Hubris, Yale, Medicine, and God.

A narrative.

Southall A. Miller never questioned his place in the world. The Millers were of pure Anglican stock, residents of Atlanta since before the Unpleasantries left the city in ashes. 

When Southall turned 13, his parents sent him to boarding school in New Hampshire. The school nurtured America’s aristocracy for entry into the Great World. For Southall, this meant taking his place as a sixth-generation Yale man. 

Yale felt as comfortable as a freshman as it had when his father first showed him the campus in grade school. 

“This will all be yours, Southall,” his father had told him then. 

Mr. Miller knew that Southall’s lineage would keep his son safe. Southall drank from Yale’s bosom and succeeded wildly at nothing. When his freshmen suitemates compared SAT scores after a few beers, Southall’s response was 1881 of 1600. He did not deign to explain. 1881 was the year the first Miller man graduated from Yale. He never thought of himself as a legacy student, but rather one of destiny.

The campus provided a measure of refuge for the homeless woman who stood daily in front of Sterling Library and recited Shakespeare for change. Most found this demeaning and just gave her money. Others thought the trade retained her dignity. Southall didn’t give a damn either way. He engaged her services when he pleased, often for an hour or more, verse after verse, dollar after dollar. She was good. When other students listened to the recitations he had paid for, he congratulated himself for having shared her. He even bowed. The woman shivered, for at that moment, she could see his black heart. His money made her fingers filthy. 

“Kharma will follow Southall Miller like a hawk,” a fellow student said after one display. 

Despite his carelessness as a student, Southall had a vision of who he would become. I will forge a God, he thought. He repeated his goal like a skipping record, as if doing so would make it come true. That can happen. Not a Wall Street financier or a federal judge. A God. But that was longer than a decade away. In the meantime, he knew that any effort in college was an inefficient allocation of resources, so he did nothing. His admission to Yale Medical School was pre-arranged. Southall would become his family's fourth double-barreled, Yale-bred doctor. This was the way of things, so Southall’s life at Yale simply moved from Cross Campus down York Street to the medical school. 

Southall’s fate demanded that he shed all college frivolities. He needed to finish at the top of his class in order to take shape. That was no small feat. He was surrounded by the best. The opportunity to marvel at medicine from 100,000 feet and save lives on the ground fell upon his deaf ears. Medical school was a competition to him, nothing more. The winner collected spoils, and it so happened that Southall won often. When grades were posted anonymously on the wall, Southall initialed his marks for all to see. He understood the chaos he was sowing. Panic. Fear. Inferiority. His fossilized smile belied his intentions. 

Southall graduated second in his class, which was good enough. He matched with his dream residency – general surgery at Duke University Hospital, and, he promised himself, yet another 10 years in Duke’s renowned neurosurgery internship. That was where the world’s best brain surgeons were forged. Such was the plan – to become the greatest of all. To start. 

His grandfather, a respected Atlanta neurosurgeon who had blazed the same trail, dismissed every other medical specialty. 

“Neurosurgeons have the most delicate canvas of all – the brain. Miles become millimeters. No other doctor can truly say that. Cardiologists claim otherwise, but their hands tremble when they see a brain.” 

Southall loved his grandfather’s wisdom. If the old man had his share of hubris, he also loved being a doctor and had reserves of empathy for his patients. Southall would never develop that basic strain. 

At Southall’s graduation, the dean sought to congratulate him. 

“I understand you matched at Duke, Southall,” the dean said. “Even for our finest students, that’s cause for notice. Where do you think your residency will take you?” 

“I’ll stay at Duke for neurosurgery.” 

He betrayed no affect, no sense of excitement. No nothing. 

“That’s a lofty goal, but the faculty believes in you. I know you will represent us well,” the dean said warmly. 

And then Southall A. Miller of Atlanta, boarding school, Yale College, and Yale Medical School, spoke his truth. 

“Whether I represent you well is immaterial. I don’t give a damn.” 

“I beg your pardon?” 

“I don’t even want to be a doctor.” 

“Well you became one the moment you graduated this morning. Second in your class. Yale Medical School. Show some respect, son, if not for us, then for yourself.” 

Southall had prepared his response.

“Swallow your judgment. I’ll sweat through my residency and then break my back to become one of the world’s most finely crafted neurosurgeons. But where will that get me? A mere doctor? I alone will make myself into a God. Patients will live or die based upon my choices, my decisions, my whim, in ways that other doctors will never understand. You’ve never been to that mount, Dean Stewart, never harnessed that power. Yale was just a utility. The College, the Medical School, all of it. And that’s precisely how I will remember my time here. As acts in my own play.” 

In his decades at the medical school, the dean had never heard a student speak this way. In just minutes, Southall Miller shattered any confidence Dean Stewart had that the boy had actually been capable of taking the Hippocratic Oath. It was too late. The creature recited it at the start of medical school with the rest of his class. The dean said nothing as he turned and left Southall standing alone. Neither offered a parting handshake. Southall never again thought of Stewart. Dean Stewart thought often of Southall.  

Southall went to Duke and took his place as a surgical resident. He worked maniacally. His research was impeccable. He had no time for distractions. Self-deification allows for none, and joining his fellow doctors at the pub or softball field contributed to no end. 

During February of his second year as a resident, life threw Southall an unhittable curveball: War. When he received his deployment papers, he opened his dorm windows and scattered them. He wasn’t a conscientious objector. Rather, Southall Miller objected to sending Southall Miller to war. “I’m not going anywhere, he thought. More papers arrived. Fellow residents were also being drafted. 

How dare they? he thought, and so he visited the campus Army recruiter. 

