Richard Selzer, MD: Writer and Surgeon

Myself, I have always been intoxicated by words, grabbed up great armsful of them and run across the page letting fall what may, and only then pausing to select, sort, rearrange.

-Richard Selzer, MD

I have never been so angry at a drunk with a giant forehead laceration that I contemplated sewing his ears to the emergency room cart. I never looked at the husband of one of my patients and realized I was in the presence of a god. I have never contemplated that our bones will become “the keepsakes of the earth.”

I never had to. I never even thought about these things. But Richard Selzer did and I am richer because I have read his stories. He was the first surgeon-writer of whom I became aware. He died on June 15, 2016, at age 87.

A few years after it was published, I picked up a copy of his first book, Rituals of Surgery, and was astonished by his intense and often disturbing short stories. He was unafraid to create deeply flawed characters and made me cringe as his physician-protagonists forged ahead, accelerating toward disaster and the ethical abyss. He described life in the hospital and violence in the operating room with a poet’s potency, wonder, and literacy. He steered toward conflict. He wrote, “Surgery is the one branch of medicine that is the most violent. After all, it’s violent to take up a knife and cut open a person’s body and rummage around with your hands.”

I was a medical student when I read this for the first time. Is that what surgery is about, I wondered?

Each short story dove one step deeper than less daring writers might have ventured, be it physically, spiritually, or emotionally.  In one story, he becomes a man obsessed that there is a vine growing within his body. In another, a young man lashes out violently after his girlfriend sweetly forces him to have a birthmark removed, a spot his mother had told him made him special. In another, his protagonist-doctor discovers a lump in the breast of a prostitute with whom he has spent the night, all but forcing her to say the word cancer. In another, a military surgeon in Korea impregnates a local woman who dies of tuberculosis and complications of childbirth.

Selzer documented a fading era in medicine. He graduated from Albany Medical College in 1953 and served two years in Korea. He completed a surgery residency at Yale in 1960 and later joined the Yale faculty. He published Rituals of Surgery in 1974 and published a book every three to four years until 2010. He retired from surgery in 1985 (at age 57), but continued to create short stories and essays, mentor young writers, teach, edit and lead medical student writing workshops at Yale into his 80s.

His stories and essays are unflattering to doctors perhaps because he was self-aware about the importance of both surgeons and writers. “It is not the surgeon who is God’s darling,” he declared. “He is the victim of vanity. It is the poet who heals with his words, stanches the flow of blood, stills the rattling breath, applies poultice to the scalded flesh. Did you ask me why a surgeon writes? I think it is because I wish to be a doctor.”

Dr. Rita Charon, the founder of the Narrative Medicine Program at Columbia University, anointed him "among the first physicians to understand the power of writing and reading fiction within medicine. He helped to open up this whole territory to those of us who came after."

Other surgeons have published fiction and nonfiction since Selzer opened the literary door and began sharing the secrets. Atul Gawande has written several remarkable books. I recently read Bud Shaw’s Last Night in the OR: A Transplant Surgeon’s Odyssey, which tells several harrowing, self-revelatory tales from the early days of liver transplantation. I wonder if such books would have been possible without Dr. Selzer’s trailblazing work.

Selzer’s work has been on my shelf since medical school, inspiring me as I tried to be a writer and admonishing me as I tried to be a physician. He came along at a critical time in my life and I am grateful to him for making me cringe and think and create.