Travels by Michael Crichton Page B

assist healing.
    We also keep the true role of the doctor in better perspective. The doctor is not a miracle worker who can magically save us but, rather, an expert adviser who can assist us in our own recovery. We are better off when we keep that distinction clear.
    When I get sick, I go to my doctor like everyone else. A doctor has powerful tools that may help me. Or those tools may hurt me, make me worse. I have to decide. It’s my life. It’s my responsibility.

Drs. W, X, Y, and Z
 
    Mr. Erwin, a fifty-two-year-old man, was admitted to the hospital because of a spot found on a routine chest X-ray taken by his private physician. Once he was in the hospital, the X-rays were repeated. The spot was there, no doubt about it, in the upper left lobe of his lung.
    Mr. Erwin was told that he should have surgery, and he agreed. But when it came to signing the forms, he asked for time to think it over. The next day, he was again advised to have surgery, and again he agreed, only to back out at the last moment. A week passed in this way.
    Mr. Erwin never asked what was in his lung that required surgery. He never asked anything at all. And nobody volunteered to tell him. For one thing, the X-ray image was anomalous; it appeared to be some sort of tumor, but it didn’t present a classical picture. Mr. Erwin was extremely nervous, and the house staff chose to wait.
    On the other hand, a week was a week. It became difficult to justify keeping someone in an expensive bed, but the house staff didn’t want to discharge Mr. Erwin because they felt he’d never confront his illness once he left the hospital. So there was an impasse. Mr. Erwin still didn’t ask about the operation. And still no one told him.
    Finally, at the end of the week, Dr. W, a surgeon from a nearby hospital, came to conduct visiting rounds. Dr. W, a former athlete, was a big blustery man who performed surgery with drama and verve. The house staff presented him with the case of the reluctant Mr. Erwin. Dr.W was outraged at the way the staff had coddled this man, and insisted on seeing him at once.
    Dr. W walked into the man’s room and said, “Mr. Erwin, I’m Dr. W; you have cancer and I’m going to take it out!”
    Mr. Erwin burst into tears, and agreed to surgery.
    The following day, the operation was performed. A granulomatous lesion was removed. In the center of the lesion was found some stringy material identified by the pathologists as beef. Apparently Mr. Erwin had, at some earlier time, inhaled a bit of meat while eating. The beef had lodged in his lung, and had been overgrown with a protective coating of tissue.
    When Mr. Erwin awoke, he was told the good news by the delighted house staff. Mr. Erwin remained glum. He still cried frequently. As the days went on, he said he knew the house staff was lying to him, that he had cancer; Dr. W had told him so. The residents assured him that Dr. W was wrong, that there was no cancer. They showed him the pathology reports. They offered to let him see his chart. Mr. Erwin believed none of it.
    Two days later, Mr. Erwin crawled out the narrow window of his room, and jumped to his death.
    Dr. X performed surgery on the leg of a thirty-five-year-old woman. His intention was to tie off the femoral vein. Immediately after surgery, the woman complained of severe pain in the leg, which was noted to be blue and cold, with little pulse. Twenty-four hours after surgery, when there was no improvement in her condition, it was realized that Dr. X had mistakenly tied off the femoral artery, not the vein. The woman’s leg would now have to be amputated at the hip.
    Dr. X was an elderly Jewish refugee from Nazi Germany. He was known to have made such errors before, and his surgical privileges had been revoked at a suburban hospital. The question was whether Dr. X would now lose his privileges at this hospital as well.
    Two things interested me. The first was that nobody told the woman anything was amiss. In those days, before