The Nectar of the Gods

A resident at Bellevue, a cardboard cup, and a therapy fifty years ahead of its time — saved, and nearly buried, by the story he had to tell the man in charge.

I made that drink sound like the nectar of the gods.

I was a high-school junior when I first read The Making of a Surgeon, William A. Nolen's account of his surgical residency at Bellevue in the 1950s. I was turning the idea of medicine over in my hands the way you test the weight of something you're not sure you're allowed to lift — and I was not at all sure I was allowed. That part of the story belongs to another essay. What matters here is that a book found me at exactly the age when a book can decide a life, and this one did.

What hooked me was not glamour, because Nolen refused to supply any. It was the harsh realness of it: the punishing hours, the fatigue, the fear of a young doctor handed responsibility he isn't sure he's earned. A teenager reads that and understands, dimly but correctly, that this is a life of the hands and the nerve, not only the mind — an understanding that pointed me, in time, toward my own hands-on corner of medicine in cardiology. But of all the scenes in that book, one has stayed with me for fifty years, and I have only lately understood how much it was trying to tell me.

A book found me at the age when a book can decide a life. This is the scene I never put down.

The patient was a Mrs. Swan. Ten days after a bowel operation for cancer she had developed a virulent staphylococcal enteritis — the kind of relentless diarrhea that, as Nolen explains, kills by draining the body of fluid and electrolytes until the chemistry of the blood fails. The cause was iatrogenic and, to modern ears, entirely familiar: the antibiotics given before and after surgery had killed off the normal bacteria of the bowel, and resistant staphylococci had overgrown in their place. She was dying on the ward.

Then Frank Jenkins — an attending Nolen paints as the resident staff's resident maverick, forever "advocating something kooky" — turned up on rounds with an idea he'd read in the Annals of Surgery. The article described restoring a patient's normal gut bacteria by giving them normal stool by mouth. Maybe you ought to try it, he said. And where most of the house staff would have nodded and forgotten it, Ray Hogan — the resident who, Nolen tells us, "liked wild ideas" — actually did it.

He finally located some fresh stool on Third Surgery, collected it in a cardboard cup and took it back to the interns' lab. He mixed it in chocolate milk, chuckling all the while, took it to Mrs. Swan and fed it to her. The Making of a Surgeon, pp. 252–253

Nolen, who tells the story against himself, was horrified. Hogan, you damn fool, he yelled when he found out — certain they would all be ruined if the chief ever learned what had been done on his ward, off the chart, out of a cardboard cup. And Mrs. Swan got better.

Here is the part I have come to love, because it is the truest thing in the whole episode. When Dr. Stevens — the chief, a man "ready to shoot Jenkins, Hogan and me" — finally demanded to know what had been done to his patient, Hogan did not tell him the truth. He could not; the truth would have ended him on the spot. Instead he invented a sterile, sanitized, respectable version: that he had collected the specimen in a sterile container, spun it in a centrifuge, and given the patient only the clear surface fluid, free of all particles. As Hogan put it afterward, with the weary honesty of a man who knew exactly what he'd done:

I made that drink sound like the nectar of the gods. I'm sure he knew I was lying through my teeth, but he needed a story for the medical superintendent and it was better for me to be the liar than he. Ray Hogan, p. 253

The nectar of the gods, then, was never the treatment. It was the story — the palatable fiction a young doctor had to construct so that the truth could survive contact with authority. The real thing was stool in chocolate milk, fed off a cardboard cup by a resident chuckling at his own audacity. The nectar was what you told the man who could destroy you.

And Hogan paid anyway. Mrs. Swan lived, so nothing official happened — except that at year's end Hogan was quietly dropped from the program. Dr. Stevens, Nolen writes, "would never have felt safe with a wild man as resident." I will not pretend that was an injustice. This was surgical training in the 1950s, and it was brutal by design; a resident who acted outside sanction, off the record, and then lied to his chief had broken the code the era ran on, however sound his instinct. Hogan was right about the medicine and wrong about the method, and in that world the method was the thing they cashiered you for. Both facts are true. The system was not built to forgive the first for the sake of the second.

But the medicine. Sit with the medicine for a moment.

What Hogan fed Mrs. Swan off that cardboard cup — normal stool, to restore the bacteria the antibiotics had destroyed — is now, in all its essentials, a recognized and approved therapy. We call it fecal microbiota transplantation, FMT, and as of this writing in 2026 it is a standard treatment for recurrent Clostridioides difficile infection — the miserable, antibiotic-resistant overgrowth that follows exactly the mechanism Nolen described in Mrs. Swan: the normal flora wiped out, a resistant organism seizing the empty ground. There are now FDA-approved microbiota-based products built on the principle that a resident at Bellevue read in the Annals of Surgery, and acted on, off the books, in the 1950s. The wild idea was in the literature all along. It only lacked a world ready to believe it.

That is why the book still belongs on a physician's shelf, and why the scene has outlasted every other in my memory of it. We are told medicine advances from the gleaming laboratory — the sequencer, the assay, the trial — and so it does. But it also advances the other way: from a tired resident at the bedside doing the sensible, desperate, faintly disgusting thing that works, decades before the establishment can explain why, and often at a cost to the one who dared. Hogan lost his place. Mrs. Swan kept her life. And the drink he had to disguise as the nectar of the gods turned out, fifty years on, to be exactly what he said it was — only he'd said it as a lie.

There is a lesson in there that this Lounge keeps circling. The distance between what a doctor knows to be right and what a doctor is permitted to say out loud has always been medicine's most dangerous gap. Hogan closed it the only way the era allowed — by doing the right thing in the dark and dressing it in a fiction for the light. The nectar of the gods was that fiction. Sometimes the truth cannot walk into the chief's office in its own clothes. Sometimes it has to be poured into chocolate milk first.