The Scalpel's Edge: The Culture of Surgeons

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9780205270071: The Scalpel's Edge: The Culture of Surgeons
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This ethnography about the culture of surgeons describes how and why they differ significantly from other physicians. Historically rising from humble roots as lower-class, uneducated, itinerant barbers, the profession has evolved into one of the most prestigious in America, one that utilizes the most sophisticated technologies in medicine. Surgeons have nonetheless retained many aspects of their historical culture, such as their proclivity for quick decisions, surgical "cures," and their detachment and aloofness from patients and other physicians. This book describes in detail what surgeons actually do in and out of the operating room. It reveals how they think about disease, patients, and other physicians; how their thinking is often non-scientific; how they make decisions; and how they keep secrets from patients and colleagues. This book gives a detailed description of a professional culture and how the culture, especially their active posture, influences decisions which affect patients and the health care system. The book discusses the methodology used to obtain and maintain trust with the surgeons and how the behavior was interpreted (1). Chapter 2 explains how history can help us understand why particular culture traits appear in the culture of surgeons. Thorough descriptions of the barriers to effective communication between surgeons and their patients, and the implications of these barriers, are in chapters 5 and 6. Case studies describe how many decisions are made based on complex issues, including professional ties and financial interests (7, 8, and 9). And also includes a detailed description of operating room rituals (10). For anyone with an interest in medical culture.

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About the Author:

Pearl Katz, Ph.D., an anthropologist, is on the faculty of the Department of Psychiatry at The Johns Hopkins University School of Medicine in Baltimore, Maryland. and on the Adjunct Faculty in the Department of Psychiatry at Uniformed Services University of the Health Sciences in Bethesda, Maryland.

She has published on her fieldwork in a variety of cultures, including Army drill sergeants and Drill Sergeant School, Taos Pueblo Indians, violence in psychiatric hospitals, immigrants' acculturation, and rituals of psychiatrists and psychoanalysts.

Review:

"A thorough, sensitive, and insightful work written in a lively, engaging style makes for compelling reading. The 'operating room rituals' chapter is an elegant piece of work." -- Lola Romanucci-Ross, Ph.D., Professor, Department of Family and Preventive Medicine, University of California, San Diego, in a letter

"A sensitive and perceptive portrayal! She has captured the essence of the culture of surgeons with compassion and hard-headed honesty. Superb for the general reader, as well as for scholars and students... Will enable policy makers, citizens, and consumers of health care to make decisions more intelligently." -- Ramsey Pennypacker, Former Vice President, Thomas Jefferson University, Philadelphia, in a letter

"As a lay person with little prior knowledge, I found this an eye-opener and a stunning book." -- Kate Lehrer, Novelist, Washington, DC, in a letter

"It is clearly, engagingly and honestly written, and it succeeds in presenting a balanced picture. In penetrating behind the veil of self-presentation by the surgeons, she has performed a valuable service." -- Andrew Strathern, Ph.D., Andrew Mellon Professor of Anthropology, University of Pittsburgh, letter

"The Scalpel's Edge is an attractive, interesting, well-written contribution. Dr. Katz is an astute participant observer." -- Arthur Rubel, Ph.D., Professor Emeritus of Family Medicine University of California, Irvine, in a letter

"The Scalpel's Edge is invaluable to anyone who faces surgery." -- Faris R. Kirkland, Ph.D., Guest Scientist, Walter Reed Army Institute of Research, Washington, DC, letter

"The Scalpel's Edge is wonderful! It reads easily. It exposes surgical thinking. It may be painful for some of us surgeons, because it reveals our behavior that we need to examine and understand. Medical students should read this book!" -- Joel Alperstein, M.D., F.A.C.S., Clinical Associate Professor of Urology, George Washington University School of Medicine, Director, Northern Virginia Institute of Continuing Medical Education, in a letter

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