Speaking of Operations

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This Etext prepared by Kirk Pearson

"Speaking of Operations--"

by Irvin S. Cobb

Respectfully dedicated to two classes:

Those who have already been operated on
Those who have not yet been operated on

Now that the last belated bill for services professionally rendered
has been properly paid and properly receipted; now that the memory
of the event, like the mark of the stitches, has faded out from a
vivid red to a becoming pink shade; now that I pass a display of
adhesive tape in a drug-store window without flinching--I sit me
down to write a little piece about a certain matter--a small thing,
but mine own--to wit, That Operation.

For years I have noticed that persons who underwent pruning or
remodeling at the hands of a duly qualified surgeon, and survived,
like to talk about it afterward. In the event of their not surviving
I have no doubt they still liked to talk about it, but in a different
locality. Of all the readily available topics for use, whether
among friends or among strangers, an operation seems to be the
handiest and most dependable. It beats the Tariff, or Roosevelt,
or Bryan, or when this war is going to end, if ever, if you are a
man talking to other men; and it is more exciting even than the
question of how Mrs. Vernon Castle will wear her hair this season,
if you are a woman talking to other women.

For mixed companies a whale is one of the best and the easiest
things to talk about that I know of. In regard to whales and
their peculiarities you can make almost any assertion without fear
of successful contradiction. Nobody ever knows any more about
them than you do. You are not hampered by facts. If someone
mentions the blubber of the whale and you chime in and say it may
be noticed for miles on a still day when the large but emotional
creature has been moved to tears by some great sorrow coming into
its life, everybody is bound to accept the statement. For after
all how few among us really know whether a distressed whale sobs
aloud or does so under its breath? Who, with any certainty, can
tell whether a mother whale hatches her own egg her own self or
leaves it on the sheltered bosom of a fjord to be incubated by
the gentle warmth of the midnight sun? The possibilities of the
proposition for purposes of informal debate, pro and con, are
apparent at a glance.

The weather, of course, helps out amazingly when you are meeting
people for the first time, because there is nearly always more or
less weather going on somewhere and practically everybody has ideas
about it. The human breakfast is also a wonderfully good topic
to start up during one of those lulls. Try it yourself the next
time the conversation seems to drag. Just speak up in an offhand
kind of way and say that you never care much about breakfast--a
slice of toast and a cup of weak tea start you off properly for
doing a hard day's work. You will be surprised to note how things
liven up and how eagerly all present join in. The lady on your
left feels that you should know she always takes two lumps of sugar
and nearly half cream, because she simply cannot abide hot milk,
no matter what the doctors say. The gentleman on your right will
be moved to confess he likes his eggs boiled for exactly three
minutes, no more and no less. Buckwheat cakes and sausage find a
champion and oatmeal rarely lacks a warm defender.

But after all, when all is said and done, the king of all topics
is operations. Sooner or later, wherever two or more are gathered
together it is reasonably certain that somebody will bring up an
operation.

Until I passed through the experience of being operated on myself,
I never really realized what a precious conversational boon the
subject is, and how great a part it plays in our intercourse with
our fellow beings on this planet. To the teller it is enormously
interesting, for he is not only the hero of the tale but the rest
of the cast and the stage setting as well--the whole show, as they
say; and if the listener has had a similar experience--and who is
there among us in these days that has not taken a nap 'neath the
shade of the old ether cone?--it acquires a doubled value.

"Speaking of operations--" you say, just like that, even though
nobody present has spoken of them; and then you are off, with your
new acquaintance sitting on the edge of his chair, or hers as the
case may be and so frequently is, with hands clutched in polite
but painful restraint, gills working up and down with impatience,
eyes brightened with desire, tongue hung in the middle, waiting for
you to pause to catch your breath, so that he or she may break in
with a few personal recollections along the same line. From a mere
conversation it resolves itself into a symptom symposium, and a
perfectly splendid time is had by all.

If an operation is such a good thing to talk about, why isn't it a
good thing to write about, too? That is what I wish to know.
Besides, I need the money. Verily, one always needs the money
when one has but recently escaped from the ministering clutches
of the modern hospital. Therefore I write.

