Lectures

Lectures include:  

	“Richard Selzer:  Poet of the Body.”  1997-8 Medical Humanities Lecture Series at Yale Medical School.  New Haven, CT. April 30, 1998. [Text of lecture follows list.]
.	“I am very sorry that I was away, in Italy, during the time that you gave what I hear was a wonderful lecture on Dick Selzer.  I am impressed that you have devoted your career so far to our stellar writer and thinker.  If you have any reprints, I would be delighted to have them, as I have watched Dick’s career with great interest ever since he was a junior resident in surgery. Again my thanks and apologies for being away." -- Howard M. Spiro, M.D.  Program Director  The Program for Humanities and Medicine Yale University, The School of Medicine
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	“The Helping Professions:  the Power of the Positions and their Attendant Responsibilities.”  Texas Wesleyan University’s 1998-9 Humanic’s Pre-Professional Lecture Series. Fort Worth, TX: October 26, 1998.
.	“Mahala, Thank you for your participation in our Pre-Professional Program.  Much of what we accomplish in our program would not be possible without professionals like you.  You presented valuable perspectives for our students and further broadened their experience with professionals new to our program.  Thank you once again from all of us at Wesleyan for the willing contribution of your time in enriching the academic education of our students.” -- Marilyn N. Hagan, Coordinator Pre-Professional Program
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	“Richard Selzer:  The Pen and the Scalpel.”  The University of Texas Medical Branch, Institute for the Medical Humanities, Brown Bag Seminar. Galveston, TX: November 21, 1998.
.	Biography and chronology of Richard Selzer’s career; his twenty-three day coma; controversial writings, and growing legacy.  Presentation includes segments of a taped interview with Selzer in which he talks about inspiration/writing and what making the transition from doctor to writer felt like. -- during The Institute’s Twenty-fifth Anniversary Celebration Year
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	“The Doctor Stories:  Medicine, Rhetoric, and Social Taboos.”  The University of Central Arkansas (High Table Honor’s College Lecture Series). Conway, AR:  April 7, 1999.
.	“What a pleasure to have finally met you in person!  Your research is so interesting, and everyone I spoke to after your lecture was truly impressed.  Thank you so much for coming all  this way to speak to our students.  I hope that this experience was as enjoyable for you and that you’ll come to visit us again soon.” -- Karen Silverstrim, Honor’s College Lecture Coordinator
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	“An Introduction to Richard Selzer and His Major Writings.” Tarrant County College-South (Professional Development Day).  April 6, 2000 (morning).
.	“Until your brilliant presentation on Dr. Richard Selzer, most of us knew very little about him or his writing.  In addition to his figurative language, attention to detail, and use of humor, his deep compassion for humanity and his honesty permeate his wonderful narratives.  Many of us feel as though we have gained a new “silent”  friend who speaks in a language that touches and refreshes our spirit—a writer whose  narrative we will share with our students.   I especially enjoyed your integration of lecture with audio and group discussion; moreover, our participation in the short play Follow Your Heart added an extended, soul-searching experience for each of us.” “Thank you for a most unusual and interesting workshop—one that the Communications Department will long remember.” -- Evelyn Wilson Communications Department Chair
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	“Medicine in the Humanities—developing career-oriented curriculum based on World Literature.”  Tarrant County College-South (Professional Development Day). April 6, 2000 (afternoon).
.	“The Medical Humanities World Literature course you have developed offers as many intellectual challenges to your students as your presentations of how you developed the curriculum for your course did for faculty members.  In fact, I heard several of the faculty talking with others of ways they might reconstruct or add new activities to courses they teach. I thank you for providing us with an extraordinary workshop for our faculty retreat and for the inspiration to revisit methods and materials we use in our own classrooms.” -- Evelyn Wilson Communications Department Chair
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"The White Coat Ceremony: Richard Selzer's 'A Parable.'" Texas Wesleyan University, Fort Worth, TX (November 20, 2000) . “Thank you once again from all of us at Wesleyan for the willing gift of your time in enriching the academic education of our students." -- Debbie Smith Pre-Professional Program     . .  "Cloning:  Ethics, Laws, and Commerce," featuring a literary perspective including Mary Shelley's Frankenstein and Nathaniel Hawthorne's "The Birth-mark." Fourth Annual Biotechnology Conference for Secondary Science Teachers, 27th July, 2004, at Texas A & M in Dallas, Texas. Lecture includes Lesson Plan and PowerPoint slideshow--available upon request--derived from Chapter 1, "Technology's Creature," Bioethics and Medical Issues in Literature (Greenwood Press, 2004). . “On behalf of the participants and the Planning Committee, we want to thank you for taking time out of your busy schedule to make your presentation at the Biotechnology Conference for Educators.  The knowledge you presented to the teachers will be shared with hundreds of science students in North Texas. Hopefully, one of these teachers may be the one that touches the life of a future Pulitzer prize winner from Texas. Your dedication to improving science education is greatly appreciated.  The feedback from the participants has been very positive.  Thank you for helping to make the Biotechnology Conference for educators a great success." -- Dan James, Professor, Texas A & M    . .

