A surgeon mentor once told me many years ago: “Jeff, we are like plumbers.” I initially perceived this negatively. However, the positive reality of this comment became clear to me over time, particularly after reading Shop Class as Soulcraft: An Inquiry into the Value of Work by Matthew B. Crawford, who advances the argument for “work that is meaningful because it is genuinely useful.” The book not only transformed my perspective on the value of the craft trades (e.g., electricians, masons, plumbers) but also my perception of my chosen specialty, facial plastic surgery. Seek a fellowship trained facial plastic surgeon if you have aesthetic concerns about your face or neck.
Doctoring as Soul Craft: The Value of Perfecting a Physical Trade
Dr. Jeffrey Harmon
“Any discipline that deals with an authoritative, independent reality requires honesty and humility.” – Matthew B. Crawford (author)
Matthew B. Crawford, a professor in philosophy and motorcycle mechanic from the Bay Area, became an electrician as a teenager, learned the mechanics trade in his 20s, earned his PhD in philosophy and dipped his toes in the Washington D.C. think tank world as well as consulting prior to leaving it all to start a motorcycle repair shop in a grungy building in Richmond, Virginia. He now works as a professor at the University of Virginia from his home in Silicon Valley. His central argument in Shop Class as Soul Craft calls to mind the story the author Robert Pirsig tells in his book Zen and the Art of Motorcycle Maintenance: An Inquiry into Values in that both argue that “real knowledge arises through confrontations with real things.” In the case of Mr. Crawford and Mr. Pirsig, that is motorcycle mechanics.
Matthew B. Crawford praises work that is technical, requires manual dexterity, is embedded in the community, and cannot be outsourced. He includes medicine in his list of jobs as well as the building trades and mechanics. This contrasts with more traditionally white color jobs, including his work as a consultant and in a think tank, which he feels have become so systematized as to demand little independent judgement and skill. He argues that independence means having the agency to harness your own knowledge, experience, and skill to work towards an end that flows from something that physically exists. That is because there is universal validity in the end-product of the work or craft, such as a motorcycle that runs properly or a well-lifted face and neck that imparts a more naturally youthful appearance. Like a table or chair, these end-products are a long-lasting, physical example of the execution of good judgement. He provides multiple examples of problems he has encountered with motorcycles for which there are multiple possible explanations. He walks through the process by which a skilled mechanic utilizes the evidence and their understanding of the possible causes to determine a specific course of action to evaluate and treat the problem. The effort made is like an artist drawing what they see, which appears easy because of our ability to picture an image in our mind’s eye but is quite difficult to translate to a piece of paper. Like an artist, mechanic, or tradesman, surgery requires a combination of technical skill and judgement derived from study, training, and experience that allow a surgeon to see things in a way others do not.
“The surgeon’s judgement is simultaneously technical and deliberative, and that mix is the source of its power.” – Mike Rose (author)
Matthew B. Crawford states “craftsmanship means dwelling on a task for a long time and going deeply into it, because you want to get it right.” That is an apt description of medical school, residency, and fellowship that, in my case, took a decade to complete. I completed one of the most rigorous aesthetic fellowship programs in the world through the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) with Andrew Jacono MD, FACS. Not only was I trained in the most advanced facial plastic surgery procedures available by a master surgeon who developed, among other procedures, the extended deep plane facelift, but I also gained the experience of learning how to approach the complex variation that exists in the anatomy between individuals.
While we share the same basic anatomy – and this is why specific surgical procedures can be taught – there are many minor, albeit significant, variations in this anatomy that is relevant to surgery. Anatomic variation can be learned by reading, because there are normal anatomic variations that exist naturally whose chances of an encounter intraoperatively are measurable. However, there is much more to understanding anatomic variability than this, and it comes down to feeling. The feel of tissue is relevant to executing the fine steps of surgery. It is not something that can always be visualized, and it is sometimes difficult to explain. However, it factors into our clinical judgement as another data point. Haptic feedback allows our trained hands to respond reflexively to the tissue, pushing in some areas and limiting ourselves in others. We are simultaneously factoring in visual data as well as our knowledge of medical literature and experience when making judgements intraoperatively. As the author Mike Rose writes: “that mix is the source of its [surgical] power.”
“The ability to yield, to bend, to give way, to accommodate, he said, was sometimes a source of strength in men as well as in wood, so long as it was helmed by inner resolve and by principle.” – Daniel James Brown (author) of George Yeoman Pocock (Rowing Coach and Boat Builder)
I have long had a love for wooden crew boats. One of my favorite books, The Boys in the Boat: Nine Americans and Their Epic Quest for Gold at the 1936 Olympics by Daniel James Brown, tells the story of the University of Washington crew’s unlikely win over the Nazi German team in the 1936 Olympics while rowing in one of these wooden boats. My favorite part of the book is the story of George Pocock, the English boat builder and coach who was the brains and soul behind the University of Washington team, despite not being the head coach. He started a boat building company that got its financial start building planes for the United States during World War I. Pocock Racing Shells is now an internationally renowned boat-building company that still exists in the Seattle area.
The author describes the great skill and effort George Pocock exhibited when building wooden crew boats, which are composed of multiple types of wood placed in areas that maximize the natural features of the wood to optimize the performance of the boats. More detail about George Pocock’s life can be found in the book Ready All! George Yeoman Pocock and Crew Racing by Gordon Newell and Dick Erickson. His story and my love for rowing has inspired me to build my own wooden single-person crew boat. A close friend of mine’s father is a carpenter – he designed and built the frame on which my photo background hangs in the office – who built his own boat years ago. We have long discussed building a boat together. It is a dream of mine which I hope to fulfill sooner rather than later. I will make sure you all remain up to date on the process of designing and building the shell when we start.
George Pocock was an inspiration to his team and to boat builders around the world. He recognized many of the same qualities that make a master boat builder in his rowers. Matthew B. Crawford recognized the same qualities in masters of the trades, including medicine. These qualities include honesty, humility, resolve and focus.
Trust Your Face to a Facial Plastic Surgeon
It is important to seek a fellowship-trained specialist in plastic surgery of the face and neck when you have concerns about your face or neck.
Request a Consultation
Request a consultation with Dr. Harmon at Harmon Facial Plastic Surgery in Cincinnati. Visit our clinic. You will learn more about Dr. Harmon’s credentials, style, and approach. Build a relationship with our dedicated team. Do not stop searching “plastic surgery near me.” Get in touch with us to learn more.
This blog post is for educational purposes only and does not constitute direct medical advice. It is essential that you have a consultation with a qualified medical provider prior to considering any treatment. This will allow you the opportunity to discuss any potential benefits, risks, and alternatives to the treatment.