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A Piece of My Mind |

Listening to Leviticus

Bruce H. Campbell, MD
JAMA. 2008;299(8):879-880. doi:10.1001/jama.299.8.879.
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This particular day, more than most, I was working without a net. Each maneuver intensified my awareness of the potential for disaster. Repeatedly, I pressed forward, making sporadic progress, until I was forced to back off once again. With each moment of self-doubt, I would pause, regain my focus, and force my hands to return to the procedure, although my mind was beginning to doubt whether I should indeed continue.

As I worked, the din of the operating room dropped away. I twisted my body—leaning hard into the table—and deliberately extended my right index finger more deeply into the surgical wound. I focused on the unseen surface of the mass where my finger was probing and dissecting, hoping for better exposure. Each time I rearranged my hand or one of the surgical retractors, I searched the operative field for unexpected surges of blood. I worked as deliberately as possible, proceeding from known to unknown, keeping assistants and supplies ready. If all went well, with a final sweeping flourish, the baseball-sized tumor attached to the inferior end of the right thyroid lobe would soon emerge from the surgical opening like the crowning head of a newborn; only then would I know if I had exercised good judgment. As I stretched and pushed the unseen tissues, however, I wondered if that moment of release would ever arrive.


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