Yale 1998 Medical Humanities Lecture

RICHARD SELZER:  POET OF THE BODY

  Richard Selzer has been part of the Yale-New Haven community for over forty-five years.  Many of you are his colleagues or have been his patients or students.  You all know his reputation as one of today’s best-known doctor-writers. Selzer’s books are used at every level in training humanistic medical professionals; they are enjoyed as well for their literary value--their sheer aesthetics.  Since his retirement from surgery in 1985, Dr. Selzer travels all over the world holding writing seminars and giving lectures.  He has described himself as “roosting on the podia of America like some strange, exotic bird.” Of course this time of year he is in constant demand as a speaker at medical school commencements, where he stands with the graduating class and solemnly retakes the Hippocratic oath:  to be useful and to do no harm.   

But, long before Selzer retired from surgery to write full-time, he was asked the question, “Why would a surgeon write?”  His reply simply was,  “Because I wish to be a doctor.” What he means is that, to treat the whole patient, a doctor like a poet must understand complex human ambiguity.  In essays and in short stories, Selzer uses a surgeon’s eyes to physically describe a patient, and then he uses a poet’s sensibilities to evoke humanity.  This doctor-writer sensitivity evolved over a lifetime.                                               

Early Childhood Influences

            Every writer has influences rooted in childhood.  Selzer’s early doctor-writer influences fascinate because he developed both doctor and writer consciousnesses in his youth.  He was born in Troy, New York, in 1928--during the Great Depression-- the second son to Julius Selzer, a general practitioner, who wanted his son to be a doctor.  Selzer’s mother was Gertrude Schneider Selzer, a self-styled artistè, who wanted her son to be a poet.  After years of built-up resentments, a rivalry ensued between the parents for the affection and attention of their son.  The prize, Richard Selzer later wrote, was his soul.    

            The setting of this rivalry was the City of Troy, New York, located on the Hudson River midway between Montreal and New York City.  Troy was ideally suited for river commerce and had a largely Irish population.  To Selzer, the Hudson River that runs through Troy is “the very symbol of life itself.”  He writes about it in his memoir, Down From Troy, as being exotic and as spiritual as the Nile, Ganges, or Tigris.  The affection Selzer has for the life-force of the Hudson River is clear.  Indeed, he feels sorry for the riverless child who does not experience the  “green and silver in motion . . . time itself, approaching, surging past, vanishing, never to be called back.  You can tell your secrets to a river.  It just carries them away”  (51-52).  Within a six-block radius of his house near the Hudson, there were six saloons and churches with working belfries.  For an infidel like Selzer and his father, on Sunday mornings the windows had to be kept shut “lest the quarreling of all those bells shatter sleep (24).”  Since this was a river town--and during the Depression--the only thing that kept the town alive was prostitution and its spin-offs. Lucky Luciano and droves of other men  came from all the surrounding states to visit the infamous Mame Fay.  The red-blooded Julius Selzer also availed himself of the main Trojan industry, not at all deterred by its customers’ syphilis and tuberculosis.  Ironically, his family’s livelihood depended it.  

            On the poetic side influencing young Selzer was his mother, Gertrude, descended from French Catholic Montreal.  She was dramatic and given to wearing costumes--veils, sashes, and feather boas.  She would dress her prepubescent, sensitive young son in artist-to-be clothing.  Picture the neatly tailored man you now know as a child dressed in “baggy knickers, thigh-length tan cotton stockings held up by garters, a beret and a loose black bow beneath [his] collar” (70).  Attempts to send her son to school dressed in this fashion were met with the resistance of Selzer’s father; but, Gertrude Selzer insisted that young Richard recite poetry at meals--Shelley and Keats--for she meant for her son to be a writer.  

            On the other side, was Selzer’s general practitioner father, Julius Louis Selzer, M.D., who was descended from peasant Russian Jews.  The often self-abnegating Richard Selzer is fond of saying that this self-same deference runs in his own blood.  Dr. Julius Selzer was equally determined that his son be a doctor.  He took his son on house calls where young Richard might be called in to hold an arm or leg being surgically treated.  There, Richard heard the language of pain--moans and howls--and he experiencing the rituals of surgery.   Selzer talks with great affection about his father and how, one day, in an attempt to coax him from a fit of mopery, his father 

drew [him] to his knees, then gently fit the earpiece of his stethoscope into [his] ears.  Unbuttoning his [own] shirt, he placed  the disk over his heart. All at once [the boy heard] the distant muffled thudding of life itself.   

