Hektoen International

A Journal of Medical Humanities

“What’s a soul?”: Richard Selzer finds the spirit in the flesh

Mahala Stripling
Fort Worth, Texas, United States


Richard Selzer at the Elizabethan Club, 2004. Photo courtesy James L. Stripling.

When he was a child, Dickie Selzer asked his father, “What’s a soul?” Julius replied, “No such thing.” When his inquisitive son pressed him further, he gave this answer: “Oh, a little bag of air, I suppose, like a breeze or a draft or a bit of a gale, only held inside of a bubble.” Dickie’s religious sensibilities had already been molded by his attraction toward the bells, incense, and statuary of St. Peter’s Church, which kept him from accepting this response. But when his father died two years later, the distraught twelve-year-old boy “renounced religion for good and settled into an exclusion from faith,” he wrote in his 1992 memoir Down from Troy.1 Without a belief in God or the hereafter, he felt a great void that remained a source of unhappiness his entire life.

As the circumstances of his life changed, Richard Selzer found a sort of faith through compassionate acts that showed him to be a highly spiritual person “more Christian than many who kneel at prayer,” he believed.2 Although an atheist, as a surgeon he found sacramental meaning in ministering to his patients’ suffering, which he wrote about in his popular stories. In the early days, while teaching himself to write, he spent his off-hours at the local library and, seeing a need, trimmed the nails of the homeless seeking refuge. It is an activity he describes in his essay “Toenails.”3

In 2001, he told Hartford Courant reporter Jane Dee how his tenth book, The Exact Location of the Soul, had “an ironic, metaphoric title” since he did not believe in the soul. And yet he sought its whereabouts, as he explained further: “I do believe the term soul in its larger sense applies to the body of feeling or emotion that is inside a person, and, if asked to say, Where the soul is, I would point to the wound. Wherever the person is wounded, that is where the soul as I see it is most likely to reside.”4 That is, in the “imperfections” of people—infirmities of the flesh or psyche—he recognized that what gazed back at him “by some, might be called the soul.”5

Retired from his surgical practice, he commenced what he affectionately called his “ministry of loonies,” befriending six people who suffered from bipolar disorder, schizophrenia, and obsessive-compulsive disorder (OCD). Some of them were brilliant former Yale students who now haunted the city and campus. Their families could not or would not help them. “One by one, the dear loonies attached themselves to me either at the libraries, or on the street. Like burrs to a woolen sweater in October. I couldn’t shake them off, so I just gave in to them. The rewards have been all mine. I have grown fond, so I can’t be their doctor. Doctors aren’t supposed to grow fond. I’m not their minister either, as a dyed in the wool skeptic can hardly be of that stripe. I’m just there.”6

Selzer went to the apartment of the man with OCD to make sure he took his medications. “Being just a surgeon,” he did not discuss prescriptions, but “I will listen to you,” he told the poet.7 Each time Selzer had to perform an elaborate ritual at the doorstep, and if it were not perfectly executed, he would have to do it all over again to gain access. With rolled up paper in the window crack to block outside sound, Selzer read a specific sentence into a tape recorder, and after thirty tries the man felt the purity of one recording was such that he did not have to atone for any inconsistencies. Selzer then ran out the door vowing to never do it again. “But then he came to the landing and called down the stairs to thank me and tell me that I had saved his life.” After a while, when all his defenses were down, the man called Selzer to read more atonement sentences: “I was his only hope,” he felt.8 In the man’s suffering, Selzer could perceive his soul.

In a 2011 Harpers essay, the Yale-New Haven community was learning about Selzer’s “ministry” of “odd outscourings of the human race” for the first time, recalling how people would go off their medications and bad behavior ensued at the Sterling Library.9 Since it could be their only safe haven, Selzer worked tirelessly to reinstate their privileges. Noticing one of them shadowing him as he made his way about the campus environs, he acknowledged him by simply buying an orange or a beverage at the local diner, the Educated Burgher. In the marginal world of the mentally ill, some rallied while others fell into the cracks. Selzer befriended them when he could, set boundaries, and let them be who they were. Sometimes, with no direct responsibility for them, he would have to let them go.

Caroline Kwok had been in Selzer’s 1996 summer writing class at Yale. A Chinese Canadian woman living in Toronto, she was “very ill,” Selzer said. Her bipolar disorder caused extreme shifts in mood. Through their correspondence, Selzer extended his compassion. When her energy levels were high, she wrote to him several times a day, and he replied to keep her stable. But that encouraged her “rather too frequent” visits to see him, a destination she called “The New Haven of Hope.” What seemed to Selzer to be a “romantic interest” in him continued into the 2010s.10 Trying to fill the void left by an active doctor-patient exchange made him vulnerable.

