Showing 171 - 180 of 298 annotations tagged with the keyword "Surgery"
This poem explores the act of inserting an intravenous line (I.V.) into a patient just prior to induction of anesthesia or sedation. The physician-narrator is initially full of bravado, stating "I am good at this" and "I'm the best". The physicality of the act is detailed: the vein "lies stretched and succulent" and the needle "waits / like a mosquito attached / by its sucker." By the end of the second stanza, however, when the I.V. has been successfully inserted, the significance of this seemingly simple medical intervention is stated: "I am suddenly aware / I am connected to his brain."
It is this power, the fear of this power felt by both the doctor and the patient, and, by extension, the fear of anesthesia or sedation, that form the heart of the poem. The narrator states that he cannot let his own fears about anesthesia and "loss of control get in the way." Instead he accepts the power and control that the patient gives him and "bring[s] him down."
Beginning with the words, "They are and suffer, that is all they do," this poem describes the experience of those who are recovering from surgery and their treatment at the hands of impersonal doctors ("The treatment that the instruments are giving"). Suffering and pain narrow the patient's world and isolate patients who "lie apart like epochs from each other" and for whom "truth" is "how much they can bear."
The speaker also describes how difficult it is to imagine pain when one does not have it ("we stand elsewhere / For who when healthy can become a foot?"). Finally, the speaker refers to "the common world of the uninjured" where we "cannot / Imagine isolation," but share happiness, anger and "the idea of love."
The surgeon-narrator and his team of assistants (the anesthesiologist, scrub nurse, circulating nurse, surgical resident, and medical student) perform a difficult operation during the night. The patient has an infiltrating cancer of the stomach (linitis plastica) that has eroded his aorta. Because of uncontrollable bleeding, the operation (an exploratory laparotomy with attempted repair of a malignant aorto-gastric fistula) is as doomed as the patient himself.
The surgeon soon comprehends the hopelessness of the procedure as well as the patient's terminal condition. He turns off the oxygen from the gas tank and stops the patient's blood transfusion. Minutes later, the man dies. Blood is all over everything. The doctor must now deliver the bad news to the man's family. He has the medical student tag along.
Members of the patient's family are upset and some are even out of control so he dispenses tranquilizers to them. The surgeon returns to the operating room (OR) and even now finds blood everywhere. The OR team is still working. The doctor showers and then goes back to the OR once more. The room is now dark and empty but clean. The surgeon imagines the dead man's body with a row of abdominal stitches that he likens to hieroglyphics. The unsuccessful operation and the surgeon's actions are thus both concealed and unforgettable.
Fifty-two year old Pete, the hospital mailman, suddenly experiences severe abdominal pain. He is evaluated and treated in the emergency room. His diagnosis is acute surgical abdomen, but the exact cause of his pain is still unknown. The surgeon-narrator determines that the severity of Pete's condition mandates exploratory surgery. During the operation, "an old enemy" (18) is encountered--pancreatitis.
Afterwards, the surgeon assures Pete that he will get better. One week later though, the mailman dies. His death has been painful. An autopsy is scheduled, but the surgeon deliberately arrives 20 minutes late. He does not want to view the intact body of his deceased patient. No matter, the pathologist has waited for him to arrive before beginning the post-mortem examination. The pathologist closes Pete's eyelids before starting the autopsy, mindful of how the mailman's "blue eyes used to twinkle" (21) when he delivered the mail everyday.
Looking back on his first year of medical practice in an out-of-the-way section of Russia, a 25 year old physician reflects on how much he has changed both personally and professionally. He lists the year's accomplishments: performing a tracheostomy, successful intubations, amputations, many obstetrical deliveries, and setting several fractures and dislocations. With pride, the doctor calculates he has seen 15,613 patients in his first twelve months of practice.
He recalls some poignant moments. A pregnant woman has a baby while lying in the grass near a stream. The doctor pulls a soldier's carious tooth but is horrified when a piece of bone is attached to it. During a delivery, he inadvertently fractures a baby's arm and the infant is born dead.
