A Sense of Composition
This is an instructional book, or what has also been termed a “mentoring” text. The conceit is that it is the wisdom of an older and experienced doctor passing along his knowledge to a young person just beginning or considering a career in medicine. The writing, however, is anything but typical of instructional textbooks. Dense with metaphorical imagery, even the Preface is heavily dependent upon figurative language as the author describes his processes of composition which is constructed through imagery appealing to the reader’s sensory perception to appear more like a book of spiritual advice than technical counseling:
“This book was written in longhand, as is still my custom. It has to do with my inkwell, all that remains of an old Chinese inkstand. Black-and-white lacquered it was, and inlaid with mother-of-pearl. The lid of the inkwell is a bronze dragon that you pick up by the tail. Whenever you do, there is still the faint smell of sandalwood. A genie lives in this inkwell.”
Sounds Like the Start of a Joke
What’s the difference between a surgeon and an internist? Although this question sounds like it may lead into comical imagery, its actual destination is much more serious: warfare. The difference between the beginning physician and the experienced one is situated within imagery that calls into the mind a battlefield and the various approaches to winning a war:
“The surgeon, armed to the teeth, seeks to overwhelm and control the body; the medical man strives with pills and potions to cooperate with that body, even to the point of making concessions to disease. One is the stance of a warrior; the other, that of statesman…Heaven help the internist. He is not suited for such red labor. He is not blooded to it.”
The Warm Compress
When the narrator arrives at the conclusion of just how essential to medical care is a warm compress, he turns to imagery that, reconstructed, could become a poetic ode to this seemingly mundane medical practice. Through precise partnering of verbs and nouns and adjectives appealing to the senses, he transforms this simple approach into something more artistic satisfying:
“I suspect that the wet heat applied to human flesh has done more to ease the plight of the sick than all surgery…A compress gives such insinuating warmth. It cooks the tissues gently, drawing out poison, polishing and smoothing all the rough places of the body…Warm compresses are sensible…to rekindle a near-cold fire, you place on faintly glowing ember against another, fan it for a moment, then…watch a pretty flame break.”
The Sounds of Surgery
Amid multiple descriptions of the surgical process, one paragraph in particular stands out from the rest as being an excellent example of how to use imagery. The sense which the doctor appeals to here is more finite, yet no less poetic. The reader learns that a good surgeon engages his sense of hearing along with vision and touch:
“The questing dreamer leans into the patient to catch the subtlest sounds. He hears the harmonies of their two bloods, his and the patient’s. They sing of death and the beauty of the rose. He hears the playing together of their two breaths.”
