Summary:

Selzer developed Legionnaire's disease and was comatose for 23 days in 1991. In this short book, he describes his illness and prolonged convalescence. The time of his stay in the ICU is lost to him, so he invents the story of what (might have) happened when he was comatose and delirious. In fact, he invents his own death and resurrection.

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Seeking redemption in the bloody business of surgery, Selzer's narrator tells several medical stories that humbled his surgeon's pride and refers approvingly to an atheist priest in a story by Unamuno who carried on for the sake of his congregation because "their need is greater than his sacrifice." Selzer finally tells us that it is in writing, if anywhere, that the elusive soul can be represented.

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In this collection Richard Selzer brings together 25 stories from his previous books, along with two new stories, Avalanche (see this database) and "Angel, Tuning a Lute." The unifying theme is the world of medicine and healing, which Selzer explores with a keen eye and compassionate heart. These stories are firmly grounded in the foibles, suffering, and exultation of the human body.

In the Introduction Selzer sketches the path by which he became a surgeon-writer and he indicates the origin of some of the stories. Particularly interesting are the stories that do homage to literary and historical figures; for example, "Poe's Light-house," which grew out of a fragment Edgar Allan Poe wrote in his last delirium, and "The Black Swan," a re-writing of a Thomas Mann novella (Mann's The Black Swan is annotated in this database).

Likewise, the story of how "Avalanche" was written is an interesting tale in itself. Selzer's description of pruning the story from his journal reminds me of Michelangelo's comment that the sculpture already exists in the block of marble. The sculptor merely removes the unnecessary stone. The Doctor Stories contains many of Selzer's tales that have become part of the Literature and Medicine canon; these include, for example, "Tube Feeding," "Sarcophagus," Imelda, Mercy, Brute, and Four Appointments with the Discus Thrower. (See this database for annotations of the latter four.)

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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.

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This amusingly told narrative by a surgeon/author begins by describing how "wrong-headed [it is] to think of total submersion in the study and practice of medicine." He sets aside time to read at his neighborhood library, where he befriends six elderly, indigent "regulars." In spite of himself, the physician will out. His powers of medical observation and empathetic character lead him to perform a most menial task: cutting the overgrown toenails of these severely arthritic people in order to alleviate their pain.

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The Exact Location of the Soul is a collection of 26 essays along with an introduction titled "The Making of a Doctor/Writer." Most of these essays are reprinted from Selzer's earlier books (especially Mortal Lessons and Letters to a Young Doctor). Six pieces are new and include a commentary on the problem of AIDS in Haiti ("A Mask on the Face of Death"), musings on organ donation ("Brain Death: A Hesitation"), a conversation between a mother and son ("Of Nazareth and New Haven"), and the suicide of a college student ("Phantom Vision").

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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.

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A physician recounts an experience he had assisting an American plastic surgeon as he performed charity surgery in Honduras. One young woman, Imelda, dies of malignant hyperthermia prior to surgical repair of her cleft lip. After her death, the surgeon returns to the patient to finish the surgery. The narrator tries to imagine the surgeon's motivation for this act, as well as the family's reaction to it.

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In the Emergency Room at 2 AM, a doctor tries to suture a laceration on the forehead of "a huge black man," brought in by the police. The man groans and strains; he won't hold still. Finally, the doctor becomes so angry that he sutures the patient's earlobes to the mattress. Not only that, he leans over the man's face and grins: "It is the cruelest grin of my life." Then he sutures the man's wound.

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Amidst the desolate pampas of Argentina, two nameless fugitives serendipitously meet and fall deeply in love. The woman, an orphan, is running from her tragic past and sheltered life. The man, a gaucho, is fleeing from the seven vengeful brothers of a man he killed during a fight.

Although both are emotionally wounded and isolated, they become joined by the simple act of cleaning and dressing the deep laceration of the gaucho’s arm. When they discover the ecstasy and contentment of love, their passion is abruptly and violently challenged by the gaucho’s injured arm which becomes infected with tetanus.

The woman faithfully cares for her suffering lover who silently endures the fever, severe muscle spasms, and wasting of tetanus before succumbing to the painful death of lockjaw. Ironically his face is paralyzed with a twisted smile due to the persistent muscle contractions.

The brothers of the man whom the gaucho had killed arrive too late to exact their revenge so they set fire to the couple’s farmhouse and burn it to the ground. The woman places a handful of her lover’s burning ashes in her mouth thus preserving his remains and uniting his spirit with hers forever.

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