Surgery Day Quotes

Watching my parents I've learnt a lesson many do not recognize. True love is not signaled by romantic, candle light dinners, red roses glistening with dew, or even Valentine's day celebrations. While these things may accompany our feelings, love is truly more than all those! Love is being with your spouse even when its not pleasing. Sometimes, love is walking down the hall, with your spouse hanging onto your shoulders and walking at a turtle's pace down the hall, just because surgery made life a burden. Love is patient, love is kind, love is Jesus! May we always remember love is not always tied in bows!

I didn't expect to recover from my second operation but since I did, I consider that I'm living on borrowed time. Every day that dawns is a gift to me and I take it in that way. I accept it gratefully without looking beyond it. I completely forget my physical suffering and all the unpleasantness of my present condition and I think only of the joy of seeing the sun rise once more and of being able to work a little bit, even under difficult conditions.

I chose the specialty of surgery because of Matron, that steady presence during my boyhood and adolescence. 'What is the hardest thing you can possibly do?' she said when I went to her for advice on the darkest day of the first half of my life. I squirmed. How easily Matron probed the gap between ambition and expediency. 'Why must I do what is hardest?' 'Because, Marion, you are an instrument of God. Don't leave the instrument sitting in its case my son. Play! Leave no part of your instrument unexplored. Why settle for 'Three Blind Mice' when you can play the 'Gloria'? 'But, Matron, I can't dream of playing Bach...I couldn't read music. 'No, Marion,' she said her gaze soft...'No, not Bach's 'Gloria'. Yours! Your 'Gloria' lives within you. The greatest sin is not finding it, ignoring what God made possible in you.

Assimilate ubiquitously. Doublethink. To deliberately believe in lies, while knowing they're false. Examples of this in everyday life: "oh, I need to be pretty to be happy. I need surgery to be pretty. I need to be thin, famous, fashionable.". Our young men today are being told that women are **, **, things to be **, beaten, **, and shamed. This is a marketing holocaust. Twenty-fours hours a day for the rest of our lives, the powers that be are hard at work dumbing us to death. So to defend ourselves, and fight against assimilating this dullness into our thought processes, we must learn to read. To stimulate our own imagination, to cultivate our own consciousness, our own belief systems. We all need skills to defend, to preserve, our own minds.

Whether I was a genius or not did not so much concern me as the fact that I simply did not want a part of anything. The animal-drive and energy of my fellow man amazed me: that a man could change tires all day long or drive an ice cream truck or run for Congress or cut into a man's guts in surgery or murder, this was all beyond me. I did not want to begin. I still don't. Any day I that I could cheat away from this system of living seemed a good victory for me.

Time stops when someone dies. Of course it stops for them, maybe, but for the mourners time runs amok. Death comes too soon. It forgets the tides, the days growing longer and shorter, the moon. It rips up the calendar. You aren't at your desk or on the subway or fixing dinner for the children. You're reading People in a surgery waiting room, or shivering outside on a balcony smoking all night long. you stare into space, sitting in your childhood bedroom with the lobe on the desk... The bad part is that when you return to your ordinary life all the routines, the marks of the day, seem like senseless lies. all is suspect, a trick to lull us, rock us back into the placid relentlessness of time.

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.

In these days before antiseptics, doctors themselves also suffered high mortality rates. Florence Nightingale, a nurse during the Crimean War (1853-1856), watched one particularly inept surgeon cut both himself and, somehow, a bystander while blundering about during an amputation. Both men contracted an infection and died, as did the patient. Nightingale commented that it was the only surgery she'd ever seen with 300 percent mortality.

Most medical students go through a brief period when they develop all manner of imaginary illnesses – I myself had leukaemia for at least four days – until they learn, as a matter of self-preservation, that illnesses happen to patients, not to doctors.

ELM I know the bottom, she says. I know it with my great tap root: It is what you fear. I do not fear it: I have been there. Is it the sea you hear in me, Its dissatisfactions? Or the voice of nothing, that was your madness? Love is a shadow. How you lie and cry after it Listen: these are its hooves: it has gone off, like a horse. All night I shall gallop thus, impetuously, Till your head is a stone, your pillow a little turf, Echoing, echoing. Or shall I bring you the sound of poisons? This is rain now, this big hush. And this is the fruit of it: tin-white, like arsenic. I have suffered the atrocity of sunsets. Scorched to the root My red filaments burn and stand, a hand of wires. Now I break up in pieces that fly about like clubs. A wind of such violence Will tolerate no bystanding: I must shriek. The moon, also, is merciless: she would drag me Cruelly, being barren. Her radiance scathes me. Or perhaps I have caught her. I let her go. I let her go Diminished and flat, as after radical surgery. How your bad dreams possess and endow me. I am inhabited by a cry. Nightly it flaps out Looking, with its hooks, for something to love. I am terrified by this dark thing That sleeps in me; All day I feel its soft, feathery turnings, its malignity. Clouds pass and disperse. Are those the faces of love, those pale irretrievables? Is it for such I agitate my heart? I am incapable of more knowledge. What is this, this face So murderous in its strangle of branches?—— Its snaky acids hiss. It petrifies the will. These are the isolate, slow faults That kill, that kill, that kill. --written 19 April 1962

If you tell me Christian commitment is a kind of thing that has happened to you once and for all like some kind of spiritual plastic surgery, I say go to, go to, you're either pulling the wool over your own eyes or trying to pull it over mine. Every morning you should wake up in your bed and ask yourself: "Can I believe it all again today?" No, better still, don't ask it till after you've read The New York Times, till after you've studied that daily record of the world's brokenness and corruption, which should always stand side by side with your Bible. Then ask yourself if you can believe in the Gospel of Jesus Christ again for that particular day. If your answer's always Yes, then you probably don't know what believing means. At least five times out of ten the answer should be No because the No is as important as the Yes, maybe more so. The No is what proves you're human in case you should ever doubt it. And then if some morning the answer happens to be really Yes, it should be a Yes that's choked with confession and tears and. . . great laughter.

...she figured out that she was such a mess not because she was trans, but because being trans is so stigmatized. If you could leave civilization for a year, like live in an abandoned shopping mall out in the desert giving yourself injections of estrogen, working on your voice, figuring out how to dress yourself all over again and meditating eight hours a day on gendered socialization, and then get bottom surgery as a reward, it would be pretty easy to transition.

Healthy people, I have concluded, including myself, do not understand how everything changes once you have been diagnosed with a fatal illness. How you cling to hope, however false, however slight, and how reluctant most doctors are to deprive patients of that fragile beam of light in so much darkness. Indeed, many people develop what psychiatrists call ‘dissociation’ and a doctor can find himself talking to two people – they know that they are dying and yet still hope that they will live. I had noticed the same phenomenon with my mother during the last few days of her life. When faced by people who are dying you are no longer dealing with the rational consumers assumed by economic model-builders, if they ever existed in the first place.

The night before brain surgery, I thought about death. I searched out my larger values, and I asked myself, if I was going to die, did I want to do it fighting and clawing or in peaceful surrender? What sort of character did I hope to show? Was I content with myself and what I had done with my life so far? I decided that I was essentially a good person, although I could have been better--but at the same time I understood that the cancer didn't care. I asked myself what I believed. I had never prayed a lot. I hoped hard, I wished hard, but I didn't pray. I had developed a certain distrust of organized religion growing up, but I felt I had the capacity to be a spiritual person, and to hold some fervent beliefs. Quite simply, I believed I had a responsibility to be a good person, and that meant fair, honest, hardworking, and honorable. If I did that, if I was good to my family, true to my friends, if I gave back to my community or to some cause, if I wasn't a liar, a cheat, or a thief, then I believed that should be enough. At the end of the day, if there was indeed some Body or presence standing there to judge me, I hoped I would be judged on whether I had lived a true life, not on whether I believed in a certain book, or whether I'd been baptized. If there was indeed a God at the end of my days, I hoped he didn't say, 'But you were never a Christian, so you're going the other way from heaven.' If so, I was going to reply, 'You know what? You're right. Fine.' I believed, too, in the doctors and the medicine and the surgeries--I believed in that. I believed in them. A person like Dr. Einhorn [his oncologist], that's someone to believe in, I thought, a person with the mind to develop an experimental treatment 20 years ago that now could save my life. I believed in the hard currency of his intelligence and his research. Beyond that, I had no idea where to draw the line between spiritual belief and science. But I knew this much: I believed in belief, for its own shining sake. To believe in the face of utter hopelessness, every article of evidence to the contrary, to ignore apparent catastrophe--what other choice was there? We do it every day, I realized. We are so much stronger than we imagine, and belief is one of the most valiant and long-lived human characteristics. To believe, when all along we humans know that nothing can cure the briefness of this life, that there is no remedy for our basic mortality, that is a form of bravery. To continue believing in yourself, believing in the doctors, believing in the treatment, believing in whatever I chose to believe in, that was the most important thing, I decided. It had to be. Without belief, we would be left with nothing but an overwhelming doom, every single day. And it will beat you. I didn't fully see, until the cancer, how we fight every day against the creeping negatives of the world, how we struggle daily against the slow lapping of cynicism. Dispiritedness and disappointment, these were the real perils of life, not some sudden illness or cataclysmic millennium doomsday. I knew now why people fear cancer: because it is a slow and inevitable death, it is the very definition of cynicism and loss of spirit. So, I believed.

By the time he was twenty Asclepius had mastered all the arts of surgery and medicine. He embraced his teacher Chiron in a fond farewell and left to set up on his own as the world’s first physician, apothecary and healer. His fame spread around the Mediterranean with great speed. The sick, lame and unhappy flocked to his surgery, outside which he hung a sign – a wooden staff with a snake twined round it, seen to this day on many ambulances, clinics and (often disreputable) medical websites.

Listen to me and listen to me good,” she ground out. “You are an asshole. You don’t tell me what to do, ever. The day you control my life, well, that day is when hell freezes over. I’m not some weak little wife type, asshole, and I don’t need a man to control me or tell me what to do. If you ever try to pull this shit again I’ll show you weak when they have to surgically remove my shoe from your ass. When you walk in the door of my house after you find a way back there, you have five minutes to pack up your things and get the hell out or you’ll need that surgery. I want you to get on a plane, take your miserable, bitchy little bald ass out of my life, and don’t ever come near me again. Do you hear me?

