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“Woooow. Come over here Court. Come look at this,� my roommate Yana would holler from across our tiny dorm room.
“What is it?� I asked, while getting up from my desk chair and heading towards her. Putting my hand on her shoulder and leaning over, I was rudely confronted with a picture of rotting flesh. “GROSS!� I screamed, turning back to my post-colonial lit essay aglow on the computer. “Why do you do that to me?�
“Necrotizing faxciitis, flesh eating bacteria,� she announced, a smile still on her face.
Yana is not the devil. Actually she’s the closest thing I’ve ever come to knowing a real life angel. Today she is a pediatric resident at Boston Children’s Hospital. She helps teenage moms learn how to feed their toddlers. She works ungodly hours and eats crappy hospital food. She frickin’ saves babies.
Her altruism, matched with her curiosity about biology, anatomy, and health, has led her to be a doctor. When I went to visit her recently, she handed me a copy of Atul Gawande’s Complications and urged me to check it out. Not only is it really good writing, but it’s fascinating, sometimes frightening reading about the human body in all its fragility.
It seems criminal that Gawande is scientifically smart and dedicated enough to be a doctor, but also articulate and clear-headed enough to be a great writer. Nonetheless, this guy’s got it all. Complications is a riveting read that takes you through various cases, most that he’s handled, a few that he researched, with important implications for the patient-doctor relationship, the mind-body connection, and the future of medicine.
He looks at everything from the psychology of overeating with a surprisingly compassionate analysis (rare for doctors in my experience), the ethics of learning your craft on real people, and pathological blushing. And through it all, he pulls back the hospital curtain to reveal the real thinking/questioning/confusion underneath. He demystifies the ideas that doctors are all knowing, but at the same time, he instills a real trust in doctor’s effort to do the best they frickin’ can.
Often they rely on intuition. If that scares you, I understand why. So does Atul Gawande. But what’s surprisingly beautiful about it is that the practice of medicine is as human as humans—as flawed and miraculous. All we can do is create honest, trusting relationships with our health care providers and hope for the very best.
Next couple of weeks: The Terror Dream by Susan Faludi and Homeward Bound by Elaine Tyler May, side by side.
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Hey, I read this years ago, thanks for reminding me how good it is! :)
As someone with a medically fragile child, I am looking forward to reading this. I just put it on hold at my local library. Thanks for the tip.
I read this book awhile back too. It illustrates the reasons why there's so much uncertainty in medicine.
Alot of people get frustrated with medicine, and make analogies to other fields. For example, I heard someone say "my car mechanic can take my car apart down to the nuts and bolts and rebuild it from scratch, yet I cant get a proper diagnosis from a doctor, why?"
To dissect a human into its "nuts and bolts" means splitting it down to trillions of cells (which are by themselves wondrously complex machines far more complicated than any car). Fixing a human requires unique approaches that are far beyond the scope of fixing a car. There are still far too many mysteries that we dont understand about how it all works together.
A lot of people forget that the human brain is the single most dense, complex piece of matter in the universe (as far as we know).
I'm going to put this one on my list.
I'd really like to read the part about "pulling back the curtain" to see how doctors/all providers really handle their cases.
They deal with life and death, and a lack of confidence can mean someone's loved one dies.So, it's easy to develop a "God Complex" in that environment. I also think that a lot of people are sick or in pain and scared. They just want to hear that it can be "fixed" and they'll be okay.
I think doctors really do want to help and don't want to feel impotent, so all of the above can and have made a deadly combination.
I think that realizing that medicine is as much art as it is science and allowing our doctors to be responsibly human will go far in saving lives.
As a patient with a couple of rock-and-a-hard-place conditions, I would love to see more teaching hospitals take a partnership approach. To continue the mechanic metaphor, my doctor may know the "nuts and bolts" of how my body works, but I've lived in this body for 34 years. Things work best when we work from that theory and as a team.
woo hoo! I read this for class last semester in Medical Sociology. This book gives and insight into a world most of us don't have access to. And it's got some interesting and gross stories to top it off!
I'm really excited to read this! One of my academic interests is the ethics of Western Medical Practices, particularly Western Childbirth, but this will definitely have transferrable material!
Thanks!
Thank you for a piece complimentary to doctors.
"I heard someone say 'my car mechanic can take my car apart down to the nuts and bolts and rebuild it from scratch, yet I cant get a proper diagnosis from a doctor, why?'"
This person acts as if automotive professionals understand all there is to know even about cars. I should be so lucky to find mechanics who can give me the final word on what is wrong with my cars or motorcycle, instead of holding on to them for weeks or even months at a time, at a minimum of $89 per hour. My motorcycle wouldn't start, and drains a battery after a couple of days of use. Even a new battery wouldn't maintain a charge. Oh, so it's your generator. It's the relays. No it wasn't, after two new generators. Oh, it must be the electrical system. I had much of the system replaced. Still nothing. We can't get the rest of the parts, so we can't know.
Finally, frustrated at putting about as much money into parts and labor (and about three months in the shop) that I originally paid for the bike, that did absolutely nothing to improve the situation, I just gave my motorcycle to my neighbor, the manager of a local motorcycle dealership who said he and his crew will have to build a new electrical system from scratch in his free time.
Perhaps this person also assumes that automotive professionals behave as ethically or more ethically than doctors. It's been about nine months, and the dealership mechanic has still not got around to replacing the defective dash display that came with my SUV (odometer and perhaps engine temperature/oil gauges inoperative) or fixing the left rear door that cannot be opened from inside, both of which the dealer and mechanic promised would be fixed (for free), as they were that way when I bought the vehicle. People should read some Reader's Digest in their occasional exposes of how mechanics and repair shops operate around the country, particularly when a female reviewer is sent out, with a car confirmed to be in perfect running condition. Let us not even get into how automotive salespeople behave.