Ethan Feig got 2nd place in the 2022 Art of Medicine competition for his work titled Icarus. Check out the amazing piece below:
I saw my first God a month before my father died.
I remember his office, tucked away in the quiet recesses of the hospital, with an open door for my mother and me. My father was already inside, what was left of his emaciated frame barely leaving an indent on the cushioned seat.
I sat on my mother’s lap as he spoke to us. I remember her reverence, the way that my father’s sunken eyes swallowed every word. The God told us that despite our faith, despite our devotion, my father would die of cancer. Everything he said had come true, and this was no different. Life was something he could foresee and foreclose.
It was after he died that I started pulling ahead in school. No matter whether we had a place to live or food to eat, I refused to miss a single day. When I graduated high school a year early with a full-ride to an Ivy-league university, my mother said it was the happiest day of her life. I was happy too, but I wasn’t surprised. It was easy for me. I knew how intelligent I was, and so did the kids that picked on me at school.
The only time I tried at anything was my medical school interviews. I had the grades, the MCAT scores, and more physician shadowing than I could fit on my CV. But even then, the interview scared me. For a whole day, I had to sell a lie to the admissions departments, sell them on believing that I was really in it for the ‘right’ reasons. For helping people, for the passion of it, for giving people the ‘gift of life.’
I wanted to become my own God, to show everyone else how it should be done.
Once I got in, the rest was easy. I collected knowledge and devotees without bothering to make a single friend. I knew very early on that I was going to be a surgeon. I knew I was qualified to control life at my fingertips. My patients would pray for salvation by my hand. I imagined they would recognize me years later at an exclusive bar with a beautiful woman on my arm and pay for our drinks out of gratitude. My residency went smoothly, especially since I was more capable than any of the other surgeons after six months. I was untouchable.
After two tedious years, I was finally a full-fledged cardiovascular surgeon. I did the general surgeries that anyone with a brain could handle for a year, then got the chance to move onto the interesting stuff. Coronary revascularizations, septal myectomies, and aortic dissection repairs kept me busy for the next ten years. I specialized in the kinds of surgeries that made the rest of them shake their heads and say it couldn’t be done. I had patients fly in from all over the world, spend more money than they made in a year, just for a few hours under my scalpel.
It was mid-December when it happened. Another surgeon in the department had to go to his grandmother’s funeral, or had a wedding or something like that, so I took his work for the day. He apparently had already told the patients that I would be doing his procedures instead. I’m sure they looked at my record and didn’t mind the free upgrade, so I didn’t bother to meet them.
The first guy was a triple bypass, easy enough. By the time I walked into the OR, the patient was already prepped. Time-in. As soon as I was handed my scalpel, I removed the blue drapes around his leg and made my first incision. The wet slurp of suctioned blood cleared the way for me to advance past the muscle tissue and into the venous space. The help was slow, but it didn’t matter. I inserted my hand into the incision, moving past the curdled-yellow fat cells. My fingertips disappeared into the red soup, slowly descending to my knuckles. I could feel the femoral artery pulsing directly beneath my middle finger and used it as a landmark to find the
nearby veins and isolate them for excision. I knew how long the veins needed to be, and once I had it measured, it was just a matter of cutting and sewing. Once the three veins were all nicely removed and lined up on my stainless-steel tray, the real work began. There’s nothing like using a pulsing bone saw to cleave someone’s chest open, it really wakes you up in the mornings. It wasn’t long before I was laying eyes on the patient’s beating heart. It took the technicians a few minutes, but under my observation, the heart-lung machine began to do its work, and the heart slowly twitched to a halt. Now it was time for some finesse. Using threads thinner than a human hair, and cuts smaller than the naked eye could detect, my fingers weaved in and out of the great arteries and vessels, re-routing the blood flow around the blockages that I had seen on the MRI earlier that day. As soon as I was done, I left the room and let my acolytes restart the heart and replace the ribcage.
A quick hand-washing and re-gowning later, and I was ready for the second surgery, a valve replacement. The only real difference with this one was that I would be going inside the heart, replacing the aortic valve with a synthetic semilunar that had been customized for the patient. The surgery should take an hour and a half, maybe faster, depending on how much my staff impeded me. I parted the ribs of the red sea and made my first incision. I assessed the area supporting the old valve in case I needed to account for it when I placed the new one. Everything seemed normal. I looked at the valve itself, gently flapping its fleshy wings with my finger to spot any tears or gaps. Nothing. The demigod beside me looked over my shoulder, his forehead crinkling under his face shield. He held out a hand to stop me briefly, turned away from the table.
