Process Analysis in Richard Selzer's 'The Knife'

A Scrapbook of Styles

scalpel - Selzer
"The scalpel is in two parts, the handle and the blade. Joined, it is six inches from tip to tip" (Richard Selzer, "The Knife"). (Stockbyte/Getty Images)

An accomplished surgeon and a professor of surgery, Richard Selzer is also one of America's most celebrated essayists. "When I put down the scalpel and picked up a pen," he once wrote, "I reveled in letting go."

The following paragraphs from "The Knife," an essay in Selzer's first collection, Mortal Lessons: Notes on the Art of Surgery (1976), vividly describe the process of "the laying open of the body of a human being."

Selzer calls the pen "the distant cousin of the knife." He once said to author and artist Peter Josyph, "Blood and ink, at least in my hands, have a certain similarity. When you use a scalpel, blood is shed; when you use a pen, ink is spilled. Something is let in each of these acts" (Letters to a Best Friend by Richard Selzer, 2009).

from "The Knife"*

by Richard Selzer

A stillness settles in my heart and is carried to my hand. It is the quietude of resolve layered over fear. And it is this resolve that lowers us, my knife and me, deeper and deeper into the person beneath. It is an entry into the body that is nothing like a caress; still, it is among the gentlest of acts. Then stroke and stroke again, and we are joined by other instruments, hemostats and forceps, until the wound blooms with strange flowers whose looped handles fall to the sides in steely array.

There is sound, the tight click of clamps fixing teeth into severed blood vessels, the snuffle and gargle of the suction machine clearing the field of blood for the next stroke, the litany of monosyllables with which one prays his way down and in: clamp, sponge, suture, tie, cut.

And there is color. The green of the cloth, the white of the sponges, the red and yellow of the body. Beneath the fat lies the fascia, the tough fibrous sheet encasing the muscles. It must be sliced and the red beef of the muscles separated. Now there are retractors to hold apart the wound. Hands move together, part, weave.

We are fully engaged, like children absorbed in a game or the craftsmen of some place like Damascus.

Deeper still. The peritoneum, pink and gleaming and membranous, bulges into the wound. It is grasped with forceps, and opened. For the first time we can see into the cavity of the abdomen. Such a primitive place. One expects to find drawings of buffalo on the walls. The sense of trespassing is keener now, heightened by the world's light illuminating the organs, their secret colors revealed--maroon and salmon and yellow. The vista is sweetly vulnerable at this moment, a kind of welcoming. An arc of the liver shines high and on the right, like a dark sun. It laps over the pink sweep of the stomach, from whose lower border the gauzy omentum is draped, and through which veil one sees, sinuous, slow as just-fed snakes, the indolent coils of the intestine.

You turn aside to wash your gloves. It is a ritual cleansing. One enters this temple doubly washed. Here is man as microcosm, representing in all his parts the earth, perhaps the universe.

 

* "The Knife," by Richard Selzer, appears in the essay collection Mortal Lessons: Notes on the Art of Surgery, originally published by Simon & Schuster in 1976, reprinted by Harcourt in 1996.