Lup-dup.  Lup-dup.  It said.  Young Richard “listened and was touched” (133). In like manner, a hound is blooded to the hunt at its master’s knee.

            Eavesdropping on his father’s visits with patients was also a part of Selzer’s life. From a second floor room, he took great pleasure in listening to his father’s visits with patients on the lower floor.  He would listen for hours as moans and cries floated up the staircase.  Often there were no words, just the howled vowels that were the language of pain.  Then, of course, there were the medical texts that Selzer reveled in as a prepubescent boy.  The pictures and diagrams inflated his curiosity and imagination.  It was during these days that things seen, heard, smelled, and tasted channeled into this curious boy’s imagination and forged his destiny.

              Besides the influences of the City of Troy, itself, and Selzer’s doctor father and artistè mother, there were other major influences that formed a doctor who writes.  For example, even though born a Jew, Selzer was attracted to St. Peter’s Catholic Church where the physical elements of religion--the bells, incense, and statuary--connected him to the rituals of surgery.  Even today, self-professed atheist Selzer is happiest in the presence of piety and seeks it out for comfort and when confronted with problems to solve. In fact, when he felt that he was living between the parentheses of his battling parents, he took refuge in St. Paul’s Episcopal Church where he was captivated by the sunlight streaming through the Tiffany stained glass. Also, the Troy Public Library became a source of solace as he became immersed in the classics and fairytales.  Then, as now, he was a voracious reader, sensitive to the insights of Homer, Ovid, Shakespeare, Keats, Poe, Emily Dickinson. . . .  All of these influences appear in his writing today.

            But, the most colorful influence of Selzer’s young life was a regular at the Central Tavern in Troy, where he delivered prescriptions for his father. Duffy, a regular at the Central, was a drunken Irishman with the gift of gab.  Selzer would listen for hours as Duffy told “with something like genius” his immense repertory of stories, having that Irish way about him as he mixed fact and fiction (Down From Troy 141).  Gertrude Selzer called him a liar.  However, Duffy was, in Selzer’s words, the bard of Troy; his stories were full of rich language.  Duffy would enter a story using narrative drive, and then would move about inside of it with a rich mixture of metaphor and allusion, often switching back and forth from highfalutin’ language into the vernacular . . . all the while testing and feeling the color and smell of his words.  Duffy tickled the fancy of the enthralled young boy, as he “rolled a cigarette, lit up and blew out a cloud of smoke and a story” (142). For instance, Selzer became completing engaged in the language as Duffy described what it used to be like when “the orchards came right up to the Troy city limits.  In April,  when the blossoms broke out [Duffy said], you could hear the apple trees singing all through the center of town” (146). Selzer learned from Duffy how to fuse reality and fiction, and life with art:  he was learning the art of poetic storytelling.  It was from Duffy that Selzer learned that “the hunger for imagery goes as deep as the hunger for food.”  He also learned that in telling a story “suspense, humor, and the grotesque were all instruments of illumination” (147).  

            The childhood that formed Selzer’s doctor-writer consciousnesses was rich. His parents, besides having varied educations and mixed religions, were two opposing forces working on a “recepticular”  child who keenly observed everything about him. Even amidst the Trojan rivalry that ensued between his parents for Selzer’s affection, he deeply loved both parents.  However, at breakfast one day when Richard’s stomach turned queasy at the sight of a yolk running from an egg, his father felt certain that his son was too sensitive--too faint-stomached--to be a doctor.  And his mother was reassured of her son’s poetic destiny.  But then, when Selzer was twelve, an event suddenly occurred that was the supreme act of seduction:  his father died.  From that day forward, Selzer dedicated himself to becoming a doctor, leaving behind the richness of his childhood. For a time, he shut out the poetic influences in his life--the creative urge resonating from his mother--as he began a lifelong search for his father through medicine.  If he could not find him in the flesh, he would find him through his work.  

Selzer’s Transition into Medical Career

            Selzer left behind the colored dreams of childhood, worked his way through high school, pre-med at Union College in Schenectady; medical school at Albany Medical College, and finally, in 1953,  he began a surgical internship at Yale Medical School. For these intervening 45 years, he has been a part of the Yale-New Haven community; except that during his second year residency at Yale medical residency, Selzer was drafted and sent to Korea, where he helped to set up a medical unit in the demilitarized zone.  There Eastern culture opened up his third, intuitive eye to a new mystical awareness that appears in his work today.  As he became immersed in this foreign culture, the creative drive reawakened in him--giving him enormous energy.  

