"The Knife," by Richard Selzer. Part 3.
One can count on absurdity. There, in the midst of our solemnities, appears, small and black and crawling, an insect: the Ant of the Absurd. The belly is open; one has seen and felt the catastrophe within. It seems the patient is already vaporizing into angelhood in the heat escaping therefrom. One could warm one's hands in that fever. All at once that ant is there, emerging from beneath one of the sterile towels that borders the operating field. For a moment one does not really see it, or else denies the sight, so impossible it is, marching precisely, heading briskly toward the open wound.
Drawn from its linen lair, where it snuggled in the steam of the great sterilizer, and survived, it comes. Closer and closer, it hurries towards the incision. Ant, art thou in the grip of some fatal ivress? Wouldst hurtle over these scarlet cliffs into the very boil of the guts? Art mad for the reek we handle? Or in some secret act of fornification engaged?
The alarm is sounded. An ant! An ant! And we are unnerved. Our fear of defilement is near to frenzy. It is not the mere physical contamination that we loathe. It is the evil of the interloper, that he scurries across our holy place, and filthies our altar. He is disease - that for whose destruction we have gathered. Powerless to destroy the sickness before us, we turn to its incarnation with a vengeance, and pluck it from the lip of the incision in the nick of time. Who would have thought an ant could move so fast?
Between thumb and forefinger, the intruder is crushed. It dies as quietly as it lived. Ah, but now there is death in the room. It is a perversion of our purpose. Albert Schweitzer would have spared it, scooped it tenderly into his hand and lowered it to the ground.
The corpselet is flicked into the specimen basin. The gloves are changed. New towels and sheets are placed where it walked. We are pleased to have done something, if only a small killing. The operation resumes, and we draw upon ourselves once more the sleeves of office and rank. Is our reverence for life in question?
In the room, the instruments lie on trays and tables. They are arranged precisely by the scrub nurse, in an order that never changes, so that you can reach blindly for a forceps or hemostate without looking away from the operating field. The instruments lie thus! Even at the beginning, when all is clean and tidy and no blood has been spilled, it is the scalpel that dominates. It has a figure the others do not have, the ertractors and the scissors. The scalpel is all grace and line, a fierceness. it grins. It is like a cat - to be respected, deferred to, but which returns no amiabiltiy. to hold it above a belly is to know the knife's force - as though were you to give it the slightest rein, it would pursue an intent of its own, driving into the flesh, a wild energy.
In a story by Borges, a deadly knife fight between two rivals is depicted. It is not, however, the men who are fighting. It is the knives themselves that are settling their own old score. The men who hold the knives are mere adjuncts to the weapons. The unguarded knife is like the unbridled war-horse that not only carries its helpless rider to his death, but tramples all beneath his hooves. The hand of the surgeon must tame this savage thing. He is a rider reining to capture a pace.
So close is the joining of surgeon and knife that they are like the Centaur - the knife, below, all equine energy, the surgeon, above, with his delicate art. One holds the knife back as much as advances it to purpose. One is the master of the scissors. One is partner, sometimes rival, to the knife. In a moment it is like the long red fingernail of the Dragon Lady. Thus does the surgeon curb in order to create, restraining the scalpel, governing it shrewdly, setting the action of the operation into a pattern, giving it form and purpose.
It is the nature of creatures to live within a tight cuirass that is both their constriction and their protection. The carapace of the turtle is his fortress and retreat, yet keeps him writhing on his back in the sand. So is the surgeon rendered impotent by his own empathy and compassion. The surgeon cannot weep. When he cuts the flesh, his own must not bleed. here it is all work. Like an asthmatic hungering for air, longing to take just one deep breath, the surgeon struggles not to feel. it is suffocating to press the feeling out. it would be easier to weep or mourn - for you know the lovely precise world of proportion contains, just beneath, there, all disaster, all disorder. In a surgical operation, a risk may flash into reality: the patient dies . . . of complication. The patient knows this too, in a more direct and personal way, and he is afraid.