It all dates back to the fair, bright morning when I went to call
on a prominent practitioner here in New York, whom I shall denominate
as Doctor X. I had a pain. I had had it for days. It was not a
dependable, locatable pain, such as a tummyache or a toothache is,
which you can put your hand on; but an indefinite, unsettled,
undecided kind of pain, which went wandering about from place to
place inside of me like a strange ghost lost in Cudjo's Cave. I
never knew until then what the personal sensations of a haunted
house are. If only the measly thing could have made up its mind
to settle down somewhere and start light housekeeping I think
should have been better satisfied. I never had such an uneasy
tenant. Alongside of it a woman with the moving fever would be
comparatively a fixed and stationary object.

Having always, therefore, enjoyed perfectly riotous and absolutely
unbridled health, never feeling weak and distressed unless dinner
happened to be ten or fifteen minutes late, I was green regarding
physicians and the ways of physicians. But I knew Doctor X slightly,
having met him last summer in one of his hours of ease in the grand
stand at a ball game, when he was expressing a desire to cut the
umpire's throat from ear to ear, free of charge; and I remembered
his name, and remembered, too, that he had impressed me at the
time as being a person of character and decision and scholarly
attainments.

He wore whiskers. Somehow in my mind whiskers are ever associated
with medical skill. I presume this is a heritage of my youth,
though I believe others labor under the same impression.

As I look back it seems to me that in childhood's days all the
doctors in our town wore whiskers.

I recall one old doctor down there in Kentucky who was practically
lurking in ambush all the time. All he needed was a few decoys
out in front of him and a pump gun to be a duck blind. He carried
his calomel about with him in a fruit jar, and when there was
cutting job he stropped his scalpel on his bootleg.

You see, in those primitive times germs had not been invented yet,
and so he did not have to take any steps to avoid them. Now we
know that loose, luxuriant whiskers are unsanitary, because they
make such fine winter quarters for germs; so, though the doctors
still wear whiskers, they do not wear them wild and waving. In
the profession bosky whiskers are taboo; they must be landscaped.
And since it is a recognized fact that germs abhor orderliness and
straight lines they now go elsewhere to reside, and the doctor may
still retain his traditional aspect and yet be practically germproof.
Doctor X was trimmed in accordance with the ethics of the newer
school. He had trellis whiskers. So I went to see him at his
offices in a fashionable district, on an expensive side street.

Before reaching him I passed through the hands of a maid and a
nurse, each of whom spoke to me in a low, sorrowful tone of voice,
which seemed to indicate that there was very little hope.

I reached an inner room where Doctor X was. He looked me over,
while I described for him as best I could what seemed to be the
matter with me, and asked me a number of intimate questions touching
on the lives, works, characters and peculiarities of my ancestors;
after which he made me stand up in front of him and take my coat
off, and he punched me hither and yon with his forefinger. He
also knocked repeatedly on my breastbone with his knuckles, and
each time, on doing this, would apply his ear to my chest and listen
intently for a spell, afterward shaking his head in a disappointed
way. Apparently there was nobody at home. For quite a time he
kept on knocking, but without getting any response.

He then took my temperature and fifteen dollars, and said it was
an interesting case--not unusual exactly, but interesting--and
that it called for an operation.

From the way my heart and other organs jumped inside of me at
that statement I knew at once that, no matter what he may have
thought, the premises were not unoccupied. Naturally I inquired
how soon he meant to operate. Personally I trusted there was no
hurry about it. I was perfectly willing to wait for several
years, if necessary. He smiled at my ignorance.

"I never operate," he said; "operating is entirely out of my line.
I am a diagnostician."

He was, too--I give him full credit for that. He was a good,
keen, close diagnostician. How did he know I had only fifteen
dollars on me? You did not have to tell this man what you had,
or how much. He knew without being told.

I asked whether he was acquainted with Doctor Y--Y being a person
whom I had met casually at a club to which I belong. Oh, yes, he
said, he knew Doctor Y. Y was a clever man, X said--very, very
clever; but Y specialized in the eyes, the ears, the nose and the
throat. I gathered from what Doctor X said that any time Doctor Y
ventured below the thorax he was out of bounds and liable to be
penalized; and that if by any chance he strayed down as far as the
lungs he would call for help and back out as rapidly as possible.

