Heart Surgeons Quotes

Politics and prostitution have to be the only jobs where inexperience is considered a virtue. In what other profession would you brag about not knowing stuff? “I’m not one of those fancy Harvard heart surgeons. I’m just an unlicensed plumber with a dream and I’d like to cut your chest open.” The crowd cheers.

I'm a heart surgeon, sure, but I'm just a mechanic. I go in and I fuck around and I fix things. Shit.

Sometimes we must yield control to others and accept our vulnerability so we can be healed.

If you lay a hand on me I'll ram your testicles so far up inside your abdomen it'll take a heart surgeon to get them out.

I’m not the only kid who grew up this way surrounded by people who used to say that rhyme about sticks and stones as if broken bones hurt more than the names we got called and we got called them all so we grew up believing no one would ever fall in love with us that we’d be lonely forever that we’d never meet someone to make us feel like the sun was something they built for us in their tool shed so broken heart strings bled the blues as we tried to empty ourselves so we would feel nothing don’t tell me that hurts less than a broken bone that an ingrown life is something surgeons can cut away that there’s no way for it to metastasize it does

Alex: Rosie, I wanted you to be the first person to no that I’ve decided to become a heart surgeon! Rosie: Cool, does it pay well? Alex: Rosie, it’s not about the money. Rosie: Where I come from, it’s all about the money. Probably because I don’t have any.

I think that is the very definition of a family: a group of individuals, bound by the essence of love, who share a life together and yet maintain their unique individuality.

The artist must be like a heart surgeon. He must approach something with sympathy, but with a sort of coldness and work and work until he finds some kind of perfection in his work. You can't have blood splashing all over the place. Things must be done very cleanly.

All heart surgeons are bastards, and Conway is no exception.

Words have power, which is why Imam Ali says, “Speak only when your words are more beautiful than the silence.” After all, everything in existence sprouted from the vibration of the divinely uttered word “Be! And it is” (36:82). So remember, your tongue is like a knife; it can either kill like the sword of a samurai or save like the scalpel of a surgeon.

A trained surgeon is also a potential killer, and an important bit of the training lies in accepting the fact. Your intent is entirely benign - or at least you hope so - but your are laying violent hands on someone, and you must be ruthless in order to do it effectively. And sometimes the person under your hands will die, and knowing that . . . you do it anyway.

Grace is God as heart surgeon, cracking open your chest, removing your heart—poisoned as it is with pride and pain—and replacing it with his own. Rather than tell you to change, he creates the change. Do you clean up so he can accept you? No, he accepts you and begins cleaning you up. His dream isn’t just to get you into heaven but to get heaven into you.

Why do you suppose the poets talk about hearts?' he asked me suddenly. 'When they discuss emotional damage? The tissue of hearts is tough as a shoe. Did you ever sew up a heart?' I shook my head. 'No, but I've watched. I know what you mean.' The walls of a heart are thick and strong, and the surgeons use heavy needles. It takes a good bit of strength, but it pulls together neatly. As much as anything it's like binding a book. The seat of human emotion should be the liver,' Doc Homer said. 'That would be an appropriate metaphor: we don't hold love in our hearts, we hold it in our livers.' I understood exactly. Once in ER I saw a woman who'd been stabbed everywhere, most severely in the liver. It's an organ with the consistency of layer upon layer of wet Kleenex. Every attempt at repair just opens new holes that tear and bleed. You try to close the wound with fresh wounds, and you try and you try and you don't give up until there's nothing left.

Some people's brilliance is in their head. A surgeon's brilliance is in her hands. But there are people who have brilliant hearts. They shine right through them.

Current / is the cure for both a stopped heart / and one that beats too much. / And if it must be shocked twice, / the surgeons call it a reluctant heart.

You can tell the character of a person by their handshake.

English heart surgeon Martyn Lloyd-Jones asserted, “Most unhappiness in life is due to the fact that you are listening to yourself rather than talking to yourself.

The hoopoe said: 'Your heart's congealed like ice; When will you free yourself from cowardice? Since you have such a short time to live here, What difference does it make? What should you fear? The world is filth and sin, and homeless men Must enter it and homeless leave again. They die, as worms, in squalid pain; if we Must perish in this quest, that, certainly, Is better than a life of filth and grief. If this great search is vain, if my belief Is groundless, it is right that I should die. So many errors throng the world - then why Should we not risk this quest? To suffer blame For love is better than a life of shame. No one has reached this goal, so why appeal To those whose blindness claims it is unreal? I'd rather die deceived by dreams than give My heart to home and trade and never live. We've been and heard so much - what have we learned? Not for one moment has the self been spurned; Fools gather round and hinder our release. When will their stale, insistent whining cease? We have no freedom to achieve our goal Until from Self and fools we free the soul. To be admitted past the veil you must Be dead to all the crowd considers just. Once past the veil you understand the Way From which the crowd's glib courtiers blindly stray. If you have any will, leave women's stories, And even if this search for hidden glories Proves blasphemy at last, be sure our quest Is not mere talk but an exacting test. The fruit of love's great tree is poverty; Whoever knows this knows humility. When love has pitched his tent in someone's breast, That man despairs of life and knows no rest. Love's pain will murder him and blandly ask A surgeon's fee for managing the task - The water that he drinks brings pain, his bread Is turned to blood immediately shed; Though he is weak, faint, feebler than an ant, Love forces him to be her combatant; He cannot take one mouthful unaware That he is floundering in a sea of care.

We abide the surgeon’s scalpel to save our own lives, our loved ones’ lives, but not to save a stranger’s life. H has no heart, but heartless is the last thing you’d call her.

Comedy is hard work. People expect you to be funny 24/7. So if you're not constantly cracking up your friends, it can hurt you professionally. They may not read your book or come to your show. 'She's a comedian? She's not that funny!' It's unfair 'cause when cardio surgeon friends say they cut chests open and hold hearts in their hands, everyone just takes their word for it.

So animated are these freestanding hearts that surgeons have been known to drop them. “We wash them off and they do just fine,” replied New York heart transplant surgeon Mehmet Oz when I asked him about it. I imagined the heart slipping across the linoleum, the looks exchanged, the rush to retrieve it and clean it off, like a bratwurst that’s rolled off the plate in a restaurant kitchen.

LOVE is the most incendiary element ever known, once it sparks the heart, the flame is inextinguishable.

And when you were their age you envisioned yourself becoming—” “A loving wife and mother.” “No, seriously—” “An open-heart surgeon,” the woman said before she

I looked inward at my heart. And indeed, there too, the criss-cross corsetry was slackened and gaping. I was all undone. Potentially, I could spill. Or tangle. And so I began to tug at my own heartstrings, pulling them up tight until there was just the right amount of tension at each criss and each cross. Then I bent down to my boots and laced them firmly too, first the left, then the right, finishing off on each side with a surgeon's shoelace knot.

I write - poignantly, in the most heartfelt way - about how I miss her and how I detest my life in this school and she responds with detailed plans for her future life as an archaeologist or philosopher or - new, this - a veterinary surgeon.