Writing Career Begins (Selzer’s many genres in bold script)

            While in Korea Selzer became desperately ill with malaria and, against his wish to remain to minister to the ill, was sent to Japan to recover.  There he wrote a novel, The Bronze Gong.  Embarrassed by this first effort, he only recently admitted writing it, a description of the intrinsic wondrous beauty of a foreign land.  The novel has been dismantled and some parts published--such as the essay “Korea” in Rituals of Surgery.  After this first writing effort during the mid-1950s, Selzer returned to Yale Medical School to finish his surgical residency and started a practice--and a family--in New Haven.  Dedicated to his surgical practice, teaching at Yale, and to his wife Janet and their three children, he had no time for anything else.  Then, one day in 1968 at the age of forty, Selzer’s creative drive returned in a flash.  Some have called it a mid-life crisis, but in Selzer’s terms it was more of an epiphany.  He was at a family summer cottage and suddenly felt first a malaise, then a warmth, at last a compulsion to write harnessed his body and soul.  It was as if the butterfly had sprung from its cocoon.  The result of this metamorphosis--and the full awakening of the literary consciousness so long dormant--was his first short story, the surgical reinterpretation of “Jonah and the Whale.”   

            Selzer called this “the quintessential surgical story, ” saying that as a surgeon he could describe the gastric mucous better than the biblical authors; he also was well acquainted with the physiology of vomiting--the casting out of Jonah.  This is how he configured the story:  

The patient lying on the table is the whale.  The surgeon, standing there, is Jonah.  Jonah enters the body of the whale--like the surgeon enters the body of the patient.  He dwells there for a period of time, after which he is cast out by the patient.  The whale swims away--or the patient is discharged from the hospital.  Both are healed--in a sense. (Paraphrase. Qtd. in Josyph 324)  

From that time on, Selzer’s compulsion to write took over.  He has since written  numerous short stories, many with biblical parallels and poetic vision, such as “The Story of Ruth and Naomi” translated into “Whither Thou Goest,” and using the story of Lazurus in Raising the Dead, an account of his twenty-three day coma.   

            But, after this first effort at writing, Selzer began writing horror stories influenced no doubt from childhood readings of Edgar Allan Poe.   Selzer says, “surgeons love horror--don’t you know,” and that it is natural material for a surgeon.  Although these horror stories demonstrate Selzer’s meticulous technique--his engaging dialogue, sense of growing tension, and similes to die for--he now considers them his juvenilia.            

            Early on in his writing career while Selzer was also a busy practicing surgeon, he says the energy just appeared for writing.  Rather than playing golf on Wednesday afternoons, he went to the library and taught himself to write.   He approached the English language as if he were learning it for the first time.  When he got home from a busy day of surgery, he ate dinner with his family and helped the children with their homework; went to bed at 8 p.m., then awoke at 1 a.m. and wrote at his kitchen table until 3 a.m.--then slept until 5 or six, when he had to go to the hospital.  As Chekhov put it:  medicine was his lawful wife and writing his mistress.   

            Much later during a 1993 personal interview, Selzer talked about his writing--the “spontaneous, seemingly thoughtless urge to create”:  

I don’t really in the beginning sit down and plot things out.  I never do that.  I just come to the page and offer it--make an offering--and that leads me on.  In my case, anyway, there are two aspects to creativity.  One is that burst of what we call inspiration.  That’s the froth of the wave.  You have to put that down in a fever, because all you have is a net of words, of language.  Then you have to catch the foam before it falls back into the sea.  That’s a very delicate and insubstantial thing to do.   

But, then, the second part, when that is over (and that is brief),   there is the endless tinkering with what you have, what has been produced in that moment of fever . . . the tinkering, endlessly, pushing the words around.             

I love them both.  In one I am not in control at all--like most artists, I am seized, taken hold of.  But in the other, I am in control, and that is  the craftsmanship, the surgery, the handiwork of it: the workbench.  The desk becomes the operating table for me again, and I am working with my hands--not suturing tissue, I am suturing words into sentences, and sentences into paragraphs, and doing them with as   much meticulous attention as I can.

Clearly, it is the craft of both surgery and writing that Selzer loves.  In describing the writing process, Selzer defines a tremendous life force, as his medical and literary consciousnesses merge.  Yet, even with all the effort writing takes, additional conflicts arose in his life:  his family felt deprived of his time, and early on a few medical colleagues feared that he might be revealing “the secrets of the priesthood”; so Selzer became a writer against the grain in his life.   

