What Makes a Man: Top 10 Movies Featuring Self-Surgery
“What makes a man, Mr. Lebowski? Is it being prepared to do the right thing, whatever the cost?”
Well, that’s close, but like most male self-assessments, it assumes a little too much. Most of the time, men have no idea what “the right thing” is. Oh, we’ll do it if we can figure it out, or if a woman explains it to us, but we’re not about to make it a part of our gender identity. That would be flying a bit close to the sun.
I propose a slight rewording to remove some of this unnecessary specificity: “What makes a man is being prepared to do the difficult thing, whatever the cost”.
When you consider the sorts of activities that typify the male-macho ideal (fist-fighting, lifting heavy objects while yelling, getting a woman to talk to you), these are all very difficult things that must nevertheless be done from time to time, both in life and in your movie.
A common trope in this family of macho on-screen character-building is self-surgery, the hero sewing himself up, or otherwise repairing the damage of some recent violent encounter. These scenes demonstrate not only that he is willing to do something necessary that is extremely difficult, but also that he is self-reliant, not dependent on another person (sometimes even refusing another person’s help) in order to maintain his ability to continue to function.
For the purposes of this piece, I am defining “surgery” to be an act of explicit repair to the body. Cases such as 127 Hours and Saw certainly contain very difficult acts, but I would argue that desperate self-mutilation for the purpose of survival is narratively different from the acts of surgery I want to discuss.
One candidate film for this list which may be noticeably absent is Prometheus, which features a robot-assisted cesarean section directed by the patient herself. If I had not written so recently about this scene, and if there had not been quite so many other examples for me to pull from, I probably would have included it in this list. But honestly, the list below, all featuring acts by men, hits more directly at the point I want to make about how self-surgery helps to define and proclaim the macho mystique in the modern era.
You are, of course, welcome to mentally dismiss these as yet more examples of the rampant testosterone poisoning that afflicts all contemporary media. But if you do, you are morally compelled to be equally dismissive of the backlash of femme-macho (“hembra”) bullshit, like, off the top of my head, a bunch of badass women giving birth covered in mud because that’s what real women do. Both the male and female extremes of this “difficulty fetishism” are equally obscurative of the true nature of the genders, and they are both equally enlightening as artistic reflections of our complicated relationships with our own gender and others’.
Let’s take a look at the top ten films, ranked by Flickchart Global Ranking, that feature scenes of self-surgery to see what they have to tell us about male gender expression and doing the difficult thing.
10. Master and Commander (2003)
- Global ranking: 1827
- Wins 41% of its matchups
- 28,503 users have ranked it 247,395 times
- 56 have it at #1
- 1273 have it in their top 20
In an all-male cast of brawny sea-dogs, Paul Bettany‘s Doctor Maturin character stands out as the least manly officer aboard the Surprise: slight-framed, soft, romantic eyes, morally averse to the typical seaman’s diet of violence and grog, preferring the study of music and biology. Forgetting for a moment that in the early 19th century, music and science were (essentially) 100% masculine pursuits, the film’s presentation of Maturin throughout the first act is designed to portray him as borderline effeminate and clearly requiring some sort of “macho redemption” before film’s end.
He gets it when he is accidentally shot while traipsing about after a bird while the real men are gaping slack-jawed and firing weapons at random. A ball, along with a bit of shirt (which is more concerning somehow (?)), needs to be removed from his abdomen, and the surgeon’s mate (underappreciatedly played by Richard McCabe) is more of what you’d call a “drunken sawbones” than an actual surgeon capable of the task.
So in a Galapogosean tent, Maturin asks for a mirror and two stout men to soak up the spillage, and with his own hands extracts these foreign articles which have no place inside the body of a warrant officer in His Majesty’s Royal Navy. He continues to be a frail whiner for the rest of the voyage, but in this moment he achieves a sweet, Regency-era masculine divinity.
