Dispatches from the Operating Room: The Butcher’s Cleaver
By Dr Eithan Haim
We all know what our body should feel like in its normal state. So much so that we hardly ever think about it until something feels off. It usually starts out as a small pain, something we do not think about too much. But then it starts to get worse, becomes persistent, transforming into a gnawing discomfort that grows more concerning with each passing day.
When patients come to my surgery clinic for the first time, I cannot help but recognize their anxiety. The person sitting across from me is nervous because they have a problem they cannot explain and all they want is to feel normal again.
These emotions are the rational response to the situation. It is nerve-wracking to place such a high level of trust in someone you just met. You must trust that the surgeon sitting across from you is giving you accurate information. You hope they will not take you down a path that is going to make things worse. You assume that your concern for your own physical well-being is reciprocated by the surgeon's good judgment.
This emotion comes from a rational instinct—the inherent understanding that a very thin line exists between harm and benefit. And this is not unique to surgery but applies to every field of medicine. The risk-benefit analysis is part of every decision we make, whether the recommendation is medication, surgery, or sometimes, nothing at all.
It is often the case that there is not one clear answer—the balance between action and inaction is the rope on which we spend most of our careers. Do we allow nature to run its course, or do we attempt to redirect fate's trajectory? Regardless of the complexity, it all comes down to two questions—what is the cause of the patient's problem? And is there something you can do to solve it?
It is obvious when you answer these two questions correctly. Did the patient get better? Did you solve their problem? Are they back to their normal state of health? If the answer is yes, then you succeeded. Their trust was not misplaced.
Just as engineers use the laws of physics to calculate momentum and torque, doctors rely on the laws governing human biology to treat our patients. These laws are not something we create or negotiate, but something we discover. We use them as a guide to differentiate normal from abnormal, and health from illness. Our understanding of these laws informs the logic we use to correlate a patient's symptoms with an underlying disease process. Each step of the way, that logic is informed by something that is real—both observable and measurable.
Because this science-based, logic-driven approach has proven to be so effective in the treatment of human disease, modern society perceives it as the most important factor in what differentiates good medicine from bad. Although this is essential, I would contend there is something more foundational. Something that if not present, precludes the ability to practice good medicine.
Patient Dignity
This is the doctor's recognition of their patients' inherent dignity. It is dignity that properly orients a doctor's perception of the patient sitting in front of them—they are not simply a collection of biological matter but a unique individual, someone's mother or father, their sister or brother. This allows me to see beyond the jaundiced, obtunded bodies lying helplessly in ICU beds. This is what pulls me out of bed at two in the morning to operate on an overweight smoker whose stomach just perforated. Recognition of our patients' inherent dignity reminds us that they love and dream just as we do and that to someone out there, they are the most important person in the world.
It has become a popular myth that this type of mentality clouds a doctor's judgement. That this mentality prevents doctors from separating emotion from the cold hard facts in front of them. Nothing could be more untrue. It is only because we recognize the inherent dignity of our patients that we fear harming them, and therefore, use the best of our abilities to heal them.
It is this fear that drives a doctor's endless pursuit of knowledge, the respect for the biological laws that govern human disease, and the commitment to the analytical approach required to treat it. It is this fear that prevents doctors from allowing patients to dictate their own diagnoses, instead relying on our knowledge and hard-earned experience. It is this fear that encourages common sense, and logical thinking, and maintains a doctor's healthy skepticism towards unproven interventions.
It is this fear of harm that serves to build and maintain all the best attributes of a doctor.
We can see this reflected in the consummate oath of the physician to “Do No Harm.” It is often overlooked how different this is from other professions. It is not a statement in the affirmative, like “Heal Your Patients” or “Eliminate Disease.” Nor is it an expression of the highest virtues as can be seen in law enforcement's “Protect and Serve” or the military's “Support and Defend the Constitution.”
The Hippocratic Oath does not tell us what we should do but what we should not. It does not valorize our highest virtues but recognizes our greatest failure—the potential to cause harm. Therefore, it serves as an odious warning with the implication going unstated—physicians are compelled to do no harm because they should fear the consequences if they do.