To my lovely starling, Maybe there are magical words that will make you understand, but if so, I do not know them. Words are your domain. I've always been better with pictures. I fear you think I am a monster. It's true I've disrupted many graves. The way I see it, the dead are dead. If, after their death, we can learn things from the about the human form - things that will increase the sum of human knowledge and the possibilities of art - what harm is that? After death, new life, new beauty. How can that be wrong? My friends and I have made use of some of the bodies as models. some we sell to surgeons who study them with the hopes of learning something about the frail mechanisms of the human body. I don't know exactly what Dottor de Gradi does in his workshop on the Rialto, and I was as surprised as you were to stumble on it. He couldn't - he wouldn't tell me if your friend's body ended up there. But he did assure me all of his work is focused solely on extending human life. I won't lie. I did it for the money as well. Don Loredan is holding a private exhibition in his palazzo tomorrow. The entry fee was quite steep but two of my paintings were accepted. This could be the beginning for me. I could find my own patrons. I could be more than just a peasant. Tommaso's assistant. So yes; a little for money. But mostly I did for the art. I don't expect these words to change how you feel. I simply want you not to see me as a monster. I don't want to be a monster. Not anymore. Not after meeting you. I know that we disrupted you dear friend's body, and for that I am deeply regretful. But if we had not done so, if I had not lingered in the San Domenico churchyard after standing guard for my friends, you and I might never have met. Meeting you is one thing I will never regret. I hope you like the painting. Consider tit a wedding gift. How stupid of me to let my heart go. It was a lovely fantasy while it lasted, though, wasn't it? Yours, Falco

Politics and prostitution have to be the only jobs where inexperience is considered a virtue. In what other profession would you brag about not knowing stuff? “I’m not one of those fancy Harvard heart surgeons. I’m just an unlicensed plumber with a dream and I’d like to cut your chest open.

Politics and prostitution have to be the only jobs where inexperience is considered a virtue. In what other profession would you brag about not knowing stuff? “I’m not one of those fancy Harvard heart surgeons. I’m just an unlicensed plumber with a dream and I’d like to cut your chest open.” The crowd cheers. Two

H appears no different from the corpses already here. But H is different. She has made three sick people well. She has brought them extra time on Earth. To be able as a dead person to make a gift of this magnitude is phenomenal. Most people don't manage this sort of thing while they're alive. Cadavers like H are the dead's heroes. It is astounding to me and achingly sad that with 80,000 people on the waiting list for donated hearts and livers and kidneys, with sixteen a day dying there on that list, that more than half the people in the position H's family was in will say no, will choose to burn those organs or let them rot. We abide the surgeon's scalpel to save our own lives, our loved one's lives, but not to save a stranger's life. H has no heart but heartless is the last thing you'd call her.

The child's heart beat: but she was growing in the wrong place inside her extraordinary mother, south of safe...she and her mother were rushed to the hospital, where her mother was operated on by a brisk cheerful diminutive surgeon who told me after the surgery that my wife had been perhaps an hour from death from the pressure of the child growing outside the womb, the mother from the child growing, and the child from growing awry; and so my wife did not die, but our mysterious child did...Not uncommon, an ectopic pregnancy, said the surgeon...Sometimes, continued the surgeon, sometimes people who lose children before they are born continue to imagine the child who has died, and talk about her or him, it's such an utterly human thing to do, it helps deal with the pain, it's healthy within reason, and yes, people say to their other children that they actually do, in a sense, have a sister or brother, or did have a sister or brother, and she or he is elsewhere, has gone ahead, whatever the language of your belief or faith tradition. You could do that. People do that, yes. I have patients who do that, yes... One summer morning, as I wandered by a river, I remembered an Irish word I learned long ago, and now whenever I think of the daughter I have to wait to meet, I find that word in my mouth: dunnog, little dark one, the shyest and quietest and tiniest of sparrows, the one you never see but sometimes you sense, a flash in the corner of your eye, a sweet sharp note already fading by the time it catches your ear.

A trained surgeon is also a potential killer, and an important bit of the training lies in accepting the fact. Your intent is entirely benign—or at least you hope so—but you are laying violent hands on someone, and you must be ruthless in order to do it effectively. And sometimes the person under your hands will die, and knowing that … you do it anyway. I

physicians, Drs. Bill Castelli, Bill Roberts and Caldwell Esselstyn, Jr., that in their long careers they had never seen a heart disease fatality among their patients who had blood cholesterol levels below 150 mg/dL. Dr. Castelli was the long-time director of the famous Framingham Heart Study of NIH; Dr. Esselstyn was a renowned surgeon at the Cleveland Clinic who did a remarkable study reversing heart disease (chapter five); Dr. Roberts has long been editor of the prestigious medical journal Cardiology. BLOOD CHOLESTEROL AND DIET

Some days should come with cautionary labels. You know, like 'Surgeon General's Warning: Getting out of bed may result in headaches, vomiting, and homicide.

medicine is a business just like Walmart or FedEx. It’s just one of the most poorly run businesses you’ve ever seen.

the incisive observational powers of a female surgeon cutting out her own heart.

Who has more reason to worship than the astronomer who has seen the stars? Than the surgeon who has held a heart? Than the oceanographer who has pondered the depths?

Open your heart to find life. Don't let a surgeon do this job, he'd return you with arteries, vessels & blood.

If he was right and God showed His face to the living then it was the surgeons to whom we should offer our novenas. Let us pray to the ones who keep our tired hearts pumping.

He was not a good surgeon, he was not a good doctor; he was not, he believed in his heart, a good man. But he refused to stop trying.

The best surgeons didn't operate on gallbladders or spleens or hearts, they operated on the people who owned them. People with children, jobs, interests, and beliefs. They operated on lives.

Where does Death reside? In the dead, of course, and in the souls of the living; in their fears of the future and in the losses of their pasts. Death lives in the too-quiet silences, in the deepest parts of night. Death makes a home in the moments of stiffness, the seconds before a fall; in the heavy-hearted candor on the surgeon's hands, the archer's bow, the executioner's axe, the injectioner's needle. Death lurks, he stalks, he waits - or so we would believe, anyway, in our selfish vanities and prides, because Death lives so vibrantly in our consciousness that it is exceedingly difficult to imagine he might actually have a home of his own.

Once a hunter met a lion near the hungry critter's lair, and the way that lion mauled him was decidedly unfair; but the hunter never whimpered when the surgeons, with their thread, sewed up forty-seven gashes in his mutilated head; and he showed the scars in triumph, and they gave him pleasant fame, and he always blessed the lion that had camped upon his frame. Once that hunter, absent minded, sat upon a hill of ants, and about a million bit him, and you should have seen him dance! And he used up lots of language of a deep magenta tint, and apostrophized the insects in a style unfit to print. And it's thus with worldly troubles; when the big ones come along, we serenely go to meet them, feeling valiant, bold and strong, but the weary little worries with their poisoned stings and smarts, put the lid upon our courage, make us gray, and break our hearts.

The brain stem is the portion of the brain that controls basic functions like breathing, sleeping, heart rate, consciousness, and pain sensitivity. Damage it and recovery is impossible. Miracles don’t happen after this area is injured.

The seat of consciousness and intelligence was from the earliest times regarded by the Egyptians as both the heart and the bowels or abdomen. Our surgeon, however, has observed the fact that injuries to the brain affect other parts of the body, especially in his experience the lower limbs. He notes the drag or shuffle of one foot, presumably the partial paralysis resulting from a cranial wound, and the ancient commentator carefully explains the meaning of the obsolete word used for "shuffle.

