‘The Cuts that Cure’ Blog Tour: From Surgery To Writing: An Anecdote
Hi, this is Arthur Herbert, author of the new psychological suspense novel The Cuts that Cure which was just released May 11th. It’s my debut, and I have to say, I feel a little like I’m releasing my kid out into the real world: nervous, yet excited. I really appreciate the opportunity to write a guest post and let y’all see a little bit of who I am.
I was told I could write about anything I want. In thinking about this, I’ve found that my day job as a surgeon has been endless fodder for stories around campfires (which I attend all the time) or at cocktail parties (which I try to keep to a minimum). I feel like I should also emphasize that while Cuts is fairly dark and sinister, I’m not like that as a person. So as a result, I thought it would be appropriate to pass along one of my lighter stories.
I should start by saying that I trained in general surgery in the late ‘90s at a large county hospital, a massive Gothic structure built in 1939 in the middle of downtown New Orleans. It had large, cavernous wards with twenty-foot ceilings, and your footsteps would echo when you walked the ward at night. As you made your rounds, you knew that you were literally walking the same halls stalked by Michael Debakey during his internship right before World War II. The wards themselves each contained ten beds but only one television. It sat next to the ward nurses’ desk, and there were Lord-of-the-Flies- level negotiations between patients, wheeling and dealing to try to get the beds closest to the screen. The beds themselves were separated by shower curtains which hung from pipes suspended overhead through which you could hear water running, and if two normal-sized patients lying in adjacent beds were to fully extend their arms, their finger tips would almost touch. The place had a medieval feel that you either loved or hated. I was one of those who cherished every moment of my time there.
I chose to go to this program for two reasons: it had reputations for granting its surgery residents high levels of autonomy, and for treating large numbers of gunshot wounds. I quickly found both stereotypes to be accurate. We operated so much that by the time we made it to our fifth and final year of training, we were battle-hardened and fearless. I can remember as an intern looking at the Chief Residents, full of bravado yet composed and calm in crisis, and thinking they were the closest thing to God Almighty that I would ever know. Meanwhile, as a surgery intern, you were running around just trying to keep everybody alive. All of my colleagues and I lived in fear in those early days that we were going to trip over a cord and kill somebody. A popular joke among the faculty was, “The only difference between a surgery intern and a pile of dog shit in the middle of the hallway is that nobody ever went out of their way to step on a pile of dog shit.” It’s a humbling year for the best of us, and if you struggled, well—God help you. Bear all of this in mind as I relay the following. I’m only changing enough details to keep this story, although it’s now over 25 years old, HIPPA-compliant.
One of my intern colleagues was excited to do his first appendectomy. This was before we removed appendices laparoscopically, as is commonplace now. Back then, we did them through an open incision. Under normal circumstances, the operation was straightforward. After prepping and draping the patient’s abdomen, you identified the patient’s belly button, then the point where their pelvis bone juts out on the patient’s lower right side. You drew a line between those two points, and two-thirds of the way from the belly button to that jutting pelvis bone, you stopped and drew an “X”. That’s where the appendix lives. It’s a famous enough landmark that it’s even got a name: “McBurney’s point.” Then you basically just cut through the muscles of the belly wall until you find the appendix and you take it out.
My fellow intern was so excited he was beside himself. The problem was, there was nothing routine about this patient. The man had to have weighed 400 pounds. They had to get a special operating room table for him, and once asleep on the table he seemed to ooze in all directions, the fat almost puddling. As my colleague and his chief resident looked at the abdomen, they were able to identify the man’s belly button easily enough, but his pelvis bone was under several inches of fat, completely obscured. While the Chief resident was scrubbing my hands, my excited colleague made his best guess as to where McBurney’s point was on the man’s abdomen, and made a bold stroke with the scalpel blade.
As the Chief resident joined my friend, the incision grew deeper and deeper. Using a cautery device, they went through inch after inch of fat, further and further down. My friend later told me the hole seemed bottomless, and went on long enough that he began to get worried. But the Chief resident assisting him was just quietly humming to himself while they worked, so he figured everything was under control. And so, at two o’clock in the morning, they just kept spelunking. When they finally got to the patient’s abdominal wall at the bottom of that cavernous hole, my friend said he’d never had such a feeling of relief.
That sensation turned out to be only a momentary respite for his anxiety, though, when my colleague realized that the patient’s outer abdominal wall was a sickly, dark green color. This is a sign of a horrific intra-abdominal infection, far worse than routine appendicitis, an infection so severe that it has actually killed off the muscles in the abdominal wall.
“Jesus, that looks like necrotizing fasciitis,” my friend said, using the medical name for the condition.
“That can’t be,” his Chief said, looking puzzled. “Neck fash” as we pronounced it in our slang, “makes patient’s sicker ‘n hell. Like, ICU-trying-to-die sick. This guy doesn’t look near that bad.” He glanced up at the anesthesiologist’s monitors on the other side of the surgical drapes to confirm this.
