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Bruce Campbell MD - Author

A Fullness of

Uncertain Significance:

Stories of Surgery, Clarity, and Grace


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  • Writer's pictureBruce Campbell MD

A slightly differerent version of this essay was published in my book, A Fullness of Uncertain Significance: Stories of Surgery, Clarity, and Grace (Ten16 Press, 2021). I also performed it as a spoken word contribution at the Fall 2022 MedMoth storytelling event at MCW. To read other MedMoth presenters' work, visit the Transformational Times issue here.

“Dr. Campbell, this is Maurice’s sister, Tanya,” says the caller. “I have something I want to bring to your office to give you.”

“Okay,” I respond, uncertain what to expect. Maurice was a long-term patient of mine who died several months earlier after losing an extended battle with tongue cancer. I have met Tanya briefly and only once. She gives no clue as to why she wants to see me. I do not know whether or not to be nervous.

On the appointed day, she stops by my office carrying a small bag. We talk about Maurice, her only sibling. The family was close-knit, and she confirms that he had been a loving, gentle, and hard-working perfectionist.

Maurice spent his working life employed by the county doing physically and technically demanding jobs. His career had been cut short when, in the prime of life, he developed tongue cancer. Following surgery and radiation, he did well for several years. Unfortunately, the cancer returned. Despite more surgery and additional radiation and chemotherapy, the cancer grew over the course of several months. He had reluctantly stopped working and, eventually, there were no more options. He found peace and prepared for the end of his life.

Tanya sits and explains how she and Maurice differed. He was always optimistic, she tells me, an attitude that did not change even as the cancer progressed. Consistent with his approach to life, Tanya remarks that his approach to death was “rational” and “logical.”

I tell her I am not surprised by this. During his office visits, Maurice was always upbeat and analytical even as we discussed very specific details of his cancer and its treatment. I recall one visit near the end of his life when we had a frank discussion about dying as though we were talking about someone else.

Tanya tells me that she, on the other hand, had struggled mightily as his death approached. Compared to Maurice, she is a devoutly spiritual person who views life and its transitions through a very different lens. “He knew that about me, of course,” she says, “so he wasn’t surprised when I kept asking him to send a sign when he was safely on the other side.”

I am intrigued. Is this why she has come to see me? “What did he say to that?” I ask.

“He was a man of few words,” she smiles. “Whenever I asked, he nodded but never said much. Late one evening a few days before he died, though, he gave me an answer. ‘Remember when you asked for a sign?’ he said. ‘Of course,’ I replied. ‘A white butterfly,’ he said. He never mentioned it again. I didn’t know what to think.”

I try to imagine Tanya’s reaction. A butterfly? It was the middle of winter in Wisconsin. Had he said something just to appease her? In any case, Maurice died a few days later.

White butterfiles

She continues. “So, when I returned from the visitation at the funeral home, a magazine was in the mailbox,” she tells me. “I flipped it open and the first article I saw was illustrated with dozens of white butterflies.” From her bag, she pulls a framed copy of the illustration, and we look at it together. “I want you to have this to remember him. This is for you.”

I take the gift from her. “Wow,” I say. “Thank you very much. I am speechless.”

In medicine, we claim that we are anchored by certainty and precision but, if we look carefully, we notice moments we cannot explain; all sorts of things that fall outside of our scientific, rational, and logical world. As Anais Nin wrote, “The possession of knowledge does not kill the sense of wonder and mystery. There is always more mystery.”

The picture remains on my bookshelf, reminding me of Maurice and Tanya. I still don’t know exactly what to think of the white butterflies, but I remain grateful for the gift and for the life it represents.

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What Readers are Saying About
A Fullness of Uncertain Significance

In this tender and candid collection of short essays, Dr.  Bruce Campbell illuminates how much medicine is truly  the sacred act of holding vigil with and for our patients.  Through his reflections, we get a glimpse of how surgeons  hone their instincts, grow through challenges, and cope with  disappointment as they navigate the uncertainty inherent in  medicine. Through his polished lens, the reader understands  how even in the pressurized world of surgery, heavy with the  responsibility of healing through a scalpel’s cuts, there are  moments of intimacy that are filled with grace. 