            Nevertheless, he continued to write, drawing upon the discipline and craft of surgery and using his doctor-writer consciousnesses and witnessing-diagnostic imagination. In literary “medical” essays his surgeon’s eyes first described the fine anatomical details of the human body, and then he overlaid a poet’s perception upon it.  For example, in straight technical textbook medical terms (Textbook of Anatomy and Physiology) skin physically is:  

the body’s largest organ composed of two main layers (epidermis and dermis), two yards square.  It is simple squamous epithelial tissue and performs the functions of protection, excretion,  sensation, diffusion, and filtration.   (54)

  But, emotionally, Selzer describes skin as  

this seamless body-stocking, some two yards square . . . our casing, our façade, that flushes, pales, perspires, glistens, glows, furrows, tingles, crawls, itches, pleasures, and pains us all our days, at once keeper of the organs within, and sensitive probe, adventurer into the world outside.  
             (“Skin” from Mortal Lessons 105).

It remembers the touch of a lover, Selzer avers, or is scarred from lost love between two brothers.  

            In fact, is it two literature-and-medicine brothers who offer a better understanding of the two languages Selzer combines to make a humanistic connection in doctoring: that physical and emotional mind-body melding.  Harvard anatomy professor William James’s 1904 letter to his brother writer Henry James distinguished their differing languages.  Paraphrased, these concepts are:    

          The Medical ideal is to say a thing in one sentence as straight and as explicit as it can be made and then to drop it forever; while    

          The Literary ideal is to avoid naming it straight; but, rather, to build out the poor little initial perception--enveloping it in gigantic suggestive atmosphere (innuendo and associative reference)--until it grows like a germ into something vastly bigger and more substantial.  (The Letters of William James, Little 1926: 277-8)

Looking at Selzer’s work within the context of these two overlapping languages (emerging from literature-and-medicine consciousnesses) is enlightening. As both of these languages are generated in his work, he orients the reader physically (or organically) through his doctor’s side; and then using a poet’s perception he emotionally builds out the image to evoke humanity, spirituality. Because of Selzer’s dual capability, his work is central to the recent medical humanities movement.  

            These two distinct languages, appealing to medical humanists, are especially vivid in Selzer’s next genre, the case-history narration.  Material and inspiration appeared to him daily in his work as a surgeon.  Applying the diagnostic technique to both patients and writing, he took the case history of a patient, added a predicament, conflicts, acts of fate, and then waited for something to develop.  Selzer quickly points out that he was paying close attention to his medical work; but, at the same time, his literary imagination kicked in as he sutured words into case-history narrations.  The overlaying of literary subjectivity onto medical objectivity appears in his poignant story “Witness” from Letters to a Young Doctor.  In it  “the flesh becomes the spirit thickened” as Selzer reveals a father’s love (”a deep black joy”) after an operation to cut out the dead testicle from a blind boy.  Sadly, the boy’s  handicapped mind and body have left him little else.    

            It was an intellectually creative balancing act during this period of Selzer’s life to maintain a surgeon’s viewpoint while nourishing his imagination. He is especially masterful in his case-history narration “The Exact Location of the Soul” from Mortal Lessons.  Selzer writes of establishing a bond with a diabetic patient:  for the year he trimmed away the swollen blue leather that was her tissue, staving off, delaying.  He writes about how she  

could not see the great shaggy black ulcer upon her foot and ankle that threatened to encroach upon the rest of her body, for she was blind as well. There upon her foot was a Mississippi Delta brimming with corruption, sending its raw tributaries down between  her toes.  

Selzer describes her sitting upon his table, “rocking back and forth, holding her extended leg by the thigh, gripping it as though it were a rocket that must be steadied lest it explode and scatter her toes about the room.”  But, he remembers,

At last we gave up, she and I.  We could no longer run ahead of the gangrene.  We had not the legs for it.  There must be an amputation in order that she might live--and I as well.  It was to heal us both that I must take up the knife and saw, and cut off the leg. And when I could feel it drop from her body to the table, see the blessed space appear between her and that leg, I too would be well.

On the day of the operation, Selzer “invites” us into the operating room.  He uncovers the leg and sees an unexpected sight:  

There, upon her kneecap, she has drawn, blindly, upside down for me to see, a face; just a circle with two ears, two eyes, a nose, and a smiling upturned mouth.  Under it she has printed SMILE, DOCTOR.  Minutes later I listen to the sound of the saw, until a little crack at the end tells me it is done.  (16-18)

In this portrayal of his doctor-patient relationship, Selzer gives us the grisly physical details, but the truth he reveals lying hidden in the body is human spirituality. For him, doctoring is  “the tending act,” or caring for patients with both love and trepidation.  

