Dr. Allan Hamilton | Author of The Scalpel and the Soul

March 29, 2009

Dr. Kent: Welcome to Sound Authors! It’s a beautiful day out here in New York, still a little bit crisp in the air but there’s just a hint of spring coming around the corner. We have three authors on the show today and one musician; I’m excited about it. My first guest will be Dr. Allan Hamilton and his books called The Scalpel and the Soul and I’ve got a guy on who wrote a book called Abramo’s Gift – it’s a beautiful novel by Donald Greco. My third guest on the show is the youngest brother of the McCourt family. Of course there’s Frank and Maliki and this is Alphie McCourt. His book is called A Long Stones Throw, a beautiful memoir. At the end of the show I’ve got some musicians coming on as always and James Reams is joining me today with his band the Barn Stormers. So without further ado, my first guest on the show, Dr. Allan Hamilton, the writer of The Scalpel and the Soul. . Welcome to the show.

Dr. Hamilton: Thank you for having me Dr. Kent.

Dr. Kent: This is such an interesting issue. My father is a doctor and I know quite a bit about doctors just from hanging around them all my life and it’s not something you hear about too often, the soul.

Dr. Hamilton: Well it sort of one of our its we don’t feel comfortable sometimes talking about and one of the reasons that I actually tackled the topic was I went into my training and the first part of my career as a surgeon very unprepared if you will for some of the spiritual challenges and emotional challenges my patients were going to face and as you watch that process, it gradually begins to reflect on your own life and your own values and I thought that sort of took me by surprise if you will.

Dr. Kent: It’s really an experience that just about everyone has in society at one point. Being there, thinking about the scalpel and the soul as it were. In the emergency room waiting area, waiting for a family member to come out, this and that. It really is an emotional place, the hospital.

Dr. Hamilton: It is kind of a crucible and for many people it’s going to represent not just the moment of tremendous threat but also a potential challenge and even spiritual transformation. Many patients will come through a severe illness or major surgery and will have focused for them what their values really are, what they want their legacy to be and in many cases a lot of my brain tumor patients, cancer patients really have crystallized what they want their lives to be about and the purpose of their lives.

Dr. Kent: Here’s a question you might not get all the time but I have a curiosity about the word scalpel. It’s a word that came up on the campaign trail by both candidates this last year and I think we have a serious fear of that device, the scalpel and its only certain people that we trust with that and we trust them with our lives.

Dr. Hamilton: The scalpel is an interesting symbol. First off if you think about it, it really is a knife, like any other knife and yet its held with a completely different kind of grip and one of the most difficult things for young surgeons to learn is basically the way of wielding that scalpel so it actually is cutting tissue the way you want. And that when you cross that threshold, it’s really as if the scalpel suddenly has become a part of your hand, of your fingers. It’s no longer just an instrument but it carries a very special significance and you know it’s the knife that’s used in healing but still has a lot of the connotations of a knife. I always say surgery is only a few steps away from murder.

Dr. Kent: Wow. That’s a great statement, and a terrifying statement. Now, we have such a stigma attached to doctors these days. What’s your take on that? In the world of people who say I’m going to sue my doctor and this and that, there’s a real trust issue and it really does come down to there’s a fine line between murder and surgery. A lot of people think, go ahead.

Dr. Hamilton: Well I think you’re right. I think first off I think there’s a spiritual crisis going on in the midst of the whole medical health system. Medical adverse events, which is our fancy word for mistakes, errors, are the fourth leading cause of death now in the United States. Five times more people die a year from medical adverse events than those that die on the highways in America. So the publics trust in terms of public trust, the healthcare industry is right behind the food handling industry and the nuclear waste industry; we’re third.

So we really have lost the publics trust and one of the reasons is we’ve gotten farther and farther removed from the patient and the immediate relationship and sense of a partnership and the sense of being if you will united with the goal of healing. I think patients are gradually starting to feel more and more estranged. If you watch video tapes and do a study, the average time from when a surgeon walks in the room to the time the surgeon walks out with a signed consent for surgery is seven and a half minutes. So in 7-1/2 minutes you go from meeting a complete stranger to putting your life in their hands and asking people to trust a system like that I think is asking an awful lot. There’s almost no other situation in the world where we come up against that asked of us.

Dr. Kent: What’s interesting is that you talk about directly on your website, which is allanhamilton.com, there’s the soul often needs more than an intensive care unit can provide and I’ve experienced times in the intensive care unit visiting a family member and its not a place that; its an emergency place, its keeping people alive and its not a pleasant place to be. Where does the soul belong in that?

