The Scalpel's Edge: The Culture of Surgeons [Paperback]

Pearl Katz (Author)

Book Description

Publication Date: October 22, 1998 | ISBN-10: 0205270077 | ISBN-13: 978-0205270071 | Edition: 1

This ethnography about the culture of surgeons describes how and why they differ significantly from other physicians. Historically rising from humble roots as lower-class, uneducated, itinerant barbers, the profession has evolved into one of the most prestigious in America, one that utilizes the most sophisticated technologies in medicine. Surgeons have nonetheless retained many aspects of their historical culture, such as their proclivity for quick decisions, surgical "cures," and their detachment and aloofness from patients and other physicians. This book describes in detail what surgeons actually do in and out of the operating room. It reveals how they think about disease, patients, and other physicians; how their thinking is often non-scientific; how they make decisions; and how they keep secrets from patients and colleagues. This book gives a detailed description of a professional culture and how the culture, especially their active posture, influences decisions which affect patients and the health care system. The book discusses the methodology used to obtain and maintain trust with the surgeons and how the behavior was interpreted (1). Chapter 2 explains how history can help us understand why particular culture traits appear in the culture of surgeons. Thorough descriptions of the barriers to effective communication between surgeons and their patients, and the implications of these barriers, are in chapters 5 and 6. Case studies describe how many decisions are made based on complex issues, including professional ties and financial interests (7, 8, and 9). And also includes a detailed description of operating room rituals (10). For anyone with an interest in medical culture.

Editorial Reviews

Review

"A thorough, sensitive, and insightful work written in a lively, engaging style makes for compelling reading. The 'operating room rituals' chapter is an elegant piece of work." -- Lola Romanucci-Ross, Ph.D., Professor, Department of Family and Preventive Medicine, University of California, San Diego, in a letter

"A sensitive and perceptive portrayal! She has captured the essence of the culture of surgeons with compassion and hard-headed honesty. Superb for the general reader, as well as for scholars and students... Will enable policy makers, citizens, and consumers of health care to make decisions more intelligently." -- Ramsey Pennypacker, Former Vice President, Thomas Jefferson University, Philadelphia, in a letter

"As a lay person with little prior knowledge, I found this an eye-opener and a stunning book." -- Kate Lehrer, Novelist, Washington, DC, in a letter

"It is clearly, engagingly and honestly written, and it succeeds in presenting a balanced picture. In penetrating behind the veil of self-presentation by the surgeons, she has performed a valuable service." -- Andrew Strathern, Ph.D., Andrew Mellon Professor of Anthropology, University of Pittsburgh, letter

"The Scalpel's Edge is an attractive, interesting, well-written contribution. Dr. Katz is an astute participant observer." -- Arthur Rubel, Ph.D., Professor Emeritus of Family Medicine University of California, Irvine, in a letter

"The Scalpel's Edge is invaluable to anyone who faces surgery." -- Faris R. Kirkland, Ph.D., Guest Scientist, Walter Reed Army Institute of Research, Washington, DC, letter

"The Scalpel's Edge is wonderful! It reads easily. It exposes surgical thinking. It may be painful for some of us surgeons, because it reveals our behavior that we need to examine and understand. Medical students should read this book!" -- Joel Alperstein, M.D., F.A.C.S., Clinical Associate Professor of Urology, George Washington University School of Medicine, Director, Northern Virginia Institute of Continuing Medical Education, in a letter

From the Back Cover

This ethnography about the culture of surgeons describes how and why they differ significantly from other physicians. Historically rising from humble roots as lower-class, uneducated, itinerant barbers, the profession has evolved into one of the most prestigious in America, one that utilizes the most sophisticated technologies in medicine. Surgeons have nonetheless retained many aspects of their historical culture, such as their proclivity for quick decisions, surgical "cures," and their detachment and aloofness from patients and other physicians. This book describes in detail what surgeons actually do in and out of the operating room. It reveals how they think about disease, patients, and other physicians; how their thinking is often non-scientific; how they make decisions; and how they keep secrets from patients and colleagues.

This book gives a detailed description of a professional culture and how the culture, especially their active posture, influences decisions which affect patients and the health care system. The book discusses the methodology used to obtain and maintain trust with the surgeons and how the behavior was interpreted (1). Chapter 2 explains how history can help us understand why particular culture traits appear in the culture of surgeons. Thorough descriptions of the barriers to effective communication between surgeons and their patients, and the implications of these barriers, are in chapters 5 and 6. Case studies describe how many decisions are made based on complex issues, including professional ties and financial interests (7, 8, and 9). And also includes a detailed description of operating room rituals (10).