Basking in his year's worth of experience and newfound clinical confidence, the physician quickly comprehends the limits of his knowledge on the first day of his second year in practice when a mother brings her baby to the doctor. The infant's left eye appears to be missing. In its place sits an egg-like nodule. Unsure of the diagnosis and worried about the possibility of a tumor, the physician recommends cutting the nodule out. The mother refuses. One week later she returns with her child whose left eye is now normal in appearance. The doctor deduces that the boy had an abscess of the eyelid that had spontaneously ruptured.
This series of 28 poems plus an envoy describe, from the patient's point of view, a 20-month stay in an Edinburgh hospital in the 1870s. The narrator delineates--from the cold and dread of Enter Patient through the giddiness of "Discharged"--his reactions to hospital personnel (from doctors and nurses to scrub lady); to his fellow patients (from children to the elderly, during bad days and holidays), to visitors, and to death.
Because he stays for 20 months, we also witness his seesawing emotions about his own state of health. The epigraph from Balzac suggests that a person in bed and ill might become self-centered, so the narrator purposefully maintains a dispassionate tone. It is a tone so distinct yet distanced that Jerome H. Buckley (William Ernest Henley: A Study in the "Counter-Decadence" of the 'Nineties, New York: Octagon Books, 1971, c. 1945) compares the poems to steel engravings.
Selzer tells four stories of surgical loss: a surprise loss on the operating table, the drowning of a sick child in a flood in wartime Korea, the sudden death of a professor due to a perforated ulcer, and the loss of some facial mobility in a young woman following the removal of a tumor in her cheek. As we move from one vignette to the next, the narrator's mood goes from despair to accepting to redeemed, with various forms of love the agent.
Selzer begins by describing an anonymous painting of Vesalius at the dissecting table, about to cut into the cadaver in front of him, yet glancing over his shoulder at a crucifix on the wall behind him. He then tells two medical stories in which spirituality has played a crucial role.
In the first, a man who has repeatedly refused to have a brain cancer operated on turns up one day healed, attributing it to the holy water a family member brought back from Lourdes. In the second, the Dalai Lama's personal physician does rounds in an American hospital and, using ancient techniques, diagnoses correctly, and in some detail, a case of congenital heart disease.
The unnamed narrator, a physician, notices a surgeon in a "seedy cafe on the edge of town." (73) He learns from the waiter that the shabby man with the "aristocratic demeanor" is "a doctor: Surgeon once" (73). The surgeon hears the narrator call for medical papers and makes his acquaintance. One night soon thereafter the narrator notices that the surgeon, sitting and drinking alone, drains the green syrup of his absinthe "so slowly and pleasurably" (74) that he must be, in fact is, an alcoholic.
The latter approaches the narrator and begins elaborating a complicated theory of time and how it is an internalized, organically controlled, locus in the brain, no different "from an ordinary brain cell" (77). As such, he, the surgeon, proposes to cut it out, imagining, grandiloquently, vast seas of gratitude washing up on his shore as he frees humanity of the "silent madness of mortality" (78). The surgeon ends with a toast to absinthe, "a drug to be taken orally, and which is useful against time, temporarily. . . . We won’t be needing it much longer, since the surgical method’s both radical and excellent. Cheers, my dear colleague!" (78-79)
It is 1905, and a young doctor just out of internship in Chicago has decided to head for the southwest to seek his fortune. He finds himself on a slow train in southern New Mexico, sitting across from a Sister of Mercy "in her black robes, skirts and sleeves, and heavy starch." When the train stops, the doctor inquires about a group of men huddled on the platform. They surround a severely ill Mexican worker, who turns out to have appendicitis. The doctor insists that only an immediate operation will save his life, but the Mexicans are violently opposed to surgery. Eventually, the doctor enlists the nun’s help to persuade them.
In the blistering heat, they carry the man to a shed where the doctor performs an appendectomy with instruments in his black bag, including morphine and chloroform. For the next 24 hours, he and the nun watch over the man, and then carry him to the nearest town on the next train. He survives, which is good because otherwise the Mexicans have threatened to kill the doctor. The nun, who throughout has been cool toward the doctor because of his use of "rough" language, proceeds on her way to Texas.