Dr. Hamilton: Well I’ll give you a very good example. I was just with a group of residents and we were next to a little boy in the ICU after surgery for a tumor. It really was an important point to remind the residents to step away from the patient’s room and the family and the immediate area if they wanted to have a discussion about certain things. My feeling was I don’t want the patient hearing a word here or a word there that has very significant connotations. I think you need to be aware that there’s an awful lot of stress in that ICU and we don’t want to add to it we want to actually address some of those emotional demands and that’s why I think we tend to look at the body in the ICU and often forget how desperate the soul is for support at the same time.

Dr. Kent: You are a neurosurgeon and I find it fascinating that someone who deals so much with a concrete part of a human beings body in such a sensitive area also thinks about the soul and a spiritual side to things. How does the physical tactile part of things connect up with the other side?

Dr. Hamilton: I think there’s a disconnect. I think one of the reasons I got so interested is because you’re working on the brain and because yes its an organ but it is a mind, it is the personality, it is the entire life experience, the values, you know, love and its all there and yet you’re just looking at an organ and at the same time very aware that the whole integrity of a person is in that organ. You can’t see it, you can’t see what love is, you can’t see where altruism and sacrifice and hard work or fear are; you don’t see that when you’re working on it, you just know that its there and you have to be aware that this is in some ways you’re inside a temple. It isn’t like any other organ. If you take somebody’s piece of bowel out or even fix their heart, you’re not changing the fundamental character of the person and yet with this surgery we can actually end up doing that or removing speech or you can confuse sending somebody up so their completely confused or have no memory. I think it makes you feel as if you’re far more connected with something beyond just the anatomy and the physical.

Dr. Kent: So let’s talk about the book itself, The Scalpel and the Soul. Its done very well and being carried by The One Spirit Book Club at Borders among other things and now why did you decide to write a trade publication? This is certainly not written for a medical journal, it’s a wonderful read. What did you want people to take away from it?

Dr. Hamilton: Well I think it’s a conversation because on one hand as I explained earlier, people aren’t talking to us and training us as physicians that we’re going to be dealing with it and at the same time you have a huge number of patients and a growing number of patients who say no, I’m not just a body with a disease I’m a human being with a soul and a heart and that has to be addressed at the same time so I think what you have is one group of people who want to open up a dialogue with their physician and I think the other thing is you have a group of physicians who are saying why cant we even have a conversation about this?

Why can’t we all know that miracles are happening every day? We all have had patients where we’ve said this patient isn’t going to survive another week and yet they say I have to wait another four months for my son to come back from Iraq so I can say goodbye and they do it. If this is just a process, how does all that happen? How did they summon the emotional strength, the spiritual strength, the will to impose their needs over a biologic mechanistic process so they could reach closure with their loved ones. That’s really what’s miraculous and that’s where you want to have the conversation between physician and patient.

Dr. Kent: How has the reaction been from your colleagues in your community? The books done very well and I’m sure many a doctor has picked this up.

Dr. Hamilton: Well surgeons, which I’m one, we’re the arch-conservative, the republicans of the medical world so I’ve had a lot of colleagues who’ve said you’ve been a surgeon 30 years, you’ve been chairman of the surgical department, how could you have sat down and written a book about spirituality like this? I’ve gotten very good reactions from the younger doctors, they give me a lot of hope because they say we’re glad somebody’s talking about this and made the subject no longer taboo. Then you have the intermediate group; I had a colleague going up in an elevator with me I’ve known for 20 years and he was saying I cant believe this book you wrote about spirituality and then he walked out of the elevator, turns around and says to me on the other hand I always know when something bad has happened to my children even before the phone rings. I said, so you have a sense of being connected to something beyond yourself and he says yeah. I said, well that’s what the books about. So I think its run the gamut.

Dr. Kent: Wow, well it’s such a fascinating title and with your background especially fascinating and I encourage everybody to go out and pick this up. The Scalpel and the Soul and of course this is available from the Reading Group at Borders, the One Spirit Book Club. What are you working on now?

Dr. Hamilton: I’m actually working on another book about spirituality and our connection with animals so that’s the second book.

Dr. Kent: I got to say I can’t wait to read that one. I’ve got a great connection with my golden retriever so.

Dr. Hamilton: Yeah.

Dr. Kent: Well thank you so much for being on the show, this has been fascinating and we can find out more about Dr. Allan Hamilton on his website, www.allanhamilton.com and everywhere books are sold. Thank you so much for chatting with us.

Dr. Hamilton: Thank you it’s been a pleasure.

Dr. Kent: My next guest on the show is a fellow named Donald Greco and we’re going to talk to him in a minute about his novel called Abramo’s Gift. Come on back for that.

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