San José, Costa Rica, since 1956

Physician, Heal Thyself

Our second patient that day was a young woman, 25, ectomorph, very pallid, presenting a mitral stenosis of recent origin. I told my anesthesiologist to go very carefully with this one.

She was a working girl, so although we suspected more extensive damage, we elected to go in between the second and third ribs – not the smartest idea in the world, but it might save her weeks of recuperation from a per-sternum approach.

I made the primary incision; then, as my number two was inserting the rib retractor, his hand slipped and displaced the shawl cover, inadvertently exposing the right breast. Oddly enough for a patient under general anesthesia, the mammilla was fully extended.

Instantly, I thought “Omigod! This could be my wife!” I started to sweat, my hand shook, and I had to leave it to my number two while I made a dash for the bathroom.

To give you some idea how inexplicable this reaction was, I should explain that, at least in our neck of the woods, surgeons are prohibited from operating on close family.

And even more to the point, after years of cutting up morgue product and further years of clinical practice, the emotional relationship of the surgeon to the body on the table is the same as that of the repairman to the TV set he is working on. It is simply a problem to be resolved as expeditiously as possible. Consequently, this unwonted emotional response was totally shattering, as it threatened my whole professional future.

The board gave me a month off to figure it out, and I started by consulting my psych colleagues. The most I got out of them was that it was about time I came around to thinking of bodies as people, which wasn’t very helpful. Then, suddenly, in my frantic search for a cure, it dawned on me that I had been outrageously neglecting my wife.

She it was who had put me through medical school. Then, while I was working 16 hours a day learning my trade, and dead to the world for another seven, it was she who raised the children with very little help from me. And then she stood by me while a litigious generation did its level best to put me out of business. I had taken her for granted in my rush for reputation.

So now I took another six months off to repair the damage, and wooed her as I should have done all along. I think she was faintly embarrassed by my ardor, but responded well, so I knew I was on the right track. Finally, I felt competent to go back to work, and, miraculously, my phobia had vanished and I could again view a naked body as just a puzzle awaiting a solution. So my problem had been nothing more than a guilty conscience, and you can be sure that from then on I set aside a deal more time for my family. And it worked out fine.


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