Book Review: Hot Lights, Cold Steel

Although I've mentioned this book in prior posts, I thought it only fitting that one of my all time favorite medical books is given a post all to itself. First I'll include a summary, followed by my review and a link to where you can buy it off of Amazon.

Hot Lights, Cold Steel: Life, Death, and Sleepless Nights in a Surgeon's First Years
by Dr. Michael J Collins

"If he didn't feel overwhelmed before the Mayo Clinic senior orthopedic surgery resident lobbed a beeper at him with the nonchalant order, "Cover for me," 29-year-old ex-cabdriver, ex-construction worker, and, at the time, brand-new resident Collins certainly did then. It was his first day on the job, and
instantly he began fielding calls from staff nurses requesting orders for patients he hadn't laid eyes on. If it hadn't been for his innate sense of humor--brilliantly demonstrated in this memoir of his Mayo residency--and a sense of perspective derived from that experience, he might have failed. He didn't, and here he honors those who helped him along the way and those whom he helped. As a man who recognizes that he, too, makes his living with his hands, Collins anguishes over the options available to a carpenter who had severed four fingers. After assisting at a young cancer patient's leg amputation, only to learn later that she had died within months, anyway, he agonizes over what drew him to his profession in the first place and what could possibly keep him on course. "I wanted to be the guy who confronted the arbitrariness of life and strangled the unfairness out of it." Instead, while honing his craft, he learned from a Vietnam vet that the main thing patients deserve is compassion. If Collins' scalpel is as sharp as his pen, his patients are in capable hands, indeed."

Hot Lights, Cold Steele is a firsthand account of what it is like to be an orthopedic resident at one of the busiest and best hospitals in the nation. For the unindoctrinated, the Mayo Clinic is generally thought of as the best program to get into in terms of the training experience for orthopedic residents. I've heard that getting in is so difficult, that medical students who scored below a 240 on the USMLE need not apply because they will not even look at your application (a 240 and above includes only the upper 4% of test takers or so). In other words, aside from being a very interesting story in its own right, it shows what it is like at the best orthopedic training hospital in the country.

Interwoven through Dr. Collins story is the theme of choices. The story opens with a dilema as to whether he should try to save the arm of a boy who nearly had it ripped from his body when it became intangled in a combine, or amputate the arm immediately. The choice to moonlight at another hospital, or get some extra sleep. The choice to go to church with his family, or use that extra time to relax.

At once both lighthearted and introspective, Hot Lights, Cold Steel challenges the reader the reader to put themselves in the shoes of an orthopedic surgeon (which is why I loved it). It tells the story of one of the most loved patients he saw, a patient who all the nurses talked about and kept tabs on once she left the hospital, and you can't help but experience the hurt when he later finds out that she died a few months later.

During the lighter times, I found myself laughing at the similarities to my own life. When he talks about going from one clunker to the next, I'm reminded of my own experiences with cars (I've been getting in the passenger door and climbing over for the past 10 months). When he talks about making choices between medicine and family or medicine and faith, I think of all the similar choices I've had to make.

In summary, this is a book that will make you laugh and make you cry, and I don't think that you have to be a medical student, or a budding orthopedic surgeon to love it.