“Why do you think it is…”, I asked Dr. Cook … “that brain surgery, above all else—even rocket science—gets singled out as the most challenging of human feats, the one demanding the utmost of human intelligence?”
[Dr. Cook answered,] “No margin for error.”

[I] could see how nervous everybody was in the beginning and how silent it was when we had trouble with the artificial heart [during the surgery, but later in the operation, when it was working, there were moments] of loud and raucous humor.
[Commenting after reviewing the video tape of the world's first human implantation of an artificial heart.]

Curando fieri quaedam majora videmus vulnera, quae melius non tetigisse fuit.
Some wounds are made worse by treatment, as we see: it had been better not to touch them.

Epitaph of John Hunter
The Royal College of Surgeons of England have placed this tablet over the grave of Hunter, to record their admiration of his genius as a gifted interpreter of the Divine Power and Wisdom at work in the Laws of Organic Life, and their grateful veneration for his services to mankind as the Founder of Scientific Surgery.

A pair of Siamese twins in Australia, surgically separated six months ago, has been sewn back together. Apparently, each of them could remember only half the combination to their locker.

A statistical analysis, properly conducted, is a delicate dissection of uncertainties, a surgery of suppositions.

A typical triumph of modern science to find the only part of Randolph [Churchill] that was not malignant and remove it.

Again and again, often in the busiest phases of the insulin investigations, he [Frederick Banting] found time to set a fracture or perform a surgical operation on one of his army comrades or on some patient who was in need.

Amputations are much less frequent now than formerly, and there is little doubt that, in the present rapid advance in the science of surgery, and the greater perfection in its art, the time is not far removed when amputations for other cause than gangrene will be comparatively rare.

And indeed I am not humming,
Thus to sing of Cl-ke and C-ming,
Who all the universe surpasses
in cutting up and making gases;
With anatomy and chemics,
Metaphysics and polemics,
Analyzing and chirugery,
And scientific surgery …
H-slow's lectures on the cabbage
Useful are as roots of Babbage;
Fluxions and beet-root botany,
Some would call pure monotony.

As an adult she had her organs removed one by one. Now she is a mere shell with symptoms where her organs used to be.
Written as an intern on one of his patient's charts; commentary on the result of surgical treatment of non-organic disease.

Before his [Sir Astley Cooper’s] time, operations were too often frightful alternatives or hazardous compromises; and they were not seldom considered rather as the resource of despair than as a means of remedy; he always made them follow, as it were, in the natural course of treatment; he gave them a scientific character; and he moreover, succeeded, in a great degree, in divesting them of their terrors, by performing them unostentatiously, simply, confidently, and cheerfully, and thereby inspiring the patient with hope of relief, where previously resignation under misfortune had too often been all that could be expected from the sufferer.

By research in pure science I mean research made without any idea of application to industrial matters but solely with the view of extending our knowledge of the Laws of Nature. I will give just one example of the ‘utility’ of this kind of research, one that has been brought into great prominence by the War—I mean the use of X-rays in surgery. Now, not to speak of what is beyond money value, the saving of pain, or, it may be, the life of the wounded, and of bitter grief to those who loved them, the benefit which the state has derived from the restoration of so many to life and limb, able to render services which would otherwise have been lost, is almost incalculable. Now, how was this method discovered? It was not the result of a research in applied science starting to find an improved method of locating bullet wounds. This might have led to improved probes, but we cannot imagine it leading to the discovery of X-rays. No, this method is due to an investigation in pure science, made with the object of discovering what is the nature of Electricity. The experiments which led to this discovery seemed to be as remote from ‘humanistic interest’ —to use a much misappropriated word—as anything that could well be imagined. The apparatus consisted of glass vessels from which the last drops of air had been sucked, and which emitted a weird greenish light when stimulated by formidable looking instruments called induction coils. Near by, perhaps, were great coils of wire and iron built up into electro-magnets. I know well the impression it made on the average spectator, for I have been occupied in experiments of this kind nearly all my life, notwithstanding the advice, given in perfect good faith, by non-scientific visitors to the laboratory, to put that aside and spend my time on something useful.

Christ, it’s going to work!

Geology does better in reclothing dry bones and revealing lost creations, than in tracing veins of lead and beds of iron; astronomy better in opening to us the houses of heaven than in teaching navigation; surgery better in investigating organiation than in setting limbs; only it is ordained that, for our encouragement, every step we make in science adds something to its practical applicabilities.

Get a scalpel, and practice just, say, cutting a piece of meat or something like that. You sort of learn how you want to hold your fingers, and that sort of thing, and try to become graceful when you operate.

