To Cut Is To Cure? By Nick Marsh

Originally Posted: March 8th, 2010 by Nick Marsh

Full Title: To Cut is to Cure? Medicine vs Surgery

My wife and I are both vets, which makes for some very boring discussions most eveings. We do like to have our own area of expertise, however. For instance, I consider myself a medic. My wife considers herself a surgeon.

(Not that either of us have officially specialized – neither of us have quite got round to it, somehow. It was so nice not having exams after taking them every year for the first twenty-three years of our lives that we’re not in a hurry to get started again, though we both have plans in that direction at some point in the future… though this may be in the same way that I have vague plans to get bitten by a radioactive spider and develop superpowers)

The difference between medicine and surgery is relatively easy to define. Basically, pretty much anything up to the point where use a scalpel blade, and after you use suture material, is medicine. The bit in the middle is surgery.

(Incidentally, why do we call our consultations ‘surgeries’? Surgery is, literally, the one thing you’re pretty much guaranteed not to be doing when you are consulting, and considering that’s really the fun bit of the job, it’s kind of rubbing your nose in it, isn’t it?)

Now, I can really see the appeal of being a surgeon. Surgery doesn’t involve a lot of talking to owners. and life wound be so, so much easier without talking to owners. Surgey also has a much higher, shall we say – satisfaction quotient – than medicine. What I mean by that is, if you see a surgical problem (a broken leg, a ruptured diaphragm, lingerie stuck in a dogs abdomen (no, really!)), you knock the animal out, fix the problem, the animal wakes up. Job done. Instant healing work. (Incindentally, this satisfaction sometimes doesn’t matter whether the animal actually recovers or not. It has not been unknown from me to hear phrases from surgical colleagues along the lines of ‘The operation was a complete success. Unfortunately the pateint did not survive.’)

Medicine is never quite as simple as that. If you work out the animal has diabetes, or Cushing’s disease, lymphoid leukaemia or renal secondary hypoparathyroidism, you can’t just magically fix it with a swish of the blade. You’re then commited to a lifetime (well, the animal’s lifetime) of tablets, or injections, or of which can go wrong at any time and need fresh blood-sampling, fresh jiggling.

So why be a medic? There are times (including right now, when I’m writing this blog) when I wonder that very same question. Surgery is fascinating. There are times during operations, when I experience one of those ‘self’ moments – I take a step back and look at who I am, what I am doing. What I am doing is standing with my gloved hand inside another living, breathing animal, one that will recover (hopefully) and be absolutely normal. That is a strange experience, and quite a fulfilling one, too. Medicine has no comparitive Godlike moments to offer.

I think what I like about medicine is the puzzle – piecing together the history, and blood results, the symptoms. Working out the problem has a lower key buzz, but one present nevertheless, that makes me feel a bit like a veterinary Sherlock Holmes, eliminating the impossible until the truth, however unlikely, shines through.

Of course, these are romantisized views of both disciplines. There are many medical cases (surgical too – see my first blog) which defy explanation and the textbooks, are are exercises in pure frustration (we don’t get to call on Hugh Laurie to come and sort it all out, either). On the surgical side, there is a horrible, creeping sweaty feeling that only surgeons know – the feeling that something has just gone very, very badly wrong with your surgery.

(Which reminds me – a classic surgical euphamism is ‘He lost a lot of blood.’ What a lovely phrase. Kind of makes it sound like the animal’s fault, doesn’t it? Like he dropped it behind the sofa. Well, what the surgeon really means is ‘I fucked up, and cut something that I shouldn’t have, which was followed by twenty minutes of swearing and a whole lot fresh swabs.’)

Still, at least I gives me and the wife something different to talk about of an evening. One fine day, you might see the fabled letters CertSAM printed after my name. And one day, you might see me climbing a brick wall, and doing whatever a spider can.

Published Works: Past Tense and Soul Purpose (both available on Immanion Press)

Authors Webpage

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