Before I Cut

How I learned the skill of emotional detachment

Photo by Brett Jordan on Unsplash

I bring my knife to his neck. Under the silvery glow of the operating light, my patient lies waiting. For a final moment, I take in the human details of the young man’s skin. He’s tan from summer, goosebumped by nervousness, and plump with the local I’ve just injected. Then I rest my blade on the line I’ve drawn in felt-tip, waiting for that strange internal shift - call it a chill – that signals when to proceed. Am I ready? Yes, I cut.

People love to speculate about what it takes to become a surgeon, and in particular the emotional profile that enables a person to perform the therapeutic savagery of an operation. Pychologists say it’s a type, something you’re born with, relishing the overlap of personality traits between surgeons and psychopaths. Medical educators prefer the tamer explanation that clinical detachment is a skill like any other, something we learn as students alongside anatomy and blood-taking. For me though, neither explanation quite hits the mark. I learned how to control my feelings at a specific point in my childhood.

When I was ten, one of happiest periods of my life ended when my family returned to London from Washington DC - where my dad had been posted by the Foreign Office - and I was sent to boarding school. The previous three years had been blissful. From the moment Dad picked us up at Dulles airport in a shiny red Chevrolet, my American life had unfolded like a kind of technicolour dream. At school, the kids made a fuss of me just because of my exotic accent, and there was a frozen yoghurt dispenser and the teachers who actually liked us. At home, my brothers and I had our own rooms, and a huge back yard to play in and parents who seemed mysteriously sunnier than before. In no time, I forget the painfully shy, introverted girl I’d been for seven years, and morphed into a happy confident kid, with an American accent and roller-skates and a gang of close friends. We lived opposite a big city hospital there and, at night as I lay in bed, the blue and red lights from the incoming ambulances flickered through my curtains like a happy harbinger of my future.

And then one day, with no warning, dad told us we were leaving. I don’t remember my last day at school. I don’t remember how I said goodbye to the best friends I’d ever had. This was long before mobile phones and the internet and, even as a child, I knew that writing letters wouldn’t be enough. This was the 1970s, when it wouldn’t have crossed my parents’ minds, in the flurry of moving home and getting me into a new school, to ask me how I felt.

Arriving a month later at the front gate of my new boarding school, peering down the shady driveway to the austere building where I’d be living for most of the next two years, it hit me hard what I’d lost. My parents left me in the front hall and I followed a matron in uniform down a corridor carpeted in hard grey felt. I was assigned a bed in a dormitory of 18 girls. There was a rule for every breath we took, and not enough food, and no way to call home. The child in the bunk above me was homesick and tearful and it didn’t take me long to observe that being sad didn’t prompt kindness but made you a target. Quickly, I resolved not to let my feelings show.

The only times I wavered in this personal policy were on the two weekends each term that I was allowed to go home. I remember the confused relief of getting into my parents’ car, with its smell of us, only to keep accidentally calling my dad ‘sir’; the feeling of walking through the front door of a house so absurdly cosy that the shock of this, after the comfortless haunts where I now spent most days, almost knocked me sideways. On these special weekends, we only pulled into our driveway around teatime because of Saturday morning lessons. And from the first second, all I could do was ruminate on how I’d have to leave again just over twenty-four hours later, a knowledge that stained every minute of the hallowed day I’d looked forward to for weeks.

One precious Saturday night, my dad found me crying in bed. After hugging me, he asked me what was wrong and I told him I couldn’t stop thinking of going back to school the next day. He confessed that he’d felt the same way as a boy, but that he’d come up with a good trick. He’d lie in bed on his last night at home and imagine he was walking back into the boarding house and allow himself to feel overwhelmed with emotion. And then, when the time actually came, he was completely okay.

I held my dad’s hand that night and learned what he had to teach me. And as we set off the following afternoon, I turned on radio 1 to listen to the Top 40 without a tear in my eye. When we pulled into the gravel driveway of the school two hours later, I leaned across and kissed my parents and got out of the car without looking back. And twice a term on Saturdays, and on the last night of each school holiday, I practised that technique, until crying in bed started to feel almost like a performance, against the more solid reality of walking back into school, when a kind of coldness would descend on me, and I would mentally thank my dad for showing me how to protect myself.

I am not recommending any of this. There’s a good reason my husband and I didn’t send our children to boarding school. Sometimes though, at the start of a day’s operating, when I’m scrubbing at the sink, donning my gown and gloves and preparing mentally for the list ahead, I feel grateful for this dysfunctional element in my childhood. In such moments, waiting for the familiar chill, I remember the girl I once was and imagine her walking down that dark corridor, towards an adventurous future she couldn’t have even dreamed of.