—Rana Awdish, MD, FCCP, FACP, author of In Shock: My  Journey from Death to Recovery and the Redemptive Power of Hope  

Dr. Bruce Campbell turns his scalpel on his own history  as a surgeon, probing the medical field past, present, and  future. His vibrant stories illuminate the fundamental human  underpinnings of medical science, bringing to light the glories,  tragedies, imperfections, and uncertainties we must all grapple  with. Eminently readable and richly satisfying.  


—Danielle Ofri, MD, PhD, Clinical Professor of Medicine  at New York University School of Medicine, Editor-in-Chief of  Bellevue Literary Review, and author of When We Do Harm: A  Doctor Confronts Medical Error 

Dr. Campbell’s reflections will resonate with those who treat  cancer patients as well as those who have had cancer themselves.  Medical students and residents will also be inspired by his life’s  journey as a surgeon and teacher, aspiring to their own joyful  and meaningful lives in medicine. 

—Julie Ann Freischlag, MD, FACS, FRCSEd(Hon), DFSVS,  CEO Wake Forest Baptist Health, CAO Atrium Health, Dean of  the Wake Forest School of Medicine, and 2021-2022 President of  the American College of Surgeons.  

In this rich collection of stories and essays, Dr. Campbell  reflects on his years of caring for patients and training young  doctors to follow in his footsteps. With compassion, humility,  and shimmering prose, he shares the joys, pains, and somber  responsibility of being a surgeon. 

—Gayle Woodson, MD, surgeon, educator, and award winning author of After Kilimanjaro and Leaving La Jolla  

Bruce Campbell is no average surgeon and no ordinary  writer. He takes the excellence of his medical trade and weaves  the challenges, exhilarations, and tough decisions of surgery  into beautiful prose. Here is one who clearly doesn’t reduce  patients to a diagnosis, but who sees them as whole persons  worth getting to know. The chapters in this book are like  windows into the humility and generosity of a man I’d like to  have as my personal physician. 

—Peter W. Marty, editor/publisher of The Christian Century 

With his willingness to delve beneath the surface, Bruce  Campbell has created a deftly interwoven series of lessons gleaned  from poignant moments of a fulfilling surgical career. In a warm,  compassionate, and honest voice, Dr. Campbell delivers to the  reader not just insights on medicine, but truths about humanity.  

—K. Jane Lee, MD, author of Catastrophic Rupture: A  Memoir of Healing 

Humorous and humble, serious and sublime, these lean essays  offer a glimpse behind the surgical drape to show what it’s like to  be a cancer surgeon over the course of a long, rewarding career.  From Campbell’s first invitation into the “inner sanctorum” of the  O.R. as a nurse’s aide while in college, through tender interactions  with patients, to his projections about the profession when he is  long gone, this smart, sensitive surgeon illustrates how doctors can  listen to, care for, and learn from their patients. He courageously  goes to the “hard places” as well as sharing those special moments  that make it all worthwhile. Early in the collection, Campbell  writes, “Besides being a surgeon, I am also a human being.” This  beautiful book is about both. 

—Kim Suhr, MFA, Director of  Red Oak Writing and author of Nothing to Lose   

In lucid and succinct vignettes, Dr. Campbell illuminates  the myriad of emotions and sensations that accompany a life in  surgery. These stories of persistence, camaraderie, shame, grief,  guilt, and regret 

vantage point of experience. These ideas serve as the springboard  to discuss unique, personal insights whose wisdom is of import to  anyone in the healing profession. With elegant and engaging prose,  Campbell beautifully expresses the honor it is to be a physician. 

