mybetterdoctor

Brute force vs. Skill: A play in 3 acts

Posted by denitzablagev on July 3, 2019 · 1 Comment 

Act I. Can women intubate?

A study published in the American Journal of Emergency Medicine showing that “Female physicians are not inferior to male physicians in performing emergency endotracheal intubation.”

Act II. It’s not about American women – South Korea is really sexist.

Blogpost giving some background after the backlash on Twitter.

“Why did they chose [sic] intubation? I can’t say for sure but the paper gives some hints.

We hypothesized that… while successful endotracheal intubation may require both skill and strength, the importance of correct technique far outweighs physical strength.

”

Act III: Consider: Social Axe throwing – Brute force vs. Skill

I was recently invited to a social evening with friends, which entailed drinks and chatter and a friendly axe throwing competition.  With few exceptions, this was our first time axe throwing.  One man and I considered ourselves pretty good tennis players and strutted to the line with the confidence of our fast serves and demolishing forehands.  At each of our turns we threw the axe quite hard, and despite a satisfying thud as it hit the wood, it failed to wedge in, and quickly slid down.

We were easily bested by many. One woman strutted forward in her heels, “special axe throwing shoes” her husband, who was outperformed by her, joked. Her swing back and release didn’t elicit any grunts of effort, yet the axe firmly wedged into the target.

The tennis player continued to throw the axe, throwing with more force with each successive trial, until he threw it so hard it bounced off the wall and landed at his feet.

The woman in heels turned to me: “it’s because he thinks it’s all about power,” she said,  “but it’s not,” she added and winked at me.

I recall being a novice Pulmonary and Critical Care fellow learning how to intubate patients in the operating room.  I was an even more regular tennis player at that time and walked in confident of my arm strength. I lifted the patient’s head clear off the bed lifting the laryngoscope in my quest to find the epiglottis, let alone the vocal cords, so that I might pass the breathing tube and successfully intubate.  I noted that my experienced attendings did not use that much power to intubate.  As I gained experience, I too, had a much easier time intubating without necessitating so much force.

Thus, I submit to you, that there is no surer way of identifying a novice at a skill, than finding someone who believes success lies in brute force.  

As an irrelevant aside, when it comes to sports and power, people experienced in a sport use their legs and body to do things that beginners believe are done by the arms.  In tennis, the power of the serve or the ground stroke comes not from the arm, but from the legs and body moving forward.  I’m no expert, but willing to bet that similar principles apply in swimming, rock climbing, and even boxing.