“Well, what else could it be? Look at the color of his fascia covering the muscles, it’s a dusky green,” the intern said.
“Hmm. You’re right about that,” the Chief said. “Tell you what, let’s clean the fascia off and see how widespread this dead muscle is.”
They began to meticulously clean off the surface of the abdominal wall. The window of dead green fascia at the bottom of the hole went from a spot the size of a pencil to that of a quarter, then to the size of a silver dollar. After a few more minutes it was the size of a baseball, and the dead tissue showed no sign of petering out, continuing to extend in all directions. Meanwhile, the patient’s vital signs continued to ping away on the anesthesia machine, rock-solid stable.
“What in the hell’s going on, here?” my friend asked out loud, now willing to admit his ignorance if it just meant the medical mystery would be solved.
“Christ, I have no—” and then the Chief interrupted himself. He stepped back from the table three paces with his arms crossed and stared for a moment. Then he squatted down on his haunches for several seconds. Then he stood up and scowled, shaking his head.
“What—” is all my friend got out before the Chief held up a hand and cut him off, giving him that look your parents give you when they’re not in the mood.
My friend had the good sense to shut up as the Chief called the circulator nurse over and told her to go under the drapes on the patient’s right side.
“I want you to lift up the patient’s fat roll on the lower right side,” then he beckoned my colleague to watch the bottom of the hole. To my colleague’s confusion, the sickly green fascia at the bottom of the incision suddenly disappeared, replaced by a black hole. Then it just as suddenly reappeared with a wet slap. To his horror, my colleague realized what had happened.
The patient was so obese, my colleague had missed the patient’s abdomen completely and had dissected all the way through the roll of fat before coming out the back side. The sickly green color that he’d mistaken for dead fascia was actually the green surgical towels placed on the OR table.
Chagrined, my colleague backed up to the top of the incision and began angling inward at about 45 degrees and lo! Found the abdominal wall and its nice healthy white fascia and purple muscle. The rest of the appendectomy went swimmingly. All he had left to do was to explain to the man why he woke up from an appendectomy with a scar on his back. The residents were merciless in teasing him afterwards, and he spent the rest of his career hearing about his “two-holer appy.”
I hope you enjoyed this little anecdote. If you’d like a free sample of my writing, please feel free to go to Bookfunnel at the link below where you can download a short story of mine for free. Titled “Sisters,” it’ll give you an idea of my voice, and if I say so myself it’s pretty good as it spent a period of time as an Amazon #1 Best Seller in the “15-minute reads category.” Here’s the link: https://dl.bookfunnel.com/jdb524k8se. And if you’re so inclined, I’d really appreciate your support of The Cuts that Cure whether in Kindle or paperback form. Take care, and y’all stay safe.
Welcome to the tour for chilling new thriller, The Cuts that Cure by Arthur Herbert! Read on for an excerpt and a chance to win a signed edition of the book!
The Cuts that Cure
Publication Date: May 11th, 2021
Genre: Dark Suspense/ Inverted Mystery
Publisher: White Bird Publishing
Alex Brantley is a disgraced surgeon whose desperation to start a new life outside of medicine leads him to settle in a sleepy Texas town close to the Mexican border, a town that has a dark side. Its secrets and his own past catch up with him as traits he thought he’d buried in the deserts on the frontiers of the border rise up again to haunt him.
To the citizens of Three Rivers, Henry Wallis appears to be a normal Texas teenager: a lean, quiet kid from a good family whose life seems to center around his first girlfriend and Friday night football. That Henry is a cultivated illusion, however, a disguise he wears to conceal his demons. Both meticulous and brutally cruel, he manages to hide his sadistic indulgences from the world. But with that success, his impulses grow stronger until one day when a vagrant is found murdered.
When Alex’s and Henry’s paths cross, a domino effect is created leading to mangled lives and chilling choices made in the shadows along la frontera, where everything is negotiable.
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After fifteen minutes in the car, the pounding rain didn’t show any signs of letting up. Lozano sighed and hit pause. He found his glasses, zipped up the yellow rain slicker with SAPD stenciled on the back in large black letters and flipped up the hood. Swapping his loafers for rubber boots, he steeled himself before popping the car door enough to quickly open an umbrella and walked out into the pelting rain.
He legged it around an ambulance parked in the spot closest to the trailhead, and as the backs of his thighs became damp he broke into a trot, headed in the direction of a small pavilion covering a single picnic table. Once under the pavilion, Lozano had just collapsed his umbrella when a Parks Department vehicle drove by too fast, throwing a wall of spray on him.
A gangly young man with shaggy blonde hair that stuck to his cheeks like a Centurion’s helmet sat before him on the picnic table. His soul patch wicked water down his chin, and his gray Parks Department uniform—open to his navel and framing a puka necklace—now clung to his torso like he’d stepped out of the shower. He was shivering despite the warmth of the rain.
