Cutting Remarks: Insights and Recollections of a Surgeon

This book is hysterical. There were parts when I could not stop laughing. It gives a nice, well-rounded view of this surgeon's life. Interesting read.

Known for their arrogance, surgeons on the whole are a breed of doctors some people love to hate. The fact is, however, that it does take stones and a steel will, forged on the anvil of years of training, to open someone up someone's belly, fix the problem, and get out before anything worse happens. It is the first few years of this training that Dr. Schwab writes about, and any aspiring surgeon would be thrilled and truly educated in reading his experiences at UCSF. However, this book surprised me because in spite of the fact that it obviously deals with a surgery residency, the beauty of the book is Dr. Schwab's obvious heart for his patients, the dedication to his craft, and the humility (right there tires should be screeching talking about a surgeon!) that is regularly shown about how much he has to learn. There is a simple honesty to Dr. Schwab's writing that is devoid of pompous declarations or pithy statements so unfortunately found in other surgeons' writings. There is an exquisitely crafted balance between the serious and the funny, finding that sweet spot where something strikes the reader as profound yet on the whole, one doesn't feel like he takes himself too seriously. In spite of decades of surgery practice, Dr. Schwab still captures (and I'm convinced, has) that youthful energy and optimism of his formative surgical years and reads more like a conversation with an old friend than a "memoir." I think the biggest and most honest testament to this book is the following: I'm a 2nd year medical student and I came to this page to buy my 2nd copy of this book, because after reading the 1st one, I've lent it to so many classmates and friends, it's barely holding together--in fact, I don't even know who has it anymore. This next copy is mine, all mine, and I look forward to re-reading every word. [...]

Being the type of person to permanently remove the surgery channel from my TV, I didn't expect to like this book. Truthfully I didn't like it, I LOVED IT! Dr. Schwab is hilarious, brilliant, touching, and extremely insightful. It is not often we get inside such a talented and humble man's mind. This book made me laugh out loud and darned if I didn't learn a lot! I am eagerly awaiting the sequel.

This gritty and sometimes laugh-out-loud funny memoir of a surgeon's years of training in San Francisco from 1970 to 1977 caught my attention from the intro, which is headed Reality Check: "Someone said writing is easy: you just sit down at a typewriter and open a vein. As I've been in the business of preventing bleeding, this may not work out well. You wouldn't want John Updike taking out your gallbladder." This dry and self-deprecating humor is found through the entire book and helps relieve the tension of some of the more difficult surgical moments. His riffs on the surgeons who trained him are hilarious: "Lester Weisman looked like Death. Bony, stooped, hook-nosed, and spider-fingered, he spoke in a voice that was chronically hoarse, a wheezing gust from Hades... Raising a hand toward you if he addressed you, he let the fingers droop and motioned vaguely, as if it were too much effort to point. When he smiled, it looked like he smelled something putrid. He should have carried a scythe, but it would have been unseemly for a former chairman of the department." And then Schwab deadpans, "I liked him a lot." Then, his descriptions of the patients he and his colleagues worked with had me rocking with laughter. There was one story about a man with a pocket in his esophagus (a diverticulum) "who used to carry around a jar of pickled oysters. Before eating, he'd swallow one, which exactly filled the diverticulum without pushing too much on the esophagus. So he could eat, after which he'd push on the side of his neck and regurgitate the oyster into the jar. Probably didn't get invited out much." Another thing I loved was the feeling of poetry or artistic enjoyment that he shares about how surgery works. In one passage, he talks about stitching up a bowel after surgery: "As you watch the edges disappear inward, and see a row of evenly spaced sutures complete a perfect circle, no mucosa showing; as you observe the tiny nearby arteries dancing their proof that you haven't disrupted the blood supply to the edges, you know you can safely drop it back inside, a secret gift to the patient." The clarity and density of Schwab's writing allows him to pack in an enormous amount of information and insight. With most books that I am enjoying, I will read 100 pages or more in one sitting, but with this one, I wanted and needed to slow down and really savor every word, because there were so many excellent stories and well-explained surgical adventures in each chapter. His writing style, of making every word really count, really imparted the feel of a surgical internship perfectly in the sense that the pace of surgical action, emotional conundrums, and medical information (presented in a manageable way for the layman) never slowed. I'd absolutely recommend this to anyone who enjoys medical non-fiction. Schwab has a really unique voice in this field, and even after having read about twenty medical narrative non-fiction books in the last two years, I found this t

For most surgeons, residency training is long, arduous, often brutally exhausting and requires great nerves and stamina. Dr. Schwab takes the reader from the timidity of the first day as a "real Doctor" just out of medical school to a time, six years later, when he emerges competent, brave and able to handle almost any surgical situation. Framed in the world-class University of California San Francisco program, these years are spent in cardiac, transplant, vascular and trauma surgery, to name but a few of the "rotations". Fabulous stories from those days bring the reader right out of his chair, as when the "jumpers" (off the Bridge) come into the SF General Hospital Emergency Room in full cardiac arrest. This is a "can't put it down" book, which reminded me of the way I felt in 1970 when I first read M*A*S*H, which up until then was the only surgical "novel" which had both pulse-quickening operating room drama and out of the hospital humor. This book does much the same, but all of the stories are true! Although surgeons will see themselves in it's 221 pages and delight in the memories, laymen with any curiosity or interest in just how tough it is to get to the top of the surgical pile will also find it a fascinating read, and at the end, will probably resolve to pick it up in a few months to read it again. Great work, Dr. Schwab. John N. Baldwin, MD FACS (General, Vascular and Chest Surgery)