People may imagine the operating room to be a place of intense concentration and serious silence as expert surgeons perform lifesaving operations every day.
But what goes on behind the theatre doors could sometimes
be more like a soap opera, according to a new study into surgical staff's behaviour.
Surgeons and their assistants argue, flirt, throw things across the room and poke fun at their patients while they are under the knife, research has revealed.
The social structure of a surgical team has even been compared to that of a family of monkeys, in which conflict is useful.
For the study a researcher from Emory University in Atlanta, Georgia, sat in on 200 operations and recorded more than 6,000 conversations.
She found just over one in every 40 interactions between surgical staff is a fight or argument.
Television shows and movies may give the wrong impression when they portray a surgeon in a silent room asking to be handed a scalpel as a single bead of sweat runs down their forehead.
In fact, they're just as likely to be gossiping or chatting about sports or the news,
The Times
reports.
Dr Laura Jones, a medical anthropologist who studies communication and team-building among operating staff, logged 6,348 conversations during surgical procedures in the US.
She sat in on the procedures to watch how surgeons and their assistants behave at work.
Medics throw rubbish, dance, and flirt with one another
Medical staff were seen throwing rubbish across the room into the bin and celebrating when it went in, dancing to music, and rubbing each other's legs flirtatiously, according to the study.
One reportedly called an unconscious patient 'gigantic' and said they would need ten people to move her.
And another stormed out of the operating room in a huff when an assistant accidentally squirted him in the eye with bodily fluids from an infectious patient.
Dr Jones's study suggests status and 'ego' is a main cause of arguments in the theatre, and they are most likely to happen when high-ranking male surgeons try to exert their dominance.
And the main surgeons are almost always responsible – they were the cause of 118 out of 175 arguments Dr Jones observed.
Fewer conflicts when more women are in the room
However, arguments are less common when there are more women in the room, or if the surgeon is outnumbered by members of the other sex.
Nurses and junior colleagues have more chance of being the ones at whom the anger is directed.
Risky operations also get tensions running higher in the room: around 5 per cent of heart surgeries ended in a bust-up, whereas fewer than one per cent did if a patient was having a gynaecological or orthopaedic procedure.
Another of the paper's authors, Frans de Waal, an expert in the behaviour of primates, says conflict can be useful.
The researchers think the operating room has a similar structure to primates' biology – men try to gain power and authority while women want social status – but that mixed groups or gender roles can keep this more controlled.
'Avoiding conflict is not possible'
'Avoiding conflicts altogether is not going to be possible,' he said. 'It's not even good. Certain things need to be said.'
Despite the conflicts, some of which Dr Jones said could be jeopardising the safety of the unconscious patient, nearly six out of ten (59 per cent) of interactions between surgical staff were positive scenes of co-operation.
Only 2.8 per cent of interactions were conflicts.
The researchers' findings were published in the journal PNAS.