These three words remind us that our profession is different from others. Individuals will come to us in their most dire moments and place their lives in our hands. When they surrender their bodily autonomy, they deserve to know that we will act responsibly and that we recognize that our ability to heal is equal to our ability to harm. This is not a guarantee of success or that harm will never be done. It is a pledge to repay their trust with our prudence, their faith with our wisdom, their fear of the unknown with our fear of causing unnecessary harm.
Transforming the Scalpel into a Cleaver
What happens when doctors lose that fear? When they believe themselves to be the authors of laws governing biological reality. If they were to see their patients' natural health not as a state to be restored but as a mistake to be corrected? When they see a patient's dignity as contingent upon their use of powerful drugs and surgery to undergo a radical physical transformation? What would happen if the most vulnerable and innocent in our society were told that transformation was as simple as turning cucumbers into pickles or milk into cheese?
On a popular cooking website, Bon Appetit, a writer opines on gender transformation:
Fermentation is hope for trans folks. If people can conceptualize cucumbers becoming pickles, then they can grasp a trans person’s name change. If the possibility of Camembert, Parmesan, and ricotta exist within milk, then think of all the possible genders to choose from! After all, what is rennet if not the hormone replacement therapy of dairy? Transition takes patience, like waiting on life to develop in the mash. It’s a process of incremental steps with the promise of an unpredictable yet precious result.
What makes this statement so shocking is not the absurdity of the metaphor but that it has become the prevailing opinion of the largest medical and surgical organizations in this country. These formerly honorable institutions have abandoned the fear of harm. They have discarded the wisdom and prudence so necessary for the practice of good medicine and replaced it with a toxic combination of emotional frailty and oblivious, misplaced confidence. To any doctor who still carries a shred of critical thought, the warning signs are blinking emergency red.
They have undergone a Jim Jones-like conversion to the new religion of “gender-affirming care.” They have enthusiastically and uncritically adopted the anti-logic of the movement while aggressively trivializing the immense, life-altering risks. And just like Jonestown's utopian social transformation-turned-apocalyptic nightmare, their baptism will come at the cost of the most innocent of their converts—the children.
The average person knows this is wrong. They cannot look past the inherent absurdity of gender transformation. They understand that the use of powerful drugs and surgery in pursuit of an unobtainable goal is less about the risk of harm than the inevitability of it.
Future generations will ask who allowed this to happen. Although there are many parties at fault, the most guilt lies with my profession, the doctors. We are the ones who prescribe medications and perform surgeries that transform harmful delusions into permanent physical damage. We are the ones who allow a malevolent ideology to progress from the theoretical to the physical.
The reason for this monumental failure is the medical profession's abandonment of the practice of ethics. In the most basic sense, ethics is the study of the principles that inform human morality—a set of behaviors befitting the inherent dignity of the human soul.
Just as a surgeon cannot succeed without reliance on anatomical principles, a doctor cannot succeed without moral principles. And just like anatomy, morality is informed by laws that exist outside of our control—they are neither created nor negotiated but discovered. The study of these moral principles provides us with the knowledge necessary to inform our behavior, infer the consequences of their violation, and justify the fear of their abandonment.
I have always believed in the importance of ethics in medicine, but it has only been in the last few years that I realized it was more than just important. It is not that ethics is a component of medicine, but a necessary precursor. Without knowledge of moral principles, there can be no ability to heal.
If we continue down this dangerous path, it is true that a complete transformation will occur. But this is unlike the one advocated for by these gender doctors. They will never transition a male into a female, but they will succeed in transforming the doctor's scalpel into a butcher's cleaver.
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I couldn't agree more with this excellent article. Thank you for writing it.
This is an outstanding article, and I wish that every doctor would read it and give it serious consideration.
I am a clinical psychologist and my professional association has been taken over by the same pathological mass movement that supports gender ideology. Psychologists, psychiatrists and other mental health professionals have played a major role in convincing surgeons that a psychiatric condition, gender dysphoria, can be cured with surgery. There is of course a history of this practice in psychiatry, e.g., lobotomies, so the concept of "sexual reassignment surgery" was not as shocking to us as it should have been.
The healthcare professions are all morally responsible for perpetrating, facilitating or intentionally ignoring the destruction of so many childrens' lives in the name of helping them to be "their true selves."