Raiders of the Lost Art of Working Within Constraints

Indiana Jones movies involve a lot of suspenseful moments, heightened by orchestral music and culminating in epic fight scenes. One scene in Raiders of the Lost Ark is particularly memorable. I’ve included the full scene in all it’s storytelling glory here for the pop culture nerds like me, but I’ll provide a summary for those of you with no taste (just kidding, kind of :wink:)

The scene begins with Indi and Marian wandering the marketplace of Cairo, looking quite relaxed with their little monkey friend and behaving like tourists. Then the monkey runs away from them, toward a rather sinister looking character with an eye patch who can apparently communicate with monkeys. Sinister eye patch man proceeds to tell the Nazis where they can find Indi and then finds a comfortable spot to enjoy the show.

The serious looking, cigarette smoking Nazis in hats assemble their team of bandits while Indi and Marian continue to wander around none the wiser. Music intensifies telling us something epic is about to happen.

Epic fight scene begins! Starting with sword fights, a bit of fist fighting and some practical use of random instruments for bashing. Indi tries to get Marian safely away so that he can take on the group of bandits single handedly.

This involves a lot of grunt work type fighting. Punching, some knives, and Indi’s iconic whip used to disarm the enemy and add a bit of flair. Music is now a frenzy of string instruments.

Music turns a bit moody as Nazi and eye patch regroup. They can see that they don’t have the upper hand at the moment. They need to change tactic. What’s going to happen next? Suspense builds.

Meanwhile Marian shows us she’s a capable woman who can fend for herself, making good use of a frying pan to get rid of a seedy looking character with a dagger and scummy looking teeth. (Love Marian!). She finds a hiding spot as the music once again builds, telling us we’re in for another epic battle. Nazi and bandits find her thanks to the evil little monkey as we cut back to Indi.

Now Indi’s stressed. Not because of the fighting, because he can’t find Marian. Frantic music crescendos as the crowd parts and Indi comes face to face with a fancily dressed Egyptian yielding an enormous sword (I’m sure there’s a name for it, but I call it an Aladdin type sword because I’m super cultured like that). Fancy sword work coupled with the biggest string sounds from the orchestra mean this is going to be the EPIC fighting bit.

Indi draws his revolver from his holster and shoots him.

A classic movie scene if ever there was one. And it turns out, the story behind why it came about is also pretty good.

It was in fact supposed to be an epic sword fighting scene that was going to take three days to shoot, but at the time Harrison Ford was very unwell with dysentery and (not surprisingly) found long shoots difficult to manage. This was the last scene they had to shoot on location before returning to the England. Three days of physical effort wasn’t a very appealing prospect for the very unwell Ford, so he put forward the solution to Spielberg to “just shoot the son of a bitch”. Obviously, Spielberg agreed and they did just that.

Can you imagine the disappointment of the stuntman playing the expert swordsman? Apparently he’d been practicing his sword skills for months and months for this big moment to shine on screen, only to end up with a part that lasts a mere 16 seconds. At the time, I bet he was devastated. Now, perhaps he’s happy that he’s a part of pop culture history.

But what the heck has this got to do with healthcare?

For me, this is a story about working within constraints; something we come across almost as routine when we work in the business of caring.

In almost all of our professional interactions there are elements that are outside of our control and limits placed on what we can do. How much time we can spend with someone. How much we we can charge/claim for a service. Other people’s behaviour.

This isn’t a particularly fun professional headspace to exist in. It can be incredibly disheartening feeling like you’re being held back from being able to make your best contribution. For some people, it results in them begrudgingly accepting a lower standard of work. For others, it results in leaving to pursue a different industry in hope to escape the constraints. I don’t think either outcome is ideal. I think there’s a third option - to learn how to embrace our constraints and make them work for us, not against us.

I say learn on purpose, because I don’t believe it’s something that necessarily comes naturally to most people. But I believe if we want our healthcare system to thrive rather than just survive then we need to start getting a bit more creative. There isn’t an endless pool of funding. There isn’t an endless workforce. There isn’t endless goodwill and spirit of collaboration. The system and culture is not going to shift overnight. Ok. So what can we do?

Ford and Spielberg could have chosen to push through with the ideal scene as envisioned, regardless of Ford’s limitations and the resultant scene probably would have been lacklustre and forgettable. Instead, they used the opportunity to work with what they had and came up with something interesting and memorable. We can do the same. And it’s going to take effort.

What constraints do you face that you have no control over? How can you use these constraints to drive progress? How can we help patients do the same?