With doodles as her signature, a Chicago pediatric surgeon makes surgery and casts a little less scary
As school ends, summer begins and the dangerous outdoors beckon, a quick tip: If you are a child and plan to break an arm or hand, or schedule surgery on an arm or hand, try and do this before Felicity Fishman goes on vacation.
She is a pediatric surgeon at Shriners Children’s Chicago hospital in the Montclare neighborhood, and by all standards, esteemed and valued for her medical dexterity and intellectual gravitas.
She’s also an associate professor of orthopedics and rehabilitation at Loyola Medicine. She came to Chicago in 2017 after serving at the Yale University School of Medicine. She’s been an attending surgeon at a Veterans Affairs hospital in Connecticut, a peer reviewer for the Journal of Hand Surgery, and, to be frank, not so much the kind of doctor who treats emergency room accidents, but rather, the kind of doctor renowned for creating brand-new thumbs.
Now forget all of that.
If you need a surgeon, and you’re a kid, chances are, afterward, you’ll need a cast. Your friends and family will doodle their well-wishes, goofy faces and smiling suns on it.
But Dr. Felicity Fishman will send you home from the hospital with a little art.
On a recent Friday morning, moments before Fishman performed a tendon transfer on 8-year-old Beck Novak, a nurse turned to her in the brightly lit surgical unit and asked:
“Doing a drawing?”
“Yes,” Fishman said.
“Of?”
“Of an elephant.”
“Got it,” the nurse nodded.
Among the heart and oxygen monitors and tubes and craning overhead lights that fill the room, there is a rolling metal cart showcasing the kind of instruments you might imagine during a surgery: long, shiny, pointy scalpels and clamps lined up impeccably, like the spoons in a fancy restaurant. But across the room, on another cart, are the instruments Fishman wields after surgery: tight rows of water-resistant color markers.
For the past three years, Fishman has been popular among parents and kids for a single, cheerful post-op flourish. After she meets with a patient and prepares them for what is often a scary-sounding procedure, she asks a question: What would they like her to draw on their casts? She calls up pictures on her phone of past works, to give them some ideas. But she will draw whatever they want. She’s drawn about 150. In three years, she’s created dozens and dozens. Pokémon. Superheroes. Supervillains. Disney princesses. Snowmen. Unicorns. A choo-choo that ran the length of an arm. A roller-skating chicken. Japanese animé characters. Minnie Mouse. Super Mario. Sharks. Sharks eating minnows. Spider-Man is evergreen, and dinosaurs are always popular.
Beck, who is from Valparaiso and has cerebral palsy and needed surgery to give him control over his left hand, wanted an elephant. Fishman showed him cartoon elephants and one photo-realistic African elephant. The cartoon elephants would have been easy.
Beck wanted the realistic one.
“Because, of course,” Fishman says, smiling ironically.
She leaves to scrub for surgery. Beck lies on the operating table, asleep, sedated. Fishman returns with a light fixed to her forehead, like a spelunker. The bleeps from monitors and scruffs of rubber soles mark the silence. Fishman walks over to a small speaker, fiddles with an old iPod Mini, then with a look, she clears the room of visitors.
A couple of hours later, Beck was still asleep, but the surgery was done and all that showed of him was a left arm hanging out from beneath a sheet, wrapped in a blue cast. Fishman sat at his side, surrounded by assistants, sizing up her canvas. Earlier in the day, Deborah Novak, Beck’s mother, had warned her son: Art-wise, Beck, there is only so much that a surgeon can do for you. But Dr. Fishman was going to try anyway.
“That meant a lot,” Deborah said. “The elephant is his animal. It’s strong and resilient.”
Fishman is quick to note that while a surgeon adding more than a doodle to a patient’s cast sounds unusual, she is not the only one in the country who does it — there are doctors at the University of Southern California and Children’s Healthcare of Atlanta, for starters, known for their aesthetic touch.
“The pediatric world is small,” she said, “and like-minded in terms of wanting to find ways to make a visit a nicer experience. When you’re a kid, parents are making decisions. You are minimally part of the actual process. But allowing a kid a way to participate and include something meaningful to them — it can help a child who is anxious about a surgery to have some autonomy. There’s been medical research that shows just allowing a child to pick the color of their cast can help.”
Felicity Fishman is not an artist. She is a New Englander, 5-foot-2, direct, efficient and shares the same wary smile as Frances McDormand. “I would never say she thinks of herself as holding any artistic pretensions,” said Kelsey Moon, a Shriners’ physician assistant. “We were all surprised, to be honest, she drew as well as she does. I remember we had a drawing competition among staff. She said anyone could do it. That is false. And art is not the first thing I think of with her. She’s an athlete.” Indeed, she was captain of the national champion lacrosse team at Middlebury College in Vermont.
Years ago, at first, Fishman just added glitter, then she cut shapes into fiberglass casts, then she wrapped the mold in colored tape and created abstractions. Then someone said: Why not just draw something? As it became a standard step with many of her operations, colleagues would ask her occasionally if it takes a lot of time — the patient is under anesthesia after all. But it only adds about 10 minutes to standard recovery time. “I do not think of this truly as artistry,” she said, though it does dovetail with some basic surgical skills. The precision of the lines. The understanding of how anatomy is shaped.
As Beck was out, she worked fast.
She called up the elephant on her phone and left the image open for reference. A nurse slid her a tray of markers. Fishman considered the colors. “This the only gray?” she asked. She outlined a pachyderm in black marker, moving a hand steadily. As she worked, a nurse read facts. African elephants are bigger than Asian elephants and have larger ears, she said. Some male Asian elephants form tusks. All African elephants form them.
“Oh, yeah,” Fishman said, head down.
“Fun facts,” the nurse said.
Fishman raised her head: “He doing OK?” She nodded at Beck. “Everything is perfect,” another nurse said. Fishman colored in the ears with pinks and added wrinkles to the legs. A second nurse filled in the gray. The eyes on the elephant came out a little shy.
“Anyone see anything missing?” Fishman asked.
A nurse glanced over. “Shut up,” she said. “That looks really good!”
“But my toes are imprecise,” Fishman said.
A while later Beck Novak woke up and glanced down at his arm wrapped in a cast.
“My elephant,” he said faintly.
“Your elephant,” his mother said.
Some patients keep the art, cutting it from the part of a cast that eventually stinks. Fishman, 43, is flattered. But being known for her drawing, it does get a little distracting: “After seven years of training, turns out I’m also pretty good with the medical stuff, too.”
