…the surgeon and the patient

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27.
You read Richard Selzer’s essay, The Knife, where he describes his experiences in the operating theatre, proposing that ‘if the surgeon is like a poet, then the scars [he has] made on countless bodies are like verses into the fashioning of which [he has] poured [his] soul.’

You have variously equated your writing with the building of a puzzle and the archeology of a buried structure. The puzzle begins by spilling pieces onto the floor, pushing them around to find some shape. There are misplaced pieces, awkward bumps and lumps, distortions and gaps, but over time you rotate the pieces, or find a new one hiding just out of view, or you clean the dust to reveal a vividness of colour. Slowly the picture emerges.

The archeology often begins with a little light digging, turning over the soil to see if there is anything there. You may only get the hint of shape, the suggestion of story or truth, and so you continue until you are crouched low, scraping and then brushing away the earth to see what this thing is. The art of sculpture works in the same way. Something is hidden within this block of limestone. It lives and breathes, your job to reveal its true self.

You are intrigued by the visceral nature of the surgeon poet in Selzer’s essay, the idea of blood and organs, tissue and scars. Your analogies in comparison are clean and safe, except for the risk of grubby knees and grit beneath your nails. In his essay he describes… ‘the world’s light illuminating the organs, their secret colors revealed—maroon and salmon and yellow. […] An arc of the liver shines high and on the right, like a dark sun. It laps over the pink sweep of the stomach, from whose lower border the gauzy omentum is draped, and through which veil one sees, sinuous, slow as just-fed snakes, the indolent coils of the intestine.’

He feels like ‘a traveler in a dangerous country, advancing into the moist and jungly cleft [his] hands have made.’

You realise on reading this that the true nature of your writing is biological and vigorous, the fluidity of perception sticky with old and new wounds. Fiction, perhaps, is a cleaner craft, depending on your source material. But nonfiction? Writing about yourself and others? You have made scars. You have dug deep to reveal the shiny liver, to feel the sliver of just-fed snakes. There are also things you have begun to write, not knowing where it will take you, only to draw back when you felt the sharp cut of the scalpel, the quivering retraction of your own heart.

You do not want to be afraid of these stories. You are drawn to the truth, to operating in the theatre of facts until you discover a beating heart. But you have learned that while the mind can be firm and so gloatingly sure of its detached logic, the body will reflect what is happening beyond, deep within the soul. There the truth of the pain lies.

And so, how to be surgeon and patient? Selzer suggests the surgeon is ‘rendered impotent by his own empathy and compassion. […] Like an asthmatic hungering for air, longing to take just one deep breath, the surgeon struggles not to feel.’

And the patient, ‘In the very act of lying down, you have made a declaration of surrender.’

And so you are prone and surrendered, but also standing above with scalpel in hand.

As surgeon you will cut gently. You will find ways to anaesthetise. You will retreat in a timely way, and sew the wound with neat stitches.

And as patient you will follow Selzer’s gentle advice. Let yourself go, he says as his patients drift into their temporary oblivion.

It’s a pleasant sensation, he says. Give in.

(The Knife, by Richard Selzer published in The Art of the Personal Essay, Ed. Phillip Lopate)

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