J. W. called at eight-thirty. I had just opened my eyes. It was so perfectly timed it’s like I received a telepathic signal from across the universe. I answered just before my ring-tone of the Twisted Nerve whistle from Kill Bill would have been recognized like in a name that tune contest, which in this case is five beats. I could tell J was surprised when I answered so quickly. The last time I heard his voice was five years earlier, the day his wife died of metastatic melanoma. At the time, I was in the tropicals section of the Stein Nursery looking for an exotic desk-top plant I would most likely kill in the ensuing months, but I wanted to try. Again. I wondered if someone else died: –that’s how often we talked–but no one had. He called to thank me. He was as old as I am now the day I saved his life. He will be eighty this year.
There are two people, that I remember, whose lives I saved. I know there are more, but only two that I remember, like the day a man landed on the moon, or the day Kennedy was shot, or the day two jets flew into the World Trade Center; those kinds of days. Of course, it’s not just me, there’s an entire cadre of people behind that effort; however, late at night, that cadre is four, and it can be a lonely place with the pulse of one’s life between your fingers as you work while silently praying, not yet, Dear Lord. Please. Not yet.
I remember a close friend, a gynecologist, now deceased, who was noted for several aphorisms. His most oft-used one was, “All I need is a syringe of lidocaine and a housekeeper,” meaning, I need to do this case now. The humor lies in the absurdness of the statement, as though he, single-handily, had the capability to do the case alone; however, to the surgeon, all those others required, all those vital participants of that endeavor, that cadre, is lost to the mists of time and there remains in memory only the patient, the pulse of life, and the one soul trying to save another with his hands and a prayer.
When I saw J a quarter of a century ago, he was dying before my eyes. The CT scan had revealed a mesenteric vascular injury and the contrast that had been injected into his vein was running out into his peritoneal space. His pressures were being maintained with crystalloid and blood was on the way. He asked me if he could be transferred to a bigger hospital and I said no. I said that there was not enough time. Later, when he thanked me then, I told him that I did nothing remarkable. I was just doing my job, and on that day, at that time, it was my job. It could easily have been one of my partners. It simply happened to be me. J became my friend as much as I discouraged it as I try to not establish relationships with any of my patients, but he was insistent, and I relented.
My wife and I came to know J and his wife. It wasn’t only me J wanted to become friends with. He wanted to become friends with the cadre, and I remember one beautiful summer day on Lake Michigan with J and B, my anesthesiologist friend and my office nurse and our families. J and I stayed in touch over the years, a few games of golf, one afternoon shooting skeet with J’s shotguns, an annual Christmas letter, and a card sometimes returned, our primary form of communication, but I remembered him well, and I admired him. I think it was important to J to know me beyond the scope of a six-day hospitalization and ten-minute post-op office visit, because he knew. Despite my blather of just doing my job, he knew. He knew, when I told him “no” that he had not long to live. He knew before I even said the words.
People think that surgeons are paid to cut. They are not. They are paid to make decisions; continuously, before, during, and after that relatively brief interaction involving sharp edges and thread. Perhaps another would have made different decisions on that day that may have resulted in a different outcome, but on that day, when I was working to save the life of another, I made the right decisions.
J called me on Thanksgiving to thank me for saving his life, and it was I who should have thanked him for being reminded of that. He had no idea how much that meant to me; for, in my 30 years of being a surgeon it was J that I best remember for the simple reason that he would have died most certainly that day if I hadn’t worked frantically with my hands, silently praying, not yet, Dear Lord. Please. Not yet.