9. Ronin (1998)
- Global ranking: 1561
- Wins 42% of its matchups
- 18,960 users have ranked it 153,875 times
- 23 have it at #1
- 475 have it in their top 20
In Ronin, we have a very near cousin to the scene in Master and Commander: a bullet must be removed from the lower abdomen with only the help of a mirror and two non-professionals. But we have some clear, quite interesting differences.
De Niro‘s mercenary Sam does not perform his surgery directly, but rather dictates to his compatriots the specific steps that need to be performed to remove the bullet. He provides such specific direction, well-articulated, complete with warnings about what potentialities they should be on the lookout for, that it’s clear that he has extensive experience with this sort of operation.
The scene is both dramatically intense and incredibly informative into Sam’s past and character. One of Ronin‘s great strengths is how bare the script’s sketches of the characters are, only the faintest hints of history and motivation, relying on the performances and our own imaginations to fill in the gaps. But every few scenes we get a hint as to our heroes’ lives outside of the frame, and this scene paints a vivid, if oblique, picture of what Sam must have lived through before he took this ill-fated job.
And refreshingly, it’s not all that macho of a scene; De Niro does not suppress the agony his character is feeling. The one obeisance to the trope’s masculine heritage is its final line: “If you don’t mind, I’m gonna pass out.” That’s pretty badass.
8. John Wick (2014)
- Global ranking: 844
- Wins 62% of its matchups
- 2868 users have ranked it 47,304 times
- 7 have it at #1
- 167 have it in their top 20
John Wick is a film about embracing classic action movie tropes while simultaneously reinventing them. Its brief scene of self-surgery is no exception.
After John’s massive final battle with Viggo, he breaks into an animal shelter to treat his wounds. Under the watchful eyes of dogs doomed to euthanasia, he disinfects a deep laceration in his lower abdomen (I’m starting to see a pattern in where these wounds are located), and then uses a surgical skin stapler to suture it closed.
These staplers are marvelous devices, every bit as effective as hand sutures while being exponentially quicker to operate. You can get a pack of six of the disposable “John Wick” model for about $95.
By employing this plastic medical marvel, we are still able to have our macho moment with the hero where he demonstrates just how tough and self-reliant he is, without being subjected to the time-consuming and (by now) cliche sequence of threading the needle, cut to close-up on needle pulling the silk through the fake skin, cut to face either contorted in pain or stoically unemotional, cut to… etc, etc. That’s not how we do it in 2014. Oh, we still don’t go to the hospital or anything silly like that, but we do have an updated iteration of the trope to deploy, and the net result is the kind of genre-satisfaction that made this franchise so refreshing to old-school action movie fans.
7. Cast Away (2000)
- Global ranking: 610
- Wins 49% of its matchups
- 80,221 users have ranked it 607,219 times
- 509 have it at #1
- 10,021 have it in their top 20
We all know what scene I’m talking about here.
This is a film that could have been forgiven for including as much self-surgery and other macho tropes as it could fit inside thirty-five millimeters, but if it had done so, it would not have been nearly as memorable. Chuck Noland was a new breed of hero for a new millennium, reluctant and ill-equipped, faced with challenges he thought belonged to some past generation (just like all of us a few years later as we headed into the Great Recession). He reflects a generation of men whose default mode of behavior is naked emotionalism, but who are nevertheless willing to stretch their white-collar knowledge-worker training as far as it can possibly go.
And when that modern brand of common sense tells you that the tooth needs to come out, you do that shit, even if you cry while doing it.
6. First Blood (1982)
- Global ranking: 596
- Wins 48% of its matchups
- 22,873 users have ranked it 210,788 times
- 31 have it at #1
- 711 have it in their top 20
In a franchise that threatened to define masculinity at the end of the twentieth century, pretty much every macho trope is hit upon at least once, including self-surgery. The example from the first Rambo film is a long, patient scene where Rambo must sew up a gash on his upper arm using the needle and fishing line from the survival kit in the handle of his knife.