Physically he was tired and his body relaxed throughout its entire length; his mind was in much the same state, floating free, detached, as though he had taken his old favourite, the tincture of laudanum. He felt no particular anxiety. The attempt must either succeed or fail: he hoped with all his heart for success, but 'all his heart' did not amount to a great deal now that some essential part of its core seemed to have died. Yet on the other hand he felt more able to command success in that it meant no less to him - to command it with a strength that arose not from a fundamental indifference to his own fate but from something resembling it that he could not define; it had a resemblance to despair, but a despair long past, with the horror taken out of it.

another medical condition known to seriously increase the risk of heart disease is now also known to wreak havoc with the aging brain. Diabetes—in particular the persistently high blood sugar levels of poorly treated diabetes—substantially raises the risk of dementia

BEFORE I GO,” she shouted, “I THOUGHT YOU’D BE INTERESTED TO HEAR—” She held up her hands to quiet the audience. “Does anyone remember a Mrs. George Fillis—the woman who had the audacity to tell us she wanted to become a heart surgeon?” She reached into her apron pocket and pulled out a letter. “I have an update. It seems that Mrs. Fillis has not only completed her premed studies in record time but has also been accepted to medical school. Congratulations Mrs. George—no, I’m sorry—Marjorie Fillis. We never doubted you for a second.

THE WEARY OLD NINETEENTH CENTURY had advanced into the last twenty years of its life. Towards two o’clock in the afternoon, Ovid Vere (of the Royal College of Surgeons) stood at the window of his consulting-room in London, looking out at the summer sunshine, and the quiet dusty street.

Blood flashes through the brain in a matter of seconds, one quarter of all the blood from the heart, darkening as the brain takes the oxygen out of it. Thinking, perceiving and feeling, and the control of our bodies, most of it unconscious, are energy-intensive processes fuelled by oxygen.

it would be interesting in surgery if you could swallow the surgeon. You put the mechanical surgeon inside the blood vessel and it goes into the heart and “looks” around. (Of course the information has to be fed out.) It finds out which valve is the faulty one and takes a little knife and slices it out.

Your hair grows by itself, your heart beats by itself, and your breath happens pretty much by itself. Your glands secrete the essences by themselves and you do not have voluntary control over these things, and so we say they happen spontaneously. So, when you go to bed and try to go to sleep you interfere with the spontaneous process of going to sleep. If you try to breathe real hard you will find you get balled-up in your breathing. So if you are to be human, you just have to trust yourself to go to sleep, to digest your food, and to have bowel movements. Of course if something goes seriously wrong and you need a surgeon that is another matter, but by and large the healthy human being does not from the start of life need surgical interference. One lets it happen by itself, and so with the whole picture that is fundamental to it. You have to let go and let it happen, because if you don’t then you are constantly going to be trying to do what happens easily only if you do not try. When you think a bit about what people really want to do with their time, and you ask what they do when they are not being pushed around or somebody is telling them what to do, you find they like to make rhythms. They listen to music and they dance or they sing, or perhaps they do something of a rhythmic nature like playing cards, bowling, or raising their elbows. Given the chance, everybody wants to spend their time swinging.

Perched upon the stones of a bridge The soldiers had the eyes of ravens Their weapons hung black as talons Their eyes gloried in the smoke of murder To the shock of iron-heeled sticks I drew closer in the cripple’s bitter patience And before them I finally tottered Grasping to capture my elusive breath With the cockerel and swift of their knowing They watched and waited for me ‘I have come,’ said I, ‘from this road’s birth, I have come,’ said I, ‘seeking the best in us.’ The sergeant among them had red in his beard Glistening wet as he showed his teeth ‘There are few roads on this earth,’ said he, ‘that will lead you to the best in us, old one.’ ‘But you have seen all the tracks of men,’ said I ‘And where the mothers and children have fled Before your advance. Is there naught among them That you might set an old man upon?’ The surgeon among this rook had bones Under her vellum skin like a maker of limbs ‘Old one,’ said she, ‘I have dwelt In the heat of chests, among heart and lungs, And slid like a serpent between muscles, Swum the currents of slowing blood, And all these roads lead into the darkness Where the broken will at last rest. ‘Dare say I,’ she went on,‘there is no Place waiting inside where you might find In slithering exploration of mysteries All that you so boldly call the best in us.’ And then the man with shovel and pick, Who could raise fort and berm in a day Timbered of thought and measured in all things Set the gauge of his eyes upon the sun And said, ‘Look not in temples proud, Or in the palaces of the rich highborn, We have razed each in turn in our time To melt gold from icon and shrine And of all the treasures weeping in fire There was naught but the smile of greed And the thick power of possession. Know then this: all roads before you From the beginning of the ages past And those now upon us, yield no clue To the secret equations you seek, For each was built of bone and blood And the backs of the slave did bow To the laboured sentence of a life In chains of dire need and little worth. All that we build one day echoes hollow.’ ‘Where then, good soldiers, will I Ever find all that is best in us? If not in flesh or in temple bound Or wretched road of cobbled stone?’ ‘Could we answer you,’ said the sergeant, ‘This blood would cease its fatal flow, And my surgeon could seal wounds with a touch, All labours will ease before temple and road, Could we answer you,’ said the sergeant, ‘Crows might starve in our company And our talons we would cast in bogs For the gods to fight over as they will. But we have not found in all our years The best in us, until this very day.’ ‘How so?’ asked I, so lost now on the road, And said he, ‘Upon this bridge we sat Since the dawn’s bleak arrival, Our perch of despond so weary and worn, And you we watched, at first a speck Upon the strife-painted horizon So tortured in your tread as to soak our faces In the wonder of your will, yet on you came Upon two sticks so bowed in weight Seeking, say you, the best in us And now we have seen in your gift The best in us, and were treasures at hand We would set them humbly before you, A man without feet who walked a road.’ Now, soldiers with kind words are rare Enough, and I welcomed their regard As I moved among them, ’cross the bridge And onward to the long road beyond I travel seeking the best in us And one day it shall rise before me To bless this journey of mine, and this road I began upon long ago shall now end Where waits for all the best in us. ―Avas Didion Flicker Where Ravens Perch

A friend of mine (Albert R. Hibbs)* suggests a very interesting possibility for relatively small machines. He says that, although it is a very wild idea, it would be interesting in surgery if you could swallow the surgeon. You put the mechanical surgeon inside the blood vessel and it goes into the heart and “looks” around. (Of course the information has to be fed out.) It finds out which valve is the faulty one and takes a little knife and slices it out.

