Book 'em Danno!

I love to read. Surgeons love to cut. Sometimes a surgeon loves to cut and also loves to write, which creates the perfect scenario for a med-surg-groupie-bookworm like me! In fact, I've read more than a few medical memoirs/narratives over the past few months, systematically depleting the inventory available from our tri-county library system - and even purchasing a few which weren't available at the library. (See list on the left!)

All of these books were enjoyable, but 3 are tied for my first place: "Bright Lights, Cold Steel", Dr. Michael Collins, "When the Air Hits Your Brain", Dr. Frank Vertosick, and "Cutting Remarks" Dr. Sidney Schwab. Fortunately this isn't American Idol, so I don't have to vote off two in order to write about one. I like each one for different reasons, but notice that each author is a surgeon - orthopedic surgeon, neuro surgeon, and general surgeon. 3 for 3 - that must mean surgeons are the best writers, which is probably what they think too! Just kidding...or not.

However, it's the general surgeon's book, "Cutting Remarks" which has prompted this post, for several reasons. First of all, Dr. Schwab is also a masterblogger and I visit his site more often than I'd like to admit. (But if my employer ever does a desk-by-desk computer investigation, I'm going to have a lot of 'splaining to do! Even tho HR work can be a pain in the butt, it doesn't really require knowing anything about colon resectioning. But that's not what I'm trying to write about!)

Secondly, the geography in this book is familiar. The other two books are based in Cleveland (or was it Cincinnati?) and the Mayo clinic, but I've never been to either place. Dr. Schwab writes about his time in San Francisco, at UCSF and SF General Hospital. I've driven by both of those many, many times and can picture both the white, shining complex on the hill and the imposing, solid compound on the flats. Although the buildings and the medical procedures have changed, the overall setting is the same and it was intriguing to read of places which I recognize.

Reasons three, four, five, and six will be lumped together in this paragraph. Otherwise,this post may end up longer than the actual book. Three: it's funny in unexpected places. Dr. Schwab's wit is as sharp as his scalpel and seems to be used just about as frequently. Four: it's educational. I now feel so proud of having a beautiful, robins-egg blue gallbladder that I need to take back rude comments I made about that organ in a previous post. Five: it's informative. For instance, my mental pronunciation of mediastinum was all wrong. It's not me-dee-ASS-tin-um as I thought, but me-dia-STY-num. Fortunately, the word hasn't come up yet in conversation so I haven't em-bear-ASS-ed myself. :-) Six: it's honest. While most of the books mention cadaver labs as part of medical training, "Cutting Remarks" is the only one I've read so far that acknowledges animal labs. It may be politically incorrect, but Dr. Schwab provides a realistic view of exactly how surgeons gain the skills they need before approaching a sick or injuried human. Don't be scared off - there are only 2 short mentions, but it was enough to make me aware that none of the other authors were brave enough to include it. Or, maybe it was insignificant to the others.

That leads me, finally, to seven. After I turned the last page I went out to garden, mulling over this piece of writing. My conclusion is that I now have a very good understanding of the difference between an occupation and a profession. And of the difference between someone who practices a profession and someone who IS that profession - Dr. Schwab removes his surgical mask and allows his readers into the inner core of a surgeon. He has the soul of a surgeon, not just head, hands, and heart. The nuns who taught me early in life would call it a vocation. Others might call it centered. I call it very fortunate for those who were his patients over the years.

Conclusion: Book highly recommended. Not to read it might be called a crime.

San Francisco has changed in many ways though, since the 1970's when Dr. Schwab trained there. A surgeon who cuts his finger to the bone while in a patients' abdomen today will be worried about much more than losing the case to another surgeon. It was strange to read this story, and realize that HIV/AIDS had not yet started its scorched earth run through the Bay Area. It was also a time before then Governor Ronald Reagan closed down the state mental hospitals, in a brilliant budget manuever - thereby releasing thousands of mentally ill to counties and cities ill equipped to treat them. The street corners of SF and the ER at SF General reflect the long-term repercussions of that decision, with a large population of homeless, substance abusing mentally ill and inadequate resources for treatment and/or housing. On the other hand, some things haven't changed in SF, as MUNI vs Pedestrian continues on a weekly basis!