“It’s like driving a car in the fog”: The Operating Theater
A torso, swollen with gas and yellow with antiseptic – this was the only glimpse of the patient’s body visible among the draped blue sterile sheets of the operating theatre. Poking through four quarter-inch incisions across the lower abdomen were the tools of surgical intervention, seeking to render this fragment of uncanny flesh back to a person. A rod, a high-definition camera, and two robotic arms attached to miniature instruments were manned by a surgeon hunched over a console in the corner of the room. I entered the theater just as the surgeon – looking through a stereoscopic monitor giving him a three-dimensional view, while the rest of the team gazed up at a screen above the patient’s feet – began cauterizing the fat around the afflicted prostate, preparing for its removal. “Fat can really change the landscape of the body,” he explained, relieved that this patient was not overweight. “If there’s a lot, it’s like driving a car in the fog.”
I was in the operating theater as part of my doctoral research into touch in sixteenth-century French medicine and literature. In my research, I resist critical tendencies to read bodies away as merely symbolic or metaphoric. Instead, I take them for the messy, material entities that they are. Yet, I had started to become acutely aware of the lack of my own experience of the body at its most visceral. I was worried that this might be hampering my ability to understand both the patient’s body and how medical practitioners of the past really understood it. I hoped that observing modern surgery would allow a new means of grasping early modern medical touch.
However, it wasn’t the visceral image of the body on the screen but rather the surgeon’s own language that helped me begin to understand medical touch in a new way. In his quick aside, it was clear that the surgeon was first imagining, and then searching for figurative language to articulate, the haptic nature of his patient’s body – its textures, its touch. The impact of his comparison comes from the sensory indeterminacy of both fog and fat, as what we might expect to be visual images become complicated by the overlap with their imagined touch. For fog is a visual disturbance that we can’t grasp but can move through, while fat obscures with a distinctive yellow, spongy appearance but has a texture apparently wispy enough to disappear if rubbed between one’s fingers.
The visual and the haptic senses are then both mediated by the use of such minimally invasive surgery. Hands and eyes are both averted, as the monitor, screen, and instruments mediate between the medical practitioners and the patient’s body. But where the screen offers a far greater vantage-point for the surgeon, giving him a sense of tunneling inside the body and an opportunity to act with far greater precision, he has only robotic fingers to play with, ones that can’t provide any sense of texture, of depth perception, of feeling.
The force of the surgeon’s comparison therefore worked in two ways. His figurative language bridged the gap between my knowledge and experience, as he reached for a prosaic example to help me understand how the interior of the body not only looks but feels. Simultaneously, his recourse to simile also articulates how he too has to go through this imagining process when encountering the patient’s prostate, as his robotic prosthesis bridges the gap between the patient’s body and his own. One must work to “translate your knowledge about touch into vision,” he went on to explain. “You can see the body part and you know what to expect, how it should feel, and you act accordingly.”
Robotic technology is a far cry from the surgery carried out in sixteenth-century France, most often performed by barber-surgeons transplanting their practical know-how from one profession to the other. Yet, the surgeon’s simile reminded me of Ambroise Paré’s thoughts about surgery from five hundred years ago. Considered the father of modern surgery, Paré led an extraordinary career, from young barber surgeon, noticing the dangerous effects of cauterization on the battlefield, to the personal surgeon to several French kings. Paré believed that a mixture of theory and experience was key to being a successful surgeon; one “must set before his eyes certain Indications of working: Otherwise . . . only a blind temerity of fortune moves to boldness and action.”
Paré’s language of blindness and boldness mimics, almost exactly, the surgeon’s explanation above of how to face the contingencies of the patient’s body in surgery. He implores the surgeon not to hastily touch without plan, practice, or prior knowledge, but with fingers that feel through the patient’s body. Fingers, prosthetic or otherwise, have become extensions of both modern and early modern surgeons’ minds as they rely on their touch in order to grapple with – literally and metaphorically – bodies other than their own. And it is this versatile language of touch, able to accommodate literal and metaphoric meanings, that can help both me in the operating theater, and the sixteenth-century reader of Paré, to understand how this bodily knowledge works.
“It no longer feels theoretical”: The Pandemic Everyday
I went to the operating theater in December 2019, mere months before the COVID-19 pandemic would have made such a trip impossible. The past year has seen the medical anxieties of the sanitized operating theater spill out into our everyday lives. We now move through the world mask-clad and hands-sanitized, our relation to others suddenly mediated by screens or by a fretful 6-foot gap. Touch has shifted from an essential way of interacting with the world to an anxiety-inducing way for the virus to spread. New York physician Shilpi S. Mehta-Lee reflected on this touch anxiety, only emphasized further by the novelty of the virus. “As we are forced to confront the longstanding evolutionary pressure of pathogen avoidance regarding what to eat, and touch and who to be intimate with,” she says, “[contagion] no longer feels theoretical.” One touch of the sterile blue sheets in the operating theater can compromise the safety of the patient, their vulnerable bodily interior exposed; we could not have imagined, a year ago, that our everyday tactile encounters, with strangers in the supermarket but also with our loved ones at home, could feel fearful.
“Is it possible that we are in the midst not only of a health crisis, but a crisis of touch?” a BBC article asked last October. The Touch Test, a collaborative study commissioned by the BBC and the Wellcome Collection and carried out at Goldsmiths University of London between January 21 and March 30, 2020, highlighted that positive attitudes toward touch are linked with higher levels of well-being and lower levels of loneliness. This affective valence of touch has seeped through into our language, showing just how much touch structures our relation to others – we stay in touch, reach out to someone, are touched or moved by a considerate act. The surgeon in the operating theater and Paré both drew on this material and figurative flexibility of touch to bridge the gaps between the physician and their patient, observer, or reader. Now, in the pandemic, this acknowledgment of how we use our bodies to not only experience and understand the world around us but to communicate feels all the more important. The blindness and boldness of medicine has reshaped how we value our bodies and the bodily nature of our connections.
I look back on my visit to the operating theater as a pivot point between the Renaissance past and our current pandemic moment. Observing surgery helped me to grasp the importance of not only how the sense but the very language of touch helped sixteenth-century surgeons to understand the confusing, contingent bodies of their patients. But it also helped me to comprehend the enduring imaginative capacity of touch and how we still use our own bodies to understand the world we move through. This is felt all the more instinctively in the new normal of the pandemic. Touch has mediated between Paré and his reader; between the modern surgeon, his patient, and me as an observer; between the Renaissance and the present day; and finally, between the world of medicine and our everyday lives.
- Ambroise Paré, The Works Of That Famous Chirurgeon Ambrose Parey Translated Out Of Latin And Compared With The French, By Th. Johnson, Together With Three Tractates Concerning The Veins, Arteries, And Nerves; Exemplified With Large Anatomical Figures, trans. Thomas Johnson (London: Mary Clark, 1678), 3. ↑
- Shipli S. Mehta-Lee, “Touch in the era of the coronavirus pandemic,” BJOG: An International Journal of Obstetrics & Gynaecology 127, no. 9 (May 2020): 1053. ↑