I watched that plant in the office every day. Watered it; misted it. I loved thinking about it like G.T. said, but part of me was worried the tree surgery wouldn't take. Something would go wrong and then I"d be stuck with a metaphor that couldn't go the distance.

pleaded every day” with Jobs and found it “enormously frustrating that I just couldn’t connect with him.” The fights almost ruined their friendship. “That’s not how cancer works,” Levinson insisted when Jobs discussed his diet treatments. “You cannot solve this without surgery and blasting it with toxic chemicals.” Even Dr. Dean Ornish, a pioneer in alternative and nutritional methods of treating diseases, took a long walk with Jobs and insisted that sometimes traditional

In these days of physical fitness, hair dye, and plastic surgery, you can live much of your life without feeling or even looking old. But then one day, your knee goes, or your shoulder, or your back, or your hip. Your hot flashes come to an end; things droop. Spots appear. Your cleavage looks like a peach pit. If your elbows faced forward, you would kill yourself. You’re two inches shorter than you used to be. You’re ten pounds fatter and you cannot lose a pound of it to save your soul. Your hands don’t work as well as they once did and you can’t open bottles, jars, wrappers, and especially those gadgets that are encased tightly in what seems to be molded Mylar. If you were stranded on a desert island and your food were sealed in plastic packaging, you would starve to death. You take so many pills in the morning you don’t have room for breakfast. You lose close friends and discover one of the worst truths of old age: they’re irreplaceable. People who run four miles a day and eat only nuts and berries drop dead. People who drink a quart of whiskey and smoke two packs of cigarettes a day drop dead. You are suddenly in a lottery, the ultimate game of chance, and someday your luck will run out. Everybody dies. There’s nothing you can do about it. Whether or not you eat six almonds a day. Whether or not you believe in God.

Veeva squirmed up and down the length of me, vibrating like a coin operated motel bed. When she stopped kissing my mouth, I said, "It sounds so great, Veeva. Just you and me with our brand new plastic surgery noses, running for our lives, hating each other’s guts... Both of us getting to look more and more like Michael Jackson every day.

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.

It turns out that steroids given during surgery can result in mania within days or weeks.

It’s going to take a couple of years, but I’m determined to have my own veterinary surgery one day.

Note to self: Try to extend positive feelings associated with Scratch-Off win into all areas of life. Be bigger presence at work. Race up ladder (joyfully, w/smile on face), get raise. Get in best shape of life, start dressing nicer. Learn guitar? Make point of noticing beauty of world? Why not educate self re. birds, flowers, trees, constellations, become true citizen of natural world, walk around neighborhood w/kids, patiently teaching kids names of birds, flowers, etc. etc.? Why not take kids to Europe? Kids have never been. Have never, in Alps, had hot chocolate in mountain café, served by kindly white-haired innkeeper, who finds them so sophisticated/friendly relative to usual snotty/rich American kids (who always ignore his pretty but crippled daughter w/braids) that he shows them secret hiking path to incredible glade, kids frolic in glade, sit with crippled pretty girl on grass, later say it was most beautiful day of their lives, keep in touch with crippled girl via email, we arrange surgery here for her, surgeon so touched he agrees to do surgery for free, she is on front page of our paper, we are on front page of their paper in Alps? Ha ha. Just happy.

Stolen bodies working stolen land. It was an engine that did not stop, its hungry boiler fed with blood. With the surgeries that Dr. Stevens described, Cora thought, the whites had begun stealing futures in earnest. Cut you open and rip them out, dripping. Because that's what you do when you take away someone's babies - steal their future. Torture them as much as you can when they are on this earth, then take away the hope that one day their people will have it better.

You’re that reason, Portia. My reason. The reason I get out of my bed every morning. The reason I didn’t give a shit about cochlear implants and exploratory surgery. The reason I Google bird trivia and even venture into secondhand bookshops. It’s all for you. Silent you, talking you, I don’t care. It’s like I told you that day all those years ago – you are my forever.

As I was editing this chapter, a survey of more than thirty-five hundred Australian surgeons revealed a culture rife with bullying, discrimination, and sexual harassment, against women especially (although men weren’t untouched either). To give you a flavor of professional life as a woman in this field, female trainees and junior surgeons “reported feeling obliged to give their supervisors sexual favours to keep their jobs”; endured flagrantly illegal hostility toward the notion of combining career with motherhood; contended with “boys’ clubs”; and experienced entrenched sexism at all levels and “a culture of fear and reprisal, with known bullies in senior positions seen as untouchable.”68 I came back to this chapter on the very day that news broke in the state of Victoria, Australia, where I live, of a Victorian Equal Opportunity and Human Rights Commission report revealing that sexual discrimination and harassment is also shockingly prevalent in the Victorian Police, which unlawfully failed to provide an equal and safe working environment.69 I understand that attempts to identify the psychological factors that underlie sex inequalities in the workplace are well-meaning. And, of course, we shouldn’t shy away from naming (supposedly) politically unpalatable causes of those inequalities. But when you consider the women who enter and persist in highly competitive and risky occupations like surgery and policing—despite the odds stacked against them by largely unfettered sex discrimination and harassment—casual scholarly suggestions that women are relatively few in number, particularly in the higher echelons, because they’re less geared to compete in the workplace, start to seem almost offensive. Testosterone

Although Liston was renowned for his success stories—such as the removal of a forty-five-pound scrotal tumor in four minutes; prior to the operation, the poor patient had been forced to carry his scrotum around in a wheelbarrow—he also developed a reputation for the flamboyancy of his surgical failures. For instance, his joy at amputating a patient’s leg at the thigh in less than three minutes was hindered greatly when he realized he had also inadvertently sawed off the patient’s testicles. And perhaps, most famously, another leg amputation performed in less than three minutes had the unfortunate result of killing three people: the patient (who survived the surgery but died of gangrene several days later); his young assistant (whose fingers he accidentally sawed off during surgery and who would also later succumb to gangrene); and “a distinguished surgical spectator” whose coattails Liston also slashed. The man, who found himself surrounded by geysers of blood, was so convinced that the knife had pierced his vitals that he immediately “dropped dead from fright.” It was later described as “the only operation in history with a 300 percent mortality [rate].

he’s not real I can take his space. As I get into bed beside him, the strongman vanishes. I pick up my diary and record him: was there, isn’t any more. This happened in early July, 2010. I had surgery on the first of the month, and was scheduled to stay in hospital for about nine days. The last thing the surgeon said to me, on the afternoon of the procedure: ‘For you, this is a big thing, but remember, to us it is routine.’ The operation was to relieve a stricture in my bowel, before it closed completely and created an emergency. But though we had used the latest scans in preparation, neither

These days, there are so few pure country people left on the concession roads that we may be in need of a new category of membership, much as sons and daughters of veterans are now allowed to join the Legion. A few simple questions could be asked, a small fee paid and (assuming that the answers are correct) you could be granted the status of an "almost local." Here are some of the questions you might be asked: Do you have just one suit for weddings and funerals? Do you save plastic buckets? Do you leave your car doors unlocked at all times? Do you have an inside dog and an outside dog? Has your outside dog never been to town? When you pass a neighbour in the car, do you wave from the elbow or do you merely raise one finger from the steering wheel? Do you have trouble keeping the car or truck going in a straight line because you are looking at crops or livestock? Do you sometimes find yourself sitting in the car in the middle of a dirt road chatting with a neighbour out the window while other cars take the ditch to get around you? Can you tell whose tractor is going by without looking out the window? Can people recognize you from three hundred yards away by the way you walk or the tilt of your hat? If somebody honks their horn at you, do you automatically smile and wave? Do most of your conversations open with some observation about the weather? Is your most important news source the store in the village? Have you had surgery in the local hospital? If you hear about a death or a fire in the community, does the woman in your house immediately start making sandwiches or a cake? Do you sometimes find yourself referring to a farm in the neighbourhood by the name of someone who owned it more than twenty-five years ago? If you answered yes to all of the above questions, consider it official: you are a local.

EVERY WEDNESDAY, I teach an introductory fiction workshop at Harvard University, and on the first day of class I pass out a bullet-pointed list of things the students should try hard to avoid. Don’t start a story with an alarm clock going off. Don’t end a story with the whole shebang having been a suicide note. Don’t use flashy dialogue tags like intoned or queried or, God forbid, ejaculated. Twelve unbearably gifted students are sitting around the table, and they appreciate having such perimeters established. With each variable the list isolates, their imaginations soar higher. They smile and nod. The mood in the room is congenial, almost festive with learning. I feel like a very effective teacher; I can practically hear my course-evaluation scores hitting the roof. Then, when the students reach the last point on the list, the mood shifts. Some of them squint at the words as if their vision has gone blurry; others ask their neighbors for clarification. The neighbor will shake her head, looking pale and dejected, as if the last point confirms that she should have opted for that aseptic-surgery class where you operate on a fetal pig. The last point is: Don’t Write What You Know. The idea panics them for two reasons. First, like all writers, the students have been encouraged, explicitly or implicitly, for as long as they can remember, to write what they know, so the prospect of abandoning that approach now is disorienting. Second, they know an awful lot. In recent workshops, my students have included Iraq War veterans, professional athletes, a minister, a circus clown, a woman with a pet miniature elephant, and gobs of certified geniuses. They are endlessly interesting people, their lives brimming with uniquely compelling experiences, and too often they believe those experiences are what equip them to be writers. Encouraging them not to write what they know sounds as wrongheaded as a football coach telling a quarterback with a bazooka of a right arm to ride the bench. For them, the advice is confusing and heartbreaking, maybe even insulting. For me, it’s the difference between fiction that matters only to those who know the author and fiction that, well, matters.

