The Scalpel's Legacy and the Oath of Ambition
The gastric cancer surgery was still in full swing. Modern operating rooms have all sorts of ways to minimize incisions, but things were different in the 1970s. I looked toward the operating table. The wound was quite large. Anyway.
Professor Overhollman pointed to an artery deep inside the surgical site, within the open abdomen. The chief of surgery let out another sigh of admiration.
"No matter how I think about it, it's unbelievable. The CT scanner hasn't even been at Stanford long, and there's already a student who knows how to read it?"
"Thank you, sir."
I nodded. "That's why perfect dissection is so important. It lets you see the vascular pathways clearly."
The professor said quietly. Right now, you had to look closely to see them, and even then, not accurately. Once CT scan technology advanced later on, it'd be much easier to visualize, wouldn't it?
The surgery continued. The professor navigated along the artery to the stomach, avoiding the vascular anomaly. Now the anomaly was fully visible—the structure I'd pointed out before surgery. As the professor traced the vessel, the operating room fell silent for a moment.
My prediction had come true.
"One. Even the radiology professors probably don't know how to read CTs properly yet... Looks like the rumors weren't exaggerated."
"I study hard, sir."
"Tie off the vessel. Clip."
The clip pressed down on the vessel.
"Yes, sir."
"You saved this patient. When he wakes from anesthesia, go brag about it."
I nodded. With the vessel supplying blood to the stomach tied off, it was time to resect the stomach. I handed the liver retractor to the nurse, and the chief handed the scalpel back to me.
"Finish it up."
I received the scalpel solemnly. It wasn't something you handed to just anyone. Thanks to all the vessels being ligated, not a drop of blood was spilled during this major resection. Even in modern times, this level of surgical skill was rare. No wonder he was Stanford's chief of surgery.
Move carefully.
The professor stared through my hands, and I calmly, slowly cut away the rest of the stomach.
"You have a natural talent for surgery. Is it because East Asians use chopsticks so much?"
I swallowed a hollow laugh. Probably not because of chopsticks.
"Thank you, sir."
"Ever thought about doing surgery? Stanford has world-class surgeons... Wouldn't you like to learn heart transplants?"
It wasn't some special talent; I'd just done this surgery before.
"I'll think about it."
"The real doctors are the ones who wield the knife."
Professor Overhollman kept muttering. In any case, the gastrectomy was successfully completed. Time to close up. The professor took suture and needle and began stitching the incision.
And just like that, another line was added to my reputation. The surgeons spread the word fast.
There was a med student who could figure out vascular structures just by looking at the patient's face.
There was a student who could read the new CT that even radiology professors couldn't.
The OR staff, impressed by my knife skills, nicknamed me "Samurai."
Sheesh.
After surgery, I went to check on the patient in his ward. He was still groggy from anesthesia, dozing off. I looked at him. Just an ordinary American. He looked a bit gaunt from the cancer, though.
"Hello, sir."
"Who are you?"
"One of the doctors who operated on you today."
"You look awfully young for that."
I heard that sometimes—how East Asians look younger. And I'd skipped several grades, so I really was much younger than my peers...
I scratched my head. Looks weren't what mattered, right?
"I saw a vascular anomaly in your liver on the CT. I spotted it before surgery and saved your life."
"Oh, thank you. Is it serious?"
"Your gastric cancer is the serious illness here, isn't it?"
"Ah. Got it."
We'd removed the cancer, so he could rest easy! The fact that half his stomach was gone was our little secret. But it couldn't be helped. We couldn't leave it. Radiation or chemo were options, but surgery was generally best.
The patient nodded.
"The gastric cancer surgery went perfectly. No further treatment needed, but you'll want to take some nutritional supplements. Resection can cause absorption issues."
"Thank you..."
He still looked dazed, but I left the room. Another patient saved today.
Sixth year of undergrad. 1976. My rotations were wrapping up. Word had spread, and every department I rotated through had professors trying to recruit me.
"Berg, I've heard a lot about you from Professor McDevitt. With your talent, you could reach world-class levels as a researcher."
"You'll come do surgery after graduation, right? It'd be a waste not to, with those hands."
"Research and fine skills both come from clinical practice. If you aim for the top, become an internist. Even the dean is internal medicine."
Internal medicine seemed best. You saw the most patients. Research topics and opportunities stemmed from clinical work, and hospital advancement too.
Anyway. Graduation was right around the corner. Time to think about what I wanted to do next.
Lately, I'd been pondering the EpiPen. The 1970s were before it was commercialized. What's that? A device for laypeople to inject epinephrine directly into muscle. Severe allergy sufferers carry them. Simple principle, but making and commercializing it required resources.
Getting it out fast could save allergy and anaphylaxis patients. The challenge was how to make it happen.
Something to mull over.
Today's meeting was with the med school dean, Clayton Rich. An internist, naturally. He'd interviewed me for admission.
I fiddled with my tie.
"So you're the famous student. You've been through a lot."
"Hello, sir."
"I heard a student found a vascular anomaly the chief of surgery missed and saved the patient?"
"That happened, yes."
The dean stared at me intently.
"It's been ages since we had a student who makes a full scholarship feel like a bargain. I thought the era of geniuses was over... What are your plans after graduation?"
Six years at an Ivy League private med school. Without full scholarship, it'd cost as much as a few cars. Would've been brutal.
I didn't hesitate.
"I'm going to win the Nobel Prize in Medicine. Advance medicine and serve humanity."
The dean frowned.
"Stanford hasn't had a Nobel in nearly 15 years. Especially Physiology or Medicine."
Fifteen years? This world had different priorities. Anyone hearing that might think Nobels were routine. Some countries had never won one.
But I was confident I'd win.
I paused before responding to the professor. I already knew which topics would win Nobels. Just chase them. And snag that Nobel laureate parking spot.
"I'll win it, Dean."
"Haha, ambitious."
Professor Clayton just laughed. Why didn't he believe me? At least Berg was guaranteed a Nobel. McDevitt's research had strong potential too.
I bowed my head.
"Just stay at Stanford. Don't run off to Harvard or Hopkins. I'll make sure you get whatever you want..."
And so graduation day arrived. Every Stanford med student donned a white coat and gathered here. For the oath ceremony.
A fateful day. Even if I'd done it once before, it was still momentous.
-Oath.
I raised my hand.
-I swear to devote my life to serving humanity. I will put the patient first.
Would many come to the oath? Amid the crowd in the auditorium, I spotted my family. They waved bouquets, having found me in the throng. Regrettably, our golden retriever hadn't come. He was getting on in years.
-I will strive to acquire and share new knowledge with colleagues and patients.
I'd struggled hard since coming to this world. Literally running for six years to learn and share new knowledge.
Mom dabbed tears with her handkerchief. A few neighbors had come along.
-I will uphold conscience and dignity, performing my duties to the best of my ability and judgment.
Scanning the crowd, I saw Professors Berg and McDevitt, who'd researched with me, plus a few lab mates waving.
The oath continued.
-Compassion, care, humility, dedication...
I closed my eyes.
-Knowledge, wisdom, courage, empathy...
So many chances to help people. More than in my previous life. A chance to build a better world than what I'd known.
It had been that way before, and it was now. That's why I stood here swearing again.
-All these promises.
-I solemnly pledge, freely and with honor, witnessed by those who have stood here before me and those who will come after.