In the rambunctiousness of the Rambo sequels, we can forget how often First Blood slows down and let’s us really examine our hero’s process as he overcomes some serious obstacle to his survival. The sewing-up scene has only one cut, the camera remaining stationary at a fairly neutral angle. There is no artifice apparent in the filmmaking, nothing to distract us from the blood that continues to seep from the wound as he stitches it shut, or from the simple fact that despite the pain worn plainly on his face, Rambo does not stop, not even to take a breath. This is a difficult thing that must be done, both suturing the arm and surviving in the wilderness of an America that he no longer understands.
John Rambo (at least in this first film) is a fairly wholesome example of masculine ideals: strong-willed, strong-principled, resourceful, intelligent. But it is the message of this movie that modernity has grown too complex for this sort of simple morality, to the detriment of us all.
5. The Martian (2015)
- Global ranking: 534
- Wins 65% of its matchups
- 4531 users have ranked it 70,249 times
- 23 have it at #1
- 324 have it in their top 20
Like First Blood, The Martian is a meditation on self-sufficiency, albeit with more of a left-brained tilt. We watch specialist Mark Watney puzzle out challenge after challenge with surprisingly little pathos or Stallonian brooding, just that adorable, tense-lipped Damon half-smile, which when accompanied by his ever-searching eyes tells us that one hundred percent of his being is dedicated to finding solutions, even if it means doing very difficult things.
So when the airlock explodes or whatever happens, and Watney gets impregnated with its shrapnel, of course he knows what to do. I mean, it’s 2035; he’s seen this scene in Master and Commander a thousand times. He even has the presence of mind to match the piece taken out of his side (lower side abdomen again!) to the piece of equipment it used to be attached to, before using the John Wick staple gun to seal himself up.
Of the films in our list, this is the one set furthest in the future, so it makes sense that it would in many ways be the epitome of the “lone man” tropes of its genre. It doesn’t always knock these out of the park, but the self-surgery scene rings true and serves to inject intensity into what could have otherwise been a flat and static film.
4. The Fugitive (1993)
- Global ranking: 252
- Wins 53% of its matchups
- 68,194 users have ranked it 560,450 times
- 382 have it at #1
- 8338 have it in their top 20
This film gives us the only other example of self-surgery done by an actual medical professional. Like Maturin in Commander, Richard Kimble was an honest-to-God surgeon before getting swept up in the film’s plot. This gives credibility to the idea of being able to sew himself and then continue to run for his life (oh, and JUMP OFF A FUCKING DAM) and have it seem like a wise investment of time.
We are shown very little of the actual surgery itself, only one of the actual stitchings (done properly with forceps); it essentially comes down to two brief moments in the “sneaking into the hospital” montage. But a tremendous amount is communicated about Kimble’s carefulness and intelligence, which will allow him to keep fugitiving longer than anyone expects. The Fugitive succeeds as a film because it knows what details (and cliches) to skip over in order to maintain the pace.
The one detail that they left in, that I love so much, is that after the wound (in the lower side abdomen) is sutured, Kimble pulls his pants lower and gives himself an intramuscular injection in the right buttock, probably a high-dose antibiotic or a steroid to combat inflammation. This is an incredibly intelligent thing to do, revealing that his highly trained mind is considering his situation days from now and making decisions now to optimize for it. As all (but one) of the other films in this list attest, it is not something that the average filmmaker would think to include.
3. Predator (1987)
- Global ranking: 225
- Wins 53% of its matchups
- 68,206 users have ranked it 570,719 times
- 431 have it at #1
- 8817 have it in their top 20
Something else that most movies would not think to include is a self-surgery scene featuring the antagonist. As we’ve seen, usually self-surgery is used to extol the toughness and self-sufficiency of our hero. So what happens when the Predator does it? Exactly the same thing, plus a little more.
After he is wounded (entirely incidentally) by the jungle minigun firefight, we are treated to a scene of the Predator tending his wounds while sitting in a tree. Thus far, we have been given brief glimpses of the creature in both first and third person, but now the camera lingers on him in detail. We see the neon green wound in his upper leg, we watch him access the medicomp kit which he carries on his person, and we watch a procedure that is recognizable to any Earthling as field first aid, no lasers or healing wands, just metal tools and injected drugs, done with competent but trembling hands.
