Teaching a machine

I wake in the morning a bear, not in attitude (I’m a morning person) but with fingers crook’d and stiffened like claws. I exercise them (Robert says I look like a baby experimenting with fingers) to release the thickened tendons in their thickened sheaths, and unfold human hands. Doctor Four is surprised that I have five fingers locked in bear mode. He’s not seen this before, an evolution from human to bear so quick, hurried by cancer treatments. He’s offering me surgery. Five fingers. Two hands. One at a time with a month of recovery for each. Where does all this recovery fit in my time scheme?

I liked Doctor Four. He’s the third surgeon I’ve met this year. The first surgeon was all business, appalling me with all the possible side effects and moving on objectively to plan the event. The second was downright cheerful, “You were born with a heart defect. Let’s just take care of that for you right now, shall we?” Doctor Four, tall and lanky with long blond curls, that pale look of an Englishman or Scandinavian, wandered in to the room twice, in his scrubs, looking for something. His nurse’s tone was almost mothering, “Do you need something?” He looked like the kind of man who would go get somethings himself rather than bother anyone. When he talked to me, he never recommended anything. He recognized the problem in my hands, explaining that there is a nodule in the base of each finger tendon that gets caught on either side of the sheath, locking the fingers open or closed, and clicking when it releases. He said he didn’t know why I had five clicks to deal with so suddenly. “We don’t know everything, you know...not the all the ‘whys.’” He added, “There are some options for this,” and stopped. I had to actually say, “I’d like option two, please.” I got the impression he would be much happier quietly working on wrists and thumbs and such than talking, laying out the options.  Monday I find out the date he fixes the first hand. “Which one would you like done first,” he asked. “You can even wait to the day of surgery to make up your mind.” He knows me well. I’m not used to this much say in medical offices.

These places seem to me full of paradox. On the one hand, they represent the synchronized application of so much knowledge. They are like one well-oiled machine, crunching the statistics, spitting out thousands of treatments to match the conditions they encounter, just the right protocol for just the right condition. You can feel like a cog. You can get lost.  But on the other hand, when you talk to a person in the machine, you’re reminded that at the end of the day they have no idea how your body will respond to this treatment. You are unique after all and can surprise them. You have something to add in this discussion. Some doctors do better at communicating this than others, and at listening to what you have to add. Perhaps it’s a learned skill.

You can even see the machine learning. In the last two days I have been in three hospitals, all built in different eras. You can see how bits and pieces have been added on, connected by a maze of corridors going off at odd angles. In one of these hospitals we were helped by some random secretary in a random office to find our way. In the other we had to bother a staff member to open a locked door and let us go. Not visitor friendly. But in the brand new hospital I usually go to, the floor plan is much more intuitive. The newer architects cater much more to human questions and comforts and confusions.

Perhaps today, in my uniqueness, I contributed something to the learning: that human hands and overnight bear claws and cancer treatment have some connection. Maybe I made a machine a tiny bit more human. I’ll never know.