Sunday, July 30, 2017

Politically Correct or Just Correct?

Recently the staid, establishment surgical journal, Annals of Surgery, attracted some undesirable attention regarding a Presidential Address to the European Surgical Society they published in last month's issue.  The transcribed speech---- "Modern Surgeon: Still a Master of His Trade or Just an OPerator of Medical Equipment? ---by Polish surgeon Marek Krawczyk MD was roundly vilified on Twitter and elsewhere for the alleged crime of only using male pronouns when referring to surgeons.

Following the backlash, Annals took the extraordinary step of retracting the entire piece.  Their statement on the retraction is below:


In an era of expected gender equality and, furthermore, in a medical field (surgery) where women are increasingly closing the disparity gap (for the past 5 years, women have represented 40% of all general surgery residents) the idea that such an august surgical publication would perpetuate gender stereotypes is certainly unacceptable.  But a deeper dive into this episode raises some questions.  

The speech by Dr Krawczyk was a rather lumbering, anodyne review of the relationship between surgical excellence and evolving technology, i.e. can a surgeon be truly great or is greatness contingent on having the right tool at the right time.  He does a pretty standard historical overview of surgical innovation, from the Napoleanic Wars through the era of transplantation and robotics.  His conclusion is what you expect: the truly great surgeons would have been great in any era.  Cue applause at dimly lit hotel conference room in Bucharest.

The j'accuse of the matter is that Dr Krawczyk uses exclusively male pronouns when referring to surgeons in general (i.e. no one can get angry if "he" is used in reference to Dr Starzl or Dr Buchler).  I don't want to get into the minutiae of "micro-aggressions" or the "violence of discourse" but we can all certainly agree that using "he" or "him" every time to refer to "surgeon in general" is belittling and crude, especially when potentially half the audience identifies with the other gender.  It trivializes and diminishes the actual role that women play in modern surgery.

So does Dr Krawczyk actually do this?  

Well, for starters, the title of the piece is absolutely garbage.  How that slipped by the editors of Annals is head scratching.  Simply substituting one word would render much of the controversy moot.  How does this sound:  "Modern Surgeon: Master of the Trade or Just an Operator of Medical Equipment".  Better?  Less demeaning?  More inclusive?  

How about the body of the piece?  In how many instances does Dr Krawczyk flout acceptable pronoun norms?  To find out I went through the speech and counted.  (I'm a ridiculous OCD bastard when it comes to things like this.)  And I found 5 pretty clear cut instances when "him" or "he" is used to refer to a non-specific surgeon.  I also found 22 instances when he uses a term like "surgeon" (i.e. "surgeon's errors" or "assessment of surgeon performance" or "when a surgeon uses laparoscopy") instead of using "him" or "he".  He even uses the unwieldy "his or her" one time!  I mean, if Dr Krawczyk really wanted to be a cartoonish incarnation of misogyny he could have done so in a far more ostentatious and obnoxious manner.  

Further, Dr Krawczyk, in a response to Annals editor Dr Keith Lillemoe, averred that he meant no gender offense, that in Polish, the pronoun he used is gender neutral and can refer to men and women.  Apparently this was not good enough for Dr Lillemoe and, in a statement to RetractionWatch, he said:
In Polish, ‘his’ is not a gender specific term, but it is in this country, and we wanted to make it right….We didn’t want to make the suggestion that we were not sensitive to gender issues, so we wanted to jump on it quickly.
Well ok.  And jump on it, they did, retracting the piece 3 days after initial publication. That's fine I guess.  But I sort of feel bad for Dr Krawczyk.  His transgression, such as it was, seems to have been amplified by the translation process.  Retraction is one of the worst things that can happen to a scientist or researcher.  The stigma attached to having had a paper or piece retracted by a reputable medical or scientific journal can pollute a hard earned reputation and compromise future attempts to get papers published.

And so now Dr Kramczyk is known by those in the international surgical community with cursory knowledge of the whole affair as that Euro-surgeon who had an article retracted from Annals because of "gender insensitivity".  It doesn't seem fair.  Is he a misogynist?  Or just syntactically challenged?  Or perhaps neither?

Instead of going straight to DEFCON 2 and retracting the piece, perhaps the editorial staff of Annals could have simply taken down the on-line version for the 47 minutes or so that it would have taken to clean up the title and switched out a couple of the "he" and "hims" for "a surgeon" or "his/her" and then posted an explanation for why it was altered.  I don't know, that's just me.

The corrected version remains unposted at Annals.

Sunday Poem

Sound is a Wave


Love is when everything seems to fit,
To slide together with a locking click.
I remember that sound from long ago,
But it dulls and deadens,
It’s clear for just a few seconds,
Soundless action on the other side of a window.


