Cutting for Stone - Abraham Verghese [210]
He held his beer aloft. “A toast! Ladies and gentlemen. May no Ameri can venture out of this world without a foreign physician at his or her side, just as I am sure there are none who venture in.”
CHAPTER 41
One Knot at a Time
ONE AFTERNOON, in my ninth month at Our Lady of Perpetual Succour, as we were on our way to the operating room, a bailiff served Deepak Jesudass with papers. My Chief Resident took them without comment, and we went on with our work. Well after midnight, as we sat in the locker room outside the theater and smoked, he smiled at me and said, “Anyone else would have asked me what the papers were about.”
“You'll tell me if it concerns me,” I said.
Deepak was perhaps thirty-seven when I met him. He had a youthful face and boyish shoulders that belied the bags under his eyes and the gray streaks in his hair. Had you seen us all in the cafeteria, you would have guessed B. C. Gandhi was the Chief Resident, because B.C. looked the part. But when I reflect back on my surgical training, I'm indebted to a small, dark man, a self-effacing surgeon whom the world might never celebrate. In the operating room, Deepak was patient, forceful, brilliant, creative, painstaking, and decisive—a true artisan.
“Don't stutter with that needle holder.” “Self-discipline with those hands, Marion. Do each step just once, no wasted motion.” When I learned to cross my hands the way he suggested to get equal tension on both limbs of the knot, a new problem arose: “Keep your elbows in, unless you're trying to fly.” I redid more knots than I tied when I was with him. I took down entire suture lines and started again till he was satisfied. I gave new thought to light and exposure. “Working in the dark is for moles. We are surgeons.” His advice was sometimes counter intuitive: “When you are driving, you look to see where you are going, but when you are making an incision, you look to see where you have been.”
Deepak was from Mysore in southern India. That night in the locker room, he told me what I don't think he had told anyone else at Our Lady. When he graduated from medical school, his parents hastily arranged a marriage to a British-born Indian girl living in Birmingham; shed been a reluctant bride, bullied into marriage by her parents who didn't like the crowd she was hanging around with. She flew down with her family a few days before the wedding and left the day after, because she was attending college. It took six months for Deepak to get his visa and join her at her parents’ home. He found that if he opened his mouth he embarrassed her. She didn't want him near her in public or private. He left the house after a few weeks and found a house-officer position (equivalent to the internship in America) in Scotland. After a year he advanced to registrar, then to senior registrar. He passed the difficult exams to become a Fellow of the Royal College of Surgeons, the magic letters FRCS behind his name.
“I could have gone back to Mysore. With my FRCS up on a board, I would have done very well. But I pictured all the people who'd come to my wedding. I didn't want to face them … I just couldn't.”
The next step for him in England would have been to be a surgical consultant appointed to a hospital. “There aren't many consultant jobs. Someone has to die for an opening to come up.” After six years of working as a senior registrar, a consultant's understudy, doing all the emergency cases, Deepak decided to come to America.
“It meant starting all over again, because here you don't get credit for postgraduate training anywhere else. At my age, and after all the years of training, I wondered if I had it in me.”
The American system of surgical training was different: after a year of internship and then four years as a surgical resident with ever increasing responsibilities (the last year as Chief Resident), one was allowed to sit for the exam to become a board-certified surgeon, a consultant.
“I did my internship in