Surgeons Hand Quotes

...I became acutely aware of an unusual ability--a divine gift, I believe--of extraordinary eye and hand coordination. It’s my belief that God gives us all gifts, special abilities that we have the privilege of developing to help us serve Him and humanity. And the gift of eye and hand coordination has been an invaluable asset in surgery. This gift goes beyond eye-hand coordination, encompassing the ability to understand physical relationships, to think in three dimensions. Good surgeons must understand the consequences of each action, for they’re often not able to see what’s happening to see on the other side of the area in which the area they’re actually working.

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.

Is there no context for our lives? No song, no literature, no poem full of vitamins, no history connected to experience that you can pass along to help us start strong? You are an adult. The old one, the wise one. Stop thinking about saving your face. Think of our lives and tell us your particularized world. Make up a story. Narrative is radical, creating us at the very moment it is being created. We will not blame you if your reach exceeds your grasp; if love so ignites your words they go down in flames and nothing is left but their scald. Or if, with the reticence of a surgeon's hands, your words suture only the places where blood might flow. We know you can never do it properly - once and for all. Passion is never enough; neither is skill. But try. For our sake and yours forget your name in the street; tell us what the world has been to you in the dark places and in the light. Don't tell us what to believe, what to fear. Show us belief s wide skirt and the stitch that unravels fear's caul. You, old woman, blessed with blindness, can speak the language that tells us what only language can: how to see without pictures. Language alone protects us from the scariness of things with no names. Language alone is meditation.

There are jokes about breast surgeons. You know-- something like-- I've seen more breasts in this city than-- I don't know the punch line. There must be a punch line. I'm not a man who falls in love easily. I've been faithful to my wife. We fell in love when we were twenty-two. We had plans. There was justice in the world. There was justice in love. If a person was good enough, an equally good person would fall in love with that person. And then I met-- Ana. Justice had nothing to do with it. There once was a very great American surgeon named Halsted. He was married to a nurse. He loved her-- immeasurably. One day Halsted noticed that his wife's hands were chapped and red when she came back from surgery. And so he invented rubber gloves. For her. It is one of the great love stories in medicine. The difference between inspired medicine and uninspired medicine is love. When I met Ana, I knew: I loved her to the point of invention.

The surgeons like to bleed a man, to let ill humours out, so that he may face the world anew. Perhaps they should just hand him a quill and let the poisons spill from him whilst he keeps his blood for its intended purpose.

A surgeon would never hesitate to amputate a rotting hand, no matter how faithfully it had served its owner in the past.

Let him go, V. And let him take her where he needs to go." As Wrath's voice cut through the drama, the urge to go pyrotechnic became nearly irresistible. Like they needed another kibitzer? And fuck-that on the command. V squeezed the surgeon's collar trash-bag tight. "You are not taking her anywhere--" The hand on V's shoulder was heavy, and Wrath's voice had an edge like a dagger. "And you're not in charge here. She's my responsibility, not yours." Wrong thing to say. On so many levels. "She is my blood," he snarled. "And I'm the one who put her on that bed. Oh, and I'm also your cocksucking king, so you will do as I command, Vishous.

We are the centuries... We have your eoliths and your mesoliths and your neoliths. We have your Babylons and your Pompeiis, your Caesars and your chromium-plated (vital-ingredient impregnated) artifacts. We have your bloody hatchets and your Hiroshimas. We march in spite of Hell, we do – Atrophy, Entropy, and Proteus vulgaris, telling bawdy jokes about a farm girl name of Eve and a traveling salesman called Lucifer. We bury your dead and their reputations. We bury you. We are the centuries. Be born then, gasp wind, screech at the surgeon’s slap, seek manhood, taste a little godhood, feel pain, give birth, struggle a little while, succumb: (Dying, leave quietly by the rear exit, please.) Generation, regeneration, again, again, as in a ritual, with blood-stained vestments and nail-torn hands, children of Merlin, chasing a gleam. Children, too, of Eve, forever building Edens – and kicking them apart in berserk fury because somehow it isn’t the same. (AGH! AGH! AGH! – an idiot screams his mindless anguish amid the rubble. But quickly! let it be inundated by the choir, chanting Alleluias at ninety decibels.)

You don't notice the dead leaving when they really choose to leave you. You're not meant to. At most you feel them as a whisper or the wave of a whisper undulating down. I would compare it to a woman in the back of a lecture hall or theater whom no one notices until she slips out.Then only those near the door themselves, like Grandma Lynn, notice; to the rest it is like an unexplained breeze in a closed room. Grandma Lynn died several years later, but I have yet to see her here. I imagine her tying it on in her heaven, drinking mint juleps with Tennessee Williams and Dean Martin. She'll be here in her own sweet time, I'm sure. If I'm to be honest with you, I still sneak away to watch my family sometimes. I can't help it, and sometimes they still think of me. They can't help it.... It was a suprise to everyone when Lindsey found out she was pregnant...My father dreamed that one day he might teach another child to love ships in bottles. He knew there would be both sadness and joy in it; that it would always hold an echo of me. I would like to tell you that it is beautiful here, that I am, and you will one day be, forever safe. But this heaven is not about safety just as, in its graciousness, it isn't about gritty reality. We have fun. We do things that leave humans stumped and grateful, like Buckley's garden coming up one year, all of its crazy jumble of plants blooming all at once. I did that for my mother who, having stayed, found herself facing the yard again. Marvel was what she did at all the flowers and herbs and budding weeds. Marveling was what she mostly did after she came back- at the twists life took. And my parents gave my leftover possessions to the Goodwill, along with Grandma Lynn's things. They kept sharing when they felt me. Being together, thinking and talking about the dead, became a perfectly normal part of their life. And I listened to my brother, Buckley, as he beat the drums. Ray became Dr. Singh... And he had more and more moments that he chose not to disbelieve. Even if surrounding him were the serious surgeons and scientists who ruled over a world of black and white, he maintained this possibility: that the ushering strangers that sometimes appeared to the dying were not the results of strokes, that he had called Ruth by my name, and that he had, indeed, made love to me. If he ever doubted, he called Ruth. Ruth, who graduated from a closet to a closet-sized studio on the Lower East Side. Ruth, who was still trying to find a way to write down whom she saw and what she had experienced. Ruth, who wanted everyone to believe what she knew: that the dead truly talk to us, that in the air between the living, spirits bob and weave and laugh with us. They are the oxygen we breathe. Now I am in the place I call this wide wide Heaven because it includes all my simplest desires but also the most humble and grand. The word my grandfather uses is comfort. So there are cakes and pillows and colors galore, but underneath this more obvious patchwork quilt are places like a quiet room where you can go and hold someone's hand and not have to say anything. Give no story. Make no claim. Where you can live at the edge of your skin for as long as you wish. This wide wide Heaven is about flathead nails and the soft down of new leaves, wide roller coaster rides and escaped marbles that fall then hang then take you somewhere you could never have imagined in your small-heaven dreams.

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.

With savages, the weak in body or mind are soon eliminated; and those that survive commonly exhibit a vigorous state of health. We civilised men, on the other hand, do our utmost to check the process of elimination; we build asylums for the imbecile, the maimed, and the sick; we institute poor-laws; and our medical men exert their utmost skill to save the life of every one to the last moment. There is reason to believe that vaccination has preserved thousands, who from a weak constitution would formerly have succumbed to small-pox. Thus the weak members of civilised societies propagate their kind. No one who has attended to the breeding of domestic animals will doubt that this must be highly injurious to the race of man. It is surprising how soon a want of care, or care wrongly directed, leads to the degeneration of a domestic race; but excepting in the case of man himself, hardly any one is so ignorant as to allow his worst animals to breed. The aid which we feel impelled to give to the helpless is mainly an incidental result of the instinct of sympathy, which was originally acquired as part of the social instincts, but subsequently rendered, in the manner previously indicated, more tender and more widely diffused. Nor could we check our sympathy, if so urged by hard reason, without deterioration in the noblest part of our nature. The surgeon may harden himself whilst performing an operation, for he knows that he is acting for the good of his patient; but if we were intentionally to neglect the weak and helpless, it could only be for a contingent benefit, with a certain and great present evil. Hence we must bear without complaining the undoubtedly bad effects of the weak surviving and propagating their kind; but there appears to be at least one check in steady action, namely the weaker and inferior members of society not marrying so freely as the sound; and this check might be indefinitely increased, though this is more to be hoped for than expected, by the weak in body or mind refraining from marriage.