            For thirty-one years Selzer felt his patients’ pain in the operating room, but eventually, at the age of 56, his poetic evolution took him to a point where his third eye saw too much, removing the carapace so necessary to mask a surgeon’s fears, and he became vulnerable.  Uncertain of his future, in his Last Grand Rounds speech at Yale Medical School in December of ‘84, he signed himself off as the “bastard offspring of both medicine and literature.”  Selzer’s ultimate love for literature and words--his heritage from his mother, voracious reading at the Troy Public library, and a friendship with Duffy the Storyteller-- seems to have won out as he left surgery behind.  But for a time, his unorthodox language seemed to please neither the literary community that found the physical descriptions grisly nor the medical community that thought the poetic vision too flowery.  It was as though there had emerged judgmental reincarnations of Julius and Gertrude Selzer.  

            In a 1993 interview Selzer vividly described to me how, although he was unable to return to surgical life, from time to time a mist from the past fell away.   

I go to the Yale library every morning, and I usually walk; but in the evening I’m a little tired, so I take the Yale shuttle bus back up the hill.  One time, not long ago, I got on the shuttle bus, and I sat across the aisle from the driver and one seat behind. I saw that it was a new driver--someone I didn’t recognize.  He turned and asked me, “Where do you want to get off?”  And I said,  “Divinity School.”  Because that’s the stop I get off.  And when he turned I saw that his entire chin and neck, down onto his chest, had been involved in a skin graft--obviously from a burn scar that had contracted, and he had been grafted.  He wasn’t at all self-conscious about it, and he turned his head quite easily.  

I thought, “That’s a very good functional result; it isn’t perfect cosmetically.”  I could see little ridges here or there or an area of  pallor.  And then--all at once--I knew that it was I that had done that  skin graft.  I knew it.  I could remember then the little boy of about nine lying on the operating table with his chin buried in this mass of livid scar, and, in order to look, he had to wrinkle his forehead and  lift his eyebrows.  I remember that I was bending over him and comforting him.  They were putting an intravenous in his arm. Then, the next moment, he was asleep with a tube in his nostril and down into his windpipe with the anesthesia. 

 All that sprang full-grown in my memory on that bus.  I had an impulse to go up to the driver and say, “Let me feel your neck.  Let me feel your chin.  Would you show me where the skin graft was taken from?”  I wanted to . . .  Then I thought, “Would I recognize  that the way one recognizes his own handwriting?”  I thought, “Would he remember me?”  But of course I didn’t.  I stayed in my seat.  One does not return to a previous incarnation. 

And then all of a sudden, as I was sitting there completely in a dream state, I heard his voice call out:  “Divinity.”  And I got up and got off the bus.

And that was a moment when Selzer’s two incarnations came together.  

            Even though Selzer cannot return to his surgical life, he continues to employ the discipline of a surgeon and has completed an impressive body of work.  In 1992 he finished his memoirs, Down From Troy--after reading it, one does not have to wonder how he became such a fine doctor-writer. Selzer’s growing spiritual aesthetics is emerging in art essays, such as “The Ivory Christ.” He continues to write book reviews, often making keen topical observations and creating a rhetorical forum for issues such as addressing a surgeon’s fears.  

            For the past thirty years Selzer has never been without his journals (or diaries) in hand, which he declares to be the treasure-trove of his mind. The diaries demonstrate that Selzer’s thoughts emerge from inspirational images.  Like Emerson, Selzer quarries his essays and short stories out of the journals.   They may first pass through the intermediate stage of lectures.  There is no doubt that these diaries contain some of his best work and should surprise--but not offend; he is too much of a doctor still to intentionally cause hurt to anyone. The diaries are being edited at this time into a three-book series; but, first, Selzer’s The Doctor Stories will be released by Picador USA in 1998.  The two new stories collected in this volume with former favorites are:  “Avalanche,” and “Angel, Tuning a Lute.”   

            Selzer continues an extensive correspondence.  Much of it--including love letters--is now deposited in the Richard Selzer Archives officially opened at the University of Texas Medical Branch in Galveston. His belle lettres are an art form, providing a great deal of personal information otherwise unavailable. Demonstrating a Chekhovian influence, Selzer has written a play, “‘The Black Swan’ Revisited”--it was first a short story and next will be an opera.  Two other pieces of work have been adapted into plays:  “Little St. Hugh” and “A Question of Mercy.”   

