Altar and table: a phenomenology of the surgeon-priest.

I will never forget the first night I stood alone beside the operating table as the only surgeon in the room. I was beginning my fourth year of residency. Two patients from the same car wreck arrived simultaneously. Both were unstable. Both required urgent laparotomy. The sickest patient went to OR 9 with the attending surgeon. The other patient went with me to OR 6. The preliminaries were the same as ever: exposure, vascular access, betadine prep from neck to knees, suction, blood, and light. For many years I had been around the table as medical student and resident, but this time it was completely different. As I approached the table to make my midline incision, not knowing what I would find beneath the fascia, I remember swallowing hard, summoning the will to quell the tremor in my voice that betrayed the terror I suddenly perceived in the face of the awesome power extended to me by my office. This man needed the peculiar care of the surgeon’s knife, and I was the only one available to wield it. In that moment, I thought of nothing other than the technical details of the operation, but soon after I wheeled the patient up to the intensive care unit, I realized that this was not the first time I had stepped forward to a table with the same sense of awesome responsibility. Three years earlier, while stepping up to the altar at Trinity Episcopal Cathedral in Pittsburgh to consecrate the elements of bread and wine in my first Eucharist as a newly ordained priest, my experience was almost identical. For years I had been around the altar as acolyte, chorister, seminarian, and deacon, but as the presiding priest, it was completely different. I was relieved, but not entirely surprised, to discover that in both cases, my training was sufficient for the task. In the operating room, I identified and repaired several tears in the cecal serosa, and the patient made a swift and complete recovery, marked only by a scar that stretches from xyphoid to pubis. At the altar, God was once again faithful to his promise as the congregation gathered to share a foretaste of the supper of the lamb. In the years since these first experiences, I have grown more accustomed to the weight of responsibility that descends every time I step forward to each table. However, terror is never far away in either context, and I pray that the terror will never disappear entirely. From my perspective, both the altar and operating room table are holy spaces, because those who dare approach either table encounter something larger than themselves. In what follows, I aim to provide a phenomenological description of the analogies between surgeon and priest, altar and operating room table. Some will likely confirm my observations in the distinct language of their own theological tradition. Others will no doubt find such an analogy far fetched. Yet I hope that even the atheist or the agnostic will recognize in my description a crucial dimension of surgical practice that often eludes expression in the secular idiom that orders our professional discourse. My phenomenology is but one way to articulate the surgeon’s unique privilege and responsibility to provide comfort and cure by piercing the integrity of another’s body. However, regardless of philosophical or theological traditions, I contend that there is something distinctly sacramental and priestly about surgery and surgeons.