Don’t know which way to turn? No, not metaphorically. I’m asking you this: Are you really lost? If so, you may be standing in a creation made by this month’s guest in “A Conversation With …” Adrian Fisher (Fig. 1), of Dorset, England, has been building large-scale mazes for more than four decades, and has done so in 40 countries on six continents: traditional (though often gargantuan) mazes made of hedges (Fig. 2); brick-path-in-grass mazes laden with symbolism [6] (Fig. 3); theme-park mirror mazes; mazes using lights and lasers; and even mazes on the sides of very tall buildings in Dubai [2] that you should not try to solve “unless you’re Spiderman” [4] (Fig. 4) . He is widely acknowledged as the leading expert in his profession.Fig. 1: Adrian Fisher MBEFig. 2: The Marlborough Maze at Blenheim Palace, England, celebrates the Duke of Marlborough’s victory at the Battle of Blenheim in 1704. The rows of hedges portray a giant cannon firing a cannonball, stacks of other cannonballs, and the whole panoply of victory with banners, flags, and trumpets. Published with permission from Adrian Fisher.Fig. 3: The Archbishop’s Maze at Greys Court, England, was commissioned by Lady Brunner in response to a dream that Dr. Robert Runcie described in his enthronement sermon, when he used the maze as a metaphor for the Christian life. The maze abounds in symbolism about reconciliation and the spiritual journey of life. Published with permission from Adrian Fisher.Fig. 4: The Maze Tower in Dubai holds the Guinness World Record for the tallest maze, with 55 stories reaching about 600 feet in the air. The puzzle is only to be attempted by eye, unless you happen to be Spiderman. Published with permission from Adrian Fisher.But why is he here in Clinical Orthopaedics and Related Research®? Let’s take a step back and try to stay on the right path. Spiritual seekers have been walking labyrinths—so-called unicursal mazes, with only a single route to the center and no tricks (Minotaur misinformation notwithstanding; sorry Theseus)—for nearly four millennia [3]. Doing so is meditative. By contrast, navigating one of Mr. Fisher’s constructs, which you can do interactively online in three dimensions [5], is confounding, in a fun kind of way. Life brings us some of each construct, and perhaps not surprisingly, Mr. Fisher’s perspectives on life’s twists and blind alleys (as well as on fun) are illuminating. His creations are anything but abstract: Each is a product of and artfully set within its local environment, with the specific mission of helping the user find joy in the surroundings. With more than 700 mazes under his belt, we probably can learn a thing or two from Mr. Fisher about finding joy in our surroundings. If all this still seems too philosophical, how does someone who began his career as an accountant get to the point where he can design and supervise the construction of a maze with over 5 miles of paths, across 33,000 square meters, in Ningbo, China? Surely such a person has something to share on the subject of how to take on big, intimidating, complex problems, which may be a good definition for “major surgery.” Join me in a conversation with Adrian Fisher, the world’s leading designer of architectural mazes. Seth S. Leopold MD:I did not realize prior to researching your story that labyrinths and mazes differ (I think the Minotaur story threw me off the scent). Why do you prefer mazes, which are puzzles, to labyrinths, which are more like paths? Mr. Adrian Fisher: When I began creating mazes, I was intrigued by the notion of networks. I discovered “by doing” how complex and baffling passageways, tunnels, and caves could be explored, comprehended, and mastered. As a boy in 1967, I explored limestone caves in England (and later, in 1991, my first mirror maze became part of the tourist attraction at Wookey Hole Caves in those same Mendip Hills). I grasped the way that “found” networks can also unwittingly confuse, whether ancient city streets, English country lanes, untamed forests, or hundreds of islands in a Canadian lake. Yet they can be mapped, even in three dimensions. I became attracted to devising maze networks that had the main objective of confusing patrons, and how networks with an added constraint or rule could provide much more variety. This makes reaching the end goal more satisfying: We come out from the maze feeling better about ourselves (sometimes literally, with our shoulders back and spine upright), and feeling more closely bonded with the others we shared the experience with. Dr. Leopold:Elsewhere, vis-à-vis mazes, you’ve said, “If we make a mistake, only later do we begin to realize it’s a dead end, and then we have to turn around, just like in life” [1]. Can you take us deeper on that? What have you learned about life’s journey from designing large mazes, and what can we learn from tackling one of your creations in person? Mr. Fisher: The passage of time and the journey of our lives is often metaphorically referred to as The Path of Life. This also applies to real paths in the landscape. The single thread of the unicursal (single-choice) labyrinth is coiled, but has a forward motion just as relentless