Tuesday 15 February 2022

The Surgeon Poet.


The Surgeon Poet.

   I got a little ahead of myself, launching into quotations from the book before relating the difficulty in getting hold of a copy of it. At first I set out to buy a copy, after all, Amazon has everything.

   They had one copy available and t was over a thousand dollars (Yes, a were dollars!) I didn't want to own a copy of the book, I just wanted to read through it to see if I was missing anything by postponing the search for fifty-five years! Being a 'Life Member' of the Canadian Medical Association and of the College of Family Physicians of Canada, I knew I would have no difficulty in accessing the text on line. I was quite prepared to pay the going rate for online access. I checked them out, I even phoned the librarian of the CFPC without success. Fortunately, I mentioned my frustration to a family member who is faculty at Canada's senior University and he offered to try to access it for me.

   Lo and behold, the entire canon became available to me in a short time, for which I was extraordinarily grateful because as I continued my on - line search any sort of copy was unacceptably expensive. Interestingly, the copy to which I had access was last accessed several years ago, after several years in limbo.

   During the first world war Cope served in the Royal Army Medical Corps as a Major and was no 'behind the desk' officer. He saw active service in the Middle East from 1916-1919. In the WW2 he was a senior officer of the Emergency Medical Service. Two clinical volumes of the 'Official History of the War if 1939-1945 were edited by him.

  Despite his brilliance, Sir Zachary did not hesitate to use his own errors or omissions as teaching opportunities. Not an easy thing to do. The following few stanzas tell a personal story that many a physician would prefer not to publicize:

     I still remember with regret,

     Indeed I never could forget

     What drove this lesson home to me

     And now to you a guide shall be.

     All day long I had been busy

     And then with fatigue nigh dizzy

     They called me to an urgent case

     To which I went with laggard pace.

     The patients pain had been severe

     But when I saw her it was clear

     They were much less and since she seemed

     To be improving fast I deemed

     Perhaps she could be left a while;

     My conscience I did reconcile

     By thinking that the patient's state

     Might still improve if we did wait

     And in the morn at any rate

     We could if needful operate.

     But yet I knew that she was ill

     And spite of all felt doubtfull still.

     So I went home and had my rest

     With hopes all would be for the best.

     But on the morn she was much worse

     And my delay I then did curse

     For at the urgent operation

     I found a gastric perforation.

     And so the end of my sad tale is

     She came to 'exitus lethalis'. (Latin for dead.)

Two morals of this story should be starred -

When very tired be doubly on your guard,

All slackness in the surgeon should be barred.

Then, when not sure and full of hesitation

Don't wait too long before an exploration.

   The lesson in this story needs no explanation but it takes a courageous surgeon to use himself as the bad example!

Much of his advice is as relevant today as it was when he gave it. For instance,

"Examine from the head and toes,

Before you dare to diagnose.

More harm is done because you do not look

Than from not knowing what is in the book."

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