We priests are the surgeons of souls, and it is our duty to deliver them of shameful secrets they would fain conceal, with hands careful to neither wound no pollute.

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.

We are used to thinking of doctoring as a solitary, intellectual task. But making medicine go right is less often like making a difficult diagnosis than like making sure everyone washes their hands.

When you speak of your neighbour, look upon your tongue as a sharp razor in the surgeon’s hand, about to cut nerves and tendons; it should be used so carefully, as to insure that no particle more or less than the truth be said.

To tell the truth, sir, I believe I had rather sit in the shelter for a while. The cabbage seems to have turned my inward parts to water.’ Nonsense,’ said Stephen, ‘it is the most wholesome cabbage I have ever come across in the whole of my career. I hope, Mr. Herapath, that you are not going to join in the silly weak womanish unphilosophical mewling and puling about the cabbage. So it is a little yellow in certain lights, so it is a little sharp, so it smells a little strange: so much the better, say I. At least that will stop the insensate Phaeacian hogs from abusing it, as they abuse the brute creation, stuffing themselves with flesh until what little brain they have is drowned in fat. A virtuous esculent! Even its boldest detractors, ready to make the most hellish declarations and to swear through a nine-inch plank that the cabbage makes them fart and rumble, cannot deny that it cured their purpurae. Let them rumble till the heavens shake and resound again; let them fart fire and brimstone, the Gomorrhans, I will not have a single case of scurvy on my hands, the sea-surgeon’s shame, while there is a cabbage to be culled.

Emblematic of this era was the prolific Viennese surgeon Theodor Billroth. Born in 1821, Billroth studied music and surgery with almost equal verve. (The professions still often go hand in hand. Both push manual skill to its limit; both mature with practice and age; both depend on immediacy, precision, and opposable thumbs.)

To become a doctor, you spend so much time in the tunnels of preparation--head down, trying not to screw up, just going from one day to the next--that it is a shock to find yourself at the other end, with someone shaking your hand and offering you a job. But the day comes.

In any career, whether as a surgeon, a musician, or a secretary, one needs to have a confidence that says, “I can do anything, and if I can’t do it, I know how to get help.

I was an ordinary person A simple soul – a grain of sand And then you looked my way And then you held my hand And then – I was everything

Ask yourself, "What kind of evidence would convince me to change my mind?" If the answer is "no evidence could ever change my mind about vaccination," then you are putting yourself outside evidence-based rationality, outside the very critical thinking that first brought you to this point. In that case, to be consistent in your skepticism about science, next time you have an operation please ask your surgeon not to bother washing her hands.

Don't you recognize me?' 'No.' 'Eponine.' Marius bent hastily forward and saw that it was indeed that unhappy girl, clad in a man's clothes. 'How do you come to be here? What are you doing?' 'I'm dying,' she said. There are words and happenings which arouse even souls in the depths of despair. Marius cried, as though starting out of sleep: 'You're wounded! I'll carry you into the tavern. They'll dress your wound. Is it very bad? How am I to lift you without hurting you? Help, someone! But what are you doing here?' He tried to get an arm underneath her to raise her up, and in doing so touched her hand. She uttered a weak cry. 'Did I hurt you?' 'A little.' 'But I only touched your hand.' She lifted her hand for him to see, and he saw a hole in the centre of the palm. 'What happened?' he asked. 'A bullet went through it.' 'A bullet? But how?' 'Don't you remember a musket being aimed at you?' 'Yes, and a hand was clapped over it.' 'That was mine.' Marius shuddered. 'What madness! Your poor child! Still, if that's all, it might be worse. I'll get you to a bed and they'll bind you up. One doesn't die of a wounded hand.' She murmured: 'The ball passed through my hand, but it came out through my back. It's no use trying to move me. I'll tell you how you can treat my wound better than any surgeon. Sit down on that stone, close beside me.' Marius did so. She rested her head on his knee and said without looking at him: 'Oh, what happiness! What bliss! Now I don't feel any pain.

The wounded surgeon plies the steel That questions the distempered part; Beneath the bleeding hands we feel The sharp compassion of the healer’s art Resolving the enigma of the fever chart. Our only health is the disease If we obey the dying nurse Whose constant care is not to please But remind of our, and Adam’s curse, And that, to be restored, our sickness must grow worse. The whole earth is our hospital Endowed by the ruined millionaire

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.

As surgeons have ever their knives and instruments at hand for the sudden emergencies of their art, so do you keep ready the principles requisite for understanding things divine and human, and for doing all things, even the least important, in the remembrance of the bond between the two. For in neglecting this, you will scant your duty both to Gods and men.

But what do you keep of me? The memory of my bones flying up into your hands. —Anne Sexton, “The Surgeon

Religion is like a knife; in the hands of a surgeon, it heals, but in the hands of a murderer, it kills.

The physician works with his mind. The surgeon works with his hands, and his brute strength.

Amy Grech has a cinematographer's eye, and a surgeon's hand—at once brutal and tender, unsettling yet humane. These stories linger like traces of an acid trip. Highly recommended!” — Jay Bonansinga, National Best-Selling Author of Twisted, Frozen, and The Sinking of the Eastland

The tulips are too excitable; it is winter here Look at how white everything is, how quiet, how snowed in I am learning peacefulness, lying by myself quietly As 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 dayclothes to the nurses, and my history to the anesthetist, and my body to the surgeons

In a devastating of example critical thinking gone bad, highly educated, deeply caring parents avoid the vaccinations that would protect their children from killer diseases. I love critical thinking and I admire scepticism, but only in a framework that respects evidence. So if you are sceptical about the measles vaccinations, I ask you to do two things. First, make sure you know what it looks like when a child dies of measles. Most children who catch measles recover, but there is still no cure and even with the best modern medicine, one or two in every thousand will die from it. Second, ask yourself, “What kind of evidence would convince me change my mind about vaccination. If the answer is ‘no evidence could ever change my mind about vaccination,” then you are putting yourself outside evidence-based rationality, outside the very critical thinking that first brought you to this point. In that case, to be consistent in your scepticism about science, next time you have an operation please ask your surgeon not to bother washing her hands.

I left a pause. ‘You sound like a certain kind of surgeon. A lot more interested in the operation than the patient.’ ‘I should not like to be in the hands of a surgeon who did not take that view.

I recognized others’ abilities as well. But in any career, whether it’s that of a TV repairman, a musician, a secretary—or a surgeon—an individual must believe in himself and in his abilities. To do his best, one needs a confidence that says, “I can do anything, and if I can’t do it, I know how to get help.

What do you do when your flesh is rotten, when the skin is so dead even your blood turns against you?” I took her hand. “Cut it out.” “Exactly,” she said. “And if you would have me as your surgeon, I would have you as my knife.

He is a bold surgeon, they say, whose hand does not tremble when he performs an operation upon his own person; and he is often equally bold who does not hesitate to pull off the mysterious veil of self-delusion, which covers from his view the deformities of his own conduct. —ADAM SMITH

It’s all along of the unicorn’s horn – it’s all along of the glorious hand. Huzzay, three times huzzay for the doctor!’ Lord, how they cheered their surgeon! It was he who had brought the narwhal’s tusk aboard: and the severed hand, the Hand of Glory, was his property: both symbolized (and practically guaranteed) immense good fortune, virility, safety from poison or any disease you chose to name: and both had proved their worth.