For anyone with an interest in medical culture.

See all Editorial Reviews

Product Details

• Paperback: 251 pages
• Publisher: Allyn & Bacon; 1 edition (October 22, 1998)
• Language: English
• ISBN-10: 0205270077
• ISBN-13: 978-0205270071
• Product Dimensions: 9.2 x 7 x 0.6 inches
• Shipping Weight: 14.4 ounces (View shipping rates and policies)
• Average Customer Review: 3.3 out of 5 stars  See all reviews (6 customer reviews)
• Amazon Best Sellers Rank: #428,192 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

12 of 13 people found the following review helpful:

4.0 out of 5 stars Surgeons Unmasked, October 3, 2000

By A Customer

Amazon Verified Purchase

This review is from: The Scalpel's Edge: The Culture of Surgeons (Paperback)

Last year I had major surgery (at least 4 different procedures done at once) by two surgeons. The outcome was successful, but I had many follow-up visits and, while I was recovering, a lot of time to ruminate. I began to wonder what made these two very different men (both the same age) tick. What it is like to cut into someone's body? How do they handle the stress, how do they make decisions? I began reading all the books I could find by and about surgeons. Surprisingly, there weren't too many; however, the ones I did find were mostly very good. My search progressed from profiles of surgeons, to the fictionalized experiences of one very literate surgeon (Richard Selzer), to books by and about neurosurgeons. All this reading made me hungry for more information, although I was beginning to get queasy about having gone too far -- getting too much behind-the-scenes information. But I was hooked and when I saw the description for Pearl Katz's book, I just couldn't resist. It is an anthropological study, written in academic style, with information quantified and categorized. She was given astonishing access to the world of the surgeons at a large university hospital in Canada, and the results of her study may have you shaking in your boots. She reports on the non-medical influences that affect their decisions about treatment of patients. In one instance, a surgeon refers a patient to one of his colleagues, who is not the best choice, but is a buddy of the surgeon and needs to pay the mortgage on his summer house. Another time, the surgeon does not tell the patient that chemotherapy or radiation may do just as well as surgery because he and his department will lose the income to another department. She reports on how surgeons avoid intimate or direct conversations with each other and their patients and how their egos affect decisions and protocols. (A surgeon declines to x-ray the duct after a gallbladder removal because he doesn't think any stones are in the duct, even though according to Katz, there is no way to make this determination without an x-ray.) This book is fascinating for those who really want to know what's going on behind the scenes. It's helpful to those who want to take an active part in their own or a family member's medical care, and don't mind asking hard questions. If you prefer not to know more than your doctor is willing to tell you, don't read this book.

11 of 14 people found the following review helpful:

2.0 out of 5 stars Marginal at best, April 17, 2004

By 

LMB1 "LMB1" (Los Angeles, CA) - See all my reviews

This review is from: The Scalpel's Edge: The Culture of Surgeons (Paperback)

After reading the reviews for this book, I eagerly purchased my copy. I am a general surgery resident and thus I thought I would find this book especially interesting. I did not. The author makes some interesting and valid observations, however I felt the book lacked any true analysis of what it really means to be a surgeon. If I were a medical student reading this I would steer clear of a career in surgery! Specifically I was annoyed by her contention that surgeons are merely clinicians and not true scientists as well as her insistence on referring to all surgeons by the male gender (a point she made early on). Clearly I am living proof of the contrary. In short, I was extremely disappointed and had a very difficult time even finishing this book.

6 of 8 people found the following review helpful:

5.0 out of 5 stars I've never reviewed anything before but..., March 17, 2001

By 

Ashley T. "pharmer" (Huntington Beach, CA USA) - See all my reviews

This review is from: The Scalpel's Edge: The Culture of Surgeons (Paperback)

...this book made me so excited that I had to write something. I had to read this book for a Health Care Sociology class and I ended up reading half of the book in one sitting even though I had other work to do. A lot of the information in this book is really shocking about surgeons and it has made me eager to volunteer in an OR so I can see any proof of this stuff for myself. I even got to learn about some types of common procedures surgeons do and it has definitely made me feel like I was observing these surgeons with the author.