I whisper I love you in the morning with the lights off
While you’re sleeping---
My voice hoarse, halting;  as if I’d been weeping---
Might as well have been a cough


We don’t feel safe without those clicks.
We don’t know if the latch really fits.
Pressing harder is ineffectual
Pull it out, jam it in: futile forced ritual
Let it relax----
Or maybe just give it some more slack.


These little assurances are found lacking---
These sounds, these gurgling forest brooks.
An unexpected silence is menacing and grim;
A suddenly quiet pool where the children swim,
The cessation of splashing and waves lapping
Jolts us from our books.


Underwater is the sound of my own beating heart.
I used to hold my breath as long as I could and listen,
The surface world muffled and dulled and distant.
I never wanted to return---
But my chest tightened and burned
And I shot upward like a dart


If you drop your ring in the deep end I’ll find it.
It will strike the bottom with a tiny click.
Sound is a wave that travels to my heart.
I will find it in the deep dark
I will close my eyes and find it quick

7/30/17




Sunday, July 16, 2017

Sunday Poem

Takotsubo


The octopus glides through the inky darkness of the deep
While the traps float deceptively meek
Like shells, like planter pots, a garden of skulls,
A fleet of ironclad hulls.
You think you’re safe inside,
You think you’ve found a place to hide.
The creature slides in, curls its arms in an infinity sign
And never escapes its pocket of brine.
Hollowed out cove carved from fathoms of vastness
Inviting, alluring, harmlessly banal
Disarmingly curved, quiet and small----
A perfect shelter for an octopus.
Without locks or doors or gates---you’d think it a flaw.
You don’t know you’re snared, like you would
If you triggered a bear trap claw;
Jagged jaws that snap down crack on bone
Shattering the silence of the wood
With the wails of a beast caught alone.


Inside your own head, it’s all dread and doubt.
You swim back and forth.
You’re caged--- it’s a closed space---
Impossible to know south from north.
Pressure builds, the bottom balloons out.
(There’s a little give, just in case).
You act fine but I see it in your face.
Chest hurts, can’t catch your breath.
The water floods in, it’s a sudden death.
No one ever told you the stakes;
The pressure mounts and your fragile heart breaks.


Take my hand, let’s leave this place, let's swim to shore
And build a more stately mansion.
Open all the windows, let the breeze through the door,
Let sunlight gambol in the peaks of vaulted ceilings.
This is a sanctuary, a place for healing.
Look out yonder, our yard an endless expansion.
Wander through the twilight, as far as you can see.
If I lock the door, you’ll always have the key

Saturday, July 15, 2017

Weekend Poem

Poem #1

A poem is the rotten branch or fallen stick
That, whether real or just an optical trick,
Catches the corner of your eye without fail
While scranching along an overgrown trail.
The way it was bent or broken
How its shape conjured, like a cloud or ink blot
Something unsettled, unspoken        
You absently pick it up; you’re non-committal.
Take it home and try to whittle
The wood into the thing you thought

But the vision is ephemeral  
Your honed words, cleaved from their moment of conception,
Left alone are just a projection.
All that’s left of the flash of the seminal
Is just what you hold in your hand
With shavings of wood on the floor where you stand

At some point you have to put it down
It’s finished, you’ve moved on to the next thing found.
Verses are crude ventures to create a lifeline
From a lifetime of millions of half-glimpses of the sublime.
A dour collection of nouns, adjectives and verbs
Piles of sticks bundled on curbs

7/15/17

Tuesday, July 4, 2017

Off Day Poem

Wrecked

“There was no alcohol involved” the spokesman said. “The child just ran out into the street”

The world went and got itself wrecked
Shards of bone and flesh flecked
Into mangled sinews of metal.
Once we had to settle
For tonics and salves and gods
But then a 3 year old boy wandered into the street
(What were the odds!)
As a tan sedan sped past and knocked him off his feet

Blond, blue-eyed, pride of the Chicago South Side
Sacrificed for nothing; wasted filicide
He arrived lifeless, limp and blue
He had no vitals, there was nothing left to do
(In nomine Patris et Filii et Spiritus Sancti)
We stood there in our yellow gowns and gloves and masks
There was nothing to say, nothing to ask

Turn the monitors off, the attending surgeon said
This boy is gone, he’s come to us already dead
Someone pulled a blanket over his small crushed head
But none of us moved, no one said a word
(Father, Spirit, Son)
All names reductive, every one of them absurd

The monitors went dark and the trauma bay filled with silence
As quiet as a cathedral before Mass--- apse, nave, steeple
Just an accident, not an act of violence
Bad things happen to good people
Bless us this day
Now let us pray
Bless this child
His body has been defiled
He is in heaven now, he is with his savior
The things someone would have to say later
When the mother arrived
When the father arrived
When the world found out a Son had not survived

I had been awake for 38 hours
My bones ached and I needed to shower
I went home and tried to write
But the words broke into sounds, squelching and trite
No way to memorialize.
I scratched my heavy eyes.
I could not pray
I feel asleep,and straight away

7/4/17