There once was a very great American surgeon named Halsted. He was married to a nurse. He loved her—immeasurably. One day Halsted noticed that his wife’s hands were chapped and red when she came back from surgery. And so he invented rubber gloves. For her. It is one of the great love stories in medicine. The difference between inspired medicine and uninspired medicine is love. When I met Ana, I knew: I loved her to the point of invention.

ON A DAY LATE THAT JANUARY, I READ AGAIN “EAST Coker” by the poet T. S. Eliot, and saw something that I had forgotten: the stark but beautiful metaphor by which he described God as a wounded surgeon whose bleeding hands apply a scalpel to his patients so that “Beneath the bleeding hands we feel / The sharp compassion of the healer’s art.

Classical understanding is concerned with the piles and the basis for sorting and interrelating them. Romantic understanding is directed toward the handful of sand before the sorting begins. Both are valid ways of looking at the world although irreconcilable with each other. What has become an urgent necessity is a way of looking at the world that does violence to neither of these two kinds of understanding and unites them into one. Such an understanding will not reject sand-sorting or contemplation of unsorted sand for its own sake. Such an understanding will instead seek to direct attention to the endless landscape from which the sand is taken. That is what Phaedrus, the poor surgeon, was trying to do.

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

70,000 to 100,000 births; twins joined at the head occur only once in 2 to 2.5 million births. Siamese twins received their name because of the birthplace (Siam) of Chang and Eng (1811 - 1874) whom P.T. Barnum exhibited across America and Europe. Most cranio pagus Siamese twins die at birth or shortly afterward. So far as we know, not more than 50 attempts had previously been made to separate such twins. Of those, less than ten operations have resulted in two fully normal children. Aside from the skill of the operating surgeons, the success depends largely on how much and what kind of tissue the babies share. Occipital cranio pugus twins (such as the Binders) had never before been separated with both surviving.

I’d never wanted anything more in my whole life,” Aydin went on, “and I was studying to be a surgeon who would’ve gladly cut off his own hands to have her.

He has been the subject of two major documentary films, Your Life in Their Hands, which won the Royal Television Society Gold Medal, and The English Surgeon, which won an Emmy,

Sure, practice improves everybody’s skills, and it’s absolutely essential in some fields. But are gold medals at the Olympics handed out simply on the basis of how long the athletes practiced?

His polytheistic hankerings were dramatically demonstrated in 1981 when he suffered an assassination attempt in Rome, and attributed his survival to intervention by Our Lady of Fatima: 'A maternal hand guided the bullet.' One cannot help wondering why she didn't guide it to miss him altogether. Others might think the team of surgeons who operated on him for six hours deserved at least a share of the

Whereas traditionally the family was the main matchmaker, today it’s the market that tailors our romantic and sexual preferences, and then lends a hand in providing for them – for a fat fee. Previously bride and groom met in the family living room, and money passed from the hands of one father to another. Today courting is done at bars and cafés, and money passes from the hands of lovers to waitresses. Even more money is transferred to the bank accounts of fashion designers, gym managers, dieticians, cosmeticians and plastic surgeons, who help us arrive at the café looking as similar as possible to the market’s ideal of beauty.

He’s helped field surgeons operating in forests and hidden beneath camouflage tarps, washing IV tubing and plastic gloves so they can be reused again. He’s dug graves with his bare hands. He’s lived behind enemy lines.

When I closed the door Grandmother was already seated at her spinning wheel. Her foot was on the treadle but her eyes were thoughtfully on me. The spinner was beautifully carved of dark oak with leaves twining their way round and round the outer rim. It must have been very old, as the designs were too fanciful to have been made i the new England. She called to me and asked me if I could spin. I told her yes, well enough, but that I could sew better, which was a statement only half true. A camp surgeon would have a better hand with a cleaver to a limb than I with a needle on the cloth. She spun the wool through knotted fingers glistening with sheep's oil and wrapped the threads neatly around the bobbin. Gently probing, she teased out the story of our days in Billerica just as she teased out the fine thread from the mix and jumble of the coarse wool in her hands.

we are left with evidence that is modest, at best, to justify the use of moderate alcohol. What’s beyond doubt, on the other hand, is that more brains and lives are ruined by overuse of alcohol than by any other substance.

A knife can be used both to heal and hurt. Wether in the hands of a surgeon or the hands of a criminal it's the same instrument. Tools are seldom good or bad per se - You get to decide how to use them and that's what matters.

The wounded surgeon plies the steel That questions the distempered part; Beneath the bleeding hands we feel The sharp compassion of the healer’s art Resolving the enigma of the fever chart. Our only health is the disease If we obey the dying nurse Whose constant care is not to please But remind of our, and Adam’s curse, And that, to be restored, our sickness must grow worse. The whole earth is our hospital Endowed by the ruined millionaire

The medical profession has seen quite a bit of me over the years. My case history would make any surgeon blink in disbelief. On the way to the Olympics, I’ve had broken arms, hands, fingers, feet, a fractured jaw and neck and even a broken back.

The Peacemaker Colt has now been in production, without change in design, for a century. Buy one to-day and it would be indistinguishable from the one Wyatt Earp wore when he was the Marshal of Dodge City. It is the oldest hand-gun in the world, without question the most famous and, if efficiency in its designated task of maiming and killing be taken as criterion of its worth, then it is also probably the best hand-gun ever made. It is no light thing, it is true, to be wounded by some of the Peacemaker’s more highly esteemed competitors, such as the Luger or Mauser: but the high-velocity, narrow-calibre, steel-cased shell from either of those just goes straight through you, leaving a small neat hole in its wake and spending the bulk of its energy on the distant landscape whereas the large and unjacketed soft-nosed lead bullet from the Colt mushrooms on impact, tearing and smashing bone and muscle and tissue as it goes and expending all its energy on you. In short when a Peacemaker’s bullet hits you in, say, the leg, you don’t curse, step into shelter, roll and light a cigarette one-handed then smartly shoot your assailant between the eyes. When a Peacemaker bullet hits your leg you fall to the ground unconscious, and if it hits the thigh-bone and you are lucky enough to survive the torn arteries and shock, then you will never walk again without crutches because a totally disintegrated femur leaves the surgeon with no option but to cut your leg off. And so I stood absolutely motionless, not breathing, for the Peacemaker Colt that had prompted this unpleasant train of thought was pointed directly at my right thigh. Another thing about the Peacemaker: because of the very heavy and varying trigger pressure required to operate the semi-automatic mechanism, it can be wildly inaccurate unless held in a strong and steady hand. There was no such hope here. The hand that held the Colt, the hand that lay so lightly yet purposefully on the radio-operator’s table, was the steadiest hand I’ve ever seen. It was literally motionless. I could see the hand very clearly. The light in the radio cabin was very dim, the rheostat of the angled table lamp had been turned down until only a faint pool of yellow fell on the scratched metal of the table, cutting the arm off at the cuff, but the hand was very clear. Rock-steady, the gun could have lain no quieter in the marbled hand of a statue. Beyond the pool of light I could half sense, half see the dark outline of a figure leaning back against the bulkhead, head slightly tilted to one side, the white gleam of unwinking eyes under the peak of a hat. My eyes went back to the hand. The angle of the Colt hadn’t varied by a fraction of a degree. Unconsciously, almost, I braced my right leg to meet the impending shock. Defensively, this was a very good move, about as useful as holding up a sheet of newspaper in front of me. I wished to God that Colonel Sam Colt had gone in for inventing something else, something useful, like safety-pins.

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.

Certainly nothing at present could seem much less important to Lydgate than the turn of Miss Brooke's mind, or to Miss Brooke than the qualities of the woman who had attracted this young surgeon. But any one watching keenly the stealthy convergence of human lots, sees a slow preparation of effects from one life on another, which tells like a calculated irony on the indifference or the frozen stare with which we look at our unintroduced neighbor. Destiny stands by sarcastic with our dramatis personae folded in her hand.

