothoracic surgeons, we can end up with a disastrous outcome.”

Everyone agreed that if surgical teams and hospitals would adapt the habits of orchestras, the results would be music to everybody’s ears.

In my previous articles, I told you about EMT teams that drew from the experience of pit stops teams at NASCAR and saved lives, and about the lessons in customer service a doctor can learn from a visit to Zingerman’s Deli. And I wondered: should I learn from orchestras too?

My first reaction to the PBS’ show about orchestras and surgical teams was that of skepticism. Suddenly, my mind filled with doubt: Do surgical teams really need to listen to the magic of orchestras in order to realize the importance of team work? Can’t EMS teams optimize their outcomes without paying a visit to NASCAR? Can’t I find a way to better serve my patients without biting into a pastrami sandwich?

The trouble with learning from others, I thought, paraphrasing on Bill Collins’ poem “The Trouble with Poetry,” is that it encourages searching for yet other opportunities to learn from others. And how will it ever end? Should orthopedic surgeons learn from carpenters? Brain surgeons from bomb disposal experts? Urologists from plumbers?

When will we cease to attempt learning from other disciplines, and start learning from experiences more relevant to what we really do — the experience of our own discipline?

Besides, I continued to use my critical thinking (I was in that mood, you see, so I just went there!), the whole ‘learning from each other’ business may just be a futile exercise in focusing your attention on one aspect of another job while ignoring all other aspects. Here is how it might work: First, choose a profession as remote as possible from your own (say surgeons and musicians). Then, try to identify one or several traits that makes a person excellent in the other profession (teamwork, for example), while ignoring all other aspects that make the other profession what it is (playing music is not brain surgery). Then, apply what you have learned to your own profession.

And yet, the optimist, romantic me, quickly kicked back in. I thought about the lives saved by EMS members who learned from the experience of pit stop teams at NASCAR, about the lessons I took from my visit to Zingerman’s Deli, and about the joy doctors drew from listening to classical music and seeing the orchestra within themselves. And I thought to myself: yes, learning from each other’s experience might require a leap of faith, but, so what? Why not?

What can you learn from the experience of good doctors? I shall return.

Editor’s note: Dr. Shahar Madjar is a urologist working in several locations in the Upper Peninsula. Contact him at smadjar@yahoo.com or at DrMadjar.com.