Asking a writer why they like to write {in the theoretical sense of the question} is like asking a person why they breathe. For me, writing is a natural reflex to the beauty, the events, and the people I see around me. As Anais Nin put it, "We write to taste life twice." I live and then I write. The one transfers to the other, for me, in a gentle, necessary way. As prosaic as it sounds, I believe I process by writing. Part of the way I deal with stressful situations, catty people, or great joy or great trials in my own life is by conjuring it onto paper in some way; a journal entry, a blog post, my writing notebook, or my latest story. While I am a fair conversationalist, my real forte is expressing myself in words on paper. If I leave it all chasing round my head like rabbits in a warren, I'm apt to become a bug-bear to live with and my family would not thank me. Some people need counselors. Some people need long, drawn-out phone-calls with a trusted friend. Some people need to go out for a run. I need to get away to a quiet, lonesome corner--preferably on the front steps at gloaming with the North Star trembling against the darkening blue. I need to set my pen fiercely against the page {for at such moments I must be writing--not typing.} and I need to convert the stress or excitement or happiness into something to be shared with another person. The beauty of the relationship between reading and writing is its give-and-take dynamic. For years I gathered and read every book in the near vicinity and absorbed tale upon tale, story upon story, adventures and sagas and dramas and classics. I fed my fancy, my tastes, and my ideas upon good books and thus those aspects of myself grew up to be none too shabby. When I began to employ my fancy, tastes, and ideas in writing my own books, the dawning of a strange and wonderful idea tinged the horizon of thought with blush-rose colors: If I persisted and worked hard and poured myself into the craft, I could create one of those books. One of the heart-books that foster a love of reading and even writing in another person somewhere. I could have a hand in forming another person's mind. A great responsibility and a great privilege that, and one I would love to be a party to. Books can change a person. I am a firm believer in that. I cannot tell you how many sentiments or noble ideas or parts of my own personality are woven from threads of things I've read over the years. I hoard quotations and shadows of quotations and general impressions of books like a tzar of Russia hoards his icy treasures. They make up a large part of who I am. I think it's worth saying again: books can change a person. For better or for worse. As a writer it's my two-edged gift to be able to slay or heal where I will. It's my responsibility to wield that weapon aright and do only good with my words. Or only purposeful cutting. I am not set against the surgeon's method of butchery--the nicking of a person's spirit, the rubbing in of a salty, stinging salve, and the ultimate healing-over of that wound that makes for a healthier person in the end. It's the bitter herbs that heal the best, so now and again you might be called upon to write something with more cayenne than honey about it. But the end must be good. We cannot let the Light fade from our words.

So much not to ask. It was a great art, that one. He had learned to deploy it as skillfully as a surgeon his art, or a poet his. To listen; to nod; to act on what he was told as though he understood it; not to offer criticism or advice, except of the mildest kind, just to show his interest and concern; to puzzle out. To stroke Sophie's hair, and try not to deflect her sadness; to wonder how she had gone on with such a life, with such a sorrow at its heart, and never ask.

Dr. Richard Selzer is a surgeon and a favorite author of mine. He writes the most beautiful and compassionate descriptions of his patients and the human dramas they confront. In his book Letters to a Young Doctor, he said that most young people seem to be protected for a time by an imaginary membrane that shields them from horror. They walk in it every day but are hardly aware of its presence. As the immune system protects the human body from the unseen threat of harmful bacteria, so this mythical membrane guards them from life-threatening situations. Not every young person has this protection, of course, because children do die of cancer, congenital heart problems, and other disorders. But most of them are shielded—and don’t realize it. Then, as years roll by, one day it happens. Without warning, the membrane tears, and horror seeps into a person’s life or into the life of a loved one. It is at this moment that an unexpected theological crisis presents itself.

It is astounding to me, and achingly sad, that with eighty thousand people on the waiting list for donated hearts and livers and kidneys, with sixteen a day dying there on that list, that more than half of the people in the position H’s family was in will say no, will choose to burn those organs or let them rot. We abide the surgeon’s scalpel to save our own lives, our loved ones’ lives, but not to save a stranger’s life. H has no heart, but heartless is the last thing you’d call her.

One of the key reasons that rates of dementia have fallen sharply since the 1970s is the advent of improved treatments for heart ailments. What’s good for the heart is actually very good for the brain. The steps you take to keep your heart arteries unclogged also keep brain arteries open. Cholesterol-lowering drugs have dramatically reduced coronary artery disease and are effective even in people who live sedentary lifestyles and eat foods that aren’t “heart healthy.” Statins, prescribed to lower cholesterol, have lately been shown to lower the risk of Alzheimer’s disease in most people.

In Detroit, Dr. Forest Dodrill, a surgeon at Wayne State University, collaborated with engineers at General Motors Research to develop a mechanical pump capable of supporting the circulation of an adult. The resulting stainless-steel and glass device, the Dodrill-GMR mechanical heart pump, had multiple cylinders from which blood circulated and, perhaps not surprisingly, bore an uncanny resemblance to a Cadillac V-12 automobile engine. The device was intended to temporarily replace either the right or left ventricle and was first used in 1952 to support a patient for fifty minutes while Dr. Dodrill repaired a mitral valve.

Although Alice’s and my paths had crossed occasionally over the years, our romantic relationship had only begun some eighteen months earlier at a party to mark Julian’s departure to South America for a six-month trek across the Andes. This was probably his most infamous escapade, as it involved travelling with his girlfriends at the time, a pair of Finnish twins by the names of Emmi and Peppi who, he claimed, had been conjoined at birth and were only separated by an American surgeon when they were four years old. It was true that whenever I looked at them they seemed to be leaning towards each other at a slightly unnatural angle

Now sensitiveness to the state of mind of the public is a difficult thing to achieve or maintain. Any man can tell you with more or less accuracy and clearness his own reactions on any particular issue. But few men have the time or the interest or the training to develop a sense of what other persons think or feel about the same issue. In his own profession the skilled practitioner is sensitive and understanding. lhe lawyer can tell what argument will appeal to court or jury. “The salesman can tell what points to stress to his prospective buyers. The politician can tell what to emphasize to his audience, but the ability to estimate group reactions on a large scale over a wide geographic and psychological area is a specialized ability which must be developed with the same painstaking self-criticism and with the same dependence on experience that are required for the development of the clinical sense in the doctor or the surgeon. The significant revolution of modern times is not industrial or economic or political, but the revolution which is taking place in the art of creating consent among the governed. Within the life of the new generation now in control of affairs, persuasion has become a self-conscious art and a regular organ of popular government. None of us begins to understand the consequences, but it is no daring prophecy to say that the knowledge of how to create consent will alter every political premise. Under the impact of propaganda, not necessarily in the sinister meaning of the world alone, the only constants of our thinking have become variables. It is no longer possible, for example, to believe in the cardinal dogma of democracy that the knowledge needed for the management of human affairs comes up spontaneously from the human heart. Where we act on that theory we expose ourselves to self-deception and to farms of persuasion that we cannot verify. It has been demonstrated that we cannot rely upon intuition, conscience or the accidents of casual opinion if we are to deal with the world beyond our reach.

It doesn't matter if she was prettier than you when he decided to cheat. She was treated like trash because he didn't commit to her. He didn't love her soul or cherished any of her accomplishments. He just liked her face and what is that? It is nothing. That is not who she is. He didn't give his heart or time to her, She was the one that was cheated on because he went home to you. You never lost him because he didn't divorce you. So don't be so hard on the other woman. She was nothing to him. She was only something superficial that he coveted. But loving her? Knowing her? Sharing his deepest feelings with her?. No! She could have been any pretty face. It was never her but a fantasy. He didn't even know her, but for her beauty. And what is beauty? It is anything that can be bought at a plastic surgeon's office?

