Clueless at the time, when I applied to medical school, I imagined myself one day making house calls, good ol’ Doc Schwab, paid in chickens and pies, smiles, and blackberry jam. There I’d be, delivering babies on kitchen tables, patching up Old Lady Jones’s leg on the sofa, shaking out thermometers, and feeling foreheads. One of my roommates in med school was the son of such a doctor, although instead …

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When I joined The Everett Clinic forty-two years ago, we were thirty-some physicians. The main campus consisted of what’s now called the Founders’ Building and a couple of parking lots. The building was industrial and off-putting, guiding patients to various locations by way of colored stripes on the floor. TEC had just opened its first satellite office in Marysville and had negotiated an exclusive contract with a now-defunct health insurance …

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Of the many thousand operations I did in my surgical career, most were life-improving rather than life-saving. To me, life-saving implies immediate or imminent risk of death: gunshot wounds, stabbings, gastrointestinal bleeding or perforations, punctured lungs, and cracking a chest in the ER for a stab wound to the heart. Potentially life-saving but less dramatic is removing a malignancy that, untreated or treated later, would likely have killed the person.

Most …

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“Musta been the ham sandwich,” he said as he leaned onto the operating table and belched a couple of times. We were halfway through an operation, and Doug, my partner, didn’t look all that good. I’d been in practice for all of a year, still greenish, and he, ten years my senior, was my guardian angel, my guide through the vagaries of the world of private practice, and the best …

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When I think of Big Joe, I see his overalls and how he filled them. And how a couple of months after I operated on him, there was room for both of us in there. Big Joe: farmer, salt of the earth, tough, stoic. And now, bright orange. My initial recommendation, while probably justified, damn near killed him. Big Joe hadn’t been sick a day in his life. He worked …

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I didn’t know her name until it was over, much too late. What I knew was she was thirteen and that on this winter day, someone in her family had been pulling her behind their car on a sled. No doubt laughing and looking in the rear-view mirror, the person driving had whipsawed around a corner, and the young girl — probably screaming (fear? delight?) — held onto the sled …

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One of the most dramatic changes from my training to the present is the nearly complete disappearance of elective ulcer surgery. (Reminder: as I’ve said before, “elective” means non-emergent, as opposed to unnecessary.) The revolution began with the advent of drugs that effectively reduce gastric acid production and settled in for real when the relationship between ulcer formation and the bacterium known as H. pylori was worked out. I have to …

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Do you have any idea how beautiful you are? Well, OK; maybe for some it’s were. Before you got a little thick in the middle, smoked, or even just breathed city air for enough years, or drank a little, or did a few drugs, there was a time — and maybe it’s still true — when you were knock-down, take-your-breath-away gorgeous. While operating inside a belly, I’ve often stopped working …

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