Here the most sublime scene ever witnessed in the operating room was presented when the patient placed himself voluntarily upon the table, which was to become the altar of future fame. … The heroic bravery of the man who voluntarily placed himself upon the table, a subject for the surgeon’s knife, should be recorded and his name enrolled upon parchment, which should be hung upon the walls of the surgical amphitheatre in which the operation was performed. His name was Gilbert Abbott.
Description of the first public demonstration of ether at the Massachussetts General Hospital (16 Oct 1846).

I am just laboring in the vineyard. I am at the operating table, and I make my rounds. I believe there is a cross-fertilization between writing and surgery. If I withdraw from surgery, I would not have another word to write. Having become a writer makes me a better doctor.
[Reply to reporter's question whether he would rather be a full-time writer instead of a surgeon.]

I became expert at dissecting crayfish. At one point I had a crayfish claw mounted on an apparatus in such a way that I could operate the individual nerves. I could get the several-jointed claw to reach down and pick up a pencil and wave it around. I am not sure that what I was doing had much scientific value, although I did learn which nerve fiber had to be excited to inhibit the effects of another fiber so that the claw would open. And it did get me interested in robotic instrumentation, something that I have now returned to. I am trying to build better micromanipulators for surgery and the like.

I came by the horror naturally. Surgery is the one branch of medicine that is the most violent. After all, it’s violent to take up a knife and cut open a person’s body and rummage around with your hands. I think I was attracted to the horrific.

I find that most men would rather have their bellies opened for five hundred dollars than have a tooth pulled for five.

I got the bill for my surgery. Now I know what those doctors were wearing masks for.

I would have picked up the artificial heart and thrown it on the floor and walked out and said he's dead if the press had not been there.
[Recalling moments of frustration caused by difficulties during the 7½-hour surgery on Barney Clark for the first human implant of an artificial heart.]

I would like to see the day when somebody would be appointed surgeon somewhere who had no hands, for the operative part is the least part of the work.

I would never use a long word, even, where a short one would answer the purpose. I know there are professors in this country who “ligate” arteries. Other surgeons only tie them, and it stops the bleeding just as well.

I’ve always thought that my exposure to competitive sports helped me a great deal in the operating room. It teaches you endurance, and it teaches you how to cope with defeat, and with complications of all sort. I think I’m a well-coordinated person, more than average, and I think that came through my interest in sports, and athletics. … [Playing basketball] You have to make decisions promptly, and that’s true in the operating room as well.

If a physician make a large incision with an operating knife and cure it, or if he open a tumor (over the eye) with an operating knife, and saves the eye, he shall receive ten shekels in money. …
If a physician make a large incision with an operating knife, and kill him, or open a tumor with an operating knife, and cut out the eye, his hands shall be cut off. ...
If a physician heal the broken bone or diseased soft part of a man, the patient shall pay the physician five shekels in money.
[The Code of Hammurabi (a king of ancient Babylon), the earliest well-preserved ancient law code, circa 1760 B.C.]

If the love of surgery is a proof of a person’s being adapted for it, then certainly I am fitted to he a surgeon; for thou can’st hardly conceive what a high degree of enjoyment I am from day to day experiencing in this bloody and butchering department of the healing art. I am more and more delighted with my profession.

In the performance of our duty one feeling should direct us; the case we should consider as our own, and we should ask ourselves, whether, placed under similar circumstances, we should choose to submit to the pain and danger we are about to inflict.

It is not always worth the discomforts of major surgery to get minor recovery.

It is sometimes asserted that a surgical operation is or should be a work of art … fit to rank with those of the painter or sculptor. … That proposition does not admit of discussion. It is a product of the intellectual innocence which I think we surgeons may fairly claim to possess, and which is happily not inconsistent with a quite adequate worldly wisdom.

It is Surgery that, long after it has passed into obsolescence, will be remembered as the glory of Medicine.

It takes five years to learn when to operate and twenty years to learn when not to.

It was above all in the period after the devastating incursions of the Goths that all branches of knowledge which previously had flourished gloriously and been practiced in the proper manner, began to deteriorate. This happened first of all in Italy where the most fashionable physicians, spurning surgery as did the Romans of old, assigned to their servants such surgical work as their patients seemed to require and merely exercised a supervision over them in the manner of architects.

Leaving aside genetic surgery applied humans, I foresee that the coming century will place in our hands two other forms of biological technology which are less dangerous but still revolutionary enough to transform the conditions of our existence. I count these new technologies as powerful allies in the attack on Bernal's three enemies. I give them the names “biological engineering” and “self-reproducing machinery.” Biological engineering means the artificial synthesis of living organisms designed to fulfil human purposes. Self-reproducing machinery means the imitation of the function and reproduction of a living organism with non-living materials, a computer-program imitating the function of DNA and a miniature factory imitating the functions of protein molecules. After we have attained a complete understanding of the principles of organization and development of a simple multicellular organism, both of these avenues of technological exploitation should be open to us.