            Controversy:  Selzer’s essays such as “A Question of Mercy” and  “Abortion” evoke a strong response.  This work portrays human drama and develops characters and powerful images: he is making art.  He is not afraid of controversy, although his mailman complains about delivering bulk mail up the steep driveway (with the potential of developing a hernia).   Nonetheless, Selzer is primarily an artist concerned with his work’s aesthetic value; and I do not believe that in either “Abortion” or “A Question of Mercy” Selzer’s intent was to create a political forum. It is well-known that he takes no side on the abortion issue; and in his portrayal of four people contemplating the urgent logistics of a suicide, he draws an emotional portrait rather than intending to pose a moral or legal question.  In fact, as differing political factions continue to posture around each of these works and draw strength from them, Selzer is probably taken quite aback--perhaps feeling temporarily impeded from the free play of his imagination.  After all, it is art he wishes to make--just as in his long literary non-fiction work, Raising the Dead, the last genre highlighted, in which Selzer’s vivid imagination found play surrounding his own real-life event.   

            Since he metamorphosed into a writer thirty years ago at his summer cottage, Selzer has had a journal and pen in his hand every day . . . except in 1991 for about six months when his “image-maker” failed him.  It was the last day of March, and he had just come home from a speaking tour all over North America.  He went upstairs to go to bed, when suddenly his wife Janet heard a thud and went running.  He was immediately taken by ambulance to Yale-New Haven hospital where he lay in coma for 23 days.  It was only later on, since Selzer travels so much (riding in planes and staying in air-conditioned hotels) that the diagnosis of Legionnaire’s disease was made by exclusion.  

            After three weeks in coma and on the brink of death, he awoke. But, man’s greatest pleasure is to remember, Selzer says, and the black void left by this experience became intolerable; so, in the absence of medical records made unavailable to him, he reinvented his own illness in Raising the Dead, describing his twenty-three day coma (“as in the Psalm of that number”), “death” and dramatic resuscitation, delusional state, and lengthy home recovery period.  In this long work of literary non-fiction, Selzer imagines being taken to the hospital that spring day in March, falling into coma, and quickly becoming a preparation that the doctors and nurses had made as they put salve in his eyes and taped his eyelids shut, put in IVs and a catheter.  He describes himself as a piece of machinery no longer having any need to: “swallow, chew, inhale or exhale, cough, urinate, defecate, clear his throat, maintain acid-base balance, cogitate, remember, sigh, weep, laugh, desire” (28).   For him, “death would certainly be much easier to achieve than life.”

            The diuretic makes him physically desiccated, and he becomes dryer and weaker--looking more like the skeleton of a child.  In Raising the Dead Selzer takes on the persona of a curious onlooker to describe himself:  

Sometimes he seems brave and beautiful to me, although I know   I am the only one who would think so.  Look at him!  He is: A sprig of chicory blooming between paving stones, indomitable. (29)  

He “shivers like a wet dog encased in the skin of wax that is his coma.” Then, merging both his doctor’s and poet’s perceptions within their two distinct languages, Selzer evokes a spirituality in the comatose patient.   

He is like an abandoned cottage in ruins, the eaves of his ribs overhanging the scaphoid belly.  His umbilicus, that mute evidence of his ancestry, seems set directly upon the vertebral column. When the narcosis is allowed to lift, he curls up, stretches out slowly like a larva, signaling with the only sound he can make--the faint borborygmi of his bowel. At last I understand the term embedded, the way a fly trapped in a chunk of amber must  apprehend its plight.  (30)  

            It is a disquieting sight:  the hands that held both pen and scalpel are now atrophying muscles with skin as “dry and as chaste and beautiful as old paper.”

And then, suddenly, a change takes place in the patient. “He is leaving us,” the narrator says.  And although activity quickens in the room, emergency measures fail.  The EKG is flat for four and a half minutes.  The doctor matter-of-factly reports: “This man is dead.”  The patient has taken on that look of dignity that the newly dead have “because of their possession of secrets,” Selzer writes of himself.   

It is strange, this painless death.  Like stepping through a door held politely open for him.  (34)  

          Everyone has left, and a nurse--”bleary with tears”-- is alone in the room:  she has seen “the incontrovertible fixity of death many times.”   

[A] subtle change is taking place in the contents of the bed, that utter stillness of the body has been replaced by a calmness of the flesh, that beneath the closed eyelids his eyeballs roll slowly from side to side, then dart the way fish will move in a pond.  Look!  He shudders as if to shake off something which threatens to cling, and tightens those eyelids; minnow of light rising in the shallows.  Then he hears a wingbeat, and feels something fugitive, immaterial, a beige veil being drawn from his face, slowly at first then faster, until the final whisk is like a slap.  A moment later, he draws the first breath.  It is a deep sigh that might be interpreted as one either of  sorrow or of satisfaction, as though one precious thing were being relinquished and another embraced. (34)  

Then he takes his first breath--saying yes.  “Saying yes to life . . . to the burden and thrill of it” (35).  