The tulips are too excitable, it is winter here. Look how white everything is, how quiet, how snowed-in. I am learning peacefulness, lying by myself quietly As the light lies on these white walls, this bed, these hands. I am nobody; I have nothing to do with explosions. I have given my name and my day-clothes up to the nurses And my history to the anesthetist and my body to surgeons. They have propped my head between the pillow and the sheet-cuff Like an eye between two white lids that will not shut. Stupid pupil, it has to take everything in. The nurses pass and pass, they are no trouble, They pass the way gulls pass inland in their white caps, Doing things with their hands, one just the same as another, So it is impossible to tell how many there are. My body is a pebble to them, they tend it as water Tends to the pebbles it must run over, smoothing them gently. They bring me numbness in their bright needles, they bring me sleep. Now I have lost myself I am sick of baggage—— My patent leather overnight case like a black pillbox, My husband and child smiling out of the family photo; Their smiles catch onto my skin, little smiling hooks. I have let things slip, a thirty-year-old cargo boat stubbornly hanging on to my name and address. They have swabbed me clear of my loving associations. Scared and bare on the green plastic-pillowed trolley I watched my teaset, my bureaus of linen, my books Sink out of sight, and the water went over my head. I am a nun now, I have never been so pure. I didn’t want any flowers, I only wanted To lie with my hands turned up and be utterly empty. How free it is, you have no idea how free—— The peacefulness is so big it dazes you, And it asks nothing, a name tag, a few trinkets. It is what the dead close on, finally; I imagine them Shutting their mouths on it, like a Communion tablet. The tulips are too red in the first place, they hurt me. Even through the gift paper I could hear them breathe Lightly, through their white swaddlings, like an awful baby. Their redness talks to my wound, it corresponds. They are subtle : they seem to float, though they weigh me down, Upsetting me with their sudden tongues and their color, A dozen red lead sinkers round my neck. Nobody watched me before, now I am watched. The tulips turn to me, and the window behind me Where once a day the light slowly widens and slowly thins, And I see myself, flat, ridiculous, a cut-paper shadow Between the eye of the sun and the eyes of the tulips, And I have no face, I have wanted to efface myself. The vivid tulips eat my oxygen. Before they came the air was calm enough, Coming and going, breath by breath, without any fuss. Then the tulips filled it up like a loud noise. Now the air snags and eddies round them the way a river Snags and eddies round a sunken rust-red engine. They concentrate my attention, that was happy Playing and resting without committing itself. The walls, also, seem to be warming themselves. The tulips should be behind bars like dangerous animals; They are opening like the mouth of some great African cat, And I am aware of my heart: it opens and closes Its bowl of red blooms out of sheer love of me. The water I taste is warm and salt, like the sea, And comes from a country far away as health. --"Tulips", written 18 March 1961

It doesn't matter if she was prettier than you when he decided to cheat. She was treated like trash just like you. He didn't commit to her. He didn't love her soul or cherished any of her accomplishments. He just liked her face and what is that? It is nothing. That is not who she is. He didn't give his heart or time to her. She was the one that was cheated because he stayed with you. You never lost him because he never made a commitment to her. So don't be so hard on the other woman. She was treated poorly also. She was nothing to him. She was only something superficial that he coveted. But loving her? Knowing her? Sharing his deepest feelings with her?... No! She could have been any pretty face. It was never her but a fantasy. He didn't even know her, but for her beauty. And what is beauty? Isn't that something you can buy at a plastic surgeon's office?

It doesn't matter if she was prettier than you when he decided to cheat. She was treated like trash just like you. He didn't commit to her. He didn't love her soul or cherished any of her accomplishments. He just liked her face and what is that? It is nothing. That is not who she is. He didn't give his heart or time to her. She was the one that was cheated because he stayed with you. You never lost him because he never made a commitment to her. So don't be so hard on the other woman. She was treated poorly also. She was nothing to him. She was only something superficial that he coveted. But loving her? Knowing her? Sharing his deepest feelings with her?... No! She could have been any pretty face. It was never her but a fantasy. He didn't even know her, but for her beauty. And what is beauty? It is anything that can be bought at a plastic surgeon's office?

She was not enjoying her match half so much as Edmund had enjoyed his; not because she had any doubt about hitting the apple but because Susan was so tender-hearted that she almost hated to beat someone who had been beaten already. The Dwarf watched her keenly as she drew the shaft to her ear. A moment later, with a little soft thump which they could all hear in that quiet place, the apple fell to the grass with Susan’s arrow in it. “Oh, well done, Su,” shouted the other children. “It wasn’t really any better than yours,” said Susan to the Dwarf. “I think there was a tiny breath of wind as you shot.” “No, there wasn’t,” said Trumpkin. “Don’t tell me. I know when I am fairly beaten. I won’t even say that the scar of my last wound catches me a bit when I get my arm well back--” “Oh, are you wounded?” asked Lucy. “Do let me look.” “It’s not a sight for little girls,” began Trumpkin, but then he suddenly checked himself. “There I go talking like a fool again,” he said. “I suppose you’re as likely to be a great surgeon as your brother was to be a great swordsman or your sister to be a great archer.

Looking back on all my interviews for this book, how many times in how many different contexts did I hear about the vital importance of having a caring adult or mentor in every young person’s life? How many times did I hear about the value of having a coach—whether you are applying for a job for the first time at Walmart or running Walmart? How many times did I hear people stressing the importance of self-motivation and practice and taking ownership of your own career or education as the real differentiators for success? How interesting was it to learn that the highest-paying jobs in the future will be stempathy jobs—jobs that combine strong science and technology skills with the ability to empathize with another human being? How ironic was it to learn that something as simple as a chicken coop or the basic planting of trees and gardens could be the most important thing we do to stabilize parts of the World of Disorder? Who ever would have thought it would become a national security and personal security imperative for all of us to scale the Golden Rule further and wider than ever? And who can deny that when individuals get so super-empowered and interdependent at the same time, it becomes more vital than ever to be able to look into the face of your neighbor or the stranger or the refugee or the migrant and see in that person a brother or sister? Who can ignore the fact that the key to Tunisia’s success in the Arab Spring was that it had a little bit more “civil society” than any other Arab country—not cell phones or Facebook friends? How many times and in how many different contexts did people mention to me the word “trust” between two human beings as the true enabler of all good things? And whoever thought that the key to building a healthy community would be a dining room table? That’s why I wasn’t surprised that when I asked Surgeon General Murthy what was the biggest disease in America today, without hesitation he answered: “It’s not cancer. It’s not heart disease. It’s isolation. It is the pronounced isolation that so many people are experiencing that is the great pathology of our lives today.” How ironic. We are the most technologically connected generation in human history—and yet more people feel more isolated than ever. This only reinforces Murthy’s earlier point—that the connections that matter most, and are in most short supply today, are the human-to-human ones.

Army studies indicate that if a wounded soldier arrives alive at a combat support hospital where surgeons and nurses can treat him, the chances of his surviving are extremely high—greater than 90 percent. “Surviving,” of course, doesn’t necessarily entail keeping arms or legs or retaining the ability to function independently back home. The leading cause of preventable death on the battlefield is bleeding. Having a leg blown off by an IED, for instance, can be fatal if quick steps are not taken to control the blood loss. Even deadlier is internal bleeding, a problem for which medics generally don’t have a good answer. A soldier who is bleeding internally needs to be evacuated and delivered to a surgeon immediately if he is to have any hope of survival. The second-leading cause of preventable death is something called tension pneumothorax. If a bullet punctures a soldier’s lung, air can leak from that hole into the “pleural space,” or cavity outside the lungs. That air can build up and eventually interfere with the functioning of the heart. This can be a relatively simple problem to correct: a medic can simply stick a big needle in the soldier’s chest to relieve the pressure in the pleural space.

