The scalpel—a small knife used in surgical operations—represents the double-edged sword of operations and medicine in general. In order for many of Paul’s patients to be treated or operated on, their bodies or their brains must first be cut open with a scalpel. Paul describes how cutting a body open, though necessary, is also a “trespass on the sacrosanct.” The use of a scalpel mirrors the cost/benefit question that all patients must face, particularly when undergoing brain surgery. For instance, is saving a life by cutting out a tumor worth the risk of accidentally also cutting the hypothalamus, which could then cause that patient to become a slave to his or her appetites? This is no mere hypothetical question. It is something that actually happens to one of Paul’s patients, and therefore the kind of practical question that surgeons must always ask themselves. During a surgery on a brain-stem malformation, an attending doctor tells Paul that if he were to cut two millimeters deeper, the patient would have locked-in syndrome and would be completely paralyzed, except for the ability to blink. Thus, the scalpel is not only a tool for excising diseases and defects, but also a representation of the risks of surgery and medicine.
Scalpel Quotes in When Breath Becomes Air
When there’s no place for the scalpel, words are the surgeon’s only tool.
Good intentions were not enough, not when so much depended on my skills, when the difference between tragedy and triumph was defined by one or two millimeters.
Scalpel Symbol Timeline in When Breath Becomes Air
