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Doctor-Writer Disconnect
From: Columbia University
| By:
Richard Selzer |
EDITOR'S INTRODUCTION |
In the 1960s, Richard Selzer, M.D., pioneered the field of literature in medicine, giving many doctors the courage to write about their practice. Born in Troy, New York, Selzer attended Yale University for his internship and residency and has remained at Yale ever since. Toward the end of his 26 years in practice as a general surgeon, he found himself getting up a little earlier than necessary for rounds. He would come down to a darkened kitchen and write about what his patients underwent beneath his gaze. That initial practice began his ongoing career as an essayist, as a writer of short stories and as a memoirist. |
Richard Selzer discusses his career as a doctor and writer.
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 ood writing can be found almost anywhere. Take this example from the textbook of parasitology.
Tapeworms may be harbored for years, and except for the inconvenience of the gravid segments crawling out of the anus, the host continues in robust health enjoying both food and drink.
Now show me the writer who wouldn't have died to have written that. |
Discovering writing at 40
Writing came to me late, like a wisdom tooth. I was 40 years old before the energy to write appeared. I had been a surgeon for a long time before that. But it was at the age of 40 that the mesenchyme of my imagination began to flow this way and that and to roll itself up into ridges and hollow itself out into tubes, to invaginate and evaginate and do all the things that mesenchyme knows how to do. |
So I found myself with the passion to write. The only trouble was I didn't know how to do that, and I was busy full-time doing surgery. So I simply reorganized my life. I gave up everything else. I didn't ski. I didn't play bridge. I didn't go to the theater. I lived the life of a paramecium, except without the bliss of binary fission. |
Every night at one o'clock in the morning I got up and went down to the kitchen for two hours. While the rest of the world was asleep and all the light in the universe shone upon one page, I wrote my heart out. |
I chose to write horror stories. Surgeons love horror, don't you know. Besides, they're easy. If any of you have a yen to write I would suggest that you write horror stories. You don't need a whole lot of philosophical import or character development or psychological complexity. All you need to do is make your reader shiver once. |
In the dead of night I wrote dozens and dozens of these horror stories. After a few years they began to be published in such eminent journals as Ellery Queen's Mystery Magazine and Alfred Hitchcock's Mystery Magazine. I thought I had died and gone to heaven. |
Then a publisher from New York City called up and asked, "Do you have enough of those to make a book?" "Do I," I said, and backed the truck up next to his office. Out of that mess of horror he selected 20 stories. He called the book Rituals of Surgery. It had absolutely nothing to do with surgery, but he thought that would sell books. He was wrong. But there it was, a book with my name on it, Rituals of Surgery. |
On Wednesday afternoons I went to the New Haven public library while the rest of the surgeons went to play golf. The librarian at the desk is an old friend of mine and a former patient. About two weeks after the publication of Rituals of Surgery, one of those vestiges of Yankeehood that are still seen on the streets of New England towns and villages stood just ahead of me at the circulation desk. Picket-thin she was, without an ounce more soft tissue than was absolutely necessary to hook ligament to bone, and with an iron-gray bun impacted at the nape. |
Thinking to garner for me the most wonderful compliment, the librarian asked this woman, "What did you think of that book?" She was returning Rituals of Surgery. As she dropped the book between thumb and forefinger as though it were moist and disgusting, the woman said, "I would never let that man operate on me." |
That was my first experience with book reviewing. I went right home. It was two o'clock in the afternoon. I got in bed and pulled the covers over my head and I wouldn't come out until my wife came and fed me oatmeal with a long wooden spoon. |
I have since grown rather thicker-skinned about that kind of thing. I prefer now to follow the advice of the immortal Tallulah Bankhead, who said, "To hell with criticism. Praise is good enough for me." |
Family life--balancing medicine and music
I was born and raised in upstate New York, in Troy. My father was a general practitioner in the 1930s and my mother was a singer. We lived upstairs and father's office was downstairs. |
From my earliest days I would sit on the landing of the staircase and listen to the cries and moans of the patients downstairs and hear father's reassuring rumble as he tried to coax the patients to do whatever he needed them to do. Upstairs mother practiced her scales and singing. |
I was suspended between two worlds. The two of them were fighting the second Trojan War, only the prize this time was not the beauteous Helen. It was me. He wanted me to be a surgeon and she wanted me to be a poet. |
"Look at his hands," Father would say. "They're strong and gentle. They're the hands of a surgeon." |
"Nonsense," said Mother. "Look at his eyes. They already have that yonderly look as though he has departed for somewhere else." |
In his father's memory--becoming a doctor