“We’re doing the aortic valve, correct?”
The flustered nurse consulted the surgical schedule, but I knew I was correct. I didn’t make mistakes.
“Yes, it’s the aortic valve.”
It didn’t matter. It wasn’t a physical defect that I could see, and there wasn’t anything specific in the pre-op report. I carried on, using my perfect mental maps as a reference to make my incisions. It wasn’t until five minutes later that I spotted the same nurse approaching the patient, breaking the sterile field.
“Hey! What are you doing?”
I saw the blood rush from her face. She continued over to the patient’s side, exposing his right arm from underneath the blue curtain.
“What the hell are you doing?”
She looked up from his wrist, the laminated hospital band reflecting the bright lights. Her pupils were dilated.
“Sir… this is the wrong patient.” “What?
“There’s be – there’s been a mistake.” “A mistake?”
“Sir… He’s the triple bypass, sir.”
“You’re telling me that I just removed this man’s heart valve for no reason?”
It felt as though I had gone out on a walk and somehow fell off the side of the earth. It wasn’t something that was possible, until your stomach was already in your throat.
Since I had already discarded the original valve, I had to finish the replacement. It wasn’t a perfect fit, but I made it work. Then I had to do the bypass. By the time I was done, I was soaked in sweat and blood. I didn’t even get to change out of my scrubs before being cornered by the chief. The first patient’s leaky valve blew out due to the extra blood flow, sending him into irreversible cardiac arrest. He never made it out of post-op care.
I had no way of knowing. The patient’s names were Taylor Johns and John Tayler, and hospital staff had never been consistent about reading names a specific way. It was also during the holidays, so the staff that might have caught it were already on vacation. They couldn’t fire me, but what they ended up doing was far worse. They started supervising me, questioning me, trying to flay me open under my own lights. I was forced to explain every incision, every suture, to these people who knew nothing of perfection.
Of course, both the living and the dead immediately sued me. Although I had malpractice insurance, I soon realized that it wouldn’t help much, especially since I had bought the cheapest package. The hospital didn’t find any reason to press charges after conducting an internal investigation, but the court needed a villain. I was free in the eyes of the law but condemned by their glint of superiority. They wanted to cut me out like a cyst, now that sadistic lies of my incompetence had driven my patients away, the only ones who were keeping the hospital afloat. They didn’t deserve me anymore. I sold the house closest to the hospital and moved into my vacation home down south. I interviewed a few hospitals, but they tried to make me prove my worth. As far as I’m concerned, my record is still spotless. Soon there was nothing to do besides hookers, beaches, and bars.
I can’t stop thinking about this perfect storm. I bet someone messed with the schedule on purpose, maybe Ted found out I was banging his wife? Besides, the hospital should have treated me like a hero. I’m probably the only surgeon in the country who could have saved that second patient.
I’ve conned my way into seeing some pill-peddling psychiatrist, the only way I could get my hands on the heavy-duty sleeping pills. All I had to do was blab about my ‘feelings,’ choke up about how I’ve been having trouble sleeping since the hospital screwed me over. I had her wrapped around my little finger after the second session. One more sob story about how my self- image was crumbling and she did whatever I wanted. I said I was going out of town to see my imaginary sister so I could get a double dose. You know that feeling when you’ve just woken up in the morning, and for a split second you forget everything, even your name or where you are? I think I’ll get drunk tonight, take a handful of those pills, and enjoy a well-deserved rest. I’ll be fine. I don’t make mistakes.
First and foremost, this story is a complete work of fiction. It is not intended to portray any individual, and I’m sure there are plenty of medical inaccuracies that I’ll hopefully be able to correct someday.
While learning in classrooms and spending countless hours in the library has earned me a wealth of knowledge, I often take time to remind myself that there is more to this profession. I hope to become a good physician because of my capacity to empathize, not my ability to memorize facts. While writing this submission, I came up with a catchy slogan that I felt summarized things well: health is only half of healthcare.
This story was written to showcase the downfall of ignoring these components, of training physicians who are brilliant, but are solely interested in the profession for themselves. I hope to heal with both an open mind and an open heart.