The Art of Medicine at the Library

by Bill Peak

My father's internship at Louisville's old General Hospital coincided with the last great polio epidemic in America. One of Dad's favorite stories from that time involved an incident in which the hospital's chief of staff, upon entering a large polio ward, turned on the gaggle of young interns in his train and demanded, “Since when is a case of typhus in this hospital not immediately reported to me?!”

The interns all eyed each other nervously. Had the old man lost it? There hadn't been a case of typhus in Kentucky in over thirty years. “There's a patient with typhus on this ward,” the old, gray-haired doctor declared, “and I know it, because I can smell it!

Sure enough, when the doctors made their way around the room that should have contained only polio patients, they found one admitted the previous day whose ailment had been misdiagnosed. My father loved telling this story, and he especially loved the part where the chief of staff made Dad and each of his fellow interns kneel in turn by the patient's bed and take a big sniff. “Next time," the old man told them, "you'll know typhus when you smell it.”

I was reminded of my father and this story by the main character in Abraham Verghese's novel Cutting for Stone. A surgeon by training, Marion Stone takes pride in the number of diseases he can recognize by smell: “the musty ammoniacal reek of liver failure ... the freshly baked bread scent of typhoid fever ... the grapelike odor of a Pseudomonas-infected burn ... the old beer smell of scrofula-the list was huge.”

But more than this, Verghese—a physician himself—has a real appreciation for the level of human feeling necessary to a proper practice of medicine. At one point in the novel, an eminent surgeon asks a room full of interns and residents to name the important treatment one administers through the ear. When the students, stumped by his question, remain silent, the man's son, also a surgeon, provides the answer his father is waiting for, “Words of comfort.” No matter how bad the scrape, how bad the fall, Dad could always make it better. It wasn't just that he was a doctor and knew all the fancy terms for different parts of the body; no, it was the warm, wise feel of his hands as he examined you, the voice that so gently questioned, and then named, your grief.

This is a novel that goes to the heart of the doctor-patient relationship, or, as it is still sometimes called, the laying on of hands. Small wonder it has been flying off our library's shelves, for that relationship treads the uncertain ground of our own mortality, the place where one's mind, however reluctantly, must reckon with its own extinction. I have asked several local M.D.s to read the book. I invite you to as well. And I invite you all to sign up for the discussion I will be hosting on Cutting for Stone at the Talbot County Free Library next month. I look forward to hearing what you think.