A neurosurgeon once told me about operating on the brain of a young man with epilepsy. As is customary in this kind of operation, the patient was wide awake, under only local anesthesia, while the surgeon delicately explored his exposed cortex, makingsure that the parts tentatively to be removed were not absolutely vital by stimulating them electrically and asking the patient what he experienced. Some stimulations provoked visual flashes or hand-raisings, others a sort of buzzing sensation, but one spot produced a delighted response from the patient: "It's 'Outta Get Me' by Guns N' Roses. my favorite heavy metal band!" I asked the neurosurgeon If he had asked the patient to sing or hum along with the music, since it would be fascinating to learn how "high fidelity" the provoked memory was, would it be in exactly the same key and tempo as the record? Such a song (unliken"Silent Night") has one canonical version. so we could simply have superimposed a recording of the patients humming with the standard record and compared the results. Unfortunately, even though a tape recorder had been running during the operation, thesurgeon hadn't asked the patient to sing along. ''Why not?" I asked, and he replied: "I hate rock music!' Later in the conversation the neurosurgeon happened to remark that he was going to have to operate again on the same young man. and I expressed the hope that he would just check to see if he could restimulate the rock music, and this time ask the fellow to sing along. "I can't do it." replied the neurosurgeon. "since I cut out that part." "It was part of the epileptic focus?" I asked. "No,'' the surgeon replied, ''I already told you — I hate rock music.

Surgeon General’s Advice to Avoid Influenza Avoid needless crowding. . . . Smother your coughs and sneezes. . . . Your nose not your mouth was made to breathe thru. . . . Remember the 3 Cs, clean mouth, clean skin, and clean clothes. . . . Food will win the war. . . . [H]elp by choosing and chewing your food well. . . . Wash your hands before eating. . . . Don’t let the waste products of digestion accumulate. . . . Avoid tight clothes, tight shoes, tight gloves—seek to make nature your ally not your prisoner. . . . When the air is pure breathe all of it you can—breathe deeply.

Confederate surgeons usually performed “circular” amputations. They made a 360-degree cut through the skin, then scrunched it up like a shirt cuff. After sawing through the muscle and bone, they inched the skin back down to wrap the stump. This method led to less scarring and infection. Union surgeons preferred “flap” amputations: doctors left two flaps of flesh hanging beside the wound to fold over after they’d sawed through. This method was quicker and provided a more comfortable stump for prosthetics. Altogether, surgeons lopped off 60,000 fingers, toes, hands, feet, and limbs during the war.

My first day in the hospital, the chief resident said to me, "Neurosurgery residents aren't just the best surgeons -- we're the best doctors in the hospital. That's your goal. Make us proud." The chairman, passing through the ward: "Always eat with your left hand. You've got to learn to be ambidextrous.

Stephen and Higgins began bleeding all hands. They only took eight ounces from each, but this, bowl after bowl, amounted to nine good buckets with foam of an extraordinary beauty: but they had rather more than their fair share of fools who would be fainting, because as the breeze declined and the heat increased a sickly slaughterhouse reek spread about the deck; and one of them (a young Marine) actually pitched into a brimming bucket as he fell and caused three more to lurch, so angering Dr Maturin that the next half dozen patients were drained almost white, like veal, while guards were placed over the buckets that remained. However, it was all over in an hour and fifteen minutes, both surgeons being brisk hands with a fleam; the corpses were dragged away by their friends to be recovered with sea-water or vinegar, according to taste; and finally, seeing that fair was fair, each surgeon bled the other.

Robots may be used as surgeons as well as cooks and musicians. For example, one important limitation of surgery is the dexterity and accuracy of the human hand. Surgeons, like all people, become fatigued after many hours and their efficiency drops. Fingers begin to tremble. Robots may solve these problems.

You think you know what a man is? You have no idea what a man is. You think you know what a daughter is? You have no idea what a daughter is. You think you know what this country is? You have no idea what this country is. You have a false image of everything. All you know is what a fucking glove is. This country is frightening. Of course she was raped. What kind of company do you think she was keeping? Of course out there she was going to get raped. This isn't Old Rimrock, old buddy - she's out there, old buddy, in the USA. She enters that world, that loopy world out there, with whats going on out there - what do you expect? A kid from Rimrock, NJ, of course she didn't know how to behave out there, of course the shit hits the fan. What could she know? She's like a wild child out there in the world. She can't get enough of it - she's still acting up. A room off McCarter Highway. And why not? Who wouldn't? You prepare her for life milking the cows? For what kind of life? Unnatural, all artificial, all of it. Those assumptions you live with. You're still in your olf man's dream-world, Seymour, still up there with Lou Levov in glove heaven. A household tyrannized by gloves, bludgeoned by gloves, the only thing in life - ladies' gloves! Does he still tell the one about the woman who sells the gloves washing her hands in a sink between each color? Oh where oh where is that outmoded America, that decorous America where a woman had twenty-five pairs of gloves? Your kid blows your norms to kingdom come, Seymour, and you still think you know what life is?" Life is just a short period of time in which we are alive. Meredith Levov, 1964. "You wanted Ms. America? Well, you've got her, with a vengeance - she's your daughter! You wanted to be a real American jock, a real American marine, a real American hotshot with a beautiful Gentile babe on your arm? You longed to belong like everybody else to the United States of America? Well, you do now, big boy, thanks to your daughter. The reality of this place is right up in your kisser now. With the help of your daughter you're as deep in the sit as a man can get, the real American crazy shit. America amok! America amuck! Goddamn it, Seymour, goddamn you, if you were a father who loved his daughter," thunders Jerry into the phone - and the hell with the convalescent patients waiting in the corridor for him to check out their new valves and new arteries, to tell how grateful they are to him for their new lease on life, Jerry shouts away, shouts all he wants if it's shouting he wants to do, and the hell with the rules of hte hospital. He is one of the surgeons who shouts; if you disagree with him he shouts, if you cross him he shouts, if you just stand there and do nothing he shouts. He does not do what hospitals tell him to do or fathers expect him to do or wives want him to do, he does what he wants to do, does as he pleases, tells people just who and what he is every minute of the day so that nothing about him is a secret, not his opinions, his frustrations, his urges, neither his appetite nor his hatred. In the sphere of the will, he is unequivocating, uncompromising; he is king. He does not spend time regretting what he has or has not done or justifying to others how loathsome he can be. The message is simple: You will take me as I come - there is no choice. He cannot endure swallowing anything. He just lets loose. And these are two brothers, the same parents' sons, one for whom the aggression's been bred out, the other for whom the aggression's been bred in. "If you were a father who loved your daughter," Jerry shouts at the Swede, "you would never have left her in that room! You would have never let her out of your sight!

All surgeons fear an operation can go too far, to a point where they become irretrievably lost in aatomical bits and pieces. A limit beyond which Humpty Dumpty can never be put back together - at least, not perfectly. The body can never return to its pristine, original state after we've touched it with our hands.

West was the only officer on the quarterdeck, and it so happened that the party of hands making dolphins and paunch-mats on the forecastle were all Shelmerstonians. West was gaping rather vacantly over the taffrail when he saw an extraordinarily handsome woman ride along the quay, followed by a groom. She dismounted at the height of the ship, gave the groom her reins, and darted straight across the brow and so below.    'Hey there,' he cried, hurrying after her, 'this is Dr Maturin's cabin. Who are you, ma'am?'    'I am his wife, sir,' she said, 'and I beg you will desire the carpenter to sling a cot for me here.' She pointed, and then bending and peering out of the scuttle she cried 'Here they are. Pray let people stand by to help him aboard: he will be lying on a door.' She urged West out of the cabin and on deck, and there he and the amazed foremast hands saw a blue and gold coach and four, escorted by a troop of cavalry in mauve coats with silver facings, driving slowly along the quay with their captain and a Swedish officer on the box, their surgeon and his mate leaning out of the windows, and all of them, now joined by the lady on deck, singing Ah tutti contenti saremo cosí, ah tutti contenti saremo, saremo cosí with surprisingly melodious full-throated happiness.

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.

Today courting is done at bars and cafés, and money passes from the hands of lovers to waitresses. Even more money is transferred to the bank accounts of fashion designers, gym managers, dieticians, cosmeticians and plastic surgeons, who help us arrive at the café looking as similar as possible to the market’s ideal of beauty.