In Kwok’s book Free to Fly, she acknowledges how Selzer, the man she calls “Richard the Lionhearted,” helped usher her into recovery.11 Over many crucial years while she was in therapy, Selzer kept in touch through emails and phone calls. She later became an advocate, giving talks about her mental illness and emphasizing Selzer’s support and sensitivity to her Chinese heritage. “He encouraged me to write articles and make presentations, communicating with me on an intellectual level and supporting me in my worst moments,” she said, “and that is why I will always show my deepest gratitude to him.”12

David Watts, whom Selzer called the “charismatic maniac of the Elizabethan Club,” left the doctor puzzled; he had no idea what to do with him. Founded in 1911, The Lizzie was a permanent haven for intellectual discourse and intimate conversation about Shakespearean literature and other Elizabethan concerns. Located in a two-story, white-framed house at 459 College Street, it contained a vault with priceless editions, and Selzer was one of the five members with its combination. At 4 p.m., tea was served with cucumber or chicken salad sandwiches, providing a congenial forum for interaction between students and faculty that was now disrupted by Watts’ disturbing behavior and obnoxious manner — “fake English accent, tachyphemia, argumentative nature.” The 1972 Yale graduate had been a promising poet sponsored for membership, but now he bounced between street, court, and asylum.13 A menacing presence, he interrupted conversations, smoked, and followed members out to ask for money. “He now threatens to stage his own Elizabethan Drama,” Selzer said, adding that he was thrown out of shelters and even issued a phone threat to a former English professor.14

Watts remained on the street because “the police did not act to place him in the one state hospital for the insane, which is as hard as securing admission to heaven,” Selzer believed. “They must be re-opened at once,” he argued. “Someone will be killed. But wretched fellow. What will become of him if he’s not hospitalized permanently? He refuses to take his medications, has no realistic hold on life. It is a calamity waiting to befall us, himself above all.” With Watts’s “greedy, self-centered, and predatory manner, we must prepare ourselves for tragedy. At 70, it is an effort to man the barricades. Even for a man’s man like me.”15 His patience wearing thin, Selzer wrote in his diary two months later, “As for David Watts, I can do no more. Ich kann nich anders. Now I hope he can save himself. We all have our lives that must be lived.”16 It was difficult for this former doctor to harden his heart toward the mentally ill. But as winter approached, he grew weary of being accosted more frequently by the hundreds “in unimaginable straits” who roamed the streets.17

In his “ministry,” Selzer accepted these mentally ill people who existed in different social or cultural contexts, “not out of compassion or generosity of spirit,” he said, but because of his clinical interest in their diseases. “I do it out of a fascination with the abnormal, the pathological, and the suspicion that nature is more apt to reveal her secrets through her mistakes—those ‘incapable of perfectness’ as Bacon called them.”18 And yet in each human being struggling with a specific problem, the soul was visible to Selzer.

To some, Selzer might be seen as heroic, even a saint. But his own impulse was “very ordinary and unspecial,” he said. In relationship to these six people, he was just a man in touch with the real world, “and having no religious impulse—nothing—I am their ombudsman (not a psychiatrist), helping people who simply can’t cope with ordinary life.”19 He came from a generation when mental illness was more stigmatized than it is today, but Selzer’s view was egalitarian, treating people regardless of their standing in life, even if they were vagrants on the New Haven Green. He earned self-respect from his “ministry” and believed he received more than he gave.



  1. Richard Selzer, Down from Troy (New York: William Morrow, 1992), 153-4.
  2. Richard Selzer, email to author, September 8, 2011.
  3. Richard Selzer, “Toenails,” Letters to a Young Doctor (New York: Simon & Schuster), 64-9.
  4. Jane Ellen Dee, “Richard Selzer and his Arts,” The Hartford Courant, April 29. 2001.
  5. Richard Selzer, The Exact Location of the Soul (New York: Picador, 2001), 7.
  6. Richard Selzer, email to author, February 16, 2001.
  7. Richard Selzer, interview with author, 1998.
  8. Richard Selzer, Letters to a Best Friend (Albany: SUNY Press, 2009): 74 & 223-4.
  9. Richard Selzer, “Odd outscourings of the human race,” Harpers, March 2011, 20.
  10. Richard Selzer, interview with author, 1998.
  11. Caroline Fei-Yeng Kwok, Free to Fly: A Story of Manic-Depression (Toronto: Inclusion Press, 2006).
  12. Caroline Kwok, email to author, May 26, 2008.
  13. Daniel Shkolnik, “An Impossible Wicket,” Daily Nutmeg, July 22, 2015.
  14. Richard Selzer Diary, June 30, 1998. The Richard Selzer Archive. University of Texas- Galveston, Moody Medical Library, box 27, folder 14.
  15. Richard Selzer Diary, June 30, 1998. The Richard Selzer Archive. University of Texas-Galveston, Moody Medical Library, box 27, folder 14.
  16. Richard Selzer Diary, September 2, 1998. The Richard Selzer Archive. University of Texas-Galveston, Moody Medical Library, box 27, folder 14.
  17. Richard Selzer, Diary (New Haven: Yale University Press, 2001): 196.
  18. Richard Selzer, email to author, December 23, 1999.
  19. Richard Selzer, interview with author, 1998.



DR. MAHALA YATES STRIPLING knew Richard Selzer the last 25 years of his life, publishing 17 journal articles on his life and work while working on his biography, including “A Question of Mercy” in Columbia University’s Voices in Bioethics and the Selzer entry in Oxford Bibliographies in American Literature. Besides being a Yaddo fellow, she has lectured at the Yale School of Medicine and in the Great Hall of the Atheneum on Nantucket Island. Her forthcoming biography, The Resilience of Richard Selzer, Surgeon, Writer, and Pioneer of the Literature-and-Medicine Movement, shows how he elevated mankind, looking for the whereabouts of the soul. Her work can be found at medicalhumanities.net.


Spring 2022  |  Sections  |  Surgery

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