Sunday, October 22, 2006

Reviews and Reader Comments About the Book (If gushing praise annoys you, skip to the exerpts, which follow below)

"...Buy this book.

More accessible than Oliver Sacks, funnier by far than Atul Gawande, totally devoid of snarky ego, and a fascinating insight into how surgeons are made and how they evolve. Buy this book. Read it. If you work with surgeons, read it again. Stick little bits of torn-up paper in between the pages you find particularly interesting, as I did. Keep it by the bedside.

I once reviewed a book here and had hellish trouble finding anything nice to say about it. I am now having hellish trouble not fawning over Cutting Remarks. Sid neither suggested I review this book, neither did he send me boxes full of cheese curds and poutine gravy. I'm doing it on my own.

Verdict: Buy the damned book already. If we're lucky, he'll write another one." Head Nurse Blog

"Great book! You made me laugh out loud about a dozen times. And when you left the County for the last time, you made me cry. Most importantly, you really, really, really let me know what being a surgeon is all about. I think the book is unique, probably a classic" R.S., Superior Court Judge, Sacramento, CA

"I like the terseness of your writing style and the humor that seeps out inunexpected places. I like the pace you set throughout the book - never going overly long on any subject but always saying enough to paint each section vividly. I like the way you speak to readers as equals - not "dumbing down" medical procedures or terms to the level of some television series. If I needed more info, I think you assumed I'd pull out a relevant reference and find it. I like that. I also liked the fact that when I was finished, I wished there was more to read. Lord, how I hate trudging through some novel all while constantly checking how many more pages there are to go before I can put the thing away. In yours, I kept noting with regret the diminishing thickness of the pages remaining as I got closer to the end." L.S., Newspaper Columnist, Edmunds, WA

"I enjoyed it so much. It has taken me almost 30 years of nursing to understand and appreciate what a doctor must go through to become a physician and how it affects all aspects of their life.... Your book was a "don't -put-it-down-until-you've-finished" type of read." K.M., RN

The Rough Road to Surgical Excellence, June 23, 2006
Reviewer: John N. Baldwin MD "John N. Baldwin, MD" (Twain Harte, CA)
For most surgeons, residency training is long, arduous, often brutally exhausting and requires great nerves and stamina. Dr. Schwab takes the reader from the timidity of the first day as a "real Doctor" just out of medical school to a time, six years later, when he emerges competent, brave and able to handle almost any surgical situation. Framed in the world-class University of California San Francisco program, these years are spent in cardiac, transplant, vascular and trauma surgery, to name but a few of the "rotations". Fabulous stories from those days bring the reader right out of his chair, as when the "jumpers" (off the Bridge) come into the SF General Hospital Emergency Room in full cardiac arrest. This is a "can't put it down" book, which reminded me of the way I felt in 1970 when I first read M*A*S*H, which up until then was the only surgical "novel" which had both pulse-quickening operating room drama and out of the hospital humor. This book does much the same, but all of the stories are true! Although surgeons will see themselves in it's 221 pages and delight in the memories, laymen with any curiosity or interest in just how tough it is to get to the top of the surgical pile will also find it a fascinating read, and at the end, will probably resolve to pick it up in a few months to read it again. Great work, Dr. Schwab. John N. Baldwin, MD FACS (General, Vascular and Chest Surgery)

