A Software Product Manager in the Operating Room
One week ago, I stood in the corner of a sterile yet bustling operating room and watched one person’s kidney carefully removed from their body — and then watched that same kidney walked cautiously from that room to another, wherein it was placed in a different person’s body. It was an honestly phenomenal thing to see. And really quite disgusting. And fascinating. And boring.
My days leading up to this observation were spent working in software product management, and the days after it will be spent doing the same. I am a software product manager, after all. I don’t have any place in an operating room, and I believe most people feel the same. The operating room is the domain of surgeons and their help, patients and maybe, only sometimes, their loved ones.
…we’re laid bare and forced to confront a fear of invasion and death and all the other discomfort behind the operating room doors.
It’s an insulated environment for which the mysteries within aren’t so much as hidden from us, but are willfully ignored. We don’t need or want to know what the doctor’s doing in there, as long as it saves lives. We trust that. We don’t dig or pry, and instead skip right along past our discomfort by keeping the idea of surgery notably tucked far away from our daily thoughts. Until the fateful moment when it isn’t. When it’s our surgery, or our mother’s or child’s surgery. Then we’re laid bare and forced to confront a fear of invasion and death and all the other discomfort behind the operating room doors.
I was allowed the opportunity to observe a kidney transplant by way of my team at ORGANIZE, where I lead product on software efforts in the industry surrounding — of course — organ donation. Working on products around organ donation is rewarding. Sometimes you feel like you’re saving lives. And then, on the other hand, you see a transplant surgeon actually saving lives and you remember that you’re working on simplifying Internet form submission or getting a Django user model bug resolved. Still… we all do what we can — I’m unwaveringly proud of the vision at ORGANIZE and their commitment to it.
A transplant surgery is phenomenal and fascinating in the same way child-like wonder and curiosity can make things. It is, even for the doctor, an exploration. The organ removal, in our case, occurs laparoscopically — with a camera inside the body — and the doctor uses a tiny tool that both cuts and cauterizes — watching on high-definition displays as he goes. The entirety of the surgery is nearly bloodless. He’s snipping and moving, searching for arteries and connections, finding his way around abdominal fat and the insides of a person that, while scanned, still can hold mystery. Sometimes an extra artery is just there, needing addressed like any other unplanned requirement.
I can’t help but ask questions because I’m floored each time I learn something new. Kidney removal leaves the donor down a kidney, but the recipient ends up with three. If the old kidneys aren’t causing harm, they’re simply left where they are. A patient can have five. Someone says they think there was a patient with seven. How do they fit, I ponder. I’m trying to remember if I was this intrigued the last time I learned a new prototyping tool, but I think the wonder I’m sensing only occurs when you’re so lost — so far removed from what you’re seeing that you couldn’t possibly be let down by it.
And yet, the transplant is… undeniably boring. It seems a slow-moving set of rules, steps and procedures. Everything is counted. The time is tracked and allotted for. The requirements for those involved branch and tree back through days and weeks — checking out and returning scrubs, what tools are set aside for this surgery in advance and even the time in the operating room itself estimated and measured. Boring, in this case, means safe. No problems. No undue risk. No adaptations that haven’t been prepared for.
It’s the precision that we think we bring when we make exceptionally bug-free products, but it’s depth and care shows sometimes how naive software creators can be.
This boring meticulousness feels like home to me. It feels like technical specifications and quality assurance testing across multiple browser sizes and operating systems. It’s the precision that we think we bring when we make exceptionally bug-free products, but it’s depth and care shows sometimes how naive software creators can be. Ask yourself if you’d tested your product enough and you might say yes — now ask again knowing that if you’re wrong someone may die. I’m not sure I’ve ever tested my products enough to make that guarantee.
I’m a little jealous of the doctor’s world where the feedback is so tangible. A kidney turns from a pale gray to a bright pink once it’s been swiftly reconnected and the blood is flowing. The doctor gives the organ a little squeeze to make sure liquid is passing through. A closing stitch and the job of the transplant is done. There are still medications and measurements for the coming weeks and months the way we’d slave over metrics and analytics long after a business launch, but through a precision-perfect process an organ transplant is product execution at master level. We should be so lucky to build our digital products with those so able and committed to a successful launch as the transplant surgeon.
A web application is crafted across months. It may live for years or it may swiftly evaporate and yet there’s never an object you can hold with your hands and say I built this…
One of the greater challenges in a life spent building software and web products is often how decoupled it can feel from the physical reward of accomplishment. A web application is crafted across months. It may live for years or it may swiftly evaporate and yet there’s never an object you can hold with your hands and say I built this — it exists because of me and it is a good thing. Across six hours on an early Thursday morning I saw a doctor build something that I suppose he too, can’t ultimately see with his own eyes when the product is complete.
But when later, the patient wakes, smiles and leaves the hospital for home — what a phenomenal reward that must be.