Holy and gracious God, Bless the hands which hold this book, that they may do your work. Bless the eyes which scan these pages, that they may seek Your face. Bless the lips which quietly read along, that they might share Your good news. And bless the souls which understand these words, that we may belong entirely to You. In Jesus’ name, Amen.

The argument that “people now have more freedom than ever” is based on the fact that we are allowed to do almost anything we please as long as it has no practical consequences. See ISAIF, §72. Where our actions have practical consequences that may be of concern to the system (and few important practical consequences are not of concern to the system), our behavior, generally speaking, is closely regulated. Examples: We can believe in any religion we like, have sex with any consenting adult partner, take a plane to China or Timbuktu, have the shape of our nose changed, choose any from a huge variety of books, movies, musical recordings, etc., etc., etc. But these choices normally have no important practical consequences. Moreover, they do not require any serious effort on our part. We don’t change the shape of our own nose, we pay a surgeon to do it for us. We don’t go to China or Timbuktu under our own power, we pay someone to fly us there. On the other hand, within our own home city we can’t go from point A to point B without our movement being controlled by traffic regulations, we can’t buy a firearm without undergoing a background check, we can’t change jobs without having our background scrutinized by prospective employers, most people’s jobs require them to work according to rules, procedures, and schedules prescribed by their employers, we can’t start a business without getting licenses and permits, observing numerous regulations, and so forth.

Dr. Chanter, in his brilliant History of Human Thought in the Twentieth Century, has made the suggestion that only a very small proportion of people are capable of acquiring new ideas of political or social behaviour after they are twenty-five years old. On the other hand, few people become directive in these matters until they are between forty and fifty. Then they prevail for twenty years or more. The conduct of public affairs therefore is necessarily twenty years or more behind the living thought of the times. This is what Dr. Chanter calls the "delayed realisation of ideas". In the less hurried past this had not been of any great importance, but in the violent crises of the Revolutionary Period it became a primary fact. It is evident now that whatever the emergency, however obvious the new problem before our species in the nineteen-twenties, it was necessary for the whole generation that had learned nothing and could learn nothing from the Great War and its sequelae, to die out before any rational handling of world affairs could even begin. The cream of the youth of the war years had been killed; a stratum of men already middle-aged remained in control, whose ideas had already set before the Great War. It was, says Chanter, an inescapable phase. The world of the Frightened Thirties and the Brigand Forties was under the dominion of a generation of unteachable, obstinately obstructive men, blinded men, miseducating, misleading the baffled younger people for completely superseded ends. If they could have had their way, they would have blinded the whole world for ever. But the blinding was inadequate, and by the Fifties all this generation and its teachings and traditions were passing away, like a smoke-screen blown aside. Before a few years had passed it was already incredible that in the twenties and thirties of the twentieth century the whole political life of the world was still running upon the idea of competitive sovereign empires and states. Men of quite outstanding intelligence were still planning and scheming for the "hegemony" of Britain or France or Germany or Japan; they were still moving their armies and navies and air forces and making their combinations and alliances upon the dissolving chess-board of terrestrial reality. Nothing happened as they had planned it; nothing worked out as they desired; but still with a stupefying inertia they persisted. They launched armies, they starved and massacred populations. They were like a veterinary surgeon who suddenly finds he is operating upon a human being, and with a sort of blind helplessness cuts and slashes more and more desperately, according to the best equestrian rules. The history of European diplomacy between 1914 and 1944 seems now so consistent a record of incredible insincerity that it stuns the modern mind. At the time it seemed rational behaviour. It did not seem insincere. The biographical material of the period -- and these governing-class people kept themselves in countenance very largely by writing and reading each other's biographies -- the collected letters, the collected speeches, the sapient observations of the leading figures make tedious reading, but they enable the intelligent student to realise the persistence of small-society values in that swiftly expanding scene. Those values had to die out. There was no other way of escaping from them, and so, slowly and horribly, that phase of the moribund sovereign states concluded.

Rummaging through the cupboard like a wartime surgeon frantically searching for the right bandage, Peter swept aside Yogi Tea and Harmony Herbal Blend, though he hesitated for a second over chamomile. But no. Stay focused, he admonished himself. He knew it was there, that opiate of the Anglos. And his hand clutched the box just as the kettle whistled. Violent death demanded Earl Grey.

He watched Richard Gordon lurching down the street until he was out of sight in the shadow from the big trees whose branches dipped down to grow into the ground like roots. What he was thinking as he watched him was not pleasant. It is a mortal sin, he thought, a grave and deadly sin and a great cruelty, and while technically one's religion may permit the ultimate result, I cannot pardon myself. On the other hand, a surgeon cannot desist while operating for fear of hurting the patient. But why must, all operations in life be performed with out an anesthetic? If I had been a better man I would have let him beat me up. It would have been better for him. The poor stupid man. The poor homeless man. I ought to stay with him, but I know that is too much for him to bear. I am ashamed and disgusted with myself and I hate what I have done. It all may turn out badly too. But I must not think about that. I will now return to the anesthetic I have used for seventeen years and will not need much longer. Although it is probably a vice now for which I only invent excuses. Though at least it is a vice for which I am suited. But I wish I could help that poor man who I am wronging.

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

be that your cousin has influenced you in some way—but as for our Junior Surgeon,” he turned to Carausius, “I remember that when first he was posted here, you yourself, Caesar, were not too sure of his good faith. This is surely some plot of Maximian’s, to cast doubt and suspicion between the Emperor of Britain and the man who, however unworthily, serves him to the best of his ability as chief minister.” Justin stepped forward, his hands clenched at his sides. “That is a foul lie,” he said, for once without a trace of his stutter. “And you know it, Allectus; none better.” “Will you grant me also a space to speak?” Carausius said quietly, and silence fell like a blight on the lamplit chamber. He looked round at all three of them, taking his time. “I remember my doubts, Allectus. I remember also that the

Surgeons, as a group, adhere to a curious egalitarianism. They believe in practice, not talent. People often assume that you have to have great hands to become a surgeon, but it’s not true. When I interviewed to get into surgery programs, no one made me sew or take a dexterity test or checked if my hands were steady. You do not even need all ten fingers to be accepted. To be sure, talent helps. Professors say every two or three years they’ll see someone truly gifted come through a program—someone who picks up complex manual skills unusually quickly, sees the operative field as a whole, notices trouble before it happens. Nonetheless, attending surgeons say that what’s most important to them is finding people who are conscientious, industrious, and boneheaded enough to stick at practicing this one difficult thing day and night for years on end. As one professor of surgery put it to me, given a choice between a Ph.D. who had painstakingly cloned a gene and a talented sculptor, he’d pick the Ph.D. every time. Sure, he said, he’d bet on the sculptor being more physically talented; but he’d bet on the Ph.D. being less “flaky.” And in the end that matters more. Skill, surgeons believe, can be taught; tenacity cannot.

For the duration of the war, American surgery remained crude, and wound infections spread unchecked. The bullet-riddled arms and legs of more than thirty thousand Union soldiers were amputated by battlefield surgeons, many of whom had little or no experience of treating trauma patients. Knives and saws were wiped free of gore with nothing more than dirty rags, if at all. Surgeons never washed their hands and were often covered in the blood and guts of previous patients at the commencement of a new operation. When linen and cotton were scarce, army surgeons used cold, damp earth to pack open wounds. When these wounds inevitably began to suppurate, they were praised for their laudable pus. Many surgeons had never even witnessed a major amputation or treated gunshot wounds when they joined their regiments, much to the detriment of those who fell under their care.

We always hope for the easy fix: the one simple change that will erase a problem in a stroke. But few things in life work this way. Instead, success requires making a hundred small steps go right - one after the other, no slipups, no goofs, everyone pitching in. We are used to thinking of doctoring as a solitary, intellectual task. But making the medicine go right is less often like making a difficult diagnosis than like making sure everyone washes their hands.