Accurate depiction of the medical field, October 8, 2006
Reviewer: John Washburn
As a family physician, I have been disappointed with a good deal of the mainstream media portrayals of doctors. Rarely does a book, article or TV show come along that paints an accurate picture of what doctors are and what we go through to become what we are. Cutting Remarks defies that trend.
There is nothing more unique than residency training and, in many cases,nothing more challenging. It's one of those rare things that, once you go through it, you swear you'd never do it again, but wouldn't trade the experience for anything. Dr. Schwab captures the essence of that feeling in his reflections.
I like surgeons, mainly because they tend to have a sense of humor and more resemble humans than their internist counterparts. Dr. Schwab does a phenomenal job of portraying surgeons in such a light. As I read, I found myself immersed in nostalgia from my days of residency, whether it was 120 hour work weeks or cornering the market on "cutting sutures".
He takes us on a journey through the dreadful intern year, where a once triumphant fourth year medical student has to, yet again, work from the bottom of the totem pole. From trauma surgery to orthopedics to his time spent as a surgeon in Vietnam, his memories of becoming a surgeon are filled with rich descriptions of fellow residents, staff surgeons and, of course, patients. Every doctor has memories of certain patients from residency, whether they were particularly challenging or simply had a unique personality, and Dr. Schwab's memories truly make for good reading.
Schwab's writing style is also quite impressive. A common trap in memoir-writing is to get bogged down in the personal detail that fails to capture the reader's attention, while missing the main punch of the memory. Schwab avoids this trap well. His sharp descriptions mimick the very blade he has become so adept at using.
This book should be on the list of "must reads" for anyone in the medical field, especially medical students or those in pre-med and certainly for anyone considering a surgery career. But, even if you're not in the medical field, it's a great alternative to the usual doctor characterizations that you'll find on ER or House. Dr. Schwab has removed the usual mainstream physician stereotype like an inflammed appendix. This is real life. This is how doctors live, and what we have gone through to achieve our career. Bravo Dr. Schwab, you've done our profession quite a service.

September 8, 2006
Reviewer: A. Cooley "misscooley" (Bainbridge Island, WA)

Being the type of person to permanently remove the surgery channel from my TV, I didn't expect to like this book. Truthfully I didn't like it, I LOVED IT! Dr. Schwab is hilarious, brilliant, touching, and extremely insightful. It is not often we get inside such a talented and humble man's mind. This book made me laugh out loud and darned if I didn't learn a lot! I am eagerly awaiting the sequel.

A unique voice in medical non-fiction , July 28, 2006
Reviewer: gensparkie (California)
This gritty and sometimes laugh-out-loud funny memoir of a surgeon's years of training in San Francisco from 1970 to 1977 caught my attention from the intro, which is headed Reality Check:

"Someone said writing is easy: you just sit down at a typewriter and open a vein. As I've been in the business of preventing bleeding, this may not work out well. You wouldn't want John Updike taking out your gallbladder."

This dry and self-deprecating humor is found through the entire book and helps relieve the tension of some of the more difficult surgical moments. His riffs on the surgeons who trained him are hilarious: "Lester Weisman looked like Death. Bony, stooped, hook-nosed, and spider-fingered, he spoke in a voice that was chronically hoarse, a wheezing gust from Hades... Raising a hand toward you if he addressed you, he let the fingers droop and motioned vaguely, as if it were too much effort to point. When he smiled, it looked like he smelled something putrid. He should have carried a scythe, but it would have been unseemly for a former chairman of the department." And then Schwab deadpans, "I liked him a lot."

Then, his descriptions of the patients he and his colleagues worked with had me rocking with laughter. There was one story about a man with a pocket in his esophagus (a diverticulum) "who used to carry around a jar of pickled oysters. Before eating, he'd swallow one, which exactly filled the diverticulum without pushing too much on the esophagus. So he could eat, after which he'd push on the side of his neck and regurgitate the oyster into the jar. Probably didn't get invited out much."

Another thing I loved was the feeling of poetry or artistic enjoyment that he shares about how surgery works. In one passage, he talks about stitching up a bowel after surgery: "As you watch the edges disappear inward, and see a row of evenly spaced sutures complete a perfect circle, no mucosa showing; as you observe the tiny nearby arteries dancing their proof that you haven't disrupted the blood supply to the edges, you know you can safely drop it back inside, a secret gift to the patient."

The clarity and density of Schwab's writing allows him to pack in an enormous amount of information and insight. With most books that I am enjoying, I will read 100 pages or more in one sitting, but with this one, I wanted and needed to slow down and really savor every word, because there were so many excellent stories and well-explained surgical adventures in each chapter. His writing style, of making every word really count, really imparted the feel of a surgical internship perfectly in the sense that the pace of surgical action, emotional conundrums, and medical information (presented in a manageable way for the layman) never slowed.

I'd absolutely recommend this to anyone who enjoys medical non-fiction. Schwab has a really unique voice in this field, and even after having read about twenty medical narrative non-fiction books in the last two years, I found this to be a fresh and enjoyable addition to the genre.

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