Journal of the SURGICAL HUMANITIES DEPARTMENT OF SURGERY | UNIVERSITY OF SASKATCHEWAN Spring 2014 Journal of the SURGICAL HUMANITIES CONTENTS EDITOR-IN-CHIEF Francis Christian EDITORAL BOARD Francis Christian Ivar Mendez Taras Mycyk Justine Pearl Marlessa Wesolowski David Swann GRAPHIC DESIGN, COMMUNICATIONS AND MARKETING Department of Surgery University of Saskatchewan COVER PAGE Primal (96” x 60” - acrylic on canvas) Marlessa Wesolowski CONTACT US Journal of the Surgical Humanities c/o Surgical Humanities Program Department of Surgery University of Saskatchewan Health Sciences Building 107 Wiggins Road, 4th floor, Suite B419 Saskatoon SK S7N 5E5 TEL: 306.966-7323 [email protected] http://goo.gl/zdhXgN 2 | JOURNAL OF THE SURGICAL HUMANITIES 04 MESSAGE FROM THE CHAIR CONTENTS Ivar Mendez 05 EDITORIAL Francis Christian 06 ETHER DAY Murray Dease 16 MY CONVERSATION Marlessa Wesolowski 20 OLGA THE GOLDEN OWL Thompson Bird 22 FAMILY MEETING Justine Pearl 24 OSLERIUM Introduction by Francis Christian 26 A WAY OF LIFE (PART 1) Sir William Osler 28 POETRY CORNER FEATURING... Erick McNair 30 ZHIVAGO: DOCTOR IN LITERATURE Francis Christian 32 HOW TO BE A DOCTOR Stephen Butler Leacock 33 SUBMISSION GUIDELINES JOURNAL OF THE SURGICAL HUMANITIES | 3 he Surgical Humanities Program was conceived as a platform to sustain and encourage our Tfaculty, residents and students to intergrate the humanities to their daily surgical practice. We firmly believe that the humanities as expressed by activities MESSAGE such as the visual arts, music, literature, poetry and philosophy are not only complimentary to surgery but have a synergistic effect in enhancing our clinical work encouraging creativity and innovation and from the promoting education. The Surgical Humanities Journal is an important component of the Surgical Humanities Program at the University of Saskatchewan. It is our hope that this Journal will be a conduit for members of Chairman the Department of Surgery to communicate their humanistic accomplishments and contribute to enrich our activities both within and outside the operating room. We expect that, as the Journal develops and matures, the contributions and readership will extend beyond the confines of our institution. I am convinced that the Journal will have a long life and that it will inspire us for years to come. Sincere thanks to Dr. Francis Christian, Editor of Ivar Mendez, MD, PhD, FRCSC, FACS the journal and director of the Surgical Humanities Fred H. Wigmore Professor and Unified Head Program as well as the contributors to this first issue. Department of Surgery Enjoy this inaugural issue and provide us with your University of Saskatchewan feedback and contributions. Dr. Mendez sculpting the bust of Dr. Charles Drake, a world-renowned Canadian neurosurgeon. The bronze sculpture has been installed in front of the University Hospital in London, Ontario. 4 | JOURNAL OF THE SURGICAL HUMANITIES EDITORIAL t is through the enriching of and visual work that we can. by side with the rather decent Dr. one’s own life and through this, Every era believes itself different Jekyll have become so timeless Ithe enriching of the career and and the twenty first century had in their relevance to everyday life, work of healing entrusted to us, its own vociferous champions that the title of Robert Stevenson’s that an education and engagement who put forth their own hopeful novel has passed into our every in the humanities makes its case vision of a utopian future based day speech (“Jekyll and Hyde”). And for a prominent position in our on the march of scientific progress. Tolstoy’s “The Death of Ivan Illich” lives as house staff, surgeons and Remarkably, very similar forecasts will continue to speak to future physicians. Although the goals of were made, in a different context, generations about our common such an engagement may well a century ago at the dawn of the humanity and inescapable be to enhance our particular twentieth century. mortality. specialty’s understanding or dealings with patients, there is More sober reflection of course, This journal’s measure of success the inescapable, accompanying told us that whilst science may will be reckoned not so much in and sometimes imperceptible solve some of the old problems, the number of times it is read or influence of a beautiful poem or there will always be new problems re-read but in the hours and days fine novel or exquisite work of art and challenges to take their place. of quiet reflection it produces. Its or music upon our own souls and And that these problems, both old “impact factor” will not be in the sensibilities that is the first benefit and new, are rooted in the basic number of citations that result, but from this encounter. From this, assumptions of our humanity - our in whether it succeeds, however must flow