Then the long nights, that were also days, in the hospital. And the long blanks, that were also nights. Needles, and angled glass rods to suck water through. Needles, and curious enamel wedges slid under your middle. Needles, and - needles and needles and needles. Like swarms of persistent mosquitoes with unbreakable drills. The way a pincushion feels, if it could feel. Or the target of a porcupine. Or a case of not just momentary but permanently endured static electricity after you scuff across a woolen rug and then put your finger on a light switch. Even food was a needle - a jab into a vein... ("For The Rest Of Her Life")

Alexander the Magnus was once called to solve the following challenge in the Phrygian city of Gordium (as usual with Greek stories, in modern-day Turkey). When he entered Gordium, he found an old wagon, its yoke tied with a multitude of knots, all so tightly entangled that it was impossible to figure out how they were fastened. An oracle had declared that he who would untie the knot would rule all of what was then called “Asia,” that is, Asia Minor, the Levant, and the Middle East. After wrestling with the knot, the Magnus drew back from the lump of gnarled ropes, then made a proclamation that it didn’t matter for the prophecy how the tangle was to be unraveled. He then drew his sword and, with a single stroke, cut the knot in half. No “successful” academic could ever afford to follow such a policy. And no Intellectual Yet Idiot. It took medicine a long time to realize that when a patient shows up with a headache, it is much better to give him aspirin or recommend a good night’s sleep than do brain surgery, although the latter appears to be more “scientific.” But most “consultants” and others paid by the hour are not there yet.

The fact is, women aren’t having cosmetic surgery to stay beautiful. As Naomi Wolf wrote in The Beauty Myth more than twenty years ago, many women who undergo surgery are fighting to stay loved, relevant, employed, admired; they’re fighting against time running out. If they simply age naturally, don’t diet or dye their hair, we feel they’ve “let themselves go.” But if they continue to dress youthfully we feel they’re “trying too hard” or brand them as “slappers.” Poor Madonna, who has dared to be in her fifties. In order not to look like a woman in her sixth decade of life she exercises furiously, and is sniggered at by trashy magazines for having overly muscular arms and boytoy lovers. When Demi Moore’s marriage to Ashton Kutcher, fifteen years her junior, recently broke down, the media reaction was almost gleeful. Of course, it was what they had been waiting for all along: how long could a forty-eight-year-old woman expect to keep a thirty-three-year-old man? As allegations of his infidelity emerged, the Internet was flooded with images of Demi looking gaunt and unhappy—and extremely thin. Sometimes you want to say: just leave them alone. Then again, it’s mostly women who buy these magazines, and women who write the editorials and online comments and gossip columns, so you could say we’re our own worst enemies. There is already plenty of ageism and sexism out there—why do we add to the body hatred?

Negative lifestyle choices and high job stress led me down a path of alcohol and nicotine abuse, and eventually open heart surgery.

It was past seven o’clock in the evening and she’d already done a full day of appointments and surgeries.

Absenteeism runs rife, with too many unethical doctors willing to supply fake illness certificates. "My dentist was flummoxed when he was asked by a Finanza major to provide his wife with a (false) certificate claiming he’d been performing oral surgery on her on a day she had skipped work. But he did it. “What else could I do? I mean, I might need the guy for a favor sometime.

Children lose contact with their parents, and vice versa, when there is no present living moment in the family. You change careers, go traveling, play extreme sports, get plastic surgery, drive fast cars, take exotic holidays, or redecorate the house, constantly seeking presence. These strategies might work for an hour, a day, or a year, but they will not solve your inner deadness.

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.

Go be a sister, I say to her in my mind. Take her for ice cream dates, just the two of you. Bicker over what your parents let one of you do that the other can’t. Sit with her after a fight a fight with a friend or a rough day at school. Hold hands in the waiting room when one of your parents is in surgery. Savor the moments where you get lost in something together – a project, a game, making pancakes, a road trip. Go be a sister.

And so I recognized that my sojourn into open-heart territory was ultimately an open heart journey in another sense, a spiritual journey of awakening—to the reality that I am here in this life with a purpose, and have been from the day I was born.

I discussed in detail what to expect over the next couple of days: what the surgery entailed; how we'd shave only a small strip of her hair to keep it cosmetically appealing; how her arm would likely get a little weaker afterward but then stronger again; that if all went well, she'd be out of the hospital in three days; that this was just the first step in a marathon; that getting rest was important; and that I didn't expect them to retain anything I had just said and we'd go over everything again.

Oh? I thought you were a soldier. Is it not your purpose, to make endings? Is it not your duty to make these”—she taps the corpse—“from the soldiers of the enemy?” “That’s a gross perversion of the idea of soldiering,” says Mulaghesh. “Then please,” says Rada, looking up. “Enlighten me.” She is not being sarcastic or combative, Mulaghesh realizes. Rather, she is willing to follow any string of conversation down the path it leads, much like she’s willing to follow a damaged vein through a desiccated corpse. The surgery room is quiet as Mulaghesh thinks, the silence broken only by the tinkle of Rada’s utensils and the soft hush of the rain. “The word everyone forgets,” says Mulaghesh, “is ‘serve.’ ” “Serve?” “Yes. Serve. This is the service, and we soldiers are servants. Sure, when people think of a soldier, they think of soldiers taking. They think of us taking territory, taking the enemy, taking a city or a country, taking treasure, or blood. This grand, abstract idea of ‘taking,’ as if we were pirates, swaggering and brandishing our weapons, bullying and intimidating people. But a soldier, a true soldier, I think, does not take. A soldier gives.” “Gives what?” “Anything,” says Mulaghesh. “Everything, if asked of us. We’re servants, as I said. A soldier serves not to take, they don’t strive to have something, but rather they strive so that others might one day have something. And a blade isn’t a happy friend to a soldier, but a burden, a heavy one, to be used scrupulously and carefully. A good soldier does everything they can so they do not have to kill. That’s what training is for. But if we have to, we will. And when we do that we give up some part of ourselves, as we’re asked to do.” “What part do you give up, do you think?” asks Rada. “Peace, maybe. Killing echoes inside you. It never goes away. Maybe some who have killed don’t know that they’ve lost something, but they have.” “That is so,” says Rada quietly. “Deaths of all kinds echo on. And sometimes, it seems, they drown out all of life.

Sweetheart, I’ve been there with you through all of it. I was the one who camped out with you in that old tree house for days on end and held you after your mom died. It was me who sat with you while we waited for your sister to come out of the surgery that cut out her cancer. I was the one holding your hand while we waited for those test results to come back, and I was the one who supplied the alcohol to get you drunk, and the shoulder to cry on while you processed it. I understand. You don’t have to do this alone.

Be bigger presence at work. Race up ladder (joyfully, w/smile on face), get raise. Get in best shape of life, start dressing nicer. Learn guitar? Make point of noticing beauty of world? Why not educate self re. birds, flowers, trees, constellations, become true citizen of natural world, walk around neighborhood w/kids, patiently teaching kids names of birds, flowers, etc. etc.? Why not take kids to Europe? Kids have never been. Have never, in Alps, had hot chocolate in mountain café, served by kindly white- haired innkeeper, who finds them so sophisticated/friendly relative to usual snotty/rich American kids (who always ignore his pretty but crippled daughter w/braids) that he shows them secret hiking path to incredible glade, kids frolic in glade, sit with crippled pretty girl on grass, later say it was most beautiful day of their lives, keep in touch with crippled girl via email, we arrange surgery here for her, surgeon so touched he agrees to do surgery for free, she is on front page of our paper, we are on front page of their paper in Alps? Ha ha.

Sighs, the rhythms of our heartbeats, contractions of childbirth, orgasms, all flow into time just as pendulum clocks placed next to one another soon beat in unison. Fireflies in a tree flash on and off as one. The sun comes up and it goes down. The moon waxes and wanes and usually the morning paper hits the porch at six thirty-five. Time stops when someone dies. Of course it stops for them, maybe, but for the mourners time runs amok. Death comes too soon. It forgets the tides, the days growing longer and shorter, the moon. It rips up the calendar. You aren't at your desk or on the subway or fixing dinner for the children. You're reading People in a surgery waiting room, or shivering outside on a balcony smoking all night long. You stare into space, sitting in your childhood bedroom with the globe on the desk. Persia, the Belgian Congo. The bad part is that when you return to your ordinary life all the routines, the marks of the day, seem like senseless lies. All is suspect, a trick to lull us, to rock us back into the placid relentlessness of time.

Happy Valentine's Day, baby. No matter what, Gavin will always be your little boy. The first woman he ever asked to marry him. Even when he's in fifth grade and those little bitches pull out the big guns and start getting boob jobs and vaginal rejuvenation surgeries.

A couple months after school started that year, I just plain stopped going to see the Maje. I remember coming home one day and checking the answering machine in my bedroom. The first message was from the Maje. He was waiting for me to come over. He sounded feeble and desperate: "Steve, where are you? I need you? Are you coming? Please . . ." I deleted it. The next message was also from the Maje and said pretty much the same thing. Delete. There must have been a dozen messages on that machine from the Maje, all begging me, pleading with me, to come help him. I deleted every single one of them. To this day, I have no idea what happened to the Maje, no idea if he ever got that cataract surgery. That's how our relationship ended. It still makes me feel horrible to think about now: I just deleted the Maje.

Ash is out of surgery. He has a shit-ton of recovery to do, but he’s going to live to roar another day.” Cael threw his arms around Dex and squeezed him tight. Dex chuckled and hugged him back. “Okay, Chirpy. Let’s go.” His brother pulled back and wiped a tear away. “I’m

After hearing much from his patients about alleged faith-healing, a Minnesota physician named William Nolen spent a year and a half trying to track down the most striking cases. Was there clear medical evidence that the disease was really present before the ‘cure’? If so, had the disease actually disappeared after the cure, or did we just have the healer’s or the patient’s say-so? He uncovered many cases of fraud, including the first exposure in America of ‘psychic surgery’. But he found not one instance of cure of any serious organic (non-psychogenic) disease. There were no cases where gallstones or rheumatoid arthritis, say, were cured, much less cancer or cardiovascular disease. When a child’s spleen is ruptured, Nolen noted, perform a simple surgical operation and the child is completely better. But take that child to a faith-healer and she’s dead in a day.

to love Grace unconditionally—to be blind to her condition. Bonnie had already reached that point. In fact, as she realized that our culture would not affect Grace in the same way as other girls, she began to see the advantage of having a daughter with Down syndrome. On the day of her surgery, Bonnie could not bear to be the one to hand her over to the medical staff. As I held Grace in the early morning hours prior to her surgery and then eventually walked down the hall to the operating room with her, my heart swelled with emotion. I was falling in love. Suddenly, I couldn’t imagine losing my baby girl.