The curate called everything Helen's. He had a great contempt for the spirit of men who marry rich wives and then lord it over their money, as if they had done a fine thing in get- ting hold of it, and the wife had been but keeping it from its rightful owner. They do not know what a confession their whole bear- ing is, that but for their wives' money, they would be the merest, poorest nobodies. So small are they that even that suffices to make them feel big ! But Helen did not like it, especially when he would ask her if he might have this or that, or do so and so. Any com- mon man who heard him would have thought him afraid of his wife; but a large-hearted woman would at once have understood, as did Helen, that it came all of his fine sense of truth, and reality, and obligation. Still Helen would have had him forget all such matters in con- nection with her. They were one beyond obligation. She had given him herself, and what were bank-notes after that ? But he thought of her always as an angel who had taken him in, to comfort, and bless, and cherish him with love, that he might the better do the work of his God and hers ; therefore his obligation to her was his glory.

There are twelve unique nerves that sprout from the brain, exit the skull into the face, and mediate smell, sight, hearing, taste. These are called cranial nerves, and the tenth one is nicknamed the “wandering nerve” because it’s the only one out of the twelve that ventures well beyond your face and around your heart and lungs. After its exit from a tiny hole in the base of the skull, it descends in the neck tucked between the carotid artery and jugular vein. If you were to slice it and look at its cut end head-on, you’d see fibers called efferents, because they carry outbound signals to your chest cavity. These are half of the nerve fibers that your brain uses to control your heart rate in times of stress or rest; specifically, these are the fibers which are activated in rest. They are also, unsurprisingly, the pathway that Buddhist monks and others, through years of training, use to lower their heart rate with thought alone. Less well known is that the wandering nerve is a two-way street. It also carries signals (via afferent fibers) back into the skull from your heart and lungs to shower the brain with ascending information signaling the brain to enter a more calm and restful state. And these fibers can be manipulated or even hijacked. How? You can do it yourself through the intense practice of mindful breathing. Meditative breathing can calm the electrical oscillations and stress responses in your mind by resetting your vagal tone. The neuroscience term is “network reset.” So, despite the increasing popularity of inserting catheters and wires into brains, the basic ability to modify your thoughts and feelings is actually already a built-in technology in each of us. I’m not saying that mindful, meditative breathing alone would have necessarily relieved Raymond’s compulsive use of eyedrops; certainly, it would not have helped Nathan Copeland regain feeling in his fingers. But I do say this: never underestimate the power of the human brain.

He is thinking if there is any way by which he can explain just how and what it is he suffers. He is wondering if there is anyone in the whole wide world with a heart big enough to comprehend what it is he wants to tell. There are so many little things to say first, and will anyone have the patience to listen to the end? Suffering is no one thing: it is composed of invisible atoms infinite in number, each one a universe in the great macrocosm of pain. He could begin anywhere, with anything, with a silly word even, a word such as flapdoodle, and he could erect a cathedral of staggering dimensions which would not occupy so much as a pocket in the crevice of the tiniest atom. To say nothing of the surrounding terrain, of the circumambient aura, of things like coast lines, volcanic craters, fathomless lagoons, pearl studs and tons of chicken feathers. The musician has an instrument to work with, the surgeon has his implements, the architect his plans, the general his pawns, the idiot his idiocy, but the one who is suffering has everything in the universe except relief. He can run out to the periphery a trillion times but the circle never straightens out. He knows every diameter but no egress. Every exit is closed, whether it be an inch away or a billion light years distant. You crash a gate made of arms and legs only to get a butt blow behind the ear. You pick up and run on bloody, sawed-off stumps, only to fall into an endless ravine. You sit in the very center of emptiness, whimpering inaudibly, and the stars blink at you. You fall into a coma, and just when you think you've found your way back to the womb they come after you with pick and shovel, with acetylene torches. Even if you found the place of death they would find a way to blow you out of it. You know time in all its curves and infidelities. You have lived longer than it takes to grow all the countless separate parts of a thousand new universes. You have watched them grow and fall apart again. And you are still intact, like a piece of music which goes on being played forever. The instruments wear out, and the players too, but the notes are eternal, and you are made of nothing but invisible notes which even the faintest zephyr can shake a tune out of.

IT’S ONLY SOUND Let me ask you an honest question. Is your music subject to God’s approval? If you discovered that He desired for you to listen to a different kind of music, would you obey willingly and gladly? Or would you resist and cling to “what you like”? Recently in a counseling session, I was speaking with a teenage young man about the power of music. After some thought about how strongly his music was holding on to his heart, he lifted his head, sort of chuckled and said, “It’s kind of strange when you really think about it…it’s only music…it’s only sound.” Oh, but how powerful that sound is! Just try to take away or suggest danger in the favorite CD or the favorite CCM group of a supposedly “surrendered” Christian. You’ll get everything from rage to ridicule—real fruits of the Spirit—all qualities that are produced by just such “good, godly music.” I’m being intentionally sarcastic to cause you to think. If pop-styled Christian music is so spiritually effective, why aren’t we having revival? Why isn’t it producing more holy, more separated, more godly individuals? Why are young people leaving Christianity in record numbers? Why do we have to have the world’s music? Should music really be such a stronghold in the Christian heart or in the local church? Should such self-absorption be the guiding force of our choices in entertainment? Should we view our music as entertainment at all? Does God really like “all kinds” of music? Music has a much higher purpose than our pleasure. Reducing music to mere entertainment would be something like asking a brain surgeon to roast marshmallows for a living. No, music is much too powerful and spiritually significant to reduce it to a petty place of pleasure. First Corinthians 10:14 admonishes us, “Wherefore, my dearly beloved, flee from idolatry.” Again in Colossians 3:5 we’re told to, “Mortify therefore your members which are upon the earth; fornication, uncleanness, inordinate affection, evil concupiscence, and covetousness, which is idolatry.” God commands us to “mortify” or “put to death” our “members.” Anything less than full surrender of our bodies (including our ears) to God is a subtle form of idolatry. Is music an idol in your life? Is it a stronghold? Are you addicted to your style, your group, your sound? Do you find yourself putting up a wall of defense in your heart, even as you read these words? Is your primary concern that it “makes you feel good” or that you listen to “what you like”? Think about it. It’s only sound.