            Much later, after a lengthy delusional period, Selzer returned to his beloved hilltop home where “everything in and around it has a glassy air of being set back out of earshot, in a time long past” (34).  He told me how one evening, after taking a late walk, he returned up the steep driveway to his home and opened the front door.  A band of light--yellow light--flooded across the front steps.  Stepping into that band of light from the chilled night air, he declared it to be like life itself, when you lie between the two immense blacknesses of before you were born and after you die.  [Fiat lux.]  Selzer said, “I remember feeling the thrill of stepping into that stripe of brightness . . . and wanting to pause there.”
  

Richard Selzer’s Doctor-Writer Legacy to the Medical Humanities

            When we read Selzer’s work, we stand with him in the stripe of life he creates for us.  In Raising the Dead (and other Selzeriana), we revel in the wonder and transience of life that renews in us a sense of human spirituality.  As Selzer continues to employ his craft, he puts his doctor and writer  consciousnesses in play to overlay natural fact with poetic expression, and it is through this transcendence that he produces the spiritual understanding we seek. 

            “[The Poet] is the true and only doctor,” wrote Ralph Waldo Emerson.  Richard Selzer, the poet laureate of medicine, metaphorically palpates the flesh to discern its spirituality.  His growing legacy to the medical humanities comes through poetic perception that reveals complex human ambiguity, linking doctoring to humanistic healing.

Appreciation and Dedication:  I want to thank my lecture hosts, Clara Gyorgyey and Yale Medical School’s Program for the Humanities in Medicine; I appreciate Jim Stripling’s technical help and Richard Selzer’s lodging.  In closing, before I open this forum for questions or comments, I dedicate this lecture to my husband, James Lewis Stripling, Yale class of 1966; and to his grandfather, George Thompson, Jr., Yale class orator, 1912S.  

Lecture References:

Emerson, Ralph Waldo. “Poet,” and Nature.  The Selected Writings of Ralph Waldo Emerson.  Ed. Brooks Atkinson.  New York:  Random, 1968.

Hippocrates.  Precepts chapter 6, Loeb Classical Library, Vol. 1, p. 319.

James, William.  The Letters of William James.  Ed. Henry James [his son]. Boston:  Little, 1926.

Josyph, Peter.  “Richard Selzer and the Whale:  A Physician Heals Himself.”   Salmagundi 87 (Summer 1990):  322-31.

Selzer, Richard.  Down From Troy:  A Doctor Comes of Age. New York:  William Morrow,  1992.

- - - .   “The Ivory Christ.”  MD (Jan.) 1994:  40-45.

- - - .   Letters to a Young Doctor.  New York: Simon and Schuster, 1982.

- - - .   Mortal Lessons:  Notes on the Art of Surgery.  New York:  Simon and Schuster, 1976.

- - -  .  Personal interview with lecturer.  7-10 January, 1993.  New Haven, Ct.

- - - .   Raising the Dead:  A Doctor’s Encounter with His Own Mortality.  Grand Round Press: Whittle Direct Books, 1993.

Textbook of Anatomy and Physiology (Eighth Ed.).  Ed. Catherine Anthony and Norma Jane Kolthoff. St. Louis:  The C.V. Mosby Company, 1971.

  Synopsis of Lecture (theoretical underpinnings): Cognitively, Selzer developed a doctor’s consciousness at his father’s knee while on medical calls and a writer’s consciousness rooted in his mother’s artistic desires for him.  Two overlapping languages emerged from these doctor-writer consciousnesses.  When the doctor’s physical or organic orientation is  overlapped by the writer’s associative reference building out the perception, human spirituality is revealed.  Therefore, “[The poet] is the true and only doctor,” in Emerson’s words, because he can foretell that which no other man is able to see:  the complex human ambiguity that all doctors must discern to treat the whole patient.  Theoretical notation:   William James’s concepts of the medical and literary ideals in languages; Ralph Waldo Emerson’s ideal: through symbolizing natural things human’s metaphorically come to know of their spirituality; Richard Selzer’s “The facts are not always where the truth lies” (RTD 78).

Location of lecture: Beaumont Room of the Sterling Hall of Medicine at 333 Cedar Street, New Haven, CT. [SRO]
 

©1998 by Mahala Yates Stripling