The Consultation

Selzer, Richard

Primary Category: Literature / Fiction

Genre: Short Story

Annotated by:
Miksanek, Tony
  • Date of entry: May-25-2004


A surgeon attending a medical meeting becomes bored and hires a prostitute. When he awakens next to her in bed the following morning, he first observes, then palpates a suspicious lump in the right breast of the sleeping woman. Although he informs her of the abnormality and the need for further evaluation and treatment, the surgeon cannot bring himself to divulge the possibility (or even likelihood) that the breast lump is malignant.

It is the prostitute who acknowledges (and eventually proclaims) that the lump might be cancer. She realizes that breast cancer might prove fatal to her livelihood as well as her life. The surgeon appears less upset by the diagnosis and potential suffering associated with it than the realization that both he and the tumor were rivals, "each feeding on her flesh" in a competition to consume the woman.

He pays the prostitute one hundred dollars for her services and cannot wait to exit the room. She offers him ten dollars for his consultation, but the surgeon refuses the fee with the excuse that he doesn't make house calls.


This provocative story tackles a number of sensitive issues surrounding the concept of the doctor-patient relationship. It also questions the very definition of the term, "patient." Is a patient anyone who is ill? Must a patient be under medical care or at least someone who seeks medical treatment? If a sick individual does not engage a doctor's services, can they still be considered a patient?

This brief tale seeks not only to explore the boundaries of the doctor-patient relationship but also asks what defines the professional relationship between a physician and an individual. If a physician refuses payment for his services and advice (or offers them free of charge), does that absolve him from his responsibility to an individual? To what extent or extremes must a doctor resort to compel an individual to receive necessary treatment? Does the casual sexual relationship described in this story prohibit the surgeon from establishing a doctor-patient relationship?

"The Consultation" inquires how doctors separate their personal lives from their professional ones. The story also evokes questions about the frailty of the character of physicians, fear of involvement, the breakdown of communication in medical encounters, and truthfulness. It disturbingly compares doctors to disease (since both seem to share a mutual lust for the flesh). The relative value of the services rendered in this story is also intriguing--one hundred dollars for sex but only ten dollars for medical advice.

Primary Source

Rituals of Surgery


Harper's Magazine Press

Place Published

New York



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