The Poetry of the Body

...His mixture of respect and amazement, in the context of an almost loving depiction of the body's components, suggests a wise and thoughtful man seeking meaning in what he does, and sharing his sometimes unpleasant findings with those of us who would just as soon not think about them...

...Perforated ulcers and cirrhotic livers are neither conventional nor especially pleasant subjects...

...In the guise of "thanatology," death itself has now become a Crisis, with its own serious tomes...

...The illustrations—drawings by Daumier and others—are invariably apposite and enjoyable...

...One expects to find drawings of buffalo on the walls...

...but the personal confessions and reminiscences that take up the last third of the book do little for Sel-zer's stature as a writer, however much they may further one's admiration for him as a human being...

...The mystery was and is part of it...

...One only wishes there were more of Mortal Lessons, more carefully constructed...

...Selzer is a surgeon who aspires to be a poet...

...Yet the reader is confident that the cases Selzer describes are far from a random sample of his work, that they represent, as he says, the bottom line—the always-present possibility which defines the limits of his art...

...Richard Selzer's Mortal Lessons—limited though it is—is therefore an important and powerful antidote to the gray columns of statistics...

...As a result, instead of merely paying lip service to caring and compassion and pity, he can treat them properly—as the essence of his task...

...Unlike most literary doctors, who treat the priestly function of their calling as a kind of skeleton in the family closet, Selzer faces his sacerdotal role squarely, if uncomfortably...

...Even those critics eager to emphasize the non-rational sides of human health and illness, like Ivan Illich and Rick Carlson, run the risk of being buried under their own footnotes...

...A sterner editor might have insisted that Selzer expand those sections that are actually "notes on the art of surgery," and prune the rest...

...Indeed, it is astonishing to find so many reports of failure in a book written by a physician...

...Selzer faces the issue of death head on, as a part of living, and that in many ways is his outstanding characteristic...

...Lest the impression be created that Mortal Lessons is a grim affair, I should immediately emphasize that Selzer is a fervent, and irredeemably bad, punster...

...on occasion it also leaves the reader struggling desperately to disentangle subject from predicate...

...Yet in no area of public concern are emotions, symbols and the unconscious world more crucial than they are in medicine...

...At issue, after all, are such questions as the relationships between mind and body, science and mysticism, living and dying...

...More centrally, Selzer never loses sight of the fact that "Medicine, as is well known, is an offshoot of religion...

...Government-funded consulting firms produce weighty benefit-cost analyses calculating, to three decimal places, the worth of a gall bladder or kidney stone...

...Still, I hope Mortal Lessons will be widely read by those who provide medical care and, in particular, by students, planners and public-policy makers...

...The result could well have been a unified and superior work, instead of this uneven combination of brilliant illumination and mundane family hilstory...

...Palmistry, he insists, is a rather ticklish business...

...Selzer confronts it as one whose function is to oppose mortality, while still recognizing both the inscrutability and finality of this "surprise" at the core of the surgeon's work...

...Moreover, there is a lot of simple padding...

...A chapter each is devoted to bone, Che liver, urinary stones, the kidney, the skin, the stomach, and—inevitably—the corpse: sufficient, perhaps, to occupy a general surgeon for a lifetime, but disappointing in light of the tantalizing fragments on other bodily parts scattered around...

...For modern physicians, as much as for their ancestral counterparts, the ultimate mystery, of course, remains death...

...And a brief excursus on neurosurgery—the brain, he says, is like nothing so much as a thin paste —is as chilling a thing as I have ever read...

...At his best, he oan be marvelously descriptive, providing detailed images of those mysterious organs that are the indispensable components of our selves...

...Selzer believes in the cosmic giggle—to this reviewer, an eminently sensible credo—and his willingness to take pleasure when pleasure is to be had (without ever denying the seriousness of the important) frequently makes him a delight to read...

...But the point is the aspiration itself: Selzer has undertaken the task of communicating to lay readers some of the beauty, magic and terror of surgery, and of the human organism...

...In Selzer's hands, though, they become the heart of beautiful parables that give life to bodily processes without anthropomorphizing them, tie cause to effect more tellingly than textbooks ever can, and leave the reader with an understanding of his own gut profoundly deeper than he had before...

...He sees the spleen as "a manta ray in a coral cove," the abdomen as "such a primitive place...

...He knows that the incisions and excisions and sutures are only a part, at times the lesser part, of what he is doing...

...It is a very slim volume of essays, themselves often disjointed, loosely held together by a series of ruminations on related themes...

...One hopes he cuts better Chan he writes, for while his heavily-mannered style in this collection of essays produces a few opalescent sentences, more often it cloys...

...congressmen and editorialists react with alarm, never mere dismay...

...he has written one of the few contemporary books about medicine that goes further than skin deep...

...that, at least, is better than his contention that "Lot could not say Noah" to alcohol...

...Like Eliot's John Webster, Selzer sees the skull beneath the skin...

...Reviewed by Bruce C.Vladeck Center for Community Health Systems, School of Public Health, Columbia University Ever since medical care became a Crisis, it has been subject to the bureaucratic humorlessness and dogged pedantry that are apparently considered essential to approaching serious problems of modern life...