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    Knives, gunfights, pituitaries

    Neuro-ophthalmologists in battle would have altered outcome

    The idiom “Don’t bring a knife to a gunfight” is meant to convey the importance of not entering a challenging situation without the proper equipment at hand. The expression has been used in some 20 movies and is also a favorite of some politicians. The concept that one must come properly prepared and equipped to any important task or confrontation is well-appreciated by ophthalmic surgeons, but this particular expression is rarely used by ophthalmologists teaching eye surgery to residents.

    Only a philistine would not enjoy a good movie in which the protagonist, like Sean Connery in “The Untouchables,” uses this idiomatic expression to mock his opponent. I mean a philistine in the sense of its common usage of “a person who is hostile or indifferent to culture and the arts.” Of course, this word’s earlier meaning is that of a native or inhabitant of ancient Philistia. The Philistines were a powerful tribe that ranged from Lebanon to Crete to Egypt until they were conquered by the Romans.

    Didn’t get the memo

    The most famous Philistine (actually, the only one whose name I know) was Goliath the Gittite. Unfortunately for Goliath (the biblical giant whose name has become synonymous with losing in an upset), he did not get the memo about proper preparation.

    Heavily armored and with sword in hand, he faced off against a young shepherd armed with a slingshot, the gun equivalent of his day. Apparently these slingshots, with practice, were so accurate that they could be used to shoot down birds in flight. His is a textbook case of bringing the proverbial knife to the proverbial gunfight. Goliath stood there while David loaded his slingshot and fired his rock, then lay unconscious while David sliced off his head.

    Rather than causing me to think of David as a hero, this encounter has always made me think that Goliath was an idiot. Why didn’t Goliath hide behind his shield when he saw David about to shoot the rock at him or at least duck or otherwise protect his head? Why didn’t he run up close to David and just stab him?


    Peter J. McDonnell, MD
    He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of ...

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