The chef and the surgeon have much in common

From the moment I first stepped into a restaurant kitchen, it felt like home; even though for the past eight years my real home has been an operating room, as I am a surgeon.

Though many on the outside may not realize it, the chef and the surgeon have much in common. Both profess modest beginnings. Cooks were slaves and surgeons were barbers. Those who did the cutting were not even considered physicians. While I needed to go through the cultural ritual of medical school, lectures and books did not make me a doctor.

The learning of surgery, like that of chefery, is an apprenticeship, the quality of which is highly dependent on those that train you. For both professions, learning comes through the difficult and repetitive daily grind of working intimately with peers and mentors. As I rotated from team to team, and am gradually awarded more responsibility, small rewards turn terrible weeks into triumphs. Some quit. Some continue. And there is always someone there to push you forward, sometimes not in the most pleasant or enlightened manner. Some of the best in the culinary world are often the most tyrannical, and in them I hear echoes the tone of my surgical residency. “What this operation needs is five of me and none of you.”

The worlds of the chef and the surgeon attract brilliant personalities that when not destroying you can turn you into a master. Until I shook the hand of a sweaty line cook, I thought that my colleagues and I were the only ones who endured such a labile initiation into the joy of serving others. I watched with star-struck excitement as highly efficient teams exchanged assaults and high praises under immense time-pressures and sleep deprivation. We awoke early, complained, stayed late, complained, came in sick, complained, skipped holidays with family, complained, and buried our social lives in coffee and alcohol. We share other serious job hazards as well. I have ignored cuts, burns, and strains of all sorts for fear of falling behind.

“Outsiders” merely notice the end-result, but we see cooking and operating as performance sports. I still remind new medical students of three essential rules: “eat when you can, sit when you can, and sleep when you can.” Both settings are carefully choreographed. It’s why operating rooms were called theatres and I always covet the seat by an open kitchen. At work, I am constantly watched, criticized or applauded by colleagues, interns, and higher-ups, who can also be confused for friends. Mistakes are taken seriously. We dissect then at length so as not to repeat them, and discuss things in private so reputations are not tarnished. Every so often a mistake is a discovery, a recipe for success. Certain individuals have innate talents-indefinable qualities that call them to the table. If you make it, as I have, you become part of an elite group.

While my operating room is female run, if you peek into the average one you will see male prowess still prevailing. Kitchens too are boys clubs, with a few female champions. I sometimes like to dream I’m a bit of a Julia Child.

Having now experienced a kitchen’s inner workings, I think I possess the necessary attributes to be a chef. I am good with my hands; contact lenses give me 20/20 vision; and I use my sense of smell all too often during surgery. My knowledge of anatomy is invaluable-aiding in the necessary dissection of the thymus for making sweet breads.

I also suffer from several essential compulsions. In surgery, “scrubbing in” is an age-old, hand-washing ritual. The chef’s mutual intense dislike for Salmonella and E.Coli is what makes kitchens shimmer like operating rooms.

Cleanliness is part of the obsession with perfection. In some professions, competence is sufficient, but a steak ordered medium simply could not be served medium-rare. And perfect surgery is in the preparation. An operating room’s  instrument-set evokes images of the waiter’s marking tray, and pre-operative briefings mimic those performed before serving meals.

What’s more, chefs and surgeons respect artistry in a way that transcends common sense. A dish doesn’t have to please the eye, to appease the palette. Similarly, I know that stitches don’t necessarily need to align in order to heal, but I seem to instinctively require that things appear beautiful. Like with my food, I don’t choose style over function, but the perfect combination is magical.

A career combining art and science makes for a fulfilling life of trial, and occasionally error, on the quest for a key ingredient: consistency. Other people are the subjects of our experimentation. Every detail–from the host or nurse who greets you, to the light, sound and temperature in the room–affects one’s experience. Thus I understand the heavy feeling that comes not only from large frequent meals, but also from shouldering that responsibility.

We face ethical dilemmas regarding finite resources. Zealous debates on farming mirror those on health care and both contribute large slices of our economy. Research and innovation push limits but new technology does not reliably correlate with quality. Devices are great if results improve, but when I need to solve a problem, I tend to return to the basics. Likewise, I know that my favorite truffle pasta can only be delicately hand crafted.

Perhaps most vital in my day is the feeling that I contribute to some fundamental need. Of health, shelter, and food, the last may be most essential. Medical students learn a standard algorithm for writing orders where, ‘Diet’ comes first- ahead of ‘activities’ and ‘vital signs.’ The first ‘restaurants’, in 18th century France, were designed to ‘restore’ the health of those who were ill rather than entertain the bourgeoisie. And a surgeon’s job can revolve around restoring patients’ ability to chew, swallow, use the gut, and nourish the body. Luckily, not everyone needs an operation; but we must all eat! We yearn to feed and be fed, as we begin and frequently end life through this shared act, often ritualized and joyful. The personal satisfaction gained out of arousing emotion through our interactions may be the most subtle, yet significant parallel between the chef and I. It is a privilege that bonds us much more than our clogs and white coats.

Karen Devon is Assistant Professor of Surgery, University of Toronto. She can be reached on Twitter @specialkdmd.

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