Complications

Medicine is, I have found, a strange and in many ways disturbing business. The stakes are high, the liberties taken tremendous. We drug people, put needles and tubes into them, manipulate their chemistry, biology, and physics, lay them unconscious and open their bodies up to the world. We do so out of an abiding confidence in our know-how as a profession. What you find when you get in close, however—close enough to see the furrowed brows, the doubts and missteps, the failures as well as the successes—is how messy, uncertain, and also surprising medicine turns out to be.

The audience watched wide-eyed and incredulous.

The most elegant clip, however, was from a Houston, Texas, surgeon who unveiled a procedure for repairing a defect of the esophagus known as Zenker’s diverticulum. This is an abnormality that normally requires an hour or more to repair and an incision in the side of the neck, but in the film the surgeon managed to do it through a patient’s mouth in fifteen minutes with no incision at all. I stayed and watched movies for almost four hours. And when the lights went up, I walked out into the day silent, blinking, and exhilarated.

It began with a close-up of a patient’s open abdomen. The surgeon, unseen but for his gloved and bloody hands, was attempting an exceedingly difficult and dangerous operation—the excision of a cancer in the tail of a patient’s pancreas. The tumor lay deep, enveloped by loops of bowel, a latticework of blood vessels, the stomach, and the spleen. But the surgeon made getting it out seem like play. He plucked at fragile vessels and slashed through tissue millimeters from vital organs. He showed us a couple of tricks for avoiding trouble, and the next thing we knew he had half the pancreas on a tray.

In another film, a team from Strasbourg, France, removed a colon cancer from deep in a patient’s pelvis and then reconnected her bowel entirely laparoscopically—through tiny incisions that required only Band-Aids afterward. It was a startling, Houdini-like feat—