This was news to me. It would appear that these up-to-date
practitioners just go ahead and divide you up and partition you
out among themselves without saying anything to you about it. Your
torso belongs to one man and your legs are the exclusive property
of his brother practitioner down on the next block, and so on.
You may belong to as many as half a dozen specialists, most of
whom, very possibly, are total strangers to you, and yet never
know a thing about it yourself.

It has rather the air of trespass--nay, more than that, it bears
some of the aspects of unlawful entry--but I suppose it is legal.
Certainly, judging by what I am able to learn, the system is being
carried on generally. So it must be ethical. Anything doctors
do in a mass is ethical. Almost anything they do singly and on
individual responsibility is unethical. Being ethical among doctors
is practically the same thing as being a Democrat in Texas or a
Presbyterian in Scotland.

"Y will never do for you," said Doctor X, when I had rallied
somewhat from the shock of these disclosures. "I would suggest
that you go to Doctor Z, at such-and-such an address. You are
exactly in Z's line. I'll let him know that you are coming and
when, and I'll send him down my diagnosis."

So that same afternoon, the appointment having been made by
telephone, I went, full of quavery emotions, to Doctor Z's place.
As soon as I was inside his outer hallway, I realized that I was
nearing the presence of one highly distinguished in his profession.

A pussy-footed male attendant, in a livery that made him look like
a cross between a headwaiter and an undertaker's assistant, escorted
me through an anteroom into a reception-room, where a considerable
number of well-dressed men and women were sitting about in strained
attitudes, pretending to read magazines while they waited their
turns, but in reality furtively watching one another.

I sat down in a convenient chair, adhering fast to my hat and my
umbrella. They were the only friends I had there and I was
determined not to lose them without a struggle. On the wall were
many colored charts showing various portions of the human anatomy
and what ailed them. Directly in front of me was a very thrilling
illustration, evidently copied from an oil painting, of a liver
in a bad state of repair. I said to myself that if I had a liver
like that one I should keep it hidden from the public eye--I would
never permit it to sit for it's portrait. Still, there is no
accounting for tastes. I know a man who got his spleen back from
the doctors and now keeps it in a bottle of alcohol on the what-not
in the parlor, as one of his most treasured possessions, and
sometimes shows it to visitors. He, however, is of a very saving
disposition.

Presently a lady secretary, who sat behind a roll-top desk in a
corner of the room, lifted a forefinger and silently beckoned me
to her side. I moved over and sat down by her; she took down my
name and my age and my weight and my height, and a number of other
interesting facts that will come in very handy should anyone ever
be moved to write a complete history of my early life. In common
with Doctor X she shared one attribute--she manifested a deep
curiosity regarding my forefathers--wanted to know all about them.
I felt that this was carrying the thing too far. I felt like
saying to her:

"Miss or madam, so far as I know there is nothing the matter with
my ancestors of the second and third generations back, except that
they are dead. I am not here to seek medical assistance for a
grandparent who succumbed to disappointment that time when Samuel
J. Tilden got counted out, or for a great-grandparent who entered
into Eternal Rest very unexpectedly and in a manner entirely
uncalled for as a result of being an innocent bystander in one of
those feuds that were so popular in my native state immediately
following the Mexican War. Leave my ancestors alone. There is
no need of your shaking my family tree in the belief that a few
overripe patients will fall out. I alone--I, me, myself--am the
present candidate!"

However, I refrained from making this protest audibly. I judged
she was only going according to the ritual; and as she had a
printed card, with blanks in it ready to be filled out with details
regarding the remote members of the family connection, I humored
her along.

When I could not remember something she wished to know concerning
an ancestor I supplied her with thrilling details culled from the
field of fancy. When the card was entirely filled up she sent me
back to my old place to wait. I waited and waited, breeding fresh
ailments all the time. I had started out with one symptom; now if
I had one I had a million and a half. I could feel goose flesh
sprouting out all over me. If I had been taller I might have had
more, but not otherwise. Such is the power of the human imagination
when the surroundings are favorable to its development.

