You’re not recording sound, are you?
February 12, 2008 § 6 Comments
There is one question I always get when I’m filming an operation. No matter if the surgical team knows me or not, someone always asks me, with a concerned look on their face, if I’m recording the sound (photo credit).
Most of them ask because they want to speak freely, not having to go on record with anything. I tell them not to worry. Most of the times I’,m not recording sound at all. Sometimes I do, but only to make it easier for myself to navigate the material later. Nothing speeds up the editing like a surgeon mumbling “femoral artery” on the recorded soundtrack.
Sometimes I wish I did have the sound on tape. I’ve heard my shear of curses, yelps, “oops!”, “maybe we shouldn’t have cut that” and all the other things you don’t want to hear in an OR. But let’s move on. I want to say something about the sounds of an OR, and why I don’t record them.
The Sound O.R.
I’ll try to paint an aural picture of the operating room, layer by layer. Asuming there’s no music on.
Below all the other sounds is the constant, but barely audible hiss of the ventilation. This is especially strong and effective in ORs, to keep the air as clean as possible.
Slightly above lies the perpetual mechanic breathing of the respirator.
Adding to this basis is the more prominent, but still subtle machine hum of the suction pump. It’s a sound you don’t notice till it’s gone. Nothing creates a calm atmosphere like turning off the suction.
Against this constant background noise comes the busy but calm sounds of the actual surgery. The clanking of steel against steel as the scrub nurse puts instruments back on the back table. The high pitched tone from the electrocautery unit when the surgeon steps on the remote pedal. The characteristic two or three clicks of the toothed locking mechanism as a clamp is closed. The slurping sound of the suction in use.
And around all this, the murmur of the surgical team. The scrub and circulating nurses exchanging equipment and counting sponges. The surgeon calling for instruments and ordering the assistant. The laughs. The small talk.
This steady rhythm is broken now and then by the occasional blips of the surgeon’s pagers (left by the entrance), ringing of the intercom and the insistent beeping of the anesthetist’s monitors.
And that’s about it. The aural atmosphere of the OR.
So why doesn’t Edison look more impressed (photo credit)? If I was making an episode of Grey’s Anatomy I would probably want some alarm blips to add atmosphere to the romantic complications. But when it comes to inform about a procedure, these sounds are simply irrelevant and distracting. What Edison is hearing is only confusing him.
The soundtrack of my videos only contain an informative voice over describing what’s happening. This, of course, means silence between talking. I know a lot of surgical video providers can’t stand that. Or more precisely, they can’t resist the urge to put cheesy elevator muzak in there. I cannot see what this contributes to the video. It’s only drawing attention to itself, which is exactly what a soundtrack should not do. I like my videos clean (sterile?) and efficient, showing only what’s important and why.
If I was ever to use a soundtrack, though – I’d use this recording.
The Sterile Eye 
It is enough worrying if the patient is listening! A plastic surgeon who did a lot of surgery on awake patients once taught me to say “Excellent” instead of “Oops”. It made it very scary being his assistant when he said “excellent”.
You’ve captured the aural atmosphere of the OR very well. Exactly right about the calmness after turning off the annoying suction. It is even worse when using frazier tips. Few anesthetists here like to turn up the volume on the respirator because it sounds kinda cool and Darth Vader like but most of them turn the volume down.
Chris: On a few occasions I’ve experienced surgeons making very inappropriate comments about the patient’s physique. Of course that doesn’t belong anywhere anytime, but knowing that the pasient can be listening…very unprofessional.
Trauma: Thanks! Never heard about the Darth Anesthesia before. Funny!
I realized while filming yesterday that I’d forgotten one important sound.
The inflating of the cuff of the automatic blood pressure machine makes a distinct murring sound that can be heard at regular intervals.
[…] February 2008: You’re not recording sound, are you? What does it sound like in an OR, and why don’t I record these sounds? Read the post. […]
[…] concerning the auditory space of contemporary medicine: Øystein Horgmo’s work on the sounds of the operating room, and “sound artist John Wynne’s recordings of the medical soundscape at Harefield heart […]