Start Your Engines

I n surgery, to underscore safety processes, we love to make comparisons with other industries like flying. Recently, I found myself making a similar comparison to car racing. I was privileged to spend a weekend in a race car run by a professional race team. This crew ran an incredibly well-oiled machine, not only literally but also metaphorically. They raced at 24 Hours of Daytona, keeping a car and driver on the track continually for an entire day and night. As this was such a novel experience, I was at-tuned to every new aspect of the process and how it equated to our profession. The car driver and surgeon are easy to compare, the car being the best analogy for the patient and the pit crew serving as an operating room team. There is a track director who runs the track, just as the charge nurse runs the operating room board. The crew chief in many ways functions like the anesthesiologist, keeping the patient running. Mechanics prep the car as does the scrub or circulator; tire and gas men provide the supplies and tools to win the race. Their obsession with repetitive processes and the culture of safety were familiar. The checks and balances prior to ignition are reminiscent of the operating room. If you consider that the goal of racing is to win, then you must drive as fast as possible while still staying on the track with the car intact. You have to finish to win. In surgery, we are driving the patient safely to the finish line in his or her race—you get the analogy. It wasn't until I was back in the operating room that my romantic view of it all began to disintegrate. At the race track, they have a timeout called a " driv-er's meeting. " It is done prior to getting in the car, so plans can be made and safely reviewed by everyone well before the race, in time to make a difference. All the technical checks are done before the day begins, and no one asks you to sign off on anything as the green flag is dropped or after the checkered finish. The most acute and frankly sobering difference was that despite the hectic nature of racing, changing tires, gas, seat restraints, etc., it all began to slow down until the start button was pushed. The noise, fuss, and mess …