Another Damasio patient, “Elliot,” was a successful husband, father, and businessman until undergoing brain surgery on a tumor. The surgery damaged his frontal lobe and thereby affected his ability to carry through on plans. He would embark on a project only to lose sight of his goal in doing so. For example, asked to sort documents, he would go overboard: “He was likely, all of a sudden, to turn from the sorting task he had initiated to reading one of those papers carefully and intelligently, and to spend an entire day doing so. Or he might spend a whole afternoon deliberating on which principle of categorization should be applied.

but I didn’t realize how sick Leon was until he arrived at the studio in LA. He looked like the ailing patriarch in a Tennessee Williams play: a long white beard, dark glasses and a cane. He struggled to walk. He would sit in a La-Z-Boy recliner in the studio for a couple of hours a day and sing and play. That was all he could manage, but what he did in those two hours was incredible. There were moments when I wondered if his contributions to the album were going to be released posthumously. One day, his nose started running: it was fluid leaking from his brain. He was rushed into hospital for surgery and treated for heart failure and pneumonia while he was there.

What place in the future development of the South ought the Negro college and college-bred man to occupy? That the present social separation and acute race-sensitiveness must eventually yield to the influences of culture, as the South grows civilized, is clear. But such transformation calls for singular wisdom and patience. If, while the healing of this vast sore is progressing, the races are to live for many years side by side, united in economic effort, obeying a common government, sensitive to mutual thought and feeling, yet subtly and silently separate in many matters of deeper human intimacy,—if this unusual and dangerous development is to progress amid peace and order, mutual respect and growing intelligence, it will call for social surgery at once the delicatest and nicest in modern history. It will demand broad-minded, upright men, both white and black, and in its final accomplishment American civilization will triumph. So far as white men are concerned, this fact is to-day being recognized in the South, and a happy renaissance of university education seems imminent. But the very voices that cry hail to this good work are, strange to relate, largely silent or antagonistic to the higher education of the Negro. Strange to relate! for this is certain, no secure civilization can be built in the South with the Negro as an ignorant, turbulent proletariat.

Of course, the cadavers, in life, donated themselves freely to this fate, and the language surrounding the bodies in front of us soon changed to reflect that fact. We were instructed to no longer call them “cadavers”; “donors” was the preferred term. And yes, the transgressive element of dissection had certainly decreased from the bad old days. (Students no longer had to bring their own bodies, for starters, as they did in the nineteenth century. And medical schools had discontinued their support of the practice of robbing graves to procure cadavers—that looting itself a vast improvement over murder, a means once common enough to warrant its own verb: burke, which the OED defines as “to kill secretly by suffocation or strangulation, or for the purpose of selling the victim’s body for dissection.”) Yet the best-informed people—doctors—almost never donated their bodies. How informed were the donors, then? As one anatomy professor put it to me, “You wouldn’t tell a patient the gory details of a surgery if that would make them not consent.” Even if donors were informed enough—and they might well have been, notwithstanding one anatomy professor’s hedging—it wasn’t so much the thought of being dissected that galled. It was the thought of your mother, your father, your grandparents being hacked to pieces by wisecracking twenty-two-year-old medical students. Every time I read the pre-lab and saw a term like “bone saw,” I wondered if this would be the session in which I finally vomited. Yet I was rarely troubled in lab, even when I found that the “bone saw” in question was nothing more than a common, rusty wood saw. The closest I ever came to vomiting was nowhere near the lab but on a visit to my grandmother’s grave in New York, on the twentieth anniversary of her death. I found myself doubled over, almost crying, and apologizing—not to my cadaver but to my cadaver’s grandchildren. In the midst of our lab, in fact, a son requested his mother’s half-dissected body back. Yes, she had consented, but he couldn’t live with that. I knew I’d do the same. (The remains were returned.) In

cause of cavities, even more damaging than sugar consumption, bad diet, or poor hygiene. (This belief had been echoed by other dentists for a hundred years, and was endorsed by Catlin too.) Burhenne also found that mouthbreathing was both a cause of and a contributor to snoring and sleep apnea. He recommended his patients tape their mouths shut at night. “The health benefits of nose breathing are undeniable,” he told me. One of the many benefits is that the sinuses release a huge boost of nitric oxide, a molecule that plays an essential role in increasing circulation and delivering oxygen into cells. Immune function, weight, circulation, mood, and sexual function can all be heavily influenced by the amount of nitric oxide in the body. (The popular erectile dysfunction drug sildenafil, known by the commercial name Viagra, works by releasing nitric oxide into the bloodstream, which opens the capillaries in the genitals and elsewhere.) Nasal breathing alone can boost nitric oxide sixfold, which is one of the reasons we can absorb about 18 percent more oxygen than by just breathing through the mouth. Mouth taping, Burhenne said, helped a five-year-old patient of his overcome ADHD, a condition directly attributed to breathing difficulties during sleep. It helped Burhenne and his wife cure their own snoring and breathing problems. Hundreds of other patients reported similar benefits. The whole thing seemed a little sketchy until Ann Kearney, a doctor of speech-language pathology at the Stanford Voice and Swallowing Center, told me the same. Kearney helped rehabilitate patients who had swallowing and breathing disorders. She swore by mouth taping. Kearney herself had spent years as a mouthbreather due to chronic congestion. She visited an ear, nose, and throat specialist and discovered that her nasal cavities were blocked with tissue. The specialist advised that the only way to open her nose was through surgery or medications. She tried mouth taping instead. “The first night, I lasted five minutes before I ripped it off,” she told me. On the second night, she was able to tolerate the tape for ten minutes. A couple of days later, she slept through the night. Within six weeks, her nose opened up. “It’s a classic example of use it or lose it,” Kearney said. To prove her claim, she examined the noses of 50 patients who had undergone laryngectomies, a procedure in which a breathing hole is cut into the throat. Within two months to two years, every patient was suffering from complete nasal obstruction. Like other parts of the body, the nasal cavity responds to whatever inputs it receives. When the nose is denied regular use, it will atrophy. This is what happened to Kearney and many of her patients, and to so much of the general population. Snoring and sleep apnea often follow.

For more than twenty years I have offered a very simple yet powerful ritual to people before their radiation, chemotherapy, or surgery. I suggest they meet together with some of their closest friends and family the day before their procedure. Before this meeting, I suggest they find an ordinary stone, a piece of the earth, big enough to fit in the palm of their hand, and bring it to the meeting with them. The ritual begins by having everyone sit in a circle. In any order they wish to speak, each person tells the story of a time when they too faced a crisis. People may talk about the death of important persons, the loss of jobs or of relationships, or even about their own illnesses. The person who is speaking holds the stone the patient has brought. When they finish telling their story of survival, they take a moment to reflect on the personal quality that they feel helped them come through that difficult time. People will say things such as, 'What brought me through was determination,' 'What brought me through was faith,' 'What brought me through was humor.' When they have named the quality of their strength, they speak directly to the person preparing for surgery or treatment, saying, 'I put determination into this stone for you,' or, 'I put faith into this stone for you.' After everyone has spoken the stone is given back to the patient, who takes it with them to the hospital, to keep nearby and hold in their hand when things get hard. In an environment which is highly technical and sterile, it connects them to the earth and to each other.

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. It’s an odd approach to recruitment, but it continues all the way up the ranks, even in top surgery departments. They take minions with no experience in surgery, spend years training them, and then take most of their faculty from these same homegrown ranks. And it works.

I thought back to when I'd first stepped in Mimsy's garden and time has stopped, and I felt that strange joy. A crack in the universe. A shift in reality. I felt that now, too, like someone had performed surgery on my soul and tucked this strange new thing deep inside me: this knowledge of the world and what mattered in it. How there were places where you could go to escape the dark, terrifying world, at least for a little while. How beautiful things-small beautiful things-food and plants and flowers-how they could change you. That food wasn't about numbers and calories and nutrition, but beauty. That these beautiful things could be a key to unlocking a world inside you, a place that you couldn't before reach. It could be protection, an armor, a way to survive the darkness. A way to walk through the world when you wanted to hide in bed all day and night.

After surgery, he told his doctors that the pain was exactly as it was, but he did not feel it as greatly. “It’s as if,” he had said, a cool blandness in his eyes, “the pain is not being done to me.” One day, maybe in a ten years, or fifty years, a surgeon will be able to do this with disturbing precision, destroy a whirlpool of memory, an entire system of feelings, but in the meantime it’s like taking a hatchet to a spider’s web.

I saw a guy the other day at a wedding, and I told him my theory on why we’ve seen this explosion in comedies in the past fifteen years. Number one, America is tacking hard to the right. That sort of extremism always kind of kicks up the need to create comedy. But the second thing is Avid. What’s Avid? It’s a digital movie-editing program that directors use, and it’s incredibly helpful. I think Avid is hugely responsible for this boom in comedy. In the past, one would have to shoot the film and edit it, which was a big deal. Now, filmmakers can record the laughs from a test audience at a screening, and we can then cut to the rhythm of those laughs, the rhythm of the audience. We synchronize the laughs with the film. We can really get our timing down to a hundredth of a second. You can decide where you want your story to kick in, where you want a little bit of mood, where you want a hard laugh line. All of this can really be calibrated to these test screenings that we do. It doesn’t mean that it becomes mathematical. It still ultimately means that you have to make creative choices, but you can just really get a lot out of it. Sort of like surgery with a laser compared with a regular scalpel. We’re able to download a movie onto the computer and literally do all our edits in minutes. The precision is incredible. You play back the audio of the test screening and get everything timed just right. Like, “This laugh is losing this next line; let’s split the difference here.” You’re able to achieve this rolling energy. You can try experimental edits, and do multiple test screenings, and it’s all because you can move so fast with this program. Comedy is the one genre that I think has just really benefited from this more than any other.

Another common practice, the reps told us, was to take fancy meals to the entire doctor’s office (one of the perks of being a nurse or receptionist, I suppose). One doctor’s office even required alternating days of steak and lobster for lunch if the reps wanted access to the doctors. Even more shocking, we found out that physicians sometimes called the reps into the examination room (as an “expert”) to directly inform patients about the way certain drugs work. Hearing stories from the reps who sold medical devices was even more disturbing. We learned that it’s common practice for device reps to peddle their medical devices in the operating room in real time and while a surgery is under way. Janet and I were surprised at how well the pharmaceutical reps understood classic psychological persuasion strategies and how they employed them in a sophisticated and intuitive manner.

