the only Bible passage he knows, Henry adds, “Jesus wept.” I am
stupefied.
I am at my breaking point, and by some miracle, my chief resident
appears in the doorway. “How’s it going, Dave?”
“Not well, Joe. I can’t get his hands numb.”
“Where are you injecting? Did you do a regional block?” Joe asks,
sensing that I am in over my head.
“A regional block? Um, no.”
Joe helps me save face, and realizing that we never discussed the
technique of regional anesthesia, asks the nurse to draw up more numbing
medicine. “I’ll show you how,” Joe affirms, and I’m starting to feel a rush
of relief.
This is how medicine is taught—through a grueling series of trial-and-
error assignments, failures and triumphs, overwhelming insecurity and
occasional recognition. Oftentimes, when a medical student or resident
fails, a singular tidbit of knowledge is missing, spelling doom to
themselves, and more important, their patient. In a fully actualized
training environment, errors are detected early before harm occurs, and in
this case, my chief resident intervened just in the nick of time to salvage
the situation. Henry will receive the block he needs to properly cleanse his
wounds and ready him for digit reattachment tonight.
In 1540, by an Act of Parliament, the Company of Barbers and Surgeons of
London was created. This codified their respective roles—only barbers
could cut hair and shave beards, and only surgeons could engage in the
primitive acts of lancing boils, setting bones, and suturing wounds. This
was an uneasy marriage, particularly as the professionalization of surgery
increased over the next two centuries. In 1745, the barbers and surgeons
went their separate ways, with surgeons retaining the right to anatomize
the bodies of executed criminals and to practice the more invasive aspects
of their profession. Eventually, the Royal College of Surgeons of England
was formed in 1800 by royal decree, in no small part due to the pioneering
work of John Hunter, the first scientific surgeon.
Throughout the centuries, physicians continued to hold a much higher-
privilege position in English society than surgeons; they were members of
a socially elite caste, while surgeons were practitioners of a craft, and like
apothecaries, were tradesmen. Physicians did not deign to work with their