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.

Oh, yes,” said Lord Peter. He watched the cool fingers, fascinated, and the steady approach of the needle. “Yes—I’ve had it before—and, d’you know—I don’t care frightfully about it.”   He had brought up his right hand, and it closed over the surgeon’s wrist like a vise.   The silence was like a shock. The blue eyes did not waver; they burned down steadily upon the heavy white lids below them. Then these slowly lifted; the grey eyes met the blue—coldly, steadily—and held them.   When

The bullet didn’t come out. I’ve got to go in and get it.” “Have you ever done that?” she asked, quickly thrusting the bottle into my hands. I guess she thought whoever possessed the bottle had to perform the surgery. “I filled in pot holes, Jen. Not much call for field surgery in that line of work.” “What about before that?” she grasped. “Oh yeah sure, I left a lucrative and life-fulfilling job as a highly skilled surgeon to live the prosaic life of a road crew man. Filling holes seemed a much nobler profession.” “Don’t

the city of the Hague, the capital of the Seven United Provinces, was swelling in all its arteries with a black and red stream of hurried, panting, and restless citizens, who, with their knives in their girdles, muskets on their shoulders, or sticks in their hands, were pushing on to the Buytenhof, a terrible prison, the grated windows of which are still shown, where, on the charge of attempted murder preferred against him by the surgeon Tyckelaer, Cornelius de Witt, the brother of the Grand Pensionary of Holland was confined.

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 slaves destroyed tirelessly. Like the peasants in the Jacquerie or the Luddite wreckers, they were seeking their salvation in the most obvious way, the destruction of what they knew was the cause of their sufferings; and if they destroyed much it was because they had suffered much. [...] Now that they held power they did as they had been taught. In the frenzy of the first encounters they killed all. Yet they spared the priests whom they feared and the surgeons who had been kind to them. They, whose women had undergone countless violations, violated all the women who fell into their hands, often on the bodies of their still bleeding husbands, fathers and brothers. “Vengeance ! Vengeance” was their war-cry, and one of them carried a white child on a pike as a standard. And yet they were surprisingly moderate, then and afterwards, far more humane than their masters had been or would ever be to them. [...] Compared with what their masters had done to them in cold blood, what they did was negligible, and they were spurred on by the ferocity with which the whites in Le Cap treated all slave prisoners who fell into their hands.

The M & M sees avoiding error as largely a matter of will—of staying sufficiently informed and alert to anticipate the myriad ways that things can go wrong and then trying to head off each potential problem before it happens. It isn't damnable that an error occurs, but there is some shame to it. In fact, the M & M's ethos can seem paradoxical. On the one hand, it reinforces the very American idea that error is intolerable. On the other hand, the very existence of the M & M, its place on the weekly schedule, amounts to an acknowledgement that mistakes are an inevitable part of medicine.

THAT DAY, while we were in school, four men in a jeep came to visit Ghosh. They took him away as if he were a common criminal, his hands jacked up behind his back. They slapped him when he tried to protest. Hema learned this from W. W. Gonad, who told the men they were surely mistaken in taking away Missing’s surgeon. For his impertinence W.W. got a boot in his stomach. Hema refused to believe Ghosh was gone. She ran home, certain that she’d find him sunk into his armchair, his sockless feet up on the stool, reading a book. In anticipation of seeing him, in the certainty that he would be there, she was already furious with him. She burst through the front door of our bungalow. “Do you see how dangerous it is for us to associate with the General? What have I been telling you? You could get us all killed!” Whenever she came at him like that, all her cylinders firing, it was Ghosh’s habit to flourish an imaginary cape like a matador facing a charging bull. We found it funny, even if Hema never did. But the house was quiet. No matador. She went from room to room, the jingle of her anklets echoing in the hallways. She imagined Ghosh with his arm twisted behind his back, being punched in the face,

Pope John Paul II created more saints than all his predecessors of the past several centuries put together, and he had a special affinity with the Virgin Mary. His polytheistic hankerings were dramatically demonstrated in 1981 when he suffered an assassination attempt in Rome, and attributed his survival to intervention by Our Lady of Fatima: ‘A maternal hand guided the bullet.’ One cannot help wondering why she didn’t guide it to miss him altogether. Others might think the team of surgeons who operated on him for six hours deserved at least a share of the credit; but perhaps their hands, too, were maternally guided.

Working Memory is the brain’s workspace, where you can hold and manipulate a handful of facts and figures in your head. The reason multiplying 36 by 42 in your head is so difficult is that your working memory has limits—and the older you get, the tighter your limits. That’s why mathematicians, musicians, and physicists tend to do their most important work when they’re young . . . and why once-simple tasks get progressively more difficult with age. This the type of memory, which facilitates multitasking and juggling life’s responsibilities, is the type of memory most healthy people want to optimize. Working memory plus creativity is the key to productivity.

And sleep training? Guess who proposed that unique technique? Why, a surgeon-turned-sportswriter, of course, who wrote under the pseudonym Stonehenge. If babies “are left to go to sleep in their cots, and allowed to find out that they do not get their way by crying, they at once become reconciled, and after a short time will go to bed even more readily in the cot than on the lap,” Dr. John Henry Walsh wrote in his Manual of Domestic Economy in 1857. Besides doling out advice on infant sleep, John Henry also authored several books about guns, including The Shot-Gun and Sporting Rifle and The Modern Sportsman’s Gun and Rifle. (And he lost a big chunk of his left hand one day when a gun exploded in his grasp.)

A young person for Monsieur Jagiello,’ said the guard, with a grin. He stood away from the door, and there was the young person, holding a cloth-covered basket, blushing and hanging her pretty head. The others walked away to the window and talked in what they meant to be a detached, natural way; but few could help stealing glances at the maiden, and none could fail to hear Jagiello cry, ‘But my dear, dear Mademoiselle, I asked for black pudding and apples, no more. And here is foie gras, a gratin of lobster, a partridge, three kinds of cheese, two kinds of wine, a strawberry tart . . . ’ ‘I made it myself,’ said the young person. ‘I am sure it is wonderfully good: but it is much more than I can ever afford.’ ‘You must keep up your strength. You can pay for it later – or in some other way – or however you like.’ ‘But how?’ asked Jagiello, in honest amazement. ‘By a note of hand, do you mean?’ ‘Pray step into the passage,’ said she, pinker still. ‘There you are again,’ said Jack, drawing Stephen into another room. ‘Yesterday it was a thundering great patty, with truffles; and tomorrow we shall see a wedding-cake for his pudding, no doubt. What they see in him I cannot conceive. Why Jagiello, and the others ignored? Here is Fenton, for example, a fine upstanding fellow with side-whiskers that are the pride of the service – with a beard as thick as a coconut – has to shave twice a day – as strong as a horse, and a very fair seaman; but there are no patties for him.

Let me explain: There are all sorts of reasons why women pick one colorist over another. Some will go to you if you have the same kind of dog or because they like the way you look. Some will only go to a man, because they want to feel a man’s hands on them. Then, of course, you have the editorial mongrels, who will go only to whoever is in this month’s Elle or Allure. But no matter what brings them to you in the first place, they’ll drop you cold if you’re not a good colorist. Which means no mistakes. Not ever. Brain surgeons are allowed more mistakes than hair colorists. Don’t misunderstand me. I’m not saying that what I do is brain surgery or in any way important. Between you and me, it’s just hair. But a certain kind of woman cares about her hair. A lot.

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

IV.The wounded surgeon plies the steelThat questions the distempered part;Beneath the bleeding hands we feelThe sharp compassion of the healer's artResolving the enigma of the fever chart.Our only health is the diseaseIf we obey the dying nurseWhose constant care is not to pleaseBut to remind of our, and Adam's curse,And that, to be restored, our sickness must grow worse.The whole earth is our hospitalEndowed by the ruined millionaire,Wherein, if we do well, we shallDie of the absolute paternal careThat will not leave us, but prevents us everywhere.The chill ascends from feet to knees,The fever sings in mental wires.If to be warmed, then I must freezeAnd quake in frigid purgatorial firesOf which the flame is roses, and the smoke is briars.The dripping blood our only drink,The bloody flesh our only food:In spite of which we like to thinkThat we are sound, substantial flesh and bloodAgain, in spite of that, we call this Friday good.

