A Surgeon's Knot - Book Review

The title of A Surgeon’s Knot, by William Lynes, is an appropriate metaphor for Jackson Cooper’s chaotic first-year surgical internship. Unlike current TV medical sitcoms or docu-dramas, this gripping novel engages the reader from the fictional life of  Dr. Jackson Cooper’s first day of being called “Doctor” and his dealing with the death of a patient intermixed with the drama of caring for multiple diverse patients in a large Palo Alto, California, hospital in the early 1980s.

The portrayal of  Dr. Jackson’s interaction and treatment of his patients are told with sensitivity and numerous anecdotes. With respect for his training, the reader is made aware of the long, sleep-deprived hours and stressful demands that he endured reaching his goals. The engrossing story about the medical practice, dedication, decisions, and determination is not for the casual reader. Lynes takes you on rounds with Doctor Jackson and you are introduced to many of the doctor’s unforgettable patients whose personalities and medical problems are communicated with sensitivity and often humor. Their stories and prognosis were portrayed as deeply emotional and existential for Dr. Jackson.  The behind the scenes of medical emergencies and heroic measures to save patients are not for the squeamish.

The detailed thoughts and emotions of Dr. Jackson provide both information and educational insight into the medical field. It is obvious that the author, a retired physician, writes with first-hand knowledge. Cases are presented from his vast knowledge and experience, not from his imagination. He includes medical terminology with adequate and appropriate definitions. In addition of medically associated descriptions, the author’s command of detail allows the reader to be drawn into Jackson’s life.

He “collapsed in an exhausted heap, a caring casualty of modern-day medicine. With a heavy thud, he crumpled onto his tiny, unmade bed.” His life was one of crazy all-night calls, OR stints, surgical clinics and demanding “scut” work.

The complicated plot, medical theme,and well-developed characterizations keep the reader on the edge of the chair. The shared stories of patients’ misery but also of humanity and their quest to live a meaningful life in the face of death are emotionally moving.

Jackson’s personal and professional evolution includes unraveling from a happy-go-lucky urologist intern to being locked in a psychiatric ward with suicide precautions. His role flipped from physician to patient undergoing his own descent into mental illness. It is a turn with unforeseen consequences. Jackson’s set-back brought on by anxiety, fear, and exhaustion compounded by addiction and the prevalence of physician suicides is a gripping story. Alcohol and drug abuse symptoms are characterized in a detox scene; hallucinations, shaking, sweating, vomiting, seizures.

A surgeon’s knot is a compassionate and compelling look at the difficulty of reconciling devotion to the healing profession with the realities of life and man’s frailties.