Even more important than the world-building is the fact that at the end of the procedure, as the wound clamps staple the sides of the gash together, we experience through the performance and the camerawork the intensity of his pain. Given what has transpired up to this point, this may not make the Predator more sympathetic, but it does make him more than another of cinema’s ghosts in the trees. He is every bit as corporeal as his victims, and we now understand that Schwarzenegger can fight him on his own terms.
2. No Country For Old Men (2007)
- Global ranking: 173
- Wins 65% of its matchups
- 71,434 users have ranked it 763,891 times
- 960 have it at #1
- 13,903 have it in their top 20
Given what we’ve covered so far, the case of Anton Chigurh’s repair of his leg wound following his run-in with Llewelyn Moss is somewhat unremarkable. He steals some medical supplies, cuts off his pants, irrigates the wound, removes the birdshot with sterilized tweezers, then bandages it up. (No suturing is shown.) There’s one minor technical detail which is mildly interesting, his use of Lidocaine injections to deaden the nerves, proving that this stone-faced spectre of a man not only can be hurt but also cares enough to stop the hurting if he can. (We also see another intramuscular injection of… something.)
What I love about this sequence is that it’s filmed so satisfyingly, the cuts and angles as cold and systematic as we imagine Chigurh’s demented mind must be. As necessary as it is for Chigurh to repair (no other verb seems to do) the wound in his leg, so is it necessary for this film to satisfy this trope. It does not linger or try to squeeze more drama out than is left after decades of us watching such things. This film knows that it is in the post-macho era; it hits the beats it needs to hit and then moves on.
1. The Terminator (1984)
- Global ranking: 80
- Wins 60% of its matchups
- 84,296 users have ranked it 751,733 times
- 628 have it at #1
- 13,088 have it in their top 20
The best movie to feature self-surgery is the most extreme case as well as the most borderline. At first glance, none of the our discussion about the qualities and lessons about masculinity seem to apply. This is not a man; this is not a case of “surgery” so much as a self-initiated field repair of a weapon.
But we don’t really believe that. If this instance of Cyberdyne Systems Model 101 was truly unable to graduate in the audience’s mind from prop to character, then we would have no franchise. The movie knows this, and actively cultivates this ontological confusion by giving us a lot of time with him, literally having us walk in his shoes and see through his eyes. He is born to us, naked and alone, as a “he” not an “it” by overwhelming us with his masculinity, his nude form seeming, like David, to be the prototype, the exemplar, the apotheosis, something that should be etched onto a gold-anodized aluminum plaque and shot into space.
No, he’s not “a man.” He is Man.
I mean, he shouldn’t be; it’s crazy that the movie presents him this way (and that we buy it). But this was the 80s when our culture was subconsciously hungry for gods and other symbols that we kept telling ourselves we didn’t need. And so we feel all sorts of inappropriate things about CSM-101, including lust.
The movie eroticizes almost everything he does, starting with his initial power-top commands to the group of punks and culminating in the quiet, lurid, wetly indulgent scenes when he exposes to us his most tender parts. He’s all alone in that dirty hotel room, his mangled eye drawing his face up into grimace. The camera captures his operations with multiple static shots, while the soundtrack moans tunelessly, sounding halfway between discomfort and curiosity.
To repair himself, he must do himself what would seem to us to be greater injury, first cutting open his forearm then removing his left eye. This also is extremely macho, and in keeping with what we’ve discussed before. In the simplified eyes of Hollywood, women give birth and men get injured, and all gendered actions can be placed somewhere on this inverted sexual scale, from things leaving the body to things entering the body, each gender having its cinematic extreme at the opposite end from actual intercourse.
For male characters, scenes of self-surgery allow the camera to linger on these red badges of courage, and to show us how they reveal what kind of man lies beneath the skin. Sometimes we are surprised, sometimes merely reassured, but afterwards there is little doubt one way or the other about who he is and of what he is capable.