“There must be some mistake,” he told the officer. “I’m training to be a neurosurgeon. My talents are much better put to use here at home. War is a waste of my time. You must see.” 

“I see, alright,” the recruiter answered. He had read Southall’s file. “I see an arrogant, sheltered 26-year old who is about to get a not-so-gentle awakening. Your country needs doctors, so button up, pack your bags, and leave your bullshit stateside. Am I clear?” 

“Any hack doctor would be good enough,” Southall responded. 

“Right now, Miller, that’s exactly what you are. We don’t need a neurosurgeon. We need someone who can work with lives on the line and bombs exploding a click away. We need good hands. So for now, a lesser version of your grand self will be just fine. And I’ll be damned if you’re not being commissioned as an officer. God help us.” 

“They commission our full grand selves,” Southall parried. 

On the international flight aboard the military cargo plane, Southall noticed that the soldiers didn’t look like him. They were brown, black, sandy. These were not Yale men. 

Southall was not surprised that he was an immediate success in the medical corps. He worked non-stop. He saved lives and eased pain. He saw the bodies of soldiers he had operated on carried away in black bags. He was their final line of defense, and the line was always shifting. He saved more than his share of soldiers, and his colleagues took note. Inwardly, he denigrated his fellow doctors’ adulation. It made him sick. Who are you to tell me I’m the best? He was a machine – dispassionate, efficient, infallible, and empty. For all he cared, he could have been operating on deer. 

“That’s one cold cat,” another surgeon stated. Cold, not cool. It became a refrain. 

During chow one morning, Private Bartolon Jimenez raced to find Dr. Miller. 

“Please come,” he said, “a soldier took three bullets to the chest. He’s my cousin.” 

A dead man walking, Southall thought. 

“He needs you,” Jimenez pleaded. 

A spark ignited inside Southall. It was the word need, and the fact that Jimenez was one heck of a field medic. Southall often thought Bartolon could become a doctor, and he encouraged him along that path. It was the first soft spot he held for anyone. 

He saw the patient. This guy is fucked. There’s no way he survives three bullets to his chest. If his heart was compromised, this will last five minutes. He didn’t say a word to Jimenez. 

Panic surrounded Jimenez’s wounded cousin, Sergeant Louis Garcia. Two doctors were already examining him. Southall dismissed them with a flick of his hand. They knew he was the best, and they left the surgical tent quickly. They were the hacks he had described to the recruiting officer, and his contempt for them had soured into hatred. 

Southall went to work. Ten minutes later, he had opened, removed two bullets, and staunched the bleeding. He stopped to examine the patient’s heart. The last bullet was lodged to its left, almost under his shoulder. If the bullet remained, Garcia would die. If Southall removed it, he would have almost no time to stop the bleeding. There was only one logical choice – the bullet had to come out. Southall knew the outcome.

He called for his instruments. There was a serious hitch, and he was not one to wait patiently. 

“Where in heaven’s name is the surgical wire? Jesus H. Christ, you mean to tell me we have none? Surgical wire? That’s impossible. Jimenez, bust your ass and find some in the other surgical tent. You have 30 seconds” 

When Jimenez mentioned that the wire was for Dr. Miller, people hustled. 

Miller’s heartbeat didn’t skip as he removed Garcia’s third bullet. An artery began to spurt. He grabbed it. 

He turned to Jimenez, who had never seen him so serious. 

“I need to clamp the artery. I’m holding it with two fingers, but that won’t last. It’s too slippery. Listen to me carefully, Jimenez. Don’t ask any questions. Do exactly as I say, and now.” 

His instructions to Jimenez could have been mistaken as respectful. He knew Jimenez wouldn’t crack. 

“I have to hold steady or your cousin is gone. I need you to apply the final closure. You’re the best medic east of Jerusalem, Jimenez. You can do it. Don’t overthink. Just close.” He did. Under other circumstances, Southall would have been proud, but he knew better.

Dr. Miller stapled close Sergeant Garcia’s chest.  

He knew the wire would never hold. Garcia’s insides had been too compromised, shredded to bits. Miller had sutured no more than wet, shredded organs. Jimenez’s cousin had an hour at best. 

Garcia stabilized temporarily. Southall’s fellow doctors thought he had done it.

So ignorant, he thought. You fools have no idea what I saw inside him or what I did. You clap like penguins. Tomorrow you will be wonder how he could have died and guess what? There will be no one to tell you. Only one doctor on base could recognize his work for what it was, and that was him. 

Private Jimenez followed Southall out of the tent. 

“I’m in awe, Sir,” he said. “You saved my cousin.”

Southall paused. 

“I didn’t, Jimenez. Your cousin was on a tightrope when we arrived. He’s going to die, Jimenez. There was nothing from the start we could have done to change that.”

“If you knew this at the start, then why . . . ?” Jiminez stammered. 

“Private, no one cares whether your cousin dies. Everyone here is dying. He’s just part of the narrative. Take solace in this: only a God could have saved your cousin. Maybe. And he wasn’t here today.” 

“A God?” Jimenez responded. Why the article “a”? he asked himself. It struck him as odd. He had seen so many men die that he had almost abandoned his faith, but this was different. He had no idea what Southall meant, just as the doctor intended. Surely he meant “God”. 

“Are you a religious man, Sir?” Jiminez asked. 

“Not at all,” Southall responded. He sensed Jiminez’s confusion. “It’s OK, Jimenez, I know. I’m not there yet. I still have work to do. In 10 years, I will save your cousin. He will live. I promise you that. I will be the only God you’ve ever seen and the last one you’ll believe in.” 

Jiminez doubled over and vomited.

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