Operating together : the collective achievement of surgical action

The study of social interactions in medical work has primarily dealt with doctor-patient consultations in which the body is often talked about rather than actually manipulated. In surgery, the body itself is manipulated and radically transformed. By contrast, social interaction and detailed teamwork organization during operative surgery have been understudied. In this chapter, I first show how anatomy, or the surgical field as it is referred to by surgeons, is situated and collectively achieved during an operation, both through the way in which it is locally seen and interpreted, and also through the way the patient’s body is actually cut, dissected, cauterized, and repaired. Second, I show that surgical practice is an exemplary case of collaboration in which a team’s actions are timely, precise and coordinated. This paper deals with surgical practice as it is locally shaped within the course of an operation; it focuses on the way in which surgical action is temporally situated and interactively organized. In order to do that, the analyses are based on a substantial corpus of video recorded surgical operations, using open techniques as well as laparoscopic approaches. On this basis, the paper analyzes the systematic way in which surgeons coordinate their actions – in directives and requests concerning the management of instruments and of micro-actions responsible for the progression of the operation.