Dr. Rebecca Bishop

Photo courtesy of Dr. Rebecca Bishop

Dr. Rebecca Bishop is a veterinary surgeon, having overcome lack of support in school for the unique challenges of left-handed students.

"If you're left-handed, you should give up hope of becoming a surgeon."

Can you imagine a more demoralizing response to a simple question about suturing a wound?

I was a second-year DVM student with aspirations of becoming a large animal surgeon when I was told this by a laboratory instructor after asking for clarification about the cruciate suture pattern, a technique that creates a cross-shaped stitch.

Startled by the response, I went on a mission to ask every clinician I knew if this comment had merit. It didn't take long to learn that one of our highly accomplished equine surgeons was also left-handed. Bolstered by this knowledge and too stubborn to be dissuaded, I am happy to report that I went on to complete surgical training. I am now a proud diplomate of the American College of Veterinary Surgeons and work as a lecturer in equine emergency and critical care at the University of Illinois College of Veterinary Medicine.

This early experience has informed the way that I approach clinical instruction for our students and house officers.

Left-handed people in all fields and walks of life face unique challenges in a world that is largely designed by and for the right-handed majority. A few examples of right-hand-biased design come immediately to mind as I type this:

The number pad on my laptop is on the right of the keyboard, meaning I had to learn to use it with my non-dominant hand. The buttons on my watch would be more conveniently located if I wore it on my left wrist instead of the right. Scissors are another common challenge, especially if they are dull (or the dreaded "safety" scissors from grade school). Scissors are designed so that the blades naturally press together when closed with a right-handed grip; a left-handed person must apply different pressure to achieve the same effect.

At least for me, learning skills from a right-handed person that require fine motor dexterity with use of a single hand has been particularly challenging. As a kid, I was able to learn how to knit (a two-handed skill) from my right-handed grandmother but struggled for many years to pick up crochet (which is mostly one-handed). For crochet — and veterinary skills like suturing or hand-ties — I found that watching a video, slowing it down, and repeating until I can mirror the motions works the best.

While left-handed surgical instruments are available, a consistent piece of advice I received during veterinary school was to learn with the standard (meaning right-handed) instruments so that I wouldn't be reliant on equipment that isn't exactly in abundant supply. Fortunately, like learning how to use scissors in grade school, it just took a bit of trial and error to learn what worked, and then a lot of practice. Earlier this year, I published a tutorial video for the Journal of the American Veterinary Medical Association discussing left-handed use of right-handed scissors and needle drivers that I hope will be helpful for surgical teachers and trainees alike.

Using right-handed tools in our left hands isn't always feasible, though. For example, endoscopes are designed with the dials on the right, meaning you do all of the driving with the right hand. Sometimes, though, my left thumb gets in on the action, too.

Those kinds of dexterity challenges aside, one of the biggest hurdles I encountered during my veterinary training came down to communication — or a lack thereof. That instructor wasn't the only person with a less-than-helpful response. I came across other right-handed instructors who'd struggle or freeze when asked how to do something left-handed. I don't feel animosity toward them; since only 10-12% of the population is left-handed, it is understandable that most right-handed people haven't given the directionality of their motor skills a second thought. Even the word that we use to describe someone's hand skills – dexterity – shares its etymological root with the Latin "dexter," which means both "the right hand" and "skillful."

The origin of handedness is complex, with scientific studies suggesting the possible involvement of up to 40 genes, along with epigenetic factors (external environmental or behavioral influences on gene expression). There is thought to be a close association between genes governing handedness and development of the brain's language centers. Interestingly, left-handedness is overrepresented in both high achievers and people with intellectual disabilities. Left-handed people often have less lateralization, meaning that both hemispheres of the brain are involved in processing tasks. This may be why we often perform better in divergent thinking tasks (multitasking and creativity). Left-handed people are overrepresented among leaders and trailblazers throughout history, from Aristotle and da Vinci to Marie Curie and Barack Obama.

Regardless of the underlying genetic cause, many left-handed people are more flexible in their dexterity than most right-handed people. Constant problem-solving to adapt to the right-handed world likely plays a role, but left-handed people are also more likely to demonstrate mixed-handedness. I've learned to do some procedures (like suturing) with either hand, which helps me while teaching students and residents no matter what their handedness. When closing a short skin incision, I will sometimes run my subcutaneous layer righty (from right to left), and then an intradermal layer lefty (left to right), better burying my knots without changing sides of the table. There are other situations – such as arthroscopy (using a small camera to diagnose joint problems) – where both hands need to be equally involved, and I think that left-handed people are naturally inclined to be more adept at these types of procedures.

These days, I think of my left-handedness as an asset more than a detriment. It is my hope that by openly discussing these challenges and solutions, my fellow left-handers will have access to more resources rather than being discouraged. To my right-handed colleagues, I encourage you to consider how to describe skills more ambidextrously (near and far hand instead of left and right) or to find a left-handed colleague you can refer trainees to for support if needed.

Looking back, I'm grateful for the challenges that came with being a lefty in a right-handed world. They pushed me to get creative, stay patient and think about how I teach just as much as what I teach. Being left-handed has taught me that good medicine isn't about doing things one "right" way, but rather about finding the way that works best for the hands that hold the patient. And in the end, when we make space for every kind of learner, we make our profession stronger, more adaptable and more welcoming for everyone.

Dr. Rebecca Bishop is a lecturer in equine medicine and surgery at the University of Illinois Urbana-Champaign. She received her DVM from Tufts University Cummings School of Veterinary Medicine in 2017 and completed a rotating internship at Mid-Atlantic Equine Medical Center in Ringoes, New Jersey. From there, she went to the University of Illinois, where she completed an equine surgery internship, master's degree in veterinary clinical medicine, equine surgery residency, and doctorate in comparative biosciences. Dr. Bishop is a diplomate of the American College of Veterinary Surgeons (Large Animal) and is currently completing a fellowship in large animal emergency and critical care. Her primary clinical and research interests include improving diagnosis and treatment of gastrointestinal disease in horses.