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Bruce Campbell MD

A Fullness of

Uncertain Significance:

Stories of Surgery, Clarity, and Grace

BRUCE H CAMPBELL, MD FACS

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  • Bruce Campbell MD

Updated: Jan 27

One day during my residency many years ago, an older man arrived in clinic with a large neck mass that had been growing for months. The mass, which by then was the size of half a baseball, wasn’t bothering him much, so he hadn’t rushed in. He finally made an appointment to see if anything should be done. “I only came because my family has been bugging me,” he said.


One of my fellow residents evaluated him. Standing behind the man as he sat in the examination chair, the resident cupped his hand over the mass and moved it side-to-side and up-and-down. It wasn’t painful and did not seem to be extending deeply into the tissues—those were good things. As the resident continued the examination, I am certain he was asking his fingers to tell him more. Maybe he was wondering, What does this mass represent? What scans and biopsies will I need to order? What’s going on here?


Suddenly, the resident and the patient yelped simultaneously. I heard the commotion and rushed to the room. The resident and patient were both wide-eyed. “It came off!” the resident exclaimed. “As I was palpating the mass, it just fell off!” He stood still, holding the mass tightly against the man’s neck in case he had torn any underlying blood vessels. The man looked surprised but, otherwise, seemed fine. There was no blood accumulating. I reached for supplies.


“Quick!” he said. “Grab some gauze!”


I opened a couple of gauze pads and got ready. The resident gently pulled the mass away from the man’s neck. Nothing happened. The circular area where the mass had been attached was red and a bit angry looking. The surface oozed, but only a little. Within a couple of minutes, we had cleaned the neck skin, stopped the small amount of bleeding, and taped on a dressing.


The man looked in a mirror and grinned.


“You’ve got magic hands, Doc!” he said. “Now, my family will leave me alone.”


The neck was, basically, back to normal. I picked up the mass and pressed against its surface with my hand before dropping it into a specimen container. It was firm, and the size and shape of an old-style paperweight. No harm, no foul, I thought.


There was more to the story but, given the decades that have passed since then, I don’t remember either the pathology or what treatment was needed. I do know that I never again saw a large, worrisome neck mass simply come off in the physician’s hand during a physical exam.



Using our hands for work


Our hands are central to what we do. When I have had to offer virtual visits over the past couple of years, I missed the “hands-on” of clinical medicine. With a patient in front of me, I can fill in the gaps in their story while performing the examination. I check for pulses, areas of numbness, muscle strength, and joint function. I palpate tissues and press my fingertips into tender areas. I hope that my patients will trust me to use my hands wisely as I search for masses, perform procedures, and remove cancers. In return, my hands offer a moment of connection with the patient and allow me to feel my own sense of purpose more intently.


Our hands, variously, bring healing, inflict pain, and provide comfort. If all is well, our hands might signal that everything is fine. If all is not well, they might offer solace.



Our hands are integral to our identities

Too often of late, we have been forced to trade our hands-on moments for virtual visits, Zoom conferences, and social distancing. In clinic, we bump fists or wave to patients and family members when, once, we would have shaken hands or, even, hugged. I miss the personal contact. Maybe that will change again soon. Our hands are not idle, of course, since our fingers must still complete the day’s medical record notes.


Philosopher Immanuel Kant noted, “the hand is the visible part of the brain.” This makes sense to me, confirming that our hands extend into the world to fulfill our missions and gather information from everything with which we come in contact. That might be why I remember that day in clinic when a big neck mass simply came off of a patient, and I held it in my wondering hand.




_____________


A slightly different version of this essay entitled, "Using our Hands for Medicine and Wellness," appeared in the January 28, 2022 issue of the Transformational Times, a newsletter of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.


#AFoUSBook #KernInstitute


 

Upcoming Events

  • Narrative Surgery - A Conversation at Creighton University
    Fri, Apr 08
    Creighton University Medical Center
    Apr 08, 7:30 AM – 2:30 PM CDT
    Creighton University Medical Center, 2420 Cuming St, Omaha, NE 68131, USA
    An opportunity to discuss narrative medicine, reflection, and head & neck surgery
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  • Narrative Surgery - A Conversation at Johns Hopkins University
    Mar 14, 4:00 PM – 5:00 PM CDT
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    A conversation about narrative, the book, and retiring with grace.
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  • 2021 MCW Medical Humanities Lecture
    Nov 16, 2021, 12:00 AM – 1:00 PM
    TBD
    Dr. Campbell will give the 2021 annual MCW Medical Humanities Lecture at noon on Tuesday 11/16/2021.
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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