Throughout The Surgeon, the killer Warren Hoyt describes his fascination with a variety of different rituals of human sacrifice from across cultures. These descriptions are a motif that contribute to the theme of Misogyny and the Prevalence of Gender-Based Violence. They depict how women have been the target of violence by societies across the world for thousands of years and how this deep-seated misogyny reverberates into the present day.

Hoyt begins with a vivid, graphic description of the sacrifice of Iphigenia by her father King Agamemnon during the Trojan War to expiate her father’s sins against the goddess Artemis. As he states, when he thinks of the Trojan War, he sees “the image of a girl’s body, drained white, and the father standing beside her, clutching the bloody knife” (115). Later, Hoyt conflates the mythic Iphigenia with the real Dr. Cordell, noting that “her throat is as pale as Iphigenia’s must have been” (369). This illustrates how this mythic violence inspires present-day violence against women.

Hoyt also uses historic ritual practices as a framework for the erotic aspects that shape his blood lust and fantasies. He describes, for instance, the ritual sacrifice of a Viking “harlot” in 922 who was repeatedly raped and then stabbed to death. (Modern scholars like historian Dr. Christina Wade cast doubt on the veracity of Ibn Fadlan’s account of the ritual as described in The Surgeon.) He connects the spilling of her blood with the sperm the men “spilled” inside of her while they raped her, giving the entire ritual a sadistically erotic character in his mind (157). This example shows how gender-based violence, both in the present day and historically, is based in a desire to control and subjugate women through sexual humiliation.