-
Introduction: Across the Red Line
- Temple University Press
- Chapter
- Additional Information
Introduction: Across the Red Line I am sitting in a patient examining room, on a stool with wheels, waiting while a 67-year-old man rummages through his wife’s pocketbook, looking for his list of questions . I’m thinking of trying to write down what this is like. His shirt is unbuttoned and he cannot see well without his glasses and his wife is trying to help but she is nervous and in the way. “Take your time,” I say. I am in no rush. Already I see and feel some things that must be told. This man is returning for his first postoperative visit after having most of his pancreas removed. It is clear already that he is doing well—and few extra minutes for me to savor his health is just fine with me. I know the questions on his list by heart, but I know he must ask them in his order, so I wait. I am working on a way to tell what this surgical life is like. I hope to fill you with the sense of it, the feel of it, even the smell and sound of it. I wish for a book of it. I’ve thought about ways to organize things, but every time I do, the form seems contrived and drains the color out of what I experience each day. Things rush past me. Extraordinary and ordinary things fly by in a jumbled way, so an orderly progression of chapters seems not just beside the point, but contrary to the point. 1 So, I’m going to try to tell you what a life of an academic surgeon is like in the new century. It is a lush and varied story, much different and yet still the same as known by my predecessors. Like my waiting in this patient’s story, I can tell you that most of what I do is wait and respond. The practice of surgery is different from writing or original research, for rather than constructing something out of nothing, surgery is responding , adapting to the problem presented. It is less originally creative, I guess, than composing music or designing a building but it is exciting, captivating and rewarding work and for me, thirty years later, it is still neither predictable nor dull, ever. And I must make clear that these days, although I am dismayed that the costs of medicine are so high and chagrined that some surgeons seem to live a high-end lifestyle and appear to be out of touch with their patients and the world in general, I celebrate the rich privilege accorded the practicing surgeon. The surgical life is really about bearing witness to the human condition and about respecting the many almost whimsical variations of biology and about the intersection of the two. It is remarkable, really, the way I get to know people so intimately so quickly, and get to observe the brave and often noble behavior in them, while I witness the relentless push of biology, the aging and decay, the growth and development, but most especially the healing , both physical and emotional. It is this natural drive of our bodies to repair themselves from all injuries that is the centerpiece of medicine. Without it no surgeon could cut. Another piece of this life is the satisfyingly sweet tug-ofwar between the challenge and the reward, the difficulty of the case and its accomplishment, that touchdown, end2 Introduction [3.236.219.157] Project MUSE (2024-03-28 12:55 GMT) zone, spike-the-ball feeling a brave patient gets when he prospers after a difficult operation. The residents, students and I feel it too. Or the remorse and agony I feel when it does not go well. This pain is for the patient, the family, and for me. It is intimate. Can it truly be that this sadness has its own interior fulfillment? Then there is the university medical school life—one of lectures and papers and residents and students and academic trappings. It is the young that make it all worthwhile . But there’s also the political infighting, the jealousies and the small-mindedness. You should know about them, too. Even though the philosophers and historians often find medical school to be not much more than a glorified trade school (I work with my hands, after all), I get all the expectant joy and tribulation attendant to raising the young—all the while aware that I am participating...