SMILE. . . OR I'LL KICK YOUR BED!

One week in the life of an Oklahoma cardiac surgeon--who really means (hah-hah) what the title says. Goen takes us through seven days as he and his surgical assistant care for six patients and their families: some get better uneventfully, some have complications after surgery, one's condition is inoperable, and one dies after emergency surgery. Goen's basic precepts are fine. He recognizes that preoperative teaching, preparation, and attitude are all-important; he's big on keeping families informed during the long operations; he clearly understands the phases--euphoria, then depression--that patients go through afterward. But some of his methods, which may go across well on the spot, still make one wonder about his judgment--from his insistence on being called ""Tex"" (he calls all his patients by their first names) to his habit of kicking the post-operative beds of patients who don't follow his directions. (When a sulking patient refuses to get out of bed after surgery, and then also calls Goen ""Doc""--""I took a step backward, placed my right foot on the end of his bed and threatened to kick it across the room. 'Don't call me that. You don't learn your lessons very well, do you,' "") There is also much earnest hyperbole--apropos of, for instance, ""the price we must pay for the privilege of being in this 'field of honor' where the sorrow of the 'agony of defeat' serves to constantly remind us of the joy of the 'thrill of victory.'"" Goen succeeds in explaining cardiac surgery--and why preoperative preparation and emotional outlook matter--in terms that anyone can understand. What some will find hard to take, however, is his dramatic, shake-'em-up method.