Improve Surgery Teaches Young Docs to Think on Their Feet

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BOSTON.  It’s Thursday night in the cafeteria of Massachusetts General Hospital, but the lights have been dimmed so that the diners on the night shift don’t even see the customary reflection off the Jello cube and whipped cream desserts.

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“Thank you!  I’ll be here all week–be sure to tip your nurses and orderlies!”

 

“It’s cool,” says Jennifer Aronian, a paramedic who administers blood tests.  “It’s like a real comedy club.”

What Jennifer and her co-workers have come to see is two interns from Harvard Medical School who will test their skills as part of Improv Surgery, a free-wheeling program that subjects young doctors-to-be to challenges presented by the dangerous streets of Boston as patients are wheeled into the hospital’s emergency room.


“I’m guessing liver?  Spleen?  Appendicitis?”

 

Jason Kravetz, a 24-year-old from nearby Brookline, Mass. who’s wanted to be a doctor for as long as he can remember, goes first, breaking the ice with a series of doctor jokes that elicit more groans than laughs.

“A dumb blonde breaks her arm and goes to the doctor’s office to get it fixed,” he says in the set-up.  “He puts a cast on her arm and the blonde says ‘Thanks, Doc.  Just one question–will I be able to play the violin after you take the cast off?’”

“‘Sure,’ says the doctor–’shouldn’t be a problem at all.’”

“‘That’s funny,’ she says.  ‘I never could before.’”

The help behind the counter cracks up but the nurses themselves are more reserved, since their number includes several blondes.  “Did he say what I thought he just said?” asks Meghan Connor, who is blond, although artificially so.

“I don’t know,” says her friend Terri Lynn Scorzello.  “What did you thought he said?”

Meghan doesn’t bother to answer, and begins to bang her metal hot food cover with a knife, “gonging” Kravetz to an improv operation.


“You’ve been gonged.”

 

From the wings, two ER orderlies wheel a gurney on stage forcing Kravetz to make a series of rapid-fire diagnoses based on a male victim’s blood pressure, pulse and temperature.  “I’m gonna go with appendicitis,” he says as he makes a small incision in the patient’s abdomen, reaches in and feels around.  His face takes on a look of chagrin once he realizes that the vestigial organ is not inflamed, and that he has misdiagnosed the cause of the man’s agony.

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“How you all doing out there night?  Oh–not so good, huh?”

 

“I’m sorry,” booms the voice of Dr. Lionel Scala, the master of ceremonies, as he jumps on stage and grabs the microphone.  “As a consolation prize we’re going to give Jason the home version of Improv Surgery! and a year’s supply of latex surgical gloves.  Thanks for being on the show!”

Kravetz walks off to temperate applause that conveys more encouragement than enthusiasm, taking his consolation prizes with him.  “Our next contestant comes all the way from Roanoke, Virginia.  She was a micro-biology major at the University of Richmond, with an overall score on the MCATs that placed her in the 99th percentile nationwide.  Let’s give a big Improv Surgery! welcome to–Jennnny–Gilchrist!”


“Any chiropractors out there tonight?  Oh yeah?  I think you’re a pain in the neck.”

 

Gilchrist bounces on stage and launches into a high-energy routine that riffs on familiar topics such as Boston accents and drivers, then probes deeper into a Gothic take on her Southern childhood.

“You know, down South I had to fight a lot of stereotypes to go to med school,” she says.  “Every time we’d play doctor, they made me be the nurse.  I had to practice on my feeble-minded cousin Blakemore, who we kept up in the attic.  It was a Boo Radley kind of thing,” she explains, alluding to the mentally retarded character in “To Kill a Mockingbird.”

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Robert Duvall as Boo Radley

 

A hypersensitive research fellow in the audience takes exception to the innocent reference, and Jenny is gonged, bringing forth a groaning victim from offstage and a thirty-second “Lightning Round” diagnosis.

Jenny rolls the man’s eyelids back and asks “Are you on any kind of medication?”

“Just some Alleve for a stiff neck,” he says.

“How did that happen? she asks.

“I don’t know, it could have been that Strongman competition last weekend where I pulled the Hummer with just a rope in my mouth.”

In a flash, she pulls back his hospital “johnny” to reveal a protrusion of tissue.  “Inguinal hernia!” she shouts, beating the clock with ten seconds to spare.

“We have a winner, ladies and gentlemen!” the MC says as he bounds back on stage to congratulate her.  “C’mon everybody, give it up for Jenny!” he shouts in an effort to generate some enthusiasm from the audience, which has grown strangely quiet except for the sound of retching coming from the tables down front.

“Uh, doc,” Jenny says as her eyes scan the crowd.  “I think they already are.”

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