The nurse smiled and gestured to two cameras pointing at each patient—one to monitor the patient himself, the other to observe the charts. The nurse told us that these were fed by Skype directly into the intensive care unit in one of the hospitals in Washington, DC, where there was a Syrian-American ICU specialist looking at the monitors twenty-four hours a day, and adjusting the patient’s medication and ventilation based on the clinical parameters.

We know that multitasking can even be fatal when lives are at stake. In fact, we fully expect pilots and surgeons to focus on their jobs to the exclusion of everything else. And we expect that anyone in their position who gets caught doing otherwise will always be taken severely to task. We accept no arguments and have no tolerance for anything but total concentration from these professionals. And yet, here the rest of us are—living another standard. Do we not value our own job or take it as seriously? Why would we ever tolerate multitasking when we’re doing our most important work? Just because our day job doesn’t involve bypass surgery shouldn’t make focus any less critical to our success or the success of others. Your work deserves no less respect. It may not seem so in the moment, but the connectivity of everything we do ultimately means that we each not only have a job to do, but a job that deserves to be done well.

Sanders is a clear outlier in a generation that has forgotten what it means to be a public servant. The Times remarks upon his “grumpy demeanor.” But Bernie is grumpy because he’s thinking about vets who need surgeries, guest workers who’ve had their wages ripped off, kids without access to dentists or some other godforsaken problem that most of us normal people can care about for maybe a few minutes on a good day, but Bernie worries about more or less all the time.

Stolen bodies working stolen land. It was an engine that did not stop, its hungry boiler fed with blood. With the surgeries that Dr. Stevens described, Cora thought, the whites had begun stealing futures in earnest. Cut you open and rip them out, dripping. Because that's what you do when you take away someone's babies--steal their future. Torture them as much as you can when they are on this earth, then take away the hope that one day their people will have it better.

on without anesthesia. In a letter he describes: “I suffered agonies, as they related all to me, and did violence to myself in keeping to my seat. I could scarcely bear it.” Surgery on the penis, the rectum or the anus would have been a terrifying torture, especially if the patient was a five-year-old foreigner who couldn’t have possessed the coping skills, the insight or perhaps sufficient fluency in English to understand what was happening to him. It’s awful to consider what he might have imagined when a nurse changed his dressings, administered his medicines or appeared at his bedside with a supply of leeches if he had an inflammation believed to be due to an excess of blood. The nurse may have had a sweet bedside manner. She may have been strict and humorless. A typical requirement in those days was that she was single or widowed, ensuring that all her time could be devoted to the hospital. Nurses were underpaid. They worked long, grueling hours and were exposed to extraordinarily unpleasant conditions

Darwin is associated, in the popular imagination, with bloody zero-sum competition, with Tennyson’s “nature, red in tooth and claw”—with the motto “survival of the fittest.” But this wasn’t actually his phrase. It was coined by a philosopher and sociologist named Herbert Spencer and his fellow “social Darwinists,” who were promoters of white and upper-class supremacy. For Darwin, says Keltner, “survival of the kindest” would have been a better moniker. Darwin was a gentle and melancholic soul, a doting husband and adoring father of ten, deeply in love with nature from earliest childhood. His father had wanted him to be a doctor, but when at age sixteen he witnessed his first surgery, performed in those days without anesthesia, he was so horrified that for the rest of his life he couldn’t stand the sight of blood. He retreated to the woodlands and studied beetles instead. Later, he described his encounter with a Brazilian forest as “a chaos of delight, out of which a world of future & more quiet pleasure will arise.

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.

The late Fred Rogers, beloved host of the Mister Rogers’ Neighborhood television show, wrote many beautiful songs for children that hold great truths for adults as well. In “I Like to Be Told,” he writes of every child’s desire to be told “if it’s going to hurt,” if a parent is going away, or if something will be new or difficult, because “I will trust you more and more” each time these things come true. We never outgrow our desire to be told the truth. A fellow writer told me the story of waking up one morning when she was a child and being told she wouldn’t be going to kindergarten that day but tot the hospital for eye surgery. Her suitcase was already packed. She was old enough to understand that this meant her parents had withheld information from her. The memory of being betrayed is more painful than the memory of the surgery itself. Compare this with a young boy who recently faced heart surgery. He asked his grandfather if it was going to hurt. His grandfather answered with honest that engendered hope: “Yes, for a while. But every day the pain should get less and less, and it means you’ll be getting better and stronger.

Dancer finds me the next day as I practice my Aureate accent in the penthouse’s holomirror. I can see a three-dimensional depiction of my head in front of me. The teeth move strangely, catching my tongue as I try to roll my words. I am still becoming used to my body, even months after the last of the surgeries. My teeth are larger than I initially thought them. It also doesn’t help that the Goldbrows speak as though they’ve had golden shovels stuck up their bloodydamn stinkholes. So I find it easier to speak like one if I see that I am one. The arrogance comes easier.

KNEE SURGERY I’D FIRST HURT MY KNEES IN FALLUJAH WHEN THE WALL FELL on me. Cortisone shots helped for a while, but the pain kept coming back and getting worse. The docs told me I needed to have my legs operated on, but doing that would have meant I would have to take time off and miss the war. So I kept putting it off. I settled into a routine where I’d go to the doc, get a shot, go back to work. The time between shots became shorter and shorter. It got down to every two months, then every month. I made it through Ramadi, but just barely. My knees started locking and it was difficult to get down the stairs. I no longer had a choice, so, soon after I got home in 2007, I went under the knife. The surgeons cut my tendons to relieve pressure so my kneecaps would slide back over. They had to shave down my kneecaps because I had worn grooves in them. They injected synthetic cartilage material and shaved the meniscus. Somewhere along the way they also repaired an ACL. I was like a racing car, being repaired from the ground up. When they were done, they sent me to see Jason, a physical therapist who specializes in working with SEALs. He’d been a trainer for the Pittsburgh Pirates. After 9/11, he decided to devote himself to helping the country. He chose to do that by working with the military. He took a massive pay cut to help put us back together. I DIDN’T KNOW ALL THAT THE FIRST DAY WE MET. ALL I WANTED to hear was how long it was going to take to rehab. He gave me a pensive look. “This surgery—civilians need a year to get back,” he said finally. “Football players, they’re out eight months. SEALs—it’s hard to say. You hate being out of action and will punish yourselves to get back.” He finally predicted six months. I think we did it in five. But I thought I would surely die along the way. JASON PUT ME INTO A MACHINE THAT WOULD STRETCH MY knee. Every day I had to see how much further I could adjust it. I would sweat up a storm as it bent my knee. I finally got it to ninety degrees. “That’s outstanding,” he told me. “Now get more.” “More?” “More!” He also had a machine that sent a shock to my muscle through electrodes. Depending on the muscle, I would have to stretch and point my toes up and down. It doesn’t sound like much, but it is clearly a form of torture that should be outlawed by the Geneva Convention, even for use on SEALs. Naturally, Jason kept upping the voltage. But the worst of all was the simplest: the exercise. I had to do more, more, more. I remember calling Taya many times and telling her I was sure I was going to puke if not die before the day was out. She seemed sympathetic but, come to think of it in retrospect, she and Jason may have been in on it together. There was a stretch where Jason had me doing crazy amounts of ab exercises and other things to my core muscles. “Do you understand it’s my knees that were operated on?” I asked him one day when I thought I’d reached my limit. He just laughed. He had a scientific explanation about how everything in the body depends on strong core muscles, but I think he just liked kicking my ass around the gym. I swear I heard a bullwhip crack over my head any time I started to slack. I always thought the best shape I was ever in was straight out of BUD/S. But I was in far better shape after spending five months with him. Not only were my knees okay, the rest of me was in top condition. When I came back to my platoon, they all asked if I had been taking steroids.

Yes, changing your lifestyle may seem impractical. It may seem impractical to give up meat and high-fat foods, but I wonder how practical it is to be 350 pounds and have Type 2 diabetes at the age of fifteen, like the girl mentioned at the start of this chapter. I wonder how practical it is to have a lifelong condition that can’t be cured by drugs or surgery; a condition that often leads to heart disease, stroke, blindness or amputation; a condition that might require you to inject insulin into your body every day for the rest of your life. Radically changing our diets may be “impractical,” but it might also be worth it.

You’re just living a normal life — never been sick, never been unhealthy, and all of a sudden you are fighting for your life. And this is happening to individuals every day,” Thomas said. The infection went to her blood stream and bone marrow and caused septic shock and organ failure. After undergoing multiple surgeries including a bone-marrow transplant and a “never-ending cycle of antibiotics,” she survived the ordeal.1​➔​ Thomas survived relatively intact. Some don’t, losing limbs in a desperate bid to stop the infection from spreading and then living permanently debilitated lives. Others aren’t even that “lucky.” Denis

From: Bernadette Fox To: Manjula Kapoor I’m back! Did you miss me? You know how I said I was going to come up with a way to get out of going to Antarctica? What if I had emergency surgery? My dentist, Dr. Neergaard, keeps insisting I get all four wisdom teeth removed, which I haven’t been in any rush to do. But how about I call up Dr. Neergaard and ask him to remove all four wisdom teeth the day before the trip? (And when I say how about I call up Dr. Neergaard and ask him to remove all four wisdom teeth the day before the trip, what I really mean is how about you call up Dr. Neergaard and ask him to remove all four wisdom teeth the day before the trip?)

One day, Matthew, the little boy with the brain tumor who had charmed the ward a few years back, was readmitted. His hypothalamus had, in fact, been slightly damaged during the operation to remove his tumor; the adorable eight-year-old was now a twelve-year-old monster. He never stopped eating; he threw violent fits. His mother’s arms were scarred with purple scratches. Eventually Matthew was institutionalized: he had become a demon, summoned by one millimeter of damage. For every surgery, a family and a surgeon decide together that the benefits outweigh the risks, but this was still heartbreaking. No one wanted to think about what Matthew would be like as a three-hundred-pound twenty-year-old.