• No matter how open we as a society are about formerly private matters, the stigma around our emotional struggles remains formidable. We will talk about almost anyone about our physical health, even our sex lives, but bring depression, anxiety or grief , and the expression on the other person would probably be "get me out of this conversation" • We can distract our feelings with too much wine, food or surfing the internet, • Therapy is far from one-sided; it happens in a parallel process. Everyday patients are opening up questions that we have to think about for ourselves, • "The only way out is through" the only way to get out of the tunnel is to go through, not around it • Study after study shows that the most important factor in the success of your treatment is your relationship with the therapist, your experience of "feeling felt" • Attachment styles are formed early in childhood based on our interactions with our caregivers. Attachment styles are significant because they play out in peoples relationships too, influencing the kind of partners they pick, (stable or less stable), how they behave in a relationship (needy, distant, or volatile) and how the relationship tend to end (wistfully, amiably, or with an explosion) • The presenting problem, the issue somebody comes with, is often just one aspect of a larger problem, if not a red herring entirely. • "Help me understand more about the relationship" Here, here's trying to establish what’s known as a therapeutic alliance, trust that has to develop before any work can get done. • In early sessions is always more important for patients to feel understood than it is for them to gain any insight or make changes. • We can complain for free with a friend or family member, People make faulty narratives to make themselves feel better or look better in the moment, even thought it makes them feel worse over time, and that sometimes they need somebody else to read between the lines. • Here-and-now, it is when we work on what’s happening in the room, rather than focusing on patient's stories. • She didn't call him on his bullshit, which this makes patients feel unsafe, like children's whose parent's don’t hold them accountable • What is this going to feel like to the person I’m speaking to? • Neuroscientists discovered that humans have brain cells called mirror neurons, that cause them to mimic others, and when people are in a heightened state of emotion, a soothing voice can calm their nervous system and help them stay present • Don’t judge your feelings; notice them. Use them as your map. Don’t be afraid of the truth. • The things we protest against the most are often the very things we need to look at • How easy it is, I thought, to break someone’s heart, even when you take great care not to. • The purpose on inquiring about people's parent s is not to join them in blaming, judging or criticizing their parents. In fact it is not about their parents at all. It is solely about understanding how their early experiences informed who they are as adults so that they can separate the past from the present (and not wear psychological clothing that no longer fits) • But personality disorders lie on a spectrum. People with borderline personality disorder are terrified of abandonment, but for some that might mean feeling anxious when their partners don’t respond to texts right away; for others that may mean choosing to stay in volatile, dysfunctional relationships rather than being alone. • In therapy we aim for self compassion (am I a human?) versus self esteem (Am I good or bad: a judgment) • The techniques we use are a bit like the type of brain surgery in which the patient remains awake throughout the procedure, as the surgeons operate, they keep checking in with the patient: can you feel this? can you say this words? They are constantly calibrating how close they are to sensitive regions of the brain, and if they hit one, they back up so as not to damage it.

Even more than black death he dreaded the gaudy gate: the mask of sweet red rubber, the violet overhead lights, the rattling ride through washed corridors, the steaming, breathing, percolating apparatus, basins of pink sterilizer, the firm straps binding every limb, the sacred pure garb of the surgeons, their eyes alone showing, the cute knives and angled scissors, the beat of your own heart pounding through the burnished machinery, the green color of the surgeon’s enormous compassionate eyes, framed, his quick breath sucking and billowing the gauze of his mask as he carved.

Grace is God as heart surgeon, cracking open your chest, removing your heart—poisoned as it is with pride and pain—and replacing it with his own. Rather than tell you to change, he creates the change. Do you clean up so he can accept you? No, he accepts you and begins cleaning you up. His dream isn’t just to get you into heaven but to get heaven into you.

Barnard suddenly realized, with gloomy introspection, that “I had the legal system of the United States to thank for the honor of being the first surgeon in the world to have done a heart transplant.

Dr. Charles Carrico was the first doctor to examine Kennedy as the President was being wheeled into the hospital. Carrico observed two wounds: a small bullet wound in the front lower neck and a large, gaping wound in the President’s head.3 He also noted that Kennedy “was blue-white or ashen in color, had slow, agonal spasmodic respiration without any coordination; made no voluntary movements; had his eyes open with the pupils dilated without any reaction to light; evidenced no palpable pulse; and had a few chest sounds which were thought to be heart beats.”4 No less than twelve doctors were soon at work on the President and Governor Connally. This group included four general surgeons, four anesthesiologists, the hospital’s chief neurologist, a urological surgeon, an oral surgeon, and a heart specialist.5

Wait and hope, as I did while they took your arm off. I held my hand over your heart all through that final morning, so I could warn the surgeon of its faltering." "Did it falter?" "Not once. Nor will it falter now. Fly free, my brave one, my sunbird. Take back the sky. Do not be afraid.

Graegar told me that any power expended to Change What Was could alert the enemy to my presence, so I held that in reserve and tried a different tactic. I didn't know I could do it until I was forced to do it, either. I placed Kathleen Rome in a short, temporary stasis too many times to count so the surgeon and his staff could save her life. I had to do it remotely, too, as my physical body sat in a cold waiting room, seemingly anticipating an update on Kathleen's condition. The poor girl who got burned was dying, too. Should I save her if I could? It was her fault she'd been injured, but then people make dumb mistakes all the time. I learned that I could juggle several balls at once. Between Kathleen's stasis treatment, I bent power similar to that of a Larentii toward a burned girl in another hospital, repairing charred and damaged tissue. I did what I considered the important things first, lessening the injury and giving her a fighting chance before going back to Kathleen and what she needed to survive. Yes, I'd expended power to save four million people. I was still weary and in need of rest from that. Graegar had said it would take weeks to recuperate; I'd taken only a few days. By the time I knew the burned girl would live and Kathleen would survive and have no lasting damage to her heart, I was worn out. The sun dipped below the horizon when I rose to lean against the window frame and stare out at the Pacific in the distance.

If you lay a hand on me I’ll ram your testicles so far up inside your abdomen it’ll take a heart surgeon to get them out.

Here is the deeply unnerving thing: The heart, cut from the chest, keeps beating on its own. Did Poe know this when he wrote "The Tell-Tale Heart"? So animated are these freestanding hearts that surgeons have been known to drop them. "We wash them off and they do just fine,

The way to a man's heart is through his stomach" was a terrible thing to hear my surgeon say.

There is no position so critical, no office so important, that the occasional, and even the more than occasional, utter incompetent will not wind up filling it. Heart surgeons, popes, presidents, it makes no difference. Look around and you will see an existence replete with people who are betraying, in a most egregious manner, the powers and responsibilities that have been entrusted to them.

Hennick’s iliac artery and vein, as well as the artery and vein of the new kidney, were spliced together with neat embroidery stitches. Then the surgeon took a deep breath, stretched his arms like a stage conjurer, and said to me: “You’re about to witness the most wonderful sight in the history of medicine.” He removed the arterial and venous clamps in sequence, and Hennick’s blood began to pump into the withered kidney. Each beat of his heart, visible in the pumping of the arteries, caused the kidney to swell. It was like watching a process of reanimation: a refutation of death. As the kidney grew, its defeated, dimpled surface began to fill out to a lucent pink. The surgeon held up the ureter of the new kidney (the tube that carries urine to the bladder) and I watched as a bead of urine began to grow at its cut end.

The farmer pulled up to the mews at the back of the hospital. The first inkling Longmore had that it was going to be a long night was when Thompson, the head porter, called him. 'Mr Longmore, is that pig in a Land Rover in the mews anything to do with you?' 'Yes, it is.' 'Well, it has just got out and turned left along Wimpole Street.' Reluctant to make its own valuable contribution to medical progress, the pig had escaped. It is surprising how fast a pig can run, especially when its life is at stake. Still dressed in their operating theatre gowns, caps, masks and boots, the entire surgical team gave chase. The pig ran as fast as its little legs could carry it, but was no match for London's finest heart surgeons, who eventually caught it halfway up the road.

scrambled to stand.

