God in the Operating Room
Process Theology and Surgery
“In the operating room, it’s never just me. It’s the nurses, the anesthesiologist, the techs, and yes—the machines. The monitor that watches every heartbeat, the robotic arms that move with sub-millimeter precision—they’re not passive tools. Together, we form an ensemble. Each part—human or machine—responds to the others. We listen, we adjust, we act in harmony. Surgery isn’t a solo performance. It’s a kind of choreography, a relational field where trust, timing, and presence flow between us all.
And as an open and relational Christian, I believe the Spirit of God is in the room too—not as a distant overseer, but as an inwardly felt lure toward care, attentiveness, creativity, and compassion. The divine is not in control, but in the invitation—to act wisely, to respond well, to honor the life before us. The Spirit moves in the subtle intuitions, the quiet synchrony, the shared intention of healing. We are not alone in this work.”
— Dr. Marcus Llewellyn, Fictional Surgeon at Central Hospital
The Team
Imagine you are in a hospital operating room undergoing surgery. Around you are a surgeon performing the procedure, an anesthesiologist managing your sedation, a surgical nurse assisting with instruments, and a technician monitoring the systems. Surrounding them are machines: a ventilator helping you breathe, a heart monitor tracking your vital signs, an anesthesia machine regulating medication flow, an infusion pump delivering fluids, and possibly a robotic surgical assistant executing precise movements guided by the surgeon. There may also be imaging equipment, such as an ultrasound or portable X-ray, feeding real-time data into the team’s decisions. Together, these people and machines form an ensemble—a coordinated field of human–machine interaction.
One way to describe this is to say that the human beings are the true agents, making judgments, interpreting data, and bearing responsibility, while the machines serve as tools. And yet, there is also a kind of agency in the machines—not conscious or intentional, but functional and relational. The machines respond to your body in real time, adjust parameters, maintain rhythms, and issue alerts when thresholds are crossed. Their agency lies in their capacity to act within the system, to shape outcomes, and to influence human decisions. In this ensemble, agency is distributed: it arises from the dynamic interplay of expertise, feedback loops, mechanical responsiveness, and embodied presence. The result is not simply a surgery performed by humans using tools, but a collaborative process of care, emergent from the human–machine whole.
Surgery Is a Process
Surgery is often thought of as a single, decisive event—a procedure, an incision, a moment in time. But in truth, surgery is a process, unfolding for many, except in emergencies, across days and weeks, and involving a constellation of relationships. It begins well before the operating room: in the patient’s decision to pursue treatment, in the consultations and scans, in the careful weighing of risk and hope. It takes shape in conversations—between doctors and patients, families and caregivers—marked by uncertainty, vulnerability, and courage. The process begins in these early moments of discernment and trust.
During the operation itself, the process becomes visible in a different way. The surgical team becomes an ensemble of coordinated action: surgeons, nurses, anesthesiologists, technicians, and machines all working together in real time. Each participant brings knowledge, skill, and intuition to the moment. Their actions are not isolated but relational—each one responding to the other, attuned to the needs of the patient and the flow of the procedure. For those who embrace an open and relational theology, God’s presence is not distant from this scene. The Spirit of God is within each participant and within the ensemble as a whole, luring them toward wisdom, harmony, precision, and care.
Yet the process does not end when the surgery is over. Recovery is its own unfolding—a path marked by pain, patience, small victories, and deep dependence. Nurses, physical therapists, loved ones, and the patient themselves all become part of the continuing ensemble of healing. Emotional and spiritual wounds often emerge alongside physical ones, and healing must attend to the whole person. It is here that compassion, presence, and relational support matter as much as any technical procedure. The divine lure continues—not through control, but through companionship, resilience, and the call to become whole again, one moment at a time.
Surgery, then, is never merely a technical act. It is a lived process for all involved—patient, team, family, and even the machines that make modern surgery possible. It is a web of decisions, relationships, emotions, and actions held together by trust and care. In this unfolding, God is not absent. Rather, the Spirit breathes through every stage of the process, working through human hands and hearts, calling forth life from fear, and guiding the ensemble toward healing. In a world that often seeks quick fixes and isolated outcomes, remembering that surgery is a process—relational, dynamic, sacred—can help us recover the deeper meaning of what it means to care and to be cared for.
During the operation itself, the process becomes visible in a different way. The surgical team becomes an ensemble of coordinated action: surgeons, nurses, anesthesiologists, technicians, and machines all working together in real time. Each participant brings knowledge, skill, and intuition to the moment. Their actions are not isolated but relational—each one responding to the other, attuned to the needs of the patient and the flow of the procedure. For those who embrace an open and relational theology, God’s presence is not distant from this scene. The Spirit of God is within each participant and within the ensemble as a whole, luring them toward wisdom, harmony, precision, and care.
Yet the process does not end when the surgery is over. Recovery is its own unfolding—a path marked by pain, patience, small victories, and deep dependence. Nurses, physical therapists, loved ones, and the patient themselves all become part of the continuing ensemble of healing. Emotional and spiritual wounds often emerge alongside physical ones, and healing must attend to the whole person. It is here that compassion, presence, and relational support matter as much as any technical procedure. The divine lure continues—not through control, but through companionship, resilience, and the call to become whole again, one moment at a time.
Surgery, then, is never merely a technical act. It is a lived process for all involved—patient, team, family, and even the machines that make modern surgery possible. It is a web of decisions, relationships, emotions, and actions held together by trust and care. In this unfolding, God is not absent. Rather, the Spirit breathes through every stage of the process, working through human hands and hearts, calling forth life from fear, and guiding the ensemble toward healing. In a world that often seeks quick fixes and isolated outcomes, remembering that surgery is a process—relational, dynamic, sacred—can help us recover the deeper meaning of what it means to care and to be cared for.
