The Quest for the Surgeon's Soul

I always thought I wanted to be a trauma surgeon for the same reason that a lot of young doctors do.  I wanted to save the world – one dramatic, glorious exploratory laparotomy at a time. 

About two weeks ago I got just that chance.  The young man was nineteen, and he was the victim of a single gunshot wound.  Upon surgical exploration we found injuries to his transverse colon, jejunum, gallbladder, his pancreatic head, his duodenum…our eyes collectively widened as we realized that what we had in front of us was the perfect patient for the notorious trauma Whipple. 

As we worked our way through the dissection, I kept thinking of Kenneth Mattox’s chapter titled “The Wounded Surgical Soul” in Top Knife.  If any patient ever had a soul injury, then surely this one did.  Mattox describes the “seat of the soul” as a “spherical area, not much larger than a silver dollar, centered on the head of the pancreas.” He calls injuries to this area soul wounds because “they are more lethal than any other type of abdominal trauma.”[1]

It is interesting to think of one’s soul as something discrete, and even more fascinating to think of it as something curable by surgery.  There it is!  There’s his soul!  Look at it, see it pulsating, feel it in the palm of your hand. 

Why does a surgeon quest for soul wounds?  Why are we so excited to attack this particular injury?  It may be the most challenging area to operate on under ideal circumstances; in the context of trauma, it becomes harrowing.

I think we look for soul wounds because trauma provides the best mirror there is for the otherwise invisible.  We are obsessed with anatomy and yet we never get the chance to see our own.  How many times have we treated victims and imagined ourselves – or our loved ones – in their position?  I look for soul wounds because I want to see what my own soul looks like.  When I operate on a young trauma victim, on some very real level I am operating on myself. 

And what does my soul look like?  What does it feel like in the palm of my own hand? 

It’s terrifyingly fragile; impossibly compact, and beautifully functional.  I marvel at the general similarities between all of our surgical souls, and also at the subtle differences that make them unique.  And as I’ve gone through my training, I’ve learned that what is unique about my surgical soul is that it needs trauma surgery to stay alive.  I need that mirror.  I need to be reminded that I am so similar to you, and yet also so unique.  And I know enough about my own soul to realize that healing another is curative for me.  Why am I becoming a trauma surgeon, you ask?  Because I have to, for my soul’s sake. 

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[1] Hirshberg, Asher, and Kenneth L. Mattox. Top Knife: The Art & Craft of Trauma Surgery. Castle Hill Barns, Shrewsbury, UK: Tfm Pub., 2008. Print.  Page 115