From Skeptical Scalpel
“I could teach a monkey how to operate” or so some people think. This cliché has been around for years. Recently, I saw it on a Sermo [MD gripe site] post and someone said it in a comment on one of my blogs. The other day I used it in a tweet trying to entice people to read my blog on the pitfalls of dictating. And then I thought about it.
I will admit that many procedures we do are simple. I have taught physician assistants to perform such tasks as closing a wound, excising small skin lesions, draining abscesses and the like. PAs who work in cardiac surgery can harvest veins and perform other more advanced procedures. When I was teaching residents, I taught them just about all types of operations, from the most basic to the most complex.
But a Medline search has failed to produce even one paper showing that a monkey has successfully been taught to operate on even another monkey. Even if a monkey could be taught to operate, would she know when and on whom to operate?
Let me give you an example. Thanks to the ever increasing use of CT scans, I have been asked to see a number of patients who have gallstones and abdominal pain. This may surprise you, but many of these patients do not need surgery because their pain is not due to the stones. A recent study with an almost 30-year follow-up confirms this.
Sometimes we get the question, “Is that tumor resectable?” In other words, Can you take it out?” My answer is usually, “Anything is resectable [see hemicorporectomy], but will the patient survive?” That is the real question.
I don’t think a monkey is who you want making that decision.