The temptation to quit was a traitor. It would not barge in boldly during the peak of my workload; often I was too preoccupied to contemplate on the dismal state of my personal life. Instead, it would reemerge during that silent minute in between surgeries, as I slumped on the floor and waited for the next patient to be brought in. It stared at me from a corner as I waited for the elevator doors to open, me holding both stretcher bed and oxygen tank and it's only an hour past midnight. It would whisper in my ear, to wake me up from a nap on the first Sunday afternoon that I got to spend at home in a long time. It would hold open my apartment door, as I donned my white coat, grabbed my keys, and rushed to morning ward rounds.

When the National Transportation Safety Board analyzed its database of major flight accidents, it found that 73 percent occurred on a flight crew’s first day working together. Like surgeries and putts, the best flight is one in which everything goes according to routines long understood and optimized by everyone involved, with no surprises. When the path is unclear—a game of Martian tennis—those same routines no longer suffice. “Some tools work fantastically in certain situations, advancing technology in smaller but important ways, and those tools are well known and well practiced,” Andy Ouderkirk told me. “Those same tools will also pull you away from a breakthrough innovation. In fact, they’ll turn a breakthrough innovation into an incremental one.

For me, the biggest conflict with the surgery date was that it fell on the same day as Cole’s junior/senior formal at school. The formal had been a big night for Reed two years earlier, with the highlight being a special ring ceremony. Juniors receive their senior rings and ask two special people in their lives to turn the ring on their finger. Reed has asked me to be one of those two people for him, which was a special honor for me. If Cole wants me there, I will reschedule Mia’s surgery. “Cole, who are you planning on having turn your ring?” I asked. “I didn’t get a ring, Mom. I really don’t want one,” Cole replied. Seriously? I thought. Boy, are you your father’s son or what? “All I really care about is getting some really good pictures.” I knew Cole was telling me the truth. He is not about fanfare or rituals. But he did want to remember the night. “Absolutely! I’ll make sure we have plenty of pictures of you,” I exclaimed. As it turned out, I think he was the most photographed student that night. Since I could not be there in person, people texted, e-mailed, and tagged me on Facebook with pictures of him. Again, my friends and Cole’s friends’ parents did what they could to help us through this difficult time. Something as simple as taking pictures was priceless to me. Yes, Cole was completely fine with my not being at the formal, but he was also sad that he could not be at the hospital for Mia. I assured him that there’s never a good time for surgery, and he shouldn’t feel guilty about attending his event--all of us wanted him to go and have a great time.

Here’s an experiment worth conducting. Sneak into the home of a NASA skeptic in the dead of night and remove all technologies from the home and environs that were directly or indirectly influenced by space innovations: microelectronics, GPS, scratch-resistant lenses, cordless power tools, memory-foam mattresses and head cushions, ear thermometers, household water filters, shoe insoles, long-distance telecommunication devices, adjustable smoke detectors, and safety grooving of pavement, to name a few. While you’re at it, make sure to reverse the person’s LASIK surgery. Upon waking, the skeptic embarks on a newly barren existence in a state of untenable technological poverty, with bad eyesight to boot, while getting rained on without an umbrella because of not knowing the satellite-informed weather forecast for that day.

There is only one historical development that has real significance. Today, when we finally realise that the keys to happiness are in the hands of our biochemical system, we can stop wasting our time on politics and social reforms, putsches and ideologies, and focus instead on the only thing that can make us truly happy: manipulating our biochemistry. If we invest billions in understanding our brain chemistry and developing appropriate treatments, we can make people far happier than ever before, without any need of revolutions. Prozac, for example, does not change regimes, but by raising serotonin levels it lifts people out of their depression. Nothing captures the biological argument better than the famous New Age slogan: ‘Happiness begins within.’ Money, social status, plastic surgery, beautiful houses, powerful positions – none of these will bring you happiness. Lasting happiness comes only from serotonin, dopamine and oxytocin.1 In Aldous Huxley’s dystopian novel Brave New World, published in 1932 at the height of the Great Depression, happiness is the supreme value and psychiatric drugs replace the police and the ballot as the foundation of politics. Every day, each person takes a dose of ‘soma’, a synthetic drug which makes people happy without harming their productivity and efficiency. The World State that governs the entire globe is never threatened by wars, revolutions, strikes or demonstrations, because all people are supremely content with their current conditions, whatever they may be. Huxley’s vision of the future is far more troubling than George Orwell’s Nineteen Eighty-Four. Huxley’s world seems monstrous to most readers, but it is hard to explain why. Everybody is happy all the time – what could be wrong with that?

Necessities 1 A map of the world. Not the one in the atlas, but the one in our heads, the one we keep coloring in. With the blue thread of the river by which we grew up. The green smear of the woods we first made love in. The yellow city we thought was our future. The red highways not traveled, the green ones with their missed exits, the black side roads which took us where we had not meant to go. The high peaks, recorded by relatives, though we prefer certain unmarked elevations, the private alps no one knows we have climbed. The careful boundaries we draw and erase. And always, around the edges, the opaque wash of blue, concealing the drop-off they have stepped into before us, singly, mapless, not looking back. 2 The illusion of progress. Imagine our lives without it: tape measures rolled back, yardsticks chopped off. Wheels turning but going nowhere. Paintings flat, with no vanishing point. The plots of all novels circular; page numbers reversing themselves past the middle. The mountaintop no longer a goal, merely the point between ascent and descent. All streets looping back on themselves; life as a beckoning road an absurd idea. Our children refusing to grow out of their childhoods; the years refusing to drag themselves toward the new century. And hope, the puppy that bounds ahead, no longer a household animal. 3 Answers to questions, an endless supply. New ones that startle, old ones that reassure us. All of them wrong perhaps, but for the moment solutions, like kisses or surgery. Rising inflections countered by level voices, words beginning with w hushed by declarative sentences. The small, bold sphere of the period chasing after the hook, the doubter that walks on water and treads air and refuses to go away. 4 Evidence that we matter. The crash of the plane which, at the last moment, we did not take. The involuntary turn of the head, which caused the bullet to miss us. The obscene caller who wakes us at midnight to the smell of gas. The moon's full blessing when we fell in love, its black mood when it was all over. Confirm us, we say to the world, with your weather, your gifts, your warnings, your ringing telephones, your long, bleak silences. 5 Even now, the old things first things, which taught us language. Things of day and of night. Irrational lightning, fickle clouds, the incorruptible moon. Fire as revolution, grass as the heir to all revolutions. Snow as the alphabet of the dead, subtle, undeciphered. The river as what we wish it to be. Trees in their humanness, animals in their otherness. Summits. Chasms. Clearings. And stars, which gave us the word distance, so we could name our deepest sadness.

What to Make a Game About? Your dog, your cat, your child, your boyfriend, your girlfriend, your mother, your father, your grandmother, your friends, your imaginary friends, your summer vacation, your winter in the mountains, your childhood home, your current home, your future home, your first job, your worst job, the job you wish you had. Your first date, your first kiss, your first fuck, your first true love, your second true love, your relationship, your kinks, your deepest secrets, your fantasies, your guilty pleasures, your guiltless pleasures, your break-up, your make-up, your undying love, your dying love. Your hopes, your dreams, your fears, your secrets, the dream you had last night, the thing you were afraid of when you were little, the thing you’re afraid of now, the secret you think will come back and bite you, the secret you were planning to take to your grave, your hope for a better world, your hope for a better you, your hope for a better day. The passage of time, the passage of memory, the experience of forgetting, the experience of remembering, the experience of meeting a close friend from long ago on the street and not recognizing her face, the experience of meeting a close friend from long ago and not being recognized, the experience of aging, the experience of becoming more dependent on the people who love you, the experience of becoming less dependent on the people you hate. The experience of opening a business, the experience of opening the garage, the experience of opening your heart, the experience of opening someone else’s heart via risky surgery, the experience of opening the window, the experience of opening for a famous band at a concert when nobody in the audience knows who you are, the experience of opening your mind, the experience of taking drugs, the experience of your worst trip, the experience of meditation, the experience of learning a language, the experience of writing a book. A silent moment at a pond, a noisy moment in the heart of a city, a moment that caught you unprepared, a moment you spent a long time preparing for, a moment of revelation, a moment of realization, a moment when you realized the universe was not out to get you, a moment when you realized the universe was out to get you, a moment when you were totally unaware of what was going on, a moment of action, a moment of inaction, a moment of regret, a moment of victory, a slow moment, a long moment, a moment you spent in the branches of a tree. The cruelty of children, the brashness of youth, the wisdom of age, the stupidity of age, a fairy tale you heard as a child, a fairy tale you heard as an adult, the lifestyle of an imaginary creature, the lifestyle of yourself, the subtle ways in which we admit authority into our lives, the subtle ways in which we overcome authority, the subtle ways in which we become a little stronger or a little weaker each day. A trip on a boat, a trip on a plane, a trip down a vanishing path through a forest, waking up in a darkened room, waking up in a friend’s room and not knowing how you got there, waking up in a friend’s bed and not knowing how you got there, waking up after twenty years of sleep, a sunset, a sunrise, a lingering smile, a heartfelt greeting, a bittersweet goodbye. Your past lives, your future lives, lies that you’ve told, lies you plan to tell, lies, truths, grim visions, prophecy, wishes, wants, loves, hates, premonitions, warnings, fables, adages, myths, legends, stories, diary entries. Jumping over a pit, jumping into a pool, jumping into the sky and never coming down. Anything. Everything.