Pre-Op Prayer
Gracious and loving God,
You are not far off,
but here—present in every breath,
in every hand prepared to heal,
in every pulse of courage and care.
In this moment before surgery,
we acknowledge the complexity and vulnerability of this body--
a sacred and intricate process, unfolding moment by moment.
We lift up the patient: beloved, living, and becoming.
May they feel peace, surrounded by love seen and unseen.
Be with the surgical team:
guide their hands, sharpen their focus,
and awaken their attentiveness to one another.
Inspire them to listen deeply—to data, to instinct, to one another--
and to respond not just with skill, but with compassion.
Be with the machines and monitors,
the systems and signals that partner in this work.
Let them function in harmony with human care,
as part of a greater ensemble of healing.
And may your Spirit move quietly through it all--
not controlling, but gently luring each person
toward wisdom, kindness, patience, and grace.
May what unfolds here reflect your longing for life,
for beauty, for renewal.
We do not ask for certainty.
We ask for presence.
We do not demand perfection.
We ask for love to guide us.
Amen.
You are not far off,
but here—present in every breath,
in every hand prepared to heal,
in every pulse of courage and care.
In this moment before surgery,
we acknowledge the complexity and vulnerability of this body--
a sacred and intricate process, unfolding moment by moment.
We lift up the patient: beloved, living, and becoming.
May they feel peace, surrounded by love seen and unseen.
Be with the surgical team:
guide their hands, sharpen their focus,
and awaken their attentiveness to one another.
Inspire them to listen deeply—to data, to instinct, to one another--
and to respond not just with skill, but with compassion.
Be with the machines and monitors,
the systems and signals that partner in this work.
Let them function in harmony with human care,
as part of a greater ensemble of healing.
And may your Spirit move quietly through it all--
not controlling, but gently luring each person
toward wisdom, kindness, patience, and grace.
May what unfolds here reflect your longing for life,
for beauty, for renewal.
We do not ask for certainty.
We ask for presence.
We do not demand perfection.
We ask for love to guide us.
Amen.
Five Relational Principles
1. Relational Agency
Surgical success depends not on isolated individuals but on relationships. Surgeons, nurses, anesthesiologists, machines, and even the patient’s body form a dynamic field of interaction. Every action emerges from and contributes to this relational web. The surgeon is not a solitary actor but part of a living ensemble.
"We become skilled not just through knowledge, but through attunement with others."
2. Creative Responsiveness
Every surgery involves the unexpected. The open and relational approach values flexibility, improvisation, and responsiveness to emerging conditions. It mirrors the process view of reality as an unfolding process, where novelty and decision are intrinsic to life—and to healing.
"Each cut is not just planned—it’s chosen in the moment."
3. Distributed Intelligence
Machines, data systems, and monitoring technologies are part of a broader distributed cognitive system. The surgical team partners with these technologies, not as tools to control, but as intelligent collaborators. Agency is distributed, not centralized.
"The wisdom of the room is greater than the mind of any one participant."
4. Divine Lure Toward Healing
In the process view, God is present in every situation as a lure toward the best possible outcome, given the circumstances. In surgery, this might mean guiding the surgeon’s attention, deepening the team’s compassion, or inspiring creative decisions. The divine does not guarantee success but offers possibility and presence.
"God is in the flow, luring us toward care, precision, and grace."
5. Every Body Matters
The patient is not a case or object, but a living subject of experience. Healing is not only physical but also emotional and spiritual. Open and relational surgery recognizes the inherent worth of each body, each story, and each act of care.
"We’re not just operating on tissue—we’re honoring a life."
Surgical success depends not on isolated individuals but on relationships. Surgeons, nurses, anesthesiologists, machines, and even the patient’s body form a dynamic field of interaction. Every action emerges from and contributes to this relational web. The surgeon is not a solitary actor but part of a living ensemble.
"We become skilled not just through knowledge, but through attunement with others."
2. Creative Responsiveness
Every surgery involves the unexpected. The open and relational approach values flexibility, improvisation, and responsiveness to emerging conditions. It mirrors the process view of reality as an unfolding process, where novelty and decision are intrinsic to life—and to healing.
"Each cut is not just planned—it’s chosen in the moment."
3. Distributed Intelligence
Machines, data systems, and monitoring technologies are part of a broader distributed cognitive system. The surgical team partners with these technologies, not as tools to control, but as intelligent collaborators. Agency is distributed, not centralized.
"The wisdom of the room is greater than the mind of any one participant."
4. Divine Lure Toward Healing
In the process view, God is present in every situation as a lure toward the best possible outcome, given the circumstances. In surgery, this might mean guiding the surgeon’s attention, deepening the team’s compassion, or inspiring creative decisions. The divine does not guarantee success but offers possibility and presence.
"God is in the flow, luring us toward care, precision, and grace."
5. Every Body Matters
The patient is not a case or object, but a living subject of experience. Healing is not only physical but also emotional and spiritual. Open and relational surgery recognizes the inherent worth of each body, each story, and each act of care.
"We’re not just operating on tissue—we’re honoring a life."
Whatever the Outcome: Love
Surgery is more than medicine—it is a moment within a web of shared becoming. For the patient, for the team, for the family, it is a relational journey in which no one walks alone. Whatever the outcome, love remains: in the hands that held, in the voices that reassured, in the courage it took to say yes. In an open and relational universe, where God is not the puppeteer but the companion, the lure, the pulse of possibility—this love is the final word. Whatever the outcome: love.