It all started with a cotton swab. Dr. Mohan Korgaonkar was the surgeon, and Dr. Kwok Wei Chan was assisting as the anesthesiologist. The nurse stood vigilantly nearby. The patient, an elderly woman, was pleasantly snoring on the operating table. The date was October 24, 1991, and all was going as planned. An operation was scheduled and underway at the Medical Center of Central Massachusetts in Worcester, Massachusetts. Dutifully doing his job, Dr. Chan administered the anesthesia, sending the patient into a deep, sense-free slumber. With a confidence that comes from more than two decades of experience, Dr. Korgaonkar deftly began the procedure. All was going well.

Except, it seems, for our two physicians. No one knows for sure what words passed between them, but the intent was clear. These men didn't like each other. Silently the minutes ticked by, and with each passing moment the tension in the operating room grew thicker. And thicker.

Whatever the reason, at one point during the operation, Dr. Chan muttered a profanity in the surgeon's direction. Almost without thinking, Dr. Korgaonkar flicked a cotton-tipped prep stick disdainfully at the anesthesiologist. Apparently, the surgeon was a good aim, because that tiny cotton swab hit its target and sparked everything that happened next.

Dr. Chan retaliated. First came shoving. Then shouting. Then an all-out brawl between the two learned men of medicine. Fists flying and surgical goals forgotten, the doctors escalated into a wrestling, punching, jabbing, name-calling bout on the operating room floor. And our patient? She slept through it all.

Finally the two men tired a bit, regained their composure, got up and finished the operation, only marginally worse for the wear. Not long after each was fined $10,000 by the state Board of Registration in Medicine, and ordered to submit to joint psychotherapy for their aggressive tendencies. And to think, it all started with a cotton swab.