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Editorial

Surgery and the Flight of Icarus

Shin, Alexander Y. MD

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Techniques in Hand & Upper Extremity Surgery: March 2021 - Volume 25 - Issue 1 - p 1-2
doi: 10.1097/BTH.0000000000000337
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Despite having a very small footprint in Greek Mythology, the story of Icarus1,2 is one of the most known well known and illustrated (Fig. 1). The myth of Icarus starts with his father, Daedalus who was an Athenian master craftsman. Daedalus was exiled to Crete and put in the service of King Minos for murdering his nephew. After building the Labyrinth for King Minos of Crete to imprison the Minatour (half man, half bull, who was the monster born of King Minos’s wife—which is another story), Deadalus assisted Theseus (the King of Athens) to navigate the Labyrinth by helping Theseus’s lover who was King Minos’s daughter. Theseus is able to find the Minatour, behead it, and escape the Labyrinth much to the dismay of King Minos. As punishment, Daedalus and his son Icarus are incarcerated on the Island of Crete. In order to escape, Daedalus builds 2 large pairs of wings made with branches and feathers secured by wax. As the 2 donned the wings to make their escape, Daedalus advised Icarus not to fly too low, as the humidity from the seas would be destroyed the wings, and not to fly too high, because the wax would melt in the sun. The father and son successfully start their flight away from Crete when Icarus becomes excited and intoxicated with his ability to fly. Quickly gaining confidence he flies higher and higher, despite his father’s warning. The sun’s heat melts the wax binding the feathers, the wings fall apart, and Icarus falls to his death on the shores of the island which now bears his name, Icaria.

FIGURE 1
FIGURE 1:
Jacob Peter Gowy (c 1615-1661) Fall of Icarus (1635-1637), oil on canvas, Museo del Prado, Madrid. Wikimedia Commons.

From this myth there have been many common aphorisms used today: “don’t fly too close to the sun,” “he flew too high,” “he was a high flyer,” etc. There are several scholarly interpretations of the meaning of the story of Icarus. One is advice to youth to listen to their elders, another is the need to carefully consider emotions in making decisions prior to taking risk. Others have taken poetic license in glorifying Icarus’s flight toward the sun:

Never regret thy fall, O Icarus of the fearless flight for the greatest tragedy of them all is never to feel the burning light.

—Oscar Wilde

Modern aphorisms of this myth have born terms such as the Icarus Complex,3 the Icarus Paradox,4 the Icarus Phenomenon, and the Icarus Effect. Each of which in its own specific field touches on success, failure and risk. In 1990, the term Icarus Paradox was introduced by Miller in his book of the same name and referred to the phenomenon of businesses failing abruptly after a period of apparent success, where failure is brought about by the very elements that lead to success.4 The paradox is that the wings that enabled escape to freedom were what ultimately lead to demise.

The similarities in the Icarus Paradox in the business world and surgery become greater as one carefully looks at our own careers and of those around us. The Icarus Effect in Surgery has been seen in surgeons, in the medical device industry, in new surgical techniques and when we look closely in each one of us. As young surgeons, we learn first to respect the limits of getting too close to the sun or flying too low. When we learn and experience success, we push the envelope, expand indications and reach for the sun. Some surgeons will recognize their wax melting before it is too late, while others will not recognize they are too close to the sun and will succumb the fate of Icarus. We need to constantly evaluate where we are in relation to the sun and balance advancing the field while tempering our personal ambitions lest we fail to heed Deadalus’s warning to Icarus.

REFERENCES

1. Grant M. Myths of the Greeks and Romans. New York, NY: Penguin Books; 1962.
2. Graves R. The Greek Myths (Penguin books; 1026, 1027) 2 vols (370, 410 p; maps; index in vol 2). Harmondsworth: Penguin; 1955. Reprinted with amendments 1957. Revised edition 1960. Numerous reprintings.
3. Vaessen ML. The Icarus complex. Psychiatr Neurol Neurochir. 1961;64:285–304.
4. Miller D. The Icarus Paradox: How Exceptional Companies Bring About Their Own Downfall: New Lessons in the Dynamics of Corporate Success, Decline, and Renewal. New York, NY: HarperBusiness; 1990.
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