Well, I, ah, could not help but be impressed with her ladyship’s medical knowledge and I can hardly quell my outrage at the injustice of such a brilliant mind being barred from serving the community.” “Yes, it is an injustice indeed. A fact I am certain she is well aware of. Have you a point in reminding her?” Rafe drummed the fingers of his good hand on the side table. Ignoring his warning tone, Wakley nodded. “Though it is not in my power to make her a real doctor, I can give her the same examination that is received at Oxford and perhaps offer her some training, so that she may at least gain some sense of vindication.” Rafe opened his mouth to refuse, yet the words caught in his throat at the man’s logic and consideration. However, he couldn’t risk further involvement with mortals, for him or Cassandra. Not until her fate was decided. And he still had no notion how he would resolve his predicament. Hell, he hadn’t even told her about the letter from the Elders yet. He coughed. “I—” “Oh, Mr. Wakley!” Cassandra gasped in unabashed delight as she rushed down the stairs. “Would you?” The surgeon nodded. “As long as you understand that it is only a ceremonial gesture.” “I understand.” Cassandra’s voice quavered with hope and gratitude. Rafe hid the wrapped parcel by holding the microscope behind his back before she met his gaze. Slowly, she approached him, her eyes deep pools of abject longing. “Rafael…?” The question hung in the air, tangible as an embrace. He closed his eyes as his mind warred with his heart. She stood so close that her hair brushed his sleeve and he could smell her intoxicating scent. Taking a deep breath, he uttered an impractical reply. “I am certain you shall pass with alacrity.” She could be dead within the month. The least he could do was allow her to touch her dream. Cassandra rose on her toes and kissed him on the cheek. Her lips felt like a healing balm on his scars. “Thank you.

Stephen Maturin sipped his scalding coffee, the right Mocha berry, brought back from Arabia Felix in the pilgrim dhows, and considered. He was naturally a reserved and even a secretive man: his illegitimate birth (his father was an Irish officer in the service of His Most Catholic Majesty, his mother a Catalan lady) had to do with this; his activities in the cause of the liberation of Ireland had more; and his voluntary, gratuitous alliance with naval intelligence, undertaken with the sole aim of helping to defeat Bonaparte, whom he loathed with all his heart as a vile tyrant, a wicked cruel vulgar man, a destroyer of freedom and of nations, and as a betrayor of all that was good in the Revolution, had even more. Yet the power of keeping his mouth shut was innate; so perhaps was the integrity that made him one of the Admiralty’s most valued secret agents, particularly in Catalonia – a calling very well disguised by his also being an active naval surgeon, as well as a natural philosopher of international renown, one whose name was familiar to all those who cared deeply about the extinct solitaire of Rodriguez (close cousin to the dodo), the great land tortoise Testudo aubreii of the Indian Ocean, or the habits of the African aardvark. Excellent agent though he was, he was burdened with a heart, a loving heart that had very nearly broken for a woman named Diana Villiers: she had preferred an American to him – a natural preference, since Mr. Johnson was a fine upstanding witty intelligent man, and very rich, whereas Stephen was a plain bastard at the best, sallow with odd pale eyes, sparse hair and meager limbs, and rather poor.

Sleep deprivation underpins the psychopathy of the surgical mind – immunity to stress, an ability to take risks, the loss of empathy. Bit by bit I was joining that exclusive club.

He raised his blood stained hands and held the freshly severed heart under the light. 'Look at this,' he examined it and grinned in jubilation with his deep blue irises dilating behind the surgeon's mask, 'the muscles are still contracting!

He raised his blood-stained hands and held the freshly severed heart under the light. 'Look at this,' he examined it and grinned in jubilation with his deep blue irises dilating behind the surgeon's mask, 'the muscles are still contracting!

when the ACE study data started to appear on his computer screen, he realized that they had stumbled upon the gravest and most costly public health issue in the United States: child abuse. He had calculated that its overall costs exceeded those of cancer or heart disease and that eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, IV drug use, and domestic violence by three-quarters.20 It would also have a dramatic effect on workplace performance and vastly decrease the need for incarceration. When the surgeon general’s report on smoking and health was published in 1964, it unleashed a decades-long legal and medical campaign that has changed daily life and long-term health prospects for millions. The number of American smokers fell from 42 percent of adults in 1965 to 19 percent in 2010, and it is estimated that nearly 800,000 deaths from lung cancer were prevented between 1975 and 2000.21 The ACE study, however, has had no such effect. Follow-up studies and papers are still appearing around the world, but the day-to-day reality of children like Marilyn and the children in outpatient clinics and residential treatment centers around the country remains virtually the same. Only now they receive high doses of psychotropic agents, which makes them more tractable but which also impairs their ability to feel pleasure and curiosity, to grow and develop emotionally and intellectually, and to become contributing members of society.

He is thinking if there is any way by which he can explain just how and what it is he suffers. He is wondering if there is anyone in the whole wide world with a heart big enough to comprehend what it is he wants to tell. There are so many little things to say first, and will anyone have the patience to listen to the end? Suffering is no one thing: it is composed of invisible atoms infinite in number, each one a universe in the great macrocosm of pain. He could begin anywhere, with anything, with a silly word even, a word such as flapdoodle, and he could erect a cathedral of staggering dimensions which would not occupy so much as a pocket in the crevice of the tiniest atom. To say nothing of the surrounding terrain, of the circumambient aura, of things like coast lines, volcanic craters, fathomless lagoons, pearl studs and tons of chicken feathers. The musician has an instrument to work with, the surgeon has his implements, the architect his plans, the general his pawns, the idiot his idiocy, but the one who is suffering has everything in the universe except relief. He can run out to the periphery a trillion times but the circle never straightens out. He knows every diameter but no egress. Every exit is closed, whether it be an inch away or a billion light years distant. You crash a gate made of arms and legs only to get a butt blow behind the ear. You pick up and run on bloody, sawed-off stumps, only to fall into an endless ravine. You sit in the very center of emptiness, whimpering inaudibly, and the stars blink at you. You fall into a coma, and just when you think you've found your way back to the womb they come after you with pick and shovel, with acetylene torches. Even if you found the place of death they would find a way to blow you out of it. You know time in all its curves and infidelities. You have lived longer than it takes to grow all the countless separate parts of a thousand new universes. You have watched them grow and fall apart again. And you are still intact, like a piece of music which goes on being played forever. The instruments wear out, and the players too, but the notes are eternal, and you are made of nothing but invisible notes which even the faintest zephyr can shake a tune out of.

The schools, for whatever reason, are just not set up to teach the things that may make the biggest difference. I don’t know why that is, but I can tell you that I know salespeople who are making more money than heart surgeons, with far less liability and much less stress.

I don’t know what exactly it is about this moment that suddenly makes my heart hurt, and the pain I feel is far worse than the physical wounds I’ve collected in the service, because I know that there are no trauma packs for it. And I know that if I come back here without Halley, I’ll be broken in ways that no military surgeon will be able to fix.

Must not the disease be dangerous, when a tender-hearted surgeon cuts deep into the flesh? How much more when God is the operator,

Now, even as her family grieved, she was giving birth again.

In the course of his career as a naval surgeon travelling the world, Captain T.L. Cleave,97 together with South African physician G.D. Campbell, formulated the hypothesis that a variety of medical conditions – including dental caries and associated periodontal disease, peptic ulcers, obesity, diabetes, colonic stasis ‘and its complications of varicose veins and haemorrhoids’, heart attack (coronary thrombosis) and certain gut infections – are caused by diets high in sugar and refined carbohydrates, and should therefore be termed the ‘saccharine diseases’.

I was young and fearless. Seemingly invincible and massively overconfident.

Sleep deprivation is what underpins the psychopathy of the surgical mind. Immunity to stress, an ability to take risks, the loss of empathy. Bit by bit, I was being inducted into that exclusive club.