as night follows day. It makes a profound impression, both on walkers and also when presented on television. Upon reflection, I realized that some aspects of The Path of Life could not be explained by the linear passage of time. How do we grow as people, characters, and individual personalities? Very often, it’s through the grim experience of lived mistakes. Sometimes in our lives, we encounter a forked path: We have scant appreciation of the full consequences of either choice, but nonetheless, in good faith, we choose. Let’s say you make a choice in a multi-cursal (many-choiced) maze and gradually realize the path is rather overgrown and little used. Finally, you reach its dead end. Humiliated, your only course is to turn around and retrace your steps to where you last made a choice. What you cannot do is clap your hands and be teleported back to that junction—that would be like asking a bank manager to forgive your overdraft and reset your bank balance to zero. As in life, the puzzle maze has junctions, and provides a different metaphor for The Path of Life. With these ideas in mind, I can approach my maze designs with added cunning and intentional deception. It’s like chess, with the maze designer playing all his moves in advance, but ultimately, he is destined to lose. This is because I am also an entertainer — I want my visitors to solve the maze, and to solve it just before they have had enough (like all the best plays and movies). Dr. Leopold:I’ve never explored one of your mazes “in real life,” but the photos I’ve seen suggest you spend considerable effort and resources to make sure that each is harmoniously placed within its surroundings, in ways that seem like they’d help a user find joy in those surroundings. It reminds me a little of Frank Lloyd Wright. What helps you do that, and, more generally, what can we learn from you about finding joy in our surroundings? Mr. Fisher: Adding a feature to a landscape is a great privilege. The artistic contrast between a natural setting and a creative design is compelling, whether sculpture within a landscape park, a hedge maze beyond exuberantly planted gardens, or a labyrinth discovered within a distant forest setting. The first labyrinth I co-designed with Randoll Coate entailed cutting a horizontal plane surface into a sloping field, with a steep moon-shape cut into the upper bank. It was an unexpectedly moving moment: It was the first time I had reshaped the landscape of the planet. It became the frame for everything else that went within it. My most memorable and happy projects are when the creative process is like a portrait painter and subject: Until the sitter relaxes, the painter cannot capture that smile with his brush. Both depend on the other to create something together that neither could have imagined at the onset. Those who hire me know their land and their intended visitors intimately; I encounter it with a fresh eye, a different pedigree and my first impressions. Perhaps I feel most satisfied when the maze looks like it has always been there, and whilst it excites attention and involvement, it also exists effortlessly in its setting. It will bring pleasure to young and old for generations to come, giving our world of harsh reality and mindless speed a timeless oasis, a leisurely paradise, the substance of a dream. Dr. Leopold:Surgery can be intimidating (to the surgeon as well as the patient), hard to plan, and crucially dependent on how it’s executed. It’s also a team sport, which is something you’ve commented on regarding large-scale mazes [4]. In those respects, surgery seems to have much in common with many of your large-scale design projects. In what ways have you become better at coping with those elements over the span of your career, and what are the most important lessons on those themes that you can share with surgeons? Mr. Fisher: The essential steps in any capital project or operation that requires crucial teamwork are: Select, record, examine, develop, install, maintain, and decommission. Lateral thinking and rigor are crucial at every stage. Don’t assume anything. Try to not make any mistake more than once, and squeeze maximum learning value out of each setback. Get realistic. Try to halve the rate of mistakes instead of demanding zero errors, which causes everyone to become defensive and passive. Embrace the diversity of your team: Leverage their strengths and avoid a “one size fits all” approach whenever possible. For mission-critical aspects, always have a Plan B that can be put into action within the required timescale. Teamwork requires high morale. Enthusiasm (or otherwise) is contagious; a shared sense of humor helps bond a team. Something unexpected should prompt a double-check of all indicators, displays, and data. If you want to express a fairly deserved criticism, it will be better received if you express it after giving three pieces of praise first. The tone of your criticism will thereby be moderated and more effective. Never deceive. If you don’t definitively know the answer, say so, and come back within a promised timescale. Individuals and organizations are resistant to change. Don’t expect big or fast changes.