Notes on the Art of Surgery

Mortal Lessons: Notes on the Art of Surgery - Richard Selzer

Dr. Selzer (1928 - 2016) was a general surgeon and faculty member of the Yale School of Medicine. In the early Seventies, he revived a genre that has become so familiar to us 50 years down the pike: the doctor memoir in which the doc examines his thoughts and actions dealing with patients and their disorders, often with examinations of the state of contemporary medicine. See Awakenings and Intern: A Doctor’s Initiation.

Selzer was a post-modern writer in the sense that he fictionalized his OR experiences, to protect patient confidentiality and to make the “literary most” (his words) of what happens to him and his sick, dying, disabled, frail patients. Just one example: A young diabetic woman who, though blind, draws for the surgeon a smiley face and a "Smile, Doctor" on the kneecap of her gangrenous leg that he will amputate.

This 1974 collection of nineteen essays is mostly about opening human bodies with invasive procedures and inflicting massive insult for benevolent purposes. He was, like his entire cohort of children in the Thirties, exposed to lots of Longfellow. This exposure stoked his love of words – from sounds to metaphors – and the act of writing. In his childhood, teens and early twenties, he read the Harvard Classics. From medical school to about age 40, he read nothing outside of professional articles.

When he felt impelled to write creatively at about 40 years of age, he found he had access to all he had read in childhood and youth. This blossomed into an imposing and old-school style in the manner of Lamb, Chesterton, Pater, and Hazlitt. Therefore, these essays had better be read like short stories: one at a time, over time, lest we risk suffocation by redolent prose. Everybody has had the odd experience of a vivid memory being recalled by an unexpected odor, but everybody would say ‘pee-yew,’ I think, when Selzer calls the nose “the organ of nostalgia.”

In addition to more than few affected metaphors and similes, his cool and dispassionate realism may turn off sensitive readers. For instance, how medical schools store donated bodies will make squeamish readers opt for cremation. Another turn-off may be the self-regard (surgeons are stereotypically abrasive, arrogant, and difficult to work with) though he has flashes of self-deprecating humor.