HOT LIGHTS, COLD STEEL

An orthopedic surgeon’s down-to-earth, fast-paced, and frequently funny memoir of his residency.

Collins admits he felt like “the dullest scalpel in the drawer” at the start of his time at the Mayo Clinic, he admits. In short, punchy chapters he chronicles his four-year journey from terrified junior resident to skilled chief resident. Although Collins notes that surgeons are not generally known for their introspective qualities (and his memoir reflects that), he nonetheless freely describes the emotions he felt making his first incision into a living body, witnessing his first patient death, and conducting his first solo operation. As he grew in competence, he grew in confidence. Surgeons fix things, and for a time Collins rejoiced in the ability to do that increasingly well. He thrived on the gratitude and admiration of patients whose bones he had set or whose joints he had replaced. But he came to realize that it wasn’t in his power to fix everything, a point made in the stories of a young woman whose cancer could not be halted despite extremely disfiguring surgery and of a boy whose horribly mangled leg Collins failed to save. In other pieces, the surgeon touches on the ethics of the residency system, in which the patient’s right to the best care conflicts with the resident’s need to learn. While much of the action takes place at the Mayo Clinic, Collins also shares his personal life. With his wife producing a baby each year, he had to take a second job as an emergency-room doctor to feed his growing family. One old car after another died, each replaced by an equally aging wreck. The subzero Minnesota winters vied with perennial lack of sleep as worst physical indignity. Throughout, Collins depicts with a born storyteller’s skill the camaraderie among young residents as they journey to medical professionalism. We see them together in and out of the hospital, joshing, competing, and supporting each other.

Highly animated—and rich in encounters both sad and hilarious.