Time passed; to me it appeared that nearly all the time there was
passed and that we were getting along toward the shank-end of the
Christian era mighty fast. I was afraid my turn would come next
and afraid it would not. Perhaps you know this sensation. You
get it at the dentist's, and when you are on the list of after-dinner
speakers at a large banquet, and when you are waiting for the
father of the Only Girl in the World to make up his mind whether
he is willing to try to endure you as a son-in-law.

Then some more time passed.

One by one my companions, obeying a command, passed out through
the door at the back, vanishing out of my life forever. None of
them returned. I was vaguely wondering whether Doctor Z buried
his dead on the premises or had them removed by a secret passageway
in the rear, when a young woman in a nurse's costume tapped me
on the shoulder from behind.

I jumped. She hid a compassionate smile with her hand and told
me that the doctor would see me now.

As I rose to follow her--still clinging with the drowning man's
grip of desperation to my hat and my umbrella--I was astonished
to note by a glance at the calendar on the wall that this was
still the present date. I thought it would be Thursday of next
week at the very least.

Doctor Z also wore whiskers, carefully pointed up by an expert
hedge trimmer. He sat at his desk, surrounded by freewill offerings
from grateful patients and by glass cases containing other things
he had taken away from them when they were not in a condition to
object. I had expected, after all the preliminary ceremonies and
delays, that we should have a long skance together. Not so; not
at all. The modern expert in surgery charges as much for remembering
your name between visits as the family doctor used to expect for
staying up all night with you, but he does not waste any time when
you are in his presence.

I was about to find that out. And a little later on I was to find
out a lot of other things; in fact, that whole week was of immense
educational value to me.

I presume it was because he stood high in his profession, and was
almost constantly engaged in going into the best society that Doctor
Z did not appear to be the least bit excited over my having picked
him out to look into me. In the most perfunctory manner he shook
the hand that has shaken the hands of Jess Willard, George M. Cohan
and Henry Ford, and bade me be seated in a chair which was drawn
up in a strong light, where he might gaze directly at me as we
conversed and so get the full values of the composition. But if
I was a treat for him to look at he concealed his feelings very
effectually.

He certainly had his emotions under splendid control. But then,
of course, you must remember that he probably had traveled about
extensively and was used to sight-seeing.

From this point on everything passed off in a most businesslike
manner. He reached into a filing cabinet and took out an exhibit,
which I recognized as the same one his secretary had filled out
in the early part of the century. So I was already in the card-index
class. Then briefly he looked over the manifest that Doctor X had
sent him. It may not have been a manifest--it may have been an
invoice or a bill of lading. Anyhow I was in the assignee's hands.
I could only hope it would not eventually become necessary to call
in a receiver. Then he spoke:

"Yes, yes-yes," he said; "yes-yes-yes! Operation required. Small
matter--hum, hum! Let's see--this is Tuesday? Quite so. Do it
Friday! Friday at"--he glanced toward a scribbled pad of engagement
dates at his elbow--"Friday at seven A. M. No, make it seven-fifteen.
Have important tumor case at seven. St. Germicide's Hospital.
You know the place--up on Umpty-umph Street. Go' day! Miss Whoziz,
call next visitor."

And before I realized that practically the whole affair had been
settled I was outside the consultation-room in a small private
hall, and the secretary was telling me further details would be
conveyed to me by mail. I went home in a dazed state. For the
first time I was beginning to learn something about an industry in
which heretofore I had never been interested. Especially was I
struck by the difference now revealed to me in the preliminary
stages of the surgeons' business as compared with their fellow
experts in the allied cutting trades--tailors, for instance, not
to mention barbers. Every barber, you know, used to be a surgeon,
only he spelled it chirurgeon. Since then the two professions
have drifted far apart. Even a half-witted barber--the kind who
always has the first chair as you come into the shop--can easily
spend ten minutes of your time thinking of things he thinks you
should have and mentioning them to you one by one, whereas any
good, live surgeon knows what you have almost instantly.

