Thirteen
The Missing Chapter
Medical students often experience a profound, ego-wrenching shock at
the midpoint of their training, as the focus shifts from classroom to
bedside. My experience was typical, since this division was even sharper
in the 1940s than it is today. After two years' study of the scientific
underpinnings of medicine, my classmates and I thought we were pretty
smart. During long days and longer nights of lectures, notes, labs,
books, reviews, papers, and exams, we'd drunk so deeply of the distilled
wisdom of the ages that surely we must know all there was to know
about bodies and diseases. All that was left, it seemed, was learning how
to apply that knowledge as apprentice doctors. Then we began to study
with the senior members of the clinical departments, veterans of a less
scientific era, who brought us up short. Their message soon became
clear: We didn't know so damn much after all; no one did. All our
learning was fine as far as it went, but on the hectic wards of Bellevue
things often didn't go by the book.
The greatest teacher I had in those days was my surgery professor, Dr.
John Mulholland, a granite cliff of a man whose iron-gray crew cut
emphasized his uncompromising idealism. Any hint of laziness, impa-
tience, or unconcern from his students brought a brusque reprimand,
but Mulholland was gravely polite and compassionate to the dirtiest
wino who needed a doctor. He showed us countless problems and tech-
niques in his demonstration-lectures held in the nineteenth-century am-
phitheater, but he repeated one salient message over and over: "The
surgeon can cut, remove, or rearrange the tissues, and sew up the
wound, but only the patient can do the healing. Surgeons must always