a better understanding capability for great good and great imperfectly, in its goals both to of ourselves, our patients, the harm, our inherent frailties and the inform and to enrich. human story, life, suffering and specter of our mortality. mortality. The importance therefore, of a In seeking to fulfill this mandate, discipline that has a measure of “Surgical Humanities” is only too continuity from generation to aware of its inability - and the generation and is not subject to Francis Christian inability of any similar journal - the knowledge base of science Editor-in-Chief to capture completely the ideal at a particular time in history, and mountain-top of human should be obvious. The humanities experience in all its severe and provide this continuity, for the miraculous forms. But in the music of the Aeolian harp of striving after the summit, in its ancient Greece is still valid as a relentless pursuit of the ideal, we testament to beauty; so is Shelley’s will leave no stone unturned and “Ode to a Skylark,” written two will always work from issue to hundred years ago. The two-faced, issue, to bring you the best written evil depravity of Mr. Hyde set side JOURNAL OF THE SURGICAL HUMANITIES | 5 ne of the most significant events in the history of Omedicine very nearly didn’t happen. On Friday October 16, 1846, at ten o’clock in the morning, the most prominent surgeon in United States,1 Dr. John Collins Warren, was waiting to start his day. The only operation scheduled was the removal of a tumor from the neck of an otherwise healthy 20-year-old man named Gilbert Abbott. Their would-be-anesthesiologist, 27-year-old dentist and borderline con-man William T.G. ETHER Morton, was late. An event was about to occur that would cause revolutions felt well beyond the field of medicine. It would truly change the world. Elsewhere around the globe, at roughly the same time, give or take 10 years, other world changing DAY events were taking place: • In the United States war had been declared on Mexico. Abner Doubleday had recently invented baseball. Slavery was a part of American life, and the seeds of the Civil War were being sown.2 • North of the American border, Upper and Lower Canada had just united into the Province of Canada.3 The popularity of the beaver hat was diminishing in Europe and, because of this, by 1850 the fur trade had Murray Dease begun to decline. 4 Anesthesiologist • In Europe, England was in the heyday of the Victorian Age.. The Irish were running out of potatoes.2 Department of Anesthesia • Dickens, Dumas, Bronte, Poe, and Marx were writing University of Saskatchewan and their best sellers. Charles Darwin was getting into his Saskatoon Health Region act.5 6 | JOURNAL OF THE SURGICAL HUMANITIES • In the musical world, the 1840’s saw the births of of their own, and be the cause of a disquiet which favors Dvorak, Tchaikovsky, and Grieg as well as the death of neither mental nor bodily health”.9 Chopin.6 • The first telegraph sent a message from Baltimore Surgery was an awful thing before the mid 1840’s because to Washington (the message read “What hath God there were few options for surgical anesthesia, and no Wrought?”). The Colt revolver, refrigerator, and internal satisfactory ones. The methods used were either too combustion engine were invented.7 weak to be effective, or so strong that they caused death (perhaps not so bad if one was facing the prospect of Back in the medical world, Joseph Lister had just begun anesthesia-free surgery).10 Alcohol was readily available his ground-breaking work on antisepsis.8 and some patients tried getting drunk before their operation. Alcohol can be effective in numbing the Surgery at this time was a very difficult affair, involving existential pain of everyday life, but is not so effective various straps and hooks to hold the patient down as he with surgical pain.11 Alcohol had some merit as an or she screamed and writhed under the knife. Operations anesthetic, as one nineteenth century physician observed were the last resort of surgeons and patients. Walking to a case of an Irishman who had part of his face eaten by a the operating room was like going to a hanging. Surgeons pig while he was lying dead drunk on the ground, 12 but were known to weep or vomit after particularly terrible getting drunk was far from a perfect solution. operations. The following is an actual description of such an operation: Opioids had been around for centuries and they were effective pain relievers, but their pros came with some “Of the agony it occasioned, I will say nothing. Suffering so very undesirable cons. Delivery of a consistent and great as I underwent cannot be expressed in words, and effective dose was difficult as the medical syringe had fortunately cannot be recalled...the sense of desertion by not yet been invented.