—William Lydiatt, MD, Chief Medical Officer Nebraska  Methodist and Women’s Hospitals and Professor of Surgery,  Creighton University in Omaha, Nebraska 

“Over the years, I have made an uneasy truce with failure,”  says Campbell in the opening pages of his debut anthology, and  yet his stories are anything but. Captivating, heart-wrenching,  inspiring—he chooses his words as meticulously as he conducts  his surgeries. 

And it’s just like a surgeon to keep you up in the middle  of the night. “One more story,” you’ll tell yourself, but with  Campbell’s reflections, it’s hard to stop. There’s a familiar ease  with which he flourishes his pen; everything falls away, and it’s  almost as if you’re sitting across the table from him as he recalls.  You laugh when he laughs, you cry when he cries, and you wait as  he waits. His memoir of stories is sure to become a rite of passage  for future doctors and patients alike, enjoyable little tunes that all  hum together in a harmony of sound. 

Turning the last page of Campbell’s novel, I succumb to my own  “fullness of uncertain significance”—I have been charged to seek  meaning, to reflect, to sit in the silence of his reverberating truths.  

—Olivia Davies, MD, poet, writer, and dermatology resident at  Massachusetts General Hospital



The words “clarity” and “grace” take on heightened  significance in this honest yet lyrical set of essays by Bruce  Campbell. The immediacy and intensity of these stories  immediately swept me into the consulting room and OR. I felt  as if I were a privileged witness to an almost sacred encounter  between surgeon and patient. Subtle language lays bare a primal  relationship. It is impossible to read this book and not be  changed by the experience. 

—Carol Scott-Conner, MD, PhD, Professor Emeritus of  Surgery at University of Iowa Carver College of Medicine and  author of A Few Small Moments: Short Stories  

Dr. Bruce Campbell sets a new milestone for doctor-writers. As  an otolaryngologist and head and neck surgeon, he treats patients  with the most advanced and aggressive cancers imaginable. Internists  like me wonder how head and neck surgeons like him do it; this  book gives me the answer. Dr. Campbell brings luminous sight  to his work. His writerly gifts let him capture the delicate and the  solemn, the tragic and the everyday dimensions of illness. Not a  set of doctorly instructions (though instruct it does), A Fullness of  Uncertain Significance: Stories of Surgery, Clarity, & Grace lays open  the profound mysteries and truths and awe about this life of ours.  These stories will change lives. 

—Rita Charon, MD, PhD; Bernard Schoenberg Professor  of Social Medicine and Professor of Medicine; Chair of the  Department of Medical Humanities and Ethics; Executive Director  of Columbia Narrative Medicine, Columbia University, New York  City; Co-author, Principles and Practice of Narrative Medicine 



In this compelling, insightful, and beautifully written  compendium of stories, Bruce Campbell shares the lessons he  has learned, and continues to learn, throughout his medical  education and his years as a highly successful surgeon, faculty  member, and teacher. A Fullness of Uncertain Significance is  refreshingly honest and introspective, exploring not only many  of the desirable outcomes when he had been faced with a broad  array of professional challenges, some potentially life-and-death,  but also those outcomes that were less than he had hoped for.  Readers will appreciate the author’s willingness to reveal that,  “As a surgeon, I have made mistakes that have hurt people. This  should not surprise anyone since, besides being a surgeon, I also  am a human being.” Providers, teachers, and students of health  care in every field and at every level of service will benefit greatly  from what the author has accurately labeled “Stories of Surgery,  Clarity, & Grace.” This isn’t merely a book about one man’s life  as a surgeon. It is a book about the need for understanding and  compassion when dealing with others, especially those in distress. 

—Myles Hopper, PhD, JD, author of My Father’s Shadow 

In this collection of essays, Dr. Campbell pulls the reader into  his Milwaukee otolaryngology clinic, the operating room, and his  medical work in Kenya. He tells story after story with wonder,  humour, and affection. He looks back on his medical training and  fantasizes about medicine in the mid-twenty-first century. He lets us  in on his unique vantage point on humanity, and does so with such  humility and grace that his own humanity is never in question.  

—Martina Scholtens, MD, author of Your Heart is the Size of  Your Fist

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