March 3, 2023

What Top Gun, “TopKnife”, and a CI Surgical Procedure have in common

Capt Pete Mitchell, USN fighter pilot, call sign “Maverick”, swoops his fighter jet through the valley, crests the mountain top, avoiding setting off the radar guided missiles, into the crater, spies his objective: the portal to the nuclear reactor.

Activating his image guidance system, he sends a hypersonic laser guided missile with a direct hit, sending flame and fire and pressurized gases down the corridor into the reactor. 

He trained for such a moment all his life, beginning with fast motorcycles and the feeling of speed, the need for speed, the adrenalin of supersonic jets and carrier landings. 

Every flight and every mission prepared him for this moment. 

Although a team of professionals are aiding in this endeavor, at this moment he is alone in the cockpit and the success or failure of this mission is up to him, and him alone.

Col Douglas Holmes, USAF flight surgeon, retired, call sign ‘TopKnife”, drills out the mastoid cavity, skillfully drills through the facial recess, swooping over the facial nerve yet under the chorda tympani, avoiding setting off the facial nerve monitor, descends into the middle ear cavity, and sights objective:  the round window niche. 

Using high power magnification and small diamond burrs, he drills out the overhanging bone to expose the round window membrane and the opening to the scala tympani of the cochlea, feeding in a multichannel cochlear implant electrode very slowly, sending electronic signals to the previously dormant surviving cochlear nerves of the modiolus with real time feedback from his electronic monitor (NRT). 

He trained and studied for this moment all his life, beginning with hand eye coordination from pick sticks honing the required neural pathways.   

Every procedure and every training course (especially Cochelar Corp CI temporal bone lab and workshop) prepared him for this moment.  

Although a team of professionals are aiding in this endeavor, at this moment  he is alone working under the microscope,  and the success or failure of this operation is up to him, and him alone.

Though worlds apart, these two activities — a bombing mission and a surgical procedure — share so many aspects of education, training, preparation, focus, precision, technology, and performance.  The 3-D similarities are eerie.  Each has an objective that must be accomplished.  Each has the immense satisfaction of a job well done, that allows perhaps a sigh of relief, but definitely a confident feeling of peace, gratitude, accomplishment.  A fist bump, a chest bump, maybe even a smile, small as it would be.