So it went until Father felt that he might be losing the Trojan War and did the only thing for which I have never forgiven him. He died. I was 12 years old. It was long before my eyes had had their fill of him. To have your heart broken at 12 is to incur the wound that never heals. |
Oh, it may scab over from time to time, even for years at a time. But scratch it, even in your sleep, and there it'll be--open, smarting and bloody. The night the men carried the body of my father out of his waiting room, after the callers had left and the house had sunk into blackest grief, I stole downstairs to his examining room with its old metal table with the detachable stirrups, the diathermy machine, the glass-front cabinet that held his scalpels, clamps, forceps, the rolls of gauze, and next to it the table on wheels where he kept jars of ammoniated mercury and Unguentine, bottles of mercurochrome and gauze impregnated with Vaseline. |
There on his desk lay his stethoscope. I picked it up and placed the earpieces in my ears and held the disk to my lips and whispered a vow. I would do as he wished. I would become a doctor. I would be his reincarnation. That way he will not have died. He would live on in me. That night I gave myself to medicine the way a monk gives himself to God. |
It was a wise decision for a grief-stricken boy. If I could no longer find my father in the flesh, I'd find him through the work he had done. That's the way I came to know him more intimately than if we had lived together for all those many years. |
Decades later, when I'd finished with medicine, when my mother too was in the cemetery, I built for them a Taj Mahal of words to keep them both for myself until I would join them. |
Exploring the language of medicine
My father finished his office hours at eight o'clock in the evening. When my brother Billy was 8 and I was 7, we would sneak downstairs to our father's consultation room. We would go to the glass-front bookshelf where he kept his medical textbooks. We would take them down, look at the pictures and try to read the text. Our favorite was the textbook of obstetrics and gynecology. |
It was there that I first became aware of the right alliterative language of medicine. "Arteriosclerotic heart," I read, and it sounded as though it were a jewel that one wore around the neck. "Carcinoma" sounded like that aria from Rigoletto that my mother used to sing. "Cerebellum." I said that word over and over again. I let it drip off the end of my tongue like melted chocolate. "Cerebellum." |
And "sphincter." What in the world was that? Billy said, "I know what that one is. That's the lady who never got married." Then I saw the word "choledochojejunostomy." All those syllables marching across the page to end in that terminal "y." I said, "If that's the way surgeons talk, I'm gonna be one of them." |
Exposing the medical priesthood
When I began to write, in the 1960s, it was rare for a surgeon or even for a doctor to become a writer. For a long time I was perhaps the only surgeon writer in the country and maybe in the world. In those days it was considered OK for a doctor to be a patron of the arts but not to practice them. |
In a sense, surgery was a priesthood in those days. It was practically all male. You donned a special raiment, went to a place where no one else was allowed. You washed your hands and at last you performed your sacred, secret rites before the open ark of the body. |
For one member of that priesthood to stand up and reveal its secrets the way I was doing was considered quite traitorous. My colleagues in surgery at Yale were puzzled and displeased. They tried to talk me out of this madness. |
"Come, come," they coaxed me. "Forsake those roses of the mind and tend the true, the mortal flower." That's the way the surgeons at Yale talk. But like Ulysses, who poured melted wax in the ears of his sailors so they wouldn't hear the song of the sirens, I turned a deaf ear and persisted. |
There are certain similarities between surgery and writing. In surgery you use a scalpel, and it's about the same length and the same heft as a pen. When you use either one of them, something is shed. With a pen, it's ink; with a scalpel, blood. |
The pen was an instrument that was congenial to my fingers. I still write longhand, although I realize that probably is not acceptable to anyone anymore. |
Facing the Faustian bargain--writing full-time
I did both surgery and writing for 18 years. But then at the age of 58 I realized that the two were incompatible in me. |
A surgeon must remain at some emotional remove from the white heat of the event, the laying open of the body of a fellow human being. He or she must be dispassionate and calm in the face of no matter what--hemorrhage, perforation, it doesn't matter--able to perform the work coolly and casually. So the surgeon wears a kind of carapace, an insulation against feeling. It's what gives surgeons the appearance of being haughty and cold, even cruel. It is only an appearance, I assure you. |
The surgeon writer must not only perform that act but must perceive it with the third eye, the pineal eye of the artist. The third eye doesn't have any lids, and once it's opened it cannot be shut. |
At the age of 58 I realized that slowly, over the course of 18 years, I had peeled away my insulation. I no longer wore the carapace of the surgeon. The necessary perceiving of the artist had unmanned me as a surgeon. By picking up a pen and putting down my scalpel I had made a kind of Faustian bargain. So I left my beloved workbench in the operating room and became what I am now, a writer. |
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