Public Profile
Artisanal thinking, also called hand-reasoning, is the practice of arriving at a decision through reasoning performed entirely by one person, in real time, without reference to any device, guideline, checklist, decision-support system or colleague. Practitioners distinguish it from ordinary unaided thought by its deliberateness: the artisanal thinker does not merely lack assistance but has declined it, usually aloud, and regards the declination as part of the work.
The practice emerged in the East Bay of California in about 2024 among professionals whose fields had adopted automated decision support, and is most closely associated with Dr. Everett Lindqvist, a general surgeon at Codornices Medical Center in Berkeley, who on Oct. 13, 2026, dismissed a robotic surgical system from a gallbladder removal in progress and completed the procedure by narrated reasoning. Dr. Lindqvist is one of at least four surgeons in the region who identify with the practice. It has no formal organization. It has a newsletter, The Unassisted, published irregularly, and, since September 2026, a tote bag reading “THOUGHT BY HAND.”
Practitioners describe the practice in the vocabulary of craft provenance. A decision may be “single-origin” (reached by one person), “small-batch” (reached for one case, with no intention of generalizing) or “encountered” (reached in the presence of the thing decided about). The industrialization of bread, coffee and furniture is cited as precedent; the claim is that cognition has undergone the same process, with the same gains in consistency and the same unnamed loss. The term “slow thinking” is rejected by practitioners as a pejorative coined by finance offices.
The Institute for Occupational Cognitive Health in Baltimore has tracked what it calls “unassisted reasoning events” in operating rooms since 2022, and reports that the count has grown every year. Its 2025 paper on the subject found that surgeons who reasoned without external support for more than forty consecutive minutes exhibited a 31 percent increase in audible self-narration and a measurable decline in the willingness to be handed things. The institute’s director, Dr. Franklin Krause, has said that the institute does not recommend the practice but recognizes it.
Critics, principally hospital administrators and the manufacturers of decision-support systems, note that the practice extends procedure times substantially; that the “unassisted” reasoner brings to the task decades of training that were, at the time, other people’s thinking; and that the checklist was introduced for reasons that have not changed. Practitioners generally concede all three points and regard none of them as responsive.
The practice has a precedent in theoretical physics, where working alone at a desk without reference to results one has not obtained oneself was the field’s ordinary method until about 1930. Dr. Rolf Ekelund, a professor at the California Institute of Technology, has observed the practice’s constraints in full since 2019 and has concluded that every problem in physics that satisfies them has already been solved. He is the movement’s elegist, as Dr. Lindqvist is its exponent.
Articles
- Surgeon Dismisses Robot Midway Through Operation, Vowing to Finish With ‘Pure Artisanal Thinking’ — the practice’s first appearance in an operating room on the record
- Artisanal Physicist Laments That All the Easy Problems Have Been Solved, Most of Them Before 1930 — the practice in theoretical physics, where its constraints have exhausted the available problems
Articles
- Artisanal Physicist Laments That All the Easy Problems Have Been Solved, Most of Them Before 1930 — “A gallbladder is an easy problem,” Dr. Ekelund said of a Berkeley surgeon who recently removed one by hand. “He had one. I would like to know where he got it.”
- Surgeon Dismisses Robot Midway Through Operation, Vowing to Finish With 'Pure Artisanal Thinking' — The remaining 112 minutes were narrated aloud by Dr. Lindqvist, including several decisions he described as 'not strictly necessary, but mine.'