Quote from "The Dish Keepers of Honest House" ....TO TWIST THE COLD is easy when its only water you want. Tapping of the toothbrush echoes into Ella's mind like footsteps clacking a cobbled street on a bitter, dry, cold morning. Her mind pushes through sleep her body craves. It catches her head falling into a warm, soft pillow. "Go back to bed," she tells herself. "You're still asleep," Ella mumbles, pushes the blanket off, and sits up. The urgency to move persuades her to keep routines. Water from the faucet runs through paste foam like a miniature waterfall. Ella rubs sleep-deprieved eyes, then the bridge of her nose and glances into the sink. Ella's eyes astutely fixate for one, brief millisecond. Water becomes the burgundy of soldiers exiting the drain. Her mouth drops in shock. The flow turns green. It is like the bubbling fungus of flockless, fishless, stagnating ponds. Within the iridescent glimmer of her thinking -- like a brain losing blood flow, Ella's focus is the flickering flashing of gray, white dust, coal-black shadows and crows lifting from the ground. A half minute or two trails off before her mind returns to reality. Ella grasps a toothbrush between thumb and index finger. She rests the outer palm against the sink's edge, breathes in and then exhales. Tension in the brow subsides, and her chest and shoulders drop; she sighs. Ella stares at pasty foam. It exits the drain as if in a race to clear the sink of negativity -- of all germs, slimy spit, the burgundy of imagined soldiers and oppressive plaque. GRASPING THE SILKY STRAND between her fingers, Ella tucks, pulls and slides the floss gently through her teeth. Her breath is an inch or so of the mirror. Inspections leave her demeanor more alert. Clouding steam of the image tugs her conscience. She gazes into silver glass. Bits of hair loosen from the bun piled at her head's posterior. What transforms is what she imagines. The mirror becomes a window. The window possesses her Soul and Spirit. These two become concerned -- much like they did when dishonest housekeepers disrupted Ella's world in another story. Before her is a glorious bird -- shining-dark-as-coal, shimmering in hues of purple-black and black-greens. It is likened unto The Raven in Edgar Allan Poe's most famous poem of 1845. Instead of interrupting a cold December night with tapping on a chamber door, it rests its claws in the decorative, carved handle of a backrest on a stiff dining chair. It projects an air of humor and concern. It moves its head to and fro while seeking a clearer understanding. Ella studies the bird. It is surrounded in lofty bends and stretches of leafless, acorn-less, nearly lifeless, oak trees. Like fingers and arms these branches reach below. [Perhaps they are reaching for us? Rest assured; if they had designs on us, I would be someplace else, writing about something more pleasant and less frightening. Of course, you would be asleep.] Balanced in the branches is a chair. It is from Ella's childhood home. The chair sways. Ella imagines modern-day pilgrims of a distant shore. Each step is as if Mother Nature will position them upright like dolls, blown from the stability of their plastic, flat, toe-less feet. These pilgrims take fate by the hand. LIFTING A TOWEL and patting her mouth and hands, Ella pulls the towel through the rack. She walks to the bedroom, sits and picks up the newspaper. Thumbing through pages that leave fingertips black, she reads headlines: "Former Dentist Guilty of Health Care Fraud." She flips the page, pinches the tip of her nose and brushes the edge of her chin -- smearing both with ink. In the middle fold directly affront her eyes is another headline: "Dentist Punished for Misconduct." She turns the page. There is yet another: "Dentist guilty of urinating in surgery sink and using contaminated dental instruments on patients." This world contains those who are simply insane! Every profession has those who stray from goals....

In 2013 a study published in the Journal of Patient Safety8 put the number of premature deaths associated with preventable harm at more than 400,000 per year. (Categories of avoidable harm include misdiagnosis, dispensing the wrong drugs, injuring the patient during surgery, operating on the wrong part of the body, improper transfusions, falls, burns, pressure ulcers, and postoperative complications.) Testifying to a Senate hearing in the summer of 2014, Peter J. Pronovost, MD, professor at the Johns Hopkins University School of Medicine and one of the most respected clinicians in the world, pointed out that this is the equivalent of two jumbo jets falling out of the sky every twenty-four hours. “What these numbers say is that every day, a 747, two of them are crashing. Every two months, 9/11 is occurring,” he said. “We would not tolerate that degree of preventable harm in any other forum.”9 These figures place preventable medical error in hospitals as the third biggest killer in the United States—behind only heart disease and cancer.

It’s not for the weak or faint of heart. It will take a toll on you. Your body will hurt. Your soul will ache. Your family life will suffer. No one will understand what you do or why you do it, but you do it. You will work nights. You will work weekends. Holidays. You will bathe the elderly, the weak. You will clean their body, their bodily fluids. You will have to know every medication, what it does, when to stop it, when to give it, and how to get it into people. You will have to know how to interpret blood tests, when the doctor must know. You will have thirty seconds to start an IV, how to hook up an EKG machine. You will need to know how to interpret tracing or when you should give or take away oxygen. You will experience joy, grief, and sorrow in a day, sometimes within the same hour. You are the glue between the patient, the family, the doctor. It’s you who will keep everyone happy, as comfortable as possible. Code blue. Trauma evaluation. Labor. Delivery. Surgery. Babies. Postpartum. Psychology. These and more will all need to be learned. And when you think you know everything, you don’t. You’re just starting. I was asked to write this essay on why

to an AirPort Express in his hospital room, announcing his surgery. He assured them that the type of pancreatic cancer he had “represents about 1% of the total cases of pancreatic cancer diagnosed each year, and can be cured by surgical removal if diagnosed in time (mine was).” He said he would not require chemotherapy or radiation treatment, and he planned to return to work in September. “While I’m out, I’ve asked Tim Cook to be responsible for Apple’s day to day operations, so we shouldn’t miss a beat. I’m sure I’ll be calling some of you way too much in August, and I look forward to seeing you in September.” One side effect of the operation would become a problem for Jobs because of his obsessive diets and the weird routines of purging and fasting that he had practiced since he was a teenager. Because the pancreas provides the enzymes that allow the stomach to digest food and absorb nutrients, removing part of the organ makes it hard to get enough protein. Patients are advised to make sure that they eat frequent meals and maintain a nutritious diet, with a wide variety of meat and fish proteins as well as full-fat milk products. Jobs had never done this, and he never would.

I lost my first patient on a Tuesday. She was an eighty-two-year-old woman, small and trim, the healthiest person on the general surgery service, where I spent a month as an intern. (At her autopsy, the pathologist would be shocked to learn her age: “She has the organs of a fifty-year-old!”) She had been admitted for constipation from a mild bowel obstruction. After six days of hoping her bowels would untangle themselves, we did a minor operation to help sort things out. Around eight P.M. Monday night, I stopped by to check on her, and she was alert, doing fine. As we talked, I pulled from my pocket my list of the day’s work and crossed off the last item (post-op check, Mrs. Harvey). It was time to go home and get some rest. Sometime after midnight, the phone rang. The patient was crashing. With the complacency of bureaucratic work suddenly torn away, I sat up in bed and spat out orders: “One liter bolus of LR, EKG, chest X-ray, stat—I’m on my way in.” I called my chief, and she told me to add labs and to call her back when I had a better sense of things. I sped to the hospital and found Mrs. Harvey struggling for air, her heart racing, her blood pressure collapsing. She wasn’t getting better no matter what I did; and as I was the only general surgery intern on call, my pager was buzzing relentlessly, with calls I could dispense with (patients needing sleep medication) and ones I couldn’t (a rupturing aortic aneurysm in the ER). I was drowning, out of my depth, pulled in a thousand directions, and Mrs. Harvey was still not improving. I arranged a transfer to the ICU, where we blasted her with drugs and fluids to keep her from dying, and I spent the next few hours running between my patient threatening to die in the ER and my patient actively dying in the ICU. By 5:45 A.M., the patient in the ER was on his way to the OR, and Mrs. Harvey was relatively stable. She’d needed twelve liters of fluid, two units of blood, a ventilator, and three different pressors to stay alive. When I finally left the hospital, at five P.M. on Tuesday evening, Mrs. Harvey wasn’t getting better—or worse. At seven P.M., the phone rang: Mrs. Harvey had coded, and the ICU team was attempting CPR. I raced back to the hospital, and once again, she pulled through. Barely. This time, instead of going home, I grabbed dinner near the hospital, just in case. At eight P.M., my phone rang: Mrs. Harvey had died. I went home to sleep.

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.

On the eve of my move to New York, my parents sat me down to talk. “Your mother and I understand that we have a certain responsibility to prepare you for life at a coed institution,” said my father. “Have you ever heard of oxytocin?” I shook my head. “It’s the thing that’s going to make you crazy,” my mother said, swirling the ice in her glass. “You’ll lose all the good sense I’ve worked so hard to build up in you since the day you were born.” She was kidding. “Oxytocin is a hormone released during copulation,” my father went on, staring at the blank wall behind me. “Orgasm,” my mother whispered. “Biologically, oxytocin serves a purpose,” my father said. “That warm fuzzy feeling.” “It’s what bonds a couple together. Without it, the human species would have gone extinct a long time ago. Women experience its effects more powerfully than men do. It’s good to be aware of that.” “For when you’re thrown out with yesterday’s trash,” my mother said. “Men are dogs. Even professors, so don’t be fooled.” “Men don’t attach as easily. They’re more rational,” my father corrected her. After a long pause, he said, “We just want you to be careful.” “He means use a rubber.” “And take these.” My father gave me a small, pink, shell-shaped compact of birth control pills. “Gross,” was all I could say. “And your father has cancer,” my mother said. I said nothing. “Prostate isn’t like breast,” my father said, turning away. “They do surgery, and you move on.” “The man always dies first,” my mother whispered.

Elm BY SYLVIA PLATH For Ruth Fainlight I know the bottom, she says. I know it with my great tap root: It is what you fear. I do not fear it: I have been there. Is it the sea you hear in me, Its dissatisfactions? Or the voice of nothing, that was your madness? Love is a shadow. How you lie and cry after it Listen: these are its hooves: it has gone off, like a horse. All night I shall gallop thus, impetuously, Till your head is a stone, your pillow a little turf, Echoing, echoing. Or shall I bring you the sound of poisons? This is rain now, this big hush. And this is the fruit of it: tin-white, like arsenic. I have suffered the atrocity of sunsets. Scorched to the root My red filaments burn and stand, a hand of wires. Now I break up in pieces that fly about like clubs. A wind of such violence Will tolerate no bystanding: I must shriek. The moon, also, is merciless: she would drag me Cruelly, being barren. Her radiance scathes me. Or perhaps I have caught her. I let her go. I let her go Diminished and flat, as after radical surgery. How your bad dreams possess and endow me. I am inhabited by a cry. Nightly it flaps out Looking, with its hooks, for something to love. I am terrified by this dark thing That sleeps in me; All day I feel its soft, feathery turnings, its malignity. Clouds pass and disperse. Are those the faces of love, those pale irretrievables? Is it for such I agitate my heart? I am incapable of more knowledge. What is this, this face So murderous in its strangle of branches?—— Its snaky acids hiss. It petrifies the will. These are the isolate, slow faults That kill, that kill, that kill.