Yet there is dynamism in our house. Day to day, week to week, Cady blossoms: a first grasp, a first smile, a first laugh. Her pediatrician regularly records her growth on charts, tick marks indicating her progress over time. A brightening newness surrounds her. As she sits in my lap smiling, enthralled by my tuneless singing, an incandescence lights the room. Time for me is now double-edged: every day brings me further from the low of my last relapse but closer to the next recurrence—and, eventually, death. Perhaps later than I think, but certainly sooner than I desire. There are, I imagine, two responses to that realization. The most obvious might be an impulse to frantic activity: to “live life to its fullest,” to travel, to dine, to achieve a host of neglected ambitions. Part of the cruelty of cancer, though, is not only that it limits your time; it also limits your energy, vastly reducing the amount you can squeeze into a day. It is a tired hare who now races. And even if I had the energy, I prefer a more tortoiselike approach. I plod, I ponder. Some days, I simply persist. If time dilates when one moves at high speeds, does it contract when one moves barely at all? It must: the days have shortened considerably. With little to distinguish one day from the next, time has begun to feel static. In English, we use the word time in different ways: “The time is two forty-five” versus “I’m going through a tough time.” These days, time feels less like the ticking clock and more like a state of being. Languor settles in. There’s a feeling of openness. As a surgeon, focused on a patient in the OR, I might have found the position of the clock’s hands arbitrary, but I never thought them meaningless. Now the time of day means nothing, the day of the week scarcely more. Medical training is relentlessly future-oriented, all about delayed gratification; you’re always thinking about what you’ll be doing five years down the line. But now I don’t know what I’ll be doing five years down the line. I may be dead. I may not be. I may be healthy. I may be writing. I don't know. And so it's not all that useful to spend time thinking about the future - that is, beyond lunch.

The identity of Jack the Ripper is surely one of the all-time classic crime mysteries. In the late 19th Century, the Ripper is believed by general consensus to have committed five murders (although a number of later killings did also bear his hallmarks, and the fifth of the ‘confirmed’ killings still raises a number of doubts). At the time police were stumped, even arresting a man purely on anti-Semitic hearsay before apologising and letting him go. Since then, more than eighty suspects have been proposed, from members of royalty to mad surgeons, and even a suggestion that the Ripper was in fact ‘Jill’ rather than ‘Jack’. The case became muddied when a number of letters were sent to the police; some obvious hoaxes, some in fact likely to have been written in the killer’s own hand. One even included half a kidney (it should be noted that one of the victim’s had a kidney removed at the scene of the attack) with a note saying the other half had been fried and was very nice to eat. Everyone has their own view on who the Ripper was, and why the killings stopped just as suddenly as they began.

This Sarah Perez had the most beautiful eyes in the world, those green eyes spangled with gold that you love so much: the eyes of Antinous. In Rome, such eyes would have made her a concubine of Adrian; in Madrid they helped her become the princess of Eboli ensconced in the bed of the king. But Philip II was extremely jealous of those wonderful emerald eyes and their delicate transparency, and the princess - who was bored with the funereal palace and the even more funereal society of the king - had the fancy and the misfortune to cast her admirable gaze upon the Marquis de Posa while she was leaving church one day. It was on the threshold of the chapel, and the princess believed herself to be alone with her camarera mayor, but the vigilance of the clergy was equal to the challenge. She was betrayed, and that very evening, in the intimacy of their bedroom, in the course of some violent argument or tempestuous tussle, Philip threw his mistress to the floor. Blind with rage he leapt upon her, tore out her eye and devoured it in a single gulp. 'Thus was the princess covered in blood - a good title for a conte cruel, that, which Villiers de l'Isle Adam has somehow omitted to write! The princess was henceforth one-eyed: the royal pet had a gaping hole in her face. Philip II, who had the Jewess in his blood, could not cleave so closely to a princess who had only one eye. He made amends to her with some new titles and estates in the provinces and - regretful of the beautiful green eye that he had spoiled - he caused to be inserted into the empty and bloody orbit a superb emerald enshrined in silver, upon which surgeons then inscribed the semblance of a gaze. Oculists have made progress since then; the Princess of Eboli, already hurt by the ruination of her eye, died some little time afterwards, of the effects of the operation. The ways of love and surgery were equally barbarous in the time of Philip II! 'Philip, the inconsolable lover, gave the order to remove the emerald from the face of the dead princess before she was laid in the tomb, and had it mounted in a ring. He wore it about his finger, and would never take it off, even when he went to sleep - and when he died in his turn, he had the ring bearing the green tear clasped in his right hand.

It was said of Liston by his colleagues that when he amputated, “the gleam of his knife was followed so instantaneously by the sound of sawing as to make the two actions appear almost simultaneous.” His left arm was reportedly so strong that he could use it as a tourniquet, while he wielded the knife in his right hand. This was a feat that required immense strength and dexterity, given that patients often struggled against the fear and agony of the surgeon’s assault. Liston could remove a leg in less than thirty seconds, and in order to keep both hands free, he often clasped the bloody knife between his teeth while working. Liston’s speed was both a gift and a curse. Once, he accidentally sliced off a patient’s testicle along with the leg he was amputating. His most famous (and possibly apocryphal) mishap involved an operation during which he worked so rapidly that he took off three of his assistant’s fingers and, while switching blades, slashed a spectator’s coat. Both the assistant and the patient died later of gangrene, and the unfortunate bystander expired on the spot from fright. It is the only surgery in history said to have had a 300 percent fatality rate.

My luminaries!" he sang out. "I am thrilled to have you here. I have been rereading both your works in preparation for our glorious collaboration." "Collaboration?" "You will forgive my enthusiasm and my presumption. But you must accept that what we are here today to do with each other cannot be subsumed under the mantle of medical procedure alone. For me to put the scalpel into your hand, my dearest Monsieur Arosteguy, is basically a crime, you understand. Though I fully comprehend the emotional ownership of the breast involved with the husband and the wife. In the light of that ownership, the alien surgeon is an intruder, a rapist, a violator. Why should he be allowed to sever that most beautiful organ from that beloved body? Who the fuck is he anyway? No, only the husband should have the right to do that intimate severing with all its resonances of personal history. And so on. But legally it's a crime. So what's the solution in our heads? In my head, the solution is that we are not committing surgery, but are creating an art/philosophy / crime/ surgery project. The three of us. A collective. The Arosteguy Collective Project. Do you agree?" Celestine and I glanced at each other and could see that we were immediately in sync. We were overwhelmed, horrified, and also delighted.