The downpour thrummed on the pavilion’s tin roof, amplified so that Lozano had to raise his voice. “Morning, sir. I’m Detective Lozano. You the man who called this in?”
A forlorn, “Yeah.”
“Mitchell. Mitchell Gansereit.”
“Mr. Gansereit, can you tell me what happened? Start from the beginning.”
“Me and Colin McPherson was detailed to pick up some trash out of the crick that runs through the back side of the park. We knew it was ’posed to rain today so we wanted to hurry up and get to it so’s we didn’t get soaked.
“We was at it for couple’a hours and was getting close to done when a man come up to us while we was working back there. He said he was jogging on the other side of the park over where all them cedars is and that he come up on a smell that was somethin’ awful, like somethin’ died.”
“Did you get that man’s name?” Lozano asked, interrupting the man’s story.
“No, he just took off jogging again. Me and Colin didn’t think much of it, lotta deer back in here, we figured one had died.
“Anyway, I told Colin I’d go check it out, mostly just so’s I wouldn’t have to carry the bags of trash back out to the truck.
“I went back up in them cedars and right off I could smell what the fella was talking ’bout. Smelled like Bigfoot took a shit on a pile of rotten eggs. I followed to where it was getting stronger, kept thinking I’d come up on a carcass, you know?”
“Smell took me up to a blue tent about a hunnert feet off the trail. Once I figured out the smell’s comin’ from there, that’s when I started getting a bad feeling. Little sick to my stomach, not just from the smell. There’s ’bout a dozen homeless guys more or less live up in here full time. Generally, they don’t do no harm to nobody so’s we mostly don’t bother ’em. Figger live an’ let live.
“So I come sidling up to that tent, calling out, like. ‘Hello? Anybody home? Knock, knock’, like that. But I didn’t get no answer. Man, I didn’t wanna go look up under that tarp for nothing.”
His speech had been rapid to that point, but it slowed and he looked down between his feet where they rested on the table’s wooden bench, as though trying to read the graffiti carved there.
He cleared his throat then continued, “Finally, though I decided it was time to nut up. I come ’round the back of the tent and looked inside.
“Sir, if I close my eyes right now, I can see it perfect, just like I’m sittin’ here looking at you. I seen this fella, laying on his side, knees pulled up, hands folded under his head like this”—Mitchell demonstrated, pantomiming sleep—“like he was sleeping or something. I called out loud to him, ‘Hey! Wakey wakey!’ You know? But he didn’t move a muscle. Smell by then was so bad I had to pinch my nose and try just to breathe through my mouth, but that smell was so goddam strong I could taste it. It was like burning up in my eyes, my nose, all sick-sweet.”
Here he gave another shiver, closed his eyes and shook his head.
“I went to give him a shake, but when I took aholt of his leg, it was reeeeal cold. Then when I tried to turn him over onto his back, at first he wouldn’t budge, not an inch. Just stiff as a board. Finally, I just pulled hard on his leg and his whole body come up, but still without bending his arms an’ legs. They was frozen in place, just sticking out in the air like they was one a’ them dummies you see in a store window.
“That’s when I seen his face and hands was all purple and green and puffed up, like somebody’d blowed him up all full of air or something.
“But sir, it’s the last part that’ll haunt me for the rest of my days. God as my witness, it was somethin’ I’ll take with me t’ my grave.
“When he come up off the ground, his mouth was open just a little bit, and dear sweet baby Jesus I heard him make this long moan sound, like he was in pain, and for a half a second I thought he was gonna open his eyes wide and reach out to grab me, gonna grab me and hug me to him.
“Lord help me, I went ass over tea kettle backwards. I just remember gettin’ tangled up on that rope and that plastic and then runnin’ like the devil hisself was after me. Ran all the way back to the truck.”
Now his voice cracked. He reached into his shirt pocket and took out a pack of cigarettes, hands trembling. He tapped one out and put it to his lips, but his fingers shook so badly he had difficulty lighting it.
He took a long drag and restlessly bounced his leg. “Colin wasn’t no help. I asked him, hell, begged him to call it in. Chickenshit asshole kept saying that going to check out dead bodies ain’t in his job description. The son of a bitch.”
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About the Author
Arthur Herbert was born and raised in small town Texas. He worked on offshore oil rigs, as a bartender, a landscaper at a trailer park, and as a social worker before going to medical school. He chose to do a residency in general surgery, followed by a fellowship in critical care and trauma surgery. For the last seventeen years, he’s worked as a trauma and burn surgeon, operating on all ages of injured patients. He continues to run a thriving practice.
His debut novel, The Cuts that Cure, will be released by White Bird Publishing in Austin Texas on May 11th, 2021. He’s begun work on his second novel, a mystery with the working title Strutting Through the Storm.
Arthur currently lives in New Orleans, with his wife Amy and their dogs. He loves hearing from his readers, so don’t hesitate to email him at [email protected]
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