Academic Medicine:
doi: 10.1097/ACM.0b013e3181b6ab43
Medicine and the Arts

Imelda: [Excerpt]

Selzer, Richard

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Reprinted with permission from Dr. Richard Selzer. Dr. Selzer is a retired general surgeon and the author of 15 collections of stories, essays, memoirs, and diaries, many of which have to do with medicine.

“Imelda” is a short story that encapsulates the careers of two physicians, Hugh Franciscus, a renowned plastic surgeon, and the narrator, who, upon hearing that this former teacher has died, recalls what happened years before on a medical mission with Dr. Franciscus in Honduras. The first excerpt, the opening of the story, describes Dr. Franciscus as he appears to his students in his prime; the second gives the narrator’s youthful reaction to an unusual medical event in Honduras; and the third, which closes the story, summarizes, from the perspective of time, the aftermath of that event.

I heard the other day that Hugh Franciscus had died. I knew him once. He was the Chief of Plastic Surgery when I was a medical student at Albany Medical College. Dr. Franciscus was the archetype of the professor of surgery—tall, vigorous, muscular, as precise in his technique as he was impeccable in his dress. Each day a clean lab coat, monkishly starched, that sort of thing. I doubt that he ever read books. One book only, that of the human body, took the place of all others. He never raised his eyes from it. He read it like a printed page as though he knew that in the calligraphy there just beneath the skin were all the secrets of the world. To us medical students he was someone heroic, someone made up of several gods, beheld at a distance, and always from a lesser height. If he had grown accustomed to his miracles, we had not.

There are events in a doctor’s life that seem to mark the boundary between youth and age, seeing and perceiving. Like certain dreams, they illuminate a whole lifetime of past behavior. After such an event, a doctor is not the same as he was before. It had seemed to me then to have been the act of someone demented, or at least insanely arrogant.

Hugh Franciscus continued to teach for fifteen years, although he operated a good deal less, then gave it up entirely. It was as though he had grown tired of blood, of always having to be involved with blood, of having to draw it, spill it, wipe it away, stanch it. He was a quieter, softer man, I heard, the ferocity diminished. There were no more expeditions to Honduras or anywhere else …. I would like to have told him what I now know, that his unrealistic act was one of goodness, one of those small, persevering acts done, perhaps, to ward off madness. Like lighting a lamp, boiling water for tea, washing a shirt. But, of course, it is too late now.

© 2009 Association of American Medical Colleges

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