The other day, I was operating on a little girl with a congenital ear abnormality. Not life and death stuff, but delicate surgery nonetheless. My surgical scrub technician was someone with whom I hadn’t worked before, and I asked him if he was enrolled in the operating room nurse training program, as many of the new folks are.

“No, I’m just a tech.”

I stopped what I was doing and replied: “You may be a tech, but you’re not just a tech.”

All too often, those of us working in hospital systems are quick to pull rank: attending surgeon, department chief, nursing supervisor, you name it. These titles are important and do carry with them substantial experience, expertise, and knowledge. But just as often, we forget how critical certain members of our team are on a daily basis.

Merriam-Webster defines a technician as “a specialist in the technical details of a subject or occupation.” Indeed. As a surgeon, I am lost without my specialist in technical details. An anesthesiologist is breathless without an anesthesia specialist. A cardiologist would lose her rhythm without her electrocardiography specialist in a subject, and a radiologist is in the dark without his specialist in the technical details of the occupation. All “just techs.”  And the list goes on. Without these skilled specialists, hospitals, clinical laboratories, doctors’ offices would be nowhere.

Not only did this gentleman at my side in the operating room make me recognize him as a critical member of our team that day, but he also made me think about all that goes into a well-run machine that we call a hospital. The notion that there is a hierarchical pyramid is an erroneous one. Surgical instruments don’t fall from the sky; they don’t appear in our hands by chance, and the patients don’t get good care, laboratory test results, x-rays, or so many other procedures by the visible team members alone.

As a doctor who works in a large tertiary care center, I have direct and indirect contact with many types of technicians. As an operating room team member, the contact is not only direct; it can be somewhat intimate. The surgical scrub technician can work literally as one’s “right hand” during a challenging surgery. The good ones have a sixth sense regarding critical parts of surgery, imminent disaster, and the feeling of smooth sailing when all goes just right. The excellent ones, who tend to be more seasoned, read our minds: a subtle gaze over the surgical mask, the way we take an instrument handed to us, or the slight pitch raise in our voice when we ask for what we need is all they need to sense that something’s not quite right. Few clinicians get the experience of this oftentimes beautiful dance, and even fewer patients get to see and experience what goes on behind the sterile drapes.

Many surgical scrub technicians go on to nursing school and combine their technical expertise with enhanced knowledge and expertise in patient care. For those who choose not to enter nursing, being “just a tech” is more important than they may know.

Nina Shapiro is a pediatric otolaryngologist.  She is the author of Take a Deep Breath: Clear the Air for the Health of Your Child, can be reached on her self-titled site, Dr. Nina Shapiro, and can be reached on Twitter @drninashapiro.

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