As for the tailor--consider how wearisome are his methods when
you parallel them alongside the tremendous advances in this direction
made by the surgeon--how cumbersome and old-fashioned and tedious!
Why, an experienced surgeon has you all apart in half the time the
tailor takes up in deciding whether the vest shall fasten with
five buttons or six. Our own domestic tailors are bad enough in
this regard and the Old World tailors are even worse.

I remember a German tailor in Aix-la-Chapelle in the fall of 1914
who undertook to build for me a suit suitable for visiting the
battle lines informally. He was the most literary tailor I ever
met anywhere. He would drape the material over my person and
then take a piece of chalk and write quite a nice long piece on
me. Then he would rub it out and write it all over again, but
more fully. He kept this up at intervals of every other day until
he had writer's cramp. After that he used pins. He would pin the
seams together, uttering little soothing, clucking sounds in German
whenever a pin went through the goods and into me. The German
cluck is not so soothing as the cluck of the English-speaking
peoples, I find.

At the end of two long and trying weeks, which wore both of us
down noticeably, he had the job done. It was not an unqualified
success. He regarded is as a suit of clothes, but I knew better;
it was a set of slip covers, and if only I had been a two-seated
runabout it would have proved a perfect fit, I am sure; but I am
a single-seated design and it did not answer. I wore it to the
war because I had nothing else to wear that would stamp me as a
regular war correspondent, except, of course, my wrist watch; but
I shall not wear it to another war. War is terrible enough already;
and, besides, I have parted with it. On my way home through Holland
I gave that suit to a couple of poor Belgian refugees, and I presume
they are still wearing it.

So far as I have been able to observe, the surgeons and the tailors
of these times share but one common instinct: If you go to a new
surgeon or to a new tailor he is morally certain, after looking
you over, that the last surgeon you had or the last tailor, did
not do your cutting properly. There, however, is where the
resemblance ends. The tailor, as I remarked in effect just now,
wants an hour at least in which to decide how he may best cover
up and disguise the irregularities of the human form; in much less
time than that the surgeon has completely altered the form itself.

With the surgeon it is very much as it is with those learned men
who write those large, impressive works of reference which should
be permanently in every library, and which we are forever buying
from an agent because we are so passionately addicted to payments.
If the thing he seeks does not appear in the contents proper he
knows exactly where to look for it. "See appendix," says the
historian to you in a footnote. "See appendix," says the surgeon
to himself, the while humming a cheery refrain. And so he does.

Well, I went home. This was Tuesday and the operation was not
to be performed until the coming Friday. By Wednesday I had calmed
down considerably. By Thursday morning I was practically normal
again as regards my nerves. You will understand that I was still
in a blissful state of ignorance concerning the actual methods of
the surgical profession as exemplified by its leading exponents of
today. The knowledge I have touched on in the pages immediately
preceding was to come to me later.

Likewise Doctor Z's manner had been deceiving. It could not be
that he meant to carve me to any really noticeable extent--his
attitude had been entirely too casual. At our house carving is
a very serious matter. Any time I take the head of the table and
start in to carve it is fitting women and children get to a place
of safety, and onlookers should get under the table. When we first
began housekeeping and gave our first small dinner-party we had
a brace of ducks cooked in honor of the company, and I, as host,
undertook to carve them. I never knew until then that a duck was
built like a watch--that his works were inclosed in a burglarproof
case. Without the use of dynamite the Red Leary-O'Brien gang could
not have broken into those ducks. I thought so then and I think
so yet. Years have passed since then, but I may state that even
now, when there are guests for dinner, we do not have ducks.
Unless somebody else is going to carve, we have liver.

I mention this fact in passing because it shows that I had learned
to revere carving as one of the higher arts, and one not to be
approached except in a spirit of due appreciation of the magnitude
of the undertaking, and after proper consideration and thought and
reflection, and all that sort of thing.

If this were true as regards a mere duck, why not all the more so
as regards the carving of a person of whom I am so very fond as I
am of myself? Thus I reasoned. And finally, had not Doctor Z
spoken of the coming operation as a small matter? Well then?

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