As we were getting Mia’s things ready for her discharge, her nurse started to excuse herself to get a wheelchair to transport Mia to the car. Instantly, Mia said, “I’m not riding in a wheelchair.” “Yes, you are, Mia. It’s a hospital regulation,” I said, believing that was true. “Mom,” she protested, “they said I’m supposed to walk as much as possible. I’m walking to the car.” I saw a certain look in Mia’s eyes as she made this announcement, the look that says “I am going to push hard for this.” I knew she was determined, and I would fight a losing battle to try to talk her out of it. “I’m walking out of here,” she said again. I guess the medical staff noticed that look too because they allowed her to try to walk, with a nurse close beside her. Seeing that little girl limp her way down the hall, holding Reed’s hand, was one of the proudest moments of my life. I was absolutely amazed by her spunk and determination. I grabbed my cell phone from my purse and snapped a picture. She is such a fighter, I thought as Jase and I followed her. Visually, she looked roughed up, as though she had been through about fifteen rounds in a boxing match. But in that moment, she showed a level of toughness and resilience I have never seen in a child. Remembering the information we were told on that first visit to ICI when Mia was seventeen days old, that she would need physical therapy to help her walk again after this surgery, I thanked God as I watched our daughter walk right out of the hospital twenty-four hours postoperation! When we got into the car, Jase asked Mia, “Well, what do you think about that?” “I’m a little tired, but I made it,” she replied. Indeed she did.

The men entered the sumptuously furnished reception room of the office suite. After the first greeting, they were silent, uncomfortable. They didn’t know what to say. Doc Savage’s father had died from a weird cause since they last saw Doc. The elder Savage had been known throughout the world for his dominant bearing and his good work. Early in life, he had amassed a tremendous fortune— for one purpose. That purpose was to go here and there, from one end of the world to the other, looking for excitement and adventure, striving to help those who needed help, punishing those who deserved it. To that creed he had devoted his life. His fortune had dwindled to practically nothing. But as it shrank, his influence had increased. It was unbelievably wide, a heritage befitting the man. Greater even, though, was the heritage he had given his son. Not in wealth, but in training to take up his career of adventure and righting of wrongs where it left off. Clark Savage, Jr., had been reared from the cradle to become the supreme adventurer. Hardly had Doc learned to walk, when his father started him taking the routine of exercises to which he still adhered. Two hours each day, Doc exercised intensively all his muscles, senses, and his brain. As a result of these exercises, Doc possessed a strength superhuman. There was no magic about it, though. Doc had simply built up muscle intensively all his life. Doc’s mental training had started with medicine and surgery. It had branched out to include all arts and sciences. Just as Doc could easily overpower the gorilla-like Monk in spite of his great strength, so did Doc know more about chemistry. And that applied to Renny, the engineer; Long Tom, the electrical wizard; Johnny, the geologist and the archaeologist; and Ham, the lawyer. Doc had been well trained for his work.

Society would have much to gain from decriminalization. On the immediate practical level, we would feel safer in our homes and on our streets and much less concerned about the danger of our cars being burgled. In cities like Vancouver such crimes are often committed for the sake of obtaining drug money. More significantly perhaps, by exorcising this menacing devil of our own creation, we would automatically give up a lot of unnecessary fear. We could all breathe more freely. Many addicts could work at productive jobs if the imperative of seeking illegal drugs did not keep them constantly on the street. It’s interesting to learn that before the War on Drugs mentality took hold in the early twentieth century, a prominent individual such as Dr. William Stewart Halsted, a pioneer of modern surgical practice, was an opiate addict for over forty years. During those decades he did stellar and innovative work at Johns Hopkins University, where he was one of the four founding physicians. He was the first, for example, to insist that members of his surgical team wear rubber gloves — a major advance in eradicating post-operative infections. Throughout his career, however, he never got by with less than 180 milligrams of morphine a day. “On this,” said his colleague, the world-renowned Canadian physician Sir William Osler, “he could do his work comfortably and maintain his excellent vigor.” As noted at the Common Sense for Drug Policy website: Halsted’s story is revealing not only because it shows that with a morphine addiction the proper maintenance dose can be productive. It also illustrates the incredible power of the drug in question. Here was a man with almost unlimited resources — moral, physical, financial, medical — who tried everything he could think of and he was hooked until the day he died. Today we would send a man like that to prison. Instead he became the father of modern surgery.

He ran long at the White House, and arrived late to his next meeting with Hillary Clinton, Jake Sullivan and Frank Ruggiero—their first major strategy session on Taliban talks after the secret meeting with A-Rod. She was waiting in her outer office, a spacious room paneled in white and gilt wood, with tasseled blue and pink curtains and an array of colorfully upholstered chairs and couches. In my time reporting to her later, I only ever saw Clinton take the couch, with guests of honor in the large chair kitty-corner to her. She’d left it open for him that day. “He came rushing in. . . . ” Clinton later said. “And, you know, he was saying ‘oh I’m so sorry, I’m so sorry.’ ” He sat down heavily and shrugged off his coat, rattling off a litany of his latest meetings, including his stop-in at the White House. “That was typical Richard. It was, like, ‘I’m doing a million things and I’m trying to keep all the balls in the air,’ ” she remembered. As he was talking, a “scarlet red” flush went up his face, according to Clinton. He pressed his hands over his eyes, his chest heaving. “Richard, what’s the matter?” Clinton asked. “Something horrible is happening,” he said. A few minutes later, Holbrooke was in an ambulance, strapped to a gurney, headed to nearby George Washington University Hospital, where Clinton had told her own internist to prepare the emergency room. In his typically brash style, he’d demanded that the ambulance take him to the more distant Sibley Memorial Hospital. Clinton overruled him. One of our deputies on the SRAP team, Dan Feldman, rode with him and held his hand. Feldman didn’t have his BlackBerry, so he scrawled notes on a State Department expense form for a dinner at Meiwah Restaurant as Holbrooke dictated messages and a doctor assessed him. The notes are a nonlinear stream of Holbrooke’s indomitable personality, slashed through with medical realities. “Call Eric in Axelrod’s office,” the first read. Nearby: “aortic dissection—type A . . . operation risk @ > 50 percent”—that would be chance of death. A series of messages for people in his life, again interrupted by his deteriorating condition: “S”—Secretary Clinton—“why always together for medical crises?” (The year before, he’d been with Clinton when she fell to the concrete floor of the State Department garage, fracturing her elbow.) “Kids—how much love them + stepkids” . . . “best staff ever” . . . “don’t let him die here” . . . “vascular surgery” . . . “no flow, no feeling legs” . . . “clot” . . . and then, again: “don’t let him die here want to die at home w/ his fam.” The seriousness of the situation fully dawning on him, Holbrooke turned to job succession: “Tell Frank”—Ruggiero—“he’s acting.” And finally: “I love so many people . . . I have a lot left to do . . . my career in public service is over.” Holbrooke cracked wise until they put him under for surgery. “Get me anything you need,” he demanded. “A pig’s heart. Dan’s heart.

People sometimes ask what it’s like to be a surgeon who works with the living human brain each day. I think sometimes it’s like being Harry Potter—a wizard who has at his command such wonderful technologies as an MRI machine that lets us image the tissue as we remove the tumor, or a global positioning system that lets us navigate through the brain, or an operating microscope that magnifies objects forty times and lets us do very precise surgery. More often, however, it’s like Frodo Baggins in Lord of the Rings, trying to fulfill a quest against an unknown evil, surrounded by friends and working teams and helped by a little magic. You often feel vulnerable and frightened, despite a brave exterior.

can imagine, you never get a good night’s sleep or feel rested when you wake up in the morning. Sleep apnea makes you tired nearly constantly during the day so you have no energy and can’t focus. Another problem with sleep apnea is that it increases your risk of having a heart attack or stroke. Even scarier, you could die in your sleep when you stop breathing.

Too Much Sitting Humans are built to move—after all, our ancestors were hunters and gatherers. But we don’t move much anymore. Most of us lead a sedentary lifestyle, with hours of sitting every day and not many calories burned from physical activity. We have cars, remote controls, elevators, and online shopping portals. We go to the

Are vegetarian diets an effective alternative, or complement, to drugs and surgery? Although studies designed to answer this question are limited in number and small in size, their results are encouraging. In 1990, Dr. Dean Ornish demonstrated that a very low-fat vegetarian diet (less than 10 per cent calories from fat) and lifestyle changes (stress management, aerobic exercise, and group therapy) could not only slow the progression of atherosclerosis, but significantly reverse it. After one year, 82 per cent of the experimental group participants experienced regression of their disease, while in the control group the disease continued to progress. The control group followed a “heart healthy” diet commonly prescribed by physicians that provided less than 30 per cent calories from fat and less than 200 milligrams of cholesterol a day. Over the next four years, people in the experimental group continued to reverse their arterial damage, while those in the control group became steadily worse and had twice as many cardiac events. In 1999, Dr. Caldwell Esselstyn reported on a twelve-year study of eleven patients following a very low-fat vegan diet, coupled with cholesterol-lowering medication. Approximately 70 per cent experienced reversal of their disease. In the eight years prior to the study, these patients experienced a total of forty-eight cardiac events, while in over a decade of the trial, only one non-compliant patient experienced an event.

What happens to a man who loses more than half of himself? Ron Lester has searched for the answer since December 2000, when he underwent Roux-en-Y gastric bypass surgery with a duodenal switch.1 Since he realized in the third grade that his massive girth could draw laughs, Lester knew his fate was as the funny fat guy. When he moved to Hollywood — a town where funny fat guys can become millionaires — he was an overnight success. There was one problem, though: His moneymaker was slowly killing him. With a family history of heart problems, the 500-pound Lester wasn’t long for this world. Surgery saved his life. It also ended his career. A shrinking man with loose skin greeted casting directors expecting the funny fat guy, and Lester struggled to score roles post-op. Now living in Dallas nearly 15 years after his glory days, he is left to ponder whether choosing life was the right decision. “Am I alive? Yes. Am I happy? No. Did I throw away my career to be skinny? Yes,” he says. “I wouldn’t do [the surgery] again. I would much rather have died happy, rich, and kept my status and gone out on top.