Gentlemen,” the king called out, “and ladies, First Meal is getting cold.” Which was the cue for everyone to head back to the dining room and actually eat what had been only studiously ignored up until now. With Payne safe and at home, appetites were free to roam once more . . . although as God was his witness he was not going to think about what the hell that surgeon and his sister were no doubt about to get into. As he groaned, Jane tightened her arm around his waist. “Are you all right?” He glanced down at his shellan. “I don’t think my sister is old enough to have sex.” “V, she’s the same age you are.” He frowned for a moment. Was she? Or had he been born first? Yeah, only one place to go for the answer to that. Shit, he hadn’t even thought of his mother in all this. And now that he was . . . he had absolutely no desire or interest to pop up there and announce that Payne was doing great, fuck you very much. Nope. If the Scribe Virgin wanted to keep tabs on what her “children” were up to? She could look into those fakakta seeing bowls she liked so much. He kissed his shellan. “I don’t care what the calendar says or about the birth order. That’s my baby sister, and she’s never going to be old enough to . . . ‘um, yeah.’ ” Jane laughed and retucked herself under his arm. “You are a very sweet male.” “Nah.” “Yeah.” Leading her into the dining room and over to the table, he gallantly pulled her chair out for her, and then he sat to her left so that she was at his dagger hand. - Vishous & Jane

In Hiding - coming summer of 2020 WAYNE ANTHONY SEEKS REDEMPTION FROM A BAD DAY - Although warned about getting the stitches wet, he believed a hot shower was the only road to his redemption. Experienced taught him the best way to relieve the tightness in his lower back was by standing beneath the near-scalding water. Dropping the rest of his clothing, he turned the shower on full blast. The hot water rushed from the showerhead filling the tiny room with steam, instantly the small mirror on the medicine cabinet fogged up. The man quietly pulled the shower curtain back and entered the shower stall without a sound. Years of acting as another’s shadow had trained him to live soundlessly. The hot water cascaded over his body as the echo from the pounding water deadened slightly. Grabbing the sample sized soap, he pulled the paper off and tossed the wrapper over the curtain rail. Wayne rubbed the clean smelling block until his large hands disappeared beneath the lather. He ignored the folded washcloth, opting to use his hands across his body. Gently he cleaned the injury allowing the slime of bacterial soap to remove the residual of the rust-colored betadine. All that remained when he finished was the pale orange smear from the antiseptic. This scar was not the only mar to his body. The water cascaded down hard muscles making rivulets throughout the thatches of dark hair. He raised his arms gingerly as he washed beneath them; the tight muscles of his abdomen glistened beneath the torrent of water. Opening a bottle of shampoo-slash-conditioner, he applied a dab then ran his hands across his scalp. Finally, the tension in his square jaw had eased, making his handsome face more inviting. The cords of his neck stood out as he rinsed the shampoo from his hair. It coursed down his chest leading down to his groin where the scented wash caught in his pelvic hair. Wayne's body was one of perfection for any woman; if that was, she could ignore the mutilations. Knife injuries left their mark with jagged white lines. Most of these, he had doctored himself; his lack of skill resulted in crude scars. The deepest one, undulated along the left side of his abdomen, that one had required the art of a surgeon. Dropping his arms, he surrenders himself to the pelting deluge from the shower. The steamy water cascaded down his body, pulling the soap toward the drain. Across his back, it slid down several small indiscernible pockmarks left by gunshot wounds, the true extent of their damage far beneath his skin. Slowly the suds left his body, snaking down his muscular legs. It slithered down the scars on his left knee, the result of replacement surgery after a thug took a bat to it. Wayne stood until the hot water cooled, and ran translucent over his body. Finally, he washes the impact of the long day from his mind and spirit.

Though it’s best not to be born a chicken at all, it is especially bad luck to be born a cockerel. From the perspective of the poultry farmer, male chickens are useless. They can’t lay eggs, their meat is stringy, and they’re ornery to the hens that do all the hard work of putting food on our tables. Commercial hatcheries tend to treat male chicks like fabric cutoffs or scrap metal: the wasteful but necessary by-product of an industrial process. The sooner they can be disposed of—often they’re ground into animal feed—the better. But a costly problem has vexed egg farmers for millennia: It’s virtually impossible to tell the difference between male and female chickens until they’re four to six weeks old, when they begin to grow distinctive feathers and secondary sex characteristics like the rooster’s comb. Until then, they’re all just indistinguishable fluff balls that have to be housed and fed—at considerable expense. Somehow it took until the 1920s before anyone figured out a solution to this costly dilemma. The momentous discovery was made by a group of Japanese veterinary scientists, who realized that just inside the chick’s rear end there is a constellation of folds, marks, spots, and bumps that to the untrained eye appear arbitrary, but when properly read, can divulge the sex of a day-old bird. When this discovery was unveiled at the 1927 World Poultry Congress in Ottawa, it revolutionized the global hatchery industry and eventually lowered the price of eggs worldwide. The professional chicken sexer, equipped with a skill that took years to master, became one of the most valuable workers in agriculture. The best of the best were graduates of the two-year Zen-Nippon Chick Sexing School, whose standards were so rigorous that only 5 to 10 percent of students received accreditation. But those who did graduate earned as much as five hundred dollars a day and were shuttled around the world from hatchery to hatchery like top-flight business consultants. A diaspora of Japanese chicken sexers spilled across the globe. Chicken sexing is a delicate art, requiring Zen-like concentration and a brain surgeon’s dexterity. The bird is cradled in the left hand and given a gentle squeeze that causes it to evacuate its intestines (too tight and the intestines will turn inside out, killing the bird and rendering its gender irrelevant). With his thumb and forefinger, the sexer flips the bird over and parts a small flap on its hindquarters to expose the cloaca, a tiny vent where both the genitals and anus are situated, and peers deep inside. To do this properly, his fingernails have to be precisely trimmed. In the simple cases—the ones that the sexer can actually explain—he’s looking for a barely perceptible protuberance called the “bead,” about the size of a pinhead. If the bead is convex, the bird is a boy, and gets thrown to the left; concave or flat and it’s a girl, sent down a chute to the right.

The seventh day, and no wind—the burning sun Blister’d and scorch’d, and, stagnant on the sea, They lay like carcasses; and hope was none, Save in the breeze that came not; savagely They glared upon each other—all was done, Water, and wine, and food,—and you might see The longings of the cannibal arise (Although they spoke not) in their wolfish eyes. At length one whisper’d his companion, who Whisper’d another, and thus it went round, And then into a hoarser murmur grew, An ominous, and wild, and desperate sound; And when his comrade’s thought each sufferer knew, ’Twas but his own, suppress’d till now, he found: And out they spoke of lots for flesh and blood, And who should die to be his fellow’s food. But ere they came to this, they that day shared Some leathern caps, and what remain’d of shoes; And then they look’d around them and despair’d, And none to be the sacrifice would choose; At length the lots were torn up, and prepared, But of materials that much shock the Muse— Having no paper, for the want of better, They took by force from Juan Julia’s letter. The lots were made, and mark’d, and mix’d, and handed, In silent horror, and their distribution Lull’d even the savage hunger which demanded, Like the Promethean vulture, this pollution; None in particular had sought or plann’d it, ’Twas nature gnaw’d them to this resolution, By which none were permitted to be neuter— And the lot fell on Juan’s luckless tutor. He but requested to be bled to death: The surgeon had his instruments, and bled Pedrillo, and so gently ebb’d his breath, You hardly could perceive when he was dead. He died as born, a Catholic in faith, Like most in the belief in which they’re bred, And first a little crucifix he kiss’d, And then held out his jugular and wrist. The surgeon, as there was no other fee, Had his first choice of morsels for his pains; But being thirstiest at the moment, he Preferr’d a draught from the fast-flowing veins: Part was divided, part thrown in the sea, And such things as the entrails and the brains Regaled two sharks, who follow’d o’er the billow The sailors ate the rest of poor Pedrillo. The sailors ate him, all save three or four, Who were not quite so fond of animal food; To these was added Juan, who, before Refusing his own spaniel, hardly could Feel now his appetite increased much more; ’Twas not to be expected that he should, Even in extremity of their disaster, Dine with them on his pastor and his master. ’Twas better that he did not; for, in fact, The consequence was awful in the extreme; For they, who were most ravenous in the act, Went raging mad—Lord! how they did blaspheme! And foam and roll, with strange convulsions rack’d, Drinking salt water like a mountain-stream, Tearing, and grinning, howling, screeching, swearing, And, with hyaena-laughter, died despairing. Their numbers were much thinn’d by this infliction, And all the rest were thin enough, Heaven knows; And some of them had lost their recollection, Happier than they who still perceived their woes; But others ponder’d on a new dissection, As if not warn’d sufficiently by those Who had already perish’d, suffering madly, For having used their appetites so sadly. And if Pedrillo’s fate should shocking be, Remember Ugolino condescends To eat the head of his arch-enemy The moment after he politely ends His tale: if foes be food in hell, at sea ’Tis surely fair to dine upon our friends, When shipwreck’s short allowance grows too scanty, Without being much more horrible than Dante.