Let the sun never set or rise on a small bowel obstruction.
Adage expressing urgency for early operation to avoid possible fatality.

Physical misery is great everywhere out here [Africa]. Are we justified in shutting our eyes and ignoring it because our European newspapers tell us nothing about it? We civilised people have been spoilt. If any one of us is ill the doctor comes at once. Is an operation necessary, the door of some hospital or other opens to us immediately. But let every one reflect on the meaning of the fact that out here millions and millions live without help or hope of it. Every day thousands and thousands endure the most terrible sufferings, though medical science could avert them. Every day there prevails in many and many a far-off hut a despair which we could banish. Will each of my readers think what the last ten years of his family history would have been if they had been passed without medical or surgical help of any sort? It is time that we should wake from slumber and face our responsibilities!

Science is something we depend on all the time. If I develop a pain in the chest I must take an X-ray. But what if the radiation from the X-ray causes me deeper problems? Before I know it. I’m going in for surgery. Naturally, while they’re giving me oxygen an intern decides to light up a cigarette. The next thing you know I’m rocketing over the World Trade Center in bed clothes. Is this science?

So much goes into doing a transplant operation. All the way from preparing the patient, to procuring the donor. It's like being an astronaut. The astronaut gets all the credit, he gets the trip to the moon, but he had nothing to do with the creation of the rocket, or navigating the ship. He's the privileged one who gets to drive to the moon. I feel that way in some of these more difficult operations, like the heart transplant.

Surgery is always second best. If you can so something else, it’s better. Surgery is limited. It is operating on someone who has no place else to go.

Surgery is the cry of defeat in medicine.

Surgery is the red flower that blooms among the leaves and thorns that are the rest of medicine.

Surgical knowledge depends on long practice, not from speculations.

The fundamental act of medical care is assumption of responsibility. Surgery has assumed responsibility for disease which is largely acute, local or traumatic. This is responsibility for the entire range of injuries and wounds, local infections, benign and malignant tumors, as well as a large fraction of those pathologic processes and anomalies which are localized in the organs of the body. The study of surgery is a study of these diseases, the conditions and details of their care.

The greatest discoveries of surgery are anaesthesia, asepsis, and roentgenology—and none was made by a surgeon.

The heart transplant wasn’t such a big thing surgically. The point is I was prepared to take the risk. My philosophy is that the biggest risk in life is not to take the risk.

The man who inspired me most, I think, was Dr. Alfred Blalock, who was professor of surgery at Johns Hopkins. He was a rather simple man with a burning curiosity. It was through his curiosity that he made many real contributions to medical science.

The practice of medicine is a thinker’s art, the practice of surgery a plumber’s.

The steam-engine in its manifold applications, the crime-decreasing gas-lamp, the lightning conductor, the electric telegraph, the law of storms and rules for the mariner's guidance in them, the power of rendering surgical operations painless, the measures for preserving public health, and for preventing or mitigating epidemics,—such are among the more important practical results of pure scientific research, with which mankind have been blessed and States enriched.

There cannot always be fresh fields of conquest by the knife; there must be portions of the human frame that will ever remain sacred from its intrusions, at least in the surgeon's hands. That we have already, if not quite, reached these final limits, there can be little question. The abdomen, the chest, and the brain will be forever shut from the intrusion of the wise and humane surgeon.

Those who intend to practise Midwifery, ought first of all to make themselves masters of anatomy, and acquire a competent knowledge in surgery and physic; because of their connections with the obstetric art, if not always, at least in many cases. He ought to take the best opportunities he can find of being well instructed; and of practising under a master, before he attempts to deliver by himself. ... He should also embrace every occasion of being present at real labours, ... he will assist the poor as well as the rich, behaving always with charity and compassion.

We all felt the majesty of the body. In a very short period of time we had seen something that was bigger than each of us. A lot of people, even those who were not religious, were reverent and attributed the success to God. As we saw the artificial heart beat in Dr. Clark, the feeling was not aren't we great, but aren't we small.
[Comment after surgery for the world's first human implant of a total artificial heart in the chest of dentist Dr. Barney Clark ]

We can learn a lot from living organisms. An organism is a pretty complicated thing, which can tolerate surgery, which can tolerate injury, which can tolerate all kinds of perturbation provided they are not too great and do not come too suddenly. There’s something we call trauma, however. We don’t really understand what it is—but organisations can suffer from it too.

Why, in God's name, in our days, is there such a great difference between a physician and a surgeon? The physicians have abandoned operative procedures and the laity, either, as some say, because they disdain to operate with their hands, or rather, as I think, because they do not know how to perform operation. Indeed, this abuse is so inveterate that the common people look upon it as impossible for the same person to understand both surgery and medicine.