Surgery, Simply Contradictory

I'm actually holding somebody's guts. I have my hands on the slippery entrails of an actual human being. At the top end, half of the stomach is connected to the end of the small intestine, and most of the pancreas is attached to the middle. A gall bladder lies in another bowl close by. As I squeeze the head of the pancreas, I can feel a rough, gristled lump deep inside the tissue. That's why they've all been removed. Cancer.
A Whipple Procedure is a perfect demonstration of how both medicine in general and surgery in particular can be so conceptually simple yet so practically complex. The problem and the solution, on paper, are child's play- the patient has a tumour in their pancreas, so we get the surgeons to chop it out, and the surrounding bits too just to make sure the disease hasn't spread. We join the loose ends of the gut back up, and hey presto, we've cured you.
If only it were that easy. The whole thing takes around 4 hours, if you don't count the 10 years training you need to be able to run the show. I got tired just watching it, but in between his countless references to dogging, swinging, boobs and rugby, my consultant was able to get through the whole thing with minimal fuss, and still save a small amount of patience to teach me.
You could compare it with plumbing, simply removing the rusty, damaged old pipes, plugging the leaks and fixing the working pipes together again, but that denies it an intense theoretical basis. There are a million things that could go wrong, but they usually don't. And the human body is not as hardy as a set of pipes. You shouldn't be able to hack out the best part of half of the digestive system and see the patient up and about in a few days. But you can.
That's because the surgeons themselves are as enigmatic and contradictory as the artform itself. As my consultant stitches the hepatic duct onto a section of jejunum, effectively restoring the patient's ability to digest food, he asks me if I'm attached. I say "yes, for nearly two and a half years".
He guides the remaining portion of the stomach back onto the bowel with the fine detail of a seasoned professional. He asks what I like about her. I think of "chatty, sociable, sympathetic" and other such adjectives off the top of my head.
He continues to insert an enteral feeding tube into the gut in case of emergency, with great accuracy and dexterity.
"Is she from a rich family?" He continues in his inquisition.
"Not really.....", I reply.
"Bin her", he snaps, and begins to close the incision.