Final Exam: A Surgeon's Reflections on Mortality


Pauline W. Chen - 2006
    What she did not count on was how much death would be a part of her work. Almost immediately, Chen found herself wrestling with medicine’s most profound paradox, that a profession premised on caring for the ill also systematically depersonalizes dying. Final Exam follows Chen over the course of her education, training, and practice as she grapples at strikingly close range with the problem of mortality, and struggles to reconcile the lessons of her training with her innate knowledge of shared humanity, and to separate her ideas about healing from her fierce desire to cure.From her first dissection of a cadaver in gross anatomy to the moment she first puts a scalpel to a living person; from the first time she witnesses someone flatlining in the emergency room to the first time she pronounces a patient dead, Chen is struck by her own mortal fears: there was a dying friend she could not call; a young patient’s tortured death she could not forget; even the sense of shared kinship with a corpse she could not cast aside when asked to saw its pelvis in two. Gradually, as she confronts the ways in which her fears have incapacitated her, she begins to reject what she has been taught about suppressing her feelings for her patients, and she begins to carve out a new role for herself as a physician and as human being. Chen’s transfixing and beautiful rumination on how doctors negotiate the ineluctable fact of death becomes, in the end, a brilliant questioning of how we should live.Moving and provocative, motored equally by clinical expertise and extraordinary personal grace, this is a piercing and compassionate journey into the heart of a world that is hidden and yet touches all of our lives. A superb addition to the best medical literature of our time.

Do No Harm: Stories of Life, Death and Brain Surgery


Henry Marsh - 2014
    Operations on the brain carry grave risks. Every day, leading neurosurgeon Henry Marsh must make agonizing decisions, often in the face of great urgency and uncertainty.If you believe that brain surgery is a precise and exquisite craft, practiced by calm and detached doctors, this gripping, brutally honest account will make you think again. With astonishing compassion and candor, Marsh reveals the fierce joy of operating, the profoundly moving triumphs, the harrowing disasters, the haunting regrets, and the moments of black humor that characterize a brain surgeon's life.Do No Harm provides unforgettable insight into the countless human dramas that take place in a busy modern hospital. Above all, it is a lesson in the need for hope when faced with life's most difficult decisions.

Better: A Surgeon's Notes on Performance


Atul Gawande - 2007
    But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by arguably the best nonfiction doctor-writer around (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.

Dear Life: A Doctor's Story of Love and Loss


Rachel Clarke - 2020
    Every day she tries to bring care and comfort to those reaching the end of their lives and to help make dying more bearable. Rachel's training was put to the test in 2017 when her beloved GP father was diagnosed with terminal cancer. She learned that nothing - even the best palliative care - can sugar-coat the pain of losing someone you love. And yet, she argues, in a hospice there is more of what matters in life - more love, more strength, more kindness, more joy, more tenderness, more grace, more compassion - than you could ever imagine. For if there is a difference between people who know they are dying and the rest of us, it is simply this: that the terminally ill know their time is running out, while we live as though we have all the time in the world. Dear Life is a book about the vital importance of human connection, by the doctor we would all want by our sides at a time of crisis. It is a love letter - to a father, to a profession, to life itself.

The Shift: One Nurse, Twelve Hours, Four Patients' Lives


Theresa Brown - 2015
    In the span of twelve hours, lives can be lost, life-altering medical treatment decisions made, and dreams fulfilled or irrevocably stolen. In Brown’s skilled hands--as both a dedicated nurse and an insightful chronicler of events--we are given an unprecedented view into the individual struggles as well as the larger truths about medicine in this country, and by shift’s end, we have witnessed something profound about hope and healing and humanity. Every day, Theresa Brown holds patients' lives in her hands. On this day there are four. There is Mr. Hampton, a patient with lymphoma to whom Brown is charged with administering a powerful drug that could cure him--or kill him; Sheila, who may have been dangerously misdiagnosed; Candace, a returning patient who arrives (perhaps advisedly) with her own disinfectant wipes, cleansing rituals, and demands; and Dorothy, who after six weeks in the hospital may finally go home. Prioritizing and ministering to their needs takes the kind of skill, sensitivity, and, yes, humor that enable a nurse to be a patient’s most ardent advocate in a medical system marked by heartbreaking dysfunction as well as miraculous success.

Knocking on Heaven's Door: The Path to a Better Way of Death


Katy Butler - 2013
    It will inspire the necessary and difficult conversations we all need to have with loved ones as it illuminates a path to a better way of death.Like so many of us, award-winning writer Katy Butler always assumed her aging parents would experience healthy, active retire­ments before dying peacefully at home. Then her father suffered a stroke that left him incapable of easily finishing a sentence or showering without assistance. Her mother was thrust into full-time caregiving, and Katy became one of the 24 mil­lion Americans who help care for aging parents. In an effort to correct a minor and non–life threatening heart arrhythmia, doctors outfitted her father with a pacemaker. The device kept his heart beating but did nothing to prevent his slide into dementia, incontinence, near-muteness, and misery. After several years, he asked his wife for help, telling her, "I am living too long." Mother and daughter faced a series of wrench­ing moral questions: When does death cease being a curse and become a blessing? Where is the line between saving life and prolonging a dying? When is the right time to say to a doctor, "Let my loved one go"? When doctors refused to disable the pace­maker, sentencing her father to a protracted and agonizing death, Katy set out to understand why. Her quest had barely begun when her mother faced her own illness, rebelled against her doctors, refused open-heart surgery, and instead met death head-on. Knocking on Heaven's Door, a revolution­ary blend of memoir and investigative reporting, is the fruit of the Butler family's journey. With a reporter's skill, a poet's eye, and a daughter's love, Butler explores what happens when our terror of death collides with the tech­nological imperatives of modern medicine. Her provocative thesis is that advanced medicine, in its single-minded pursuit of maximum longevity, often creates more suffering than it prevents. Butler lays bare the tangled web of technology, medicine, and commerce that modern dying has become and chronicles the rise of Slow Medicine - a growing movement that promotes care over cure. Knocking on Heaven's Door is a visionary map through the labyrinth of a broken and morally adrift medical system. It will inspire the necessary and difficult conversations we all need to have with loved ones as it illuminates a path to a better way of death.

When Breath Becomes Air


Paul Kalanithi - 2016
    One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi's transformation from a naïve medical student "possessed," as he wrote, "by the question of what, given that all organisms die, makes a virtuous and meaningful life" into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality. What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir. Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. "I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything," he wrote. "Seven words from Samuel Beckett began to repeat in my head: 'I can't go on. I'll go on.'" When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.

God's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine


Victoria Sweet - 2012
    Ballet dancers and rock musicians, professors and thieves-"anyone who had fallen, or, often, leapt, onto hard times" and needed extended medical care-ended up here. So did Victoria Sweet, who came for two months and stayed for twenty years. Laguna Honda, lower tech but human paced, gave Sweet the opportunity to practice a kind of attentive medicine that has almost vanished. Gradually, the place transformed the way she understood her work. Alongside the modern view of the body as a machine to be fixed, her extraordinary patients evoked an older idea, of the body as a garden to be tended. God's Hotel tells their story and the story of the hospital itself, which, as efficiency experts, politicians, and architects descended, determined to turn it into a modern "health care facility," revealed its own surprising truths about the essence, cost, and value of caring for body and soul.

Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner


Judy Melinek - 2014
    Judy Melinek began her training as a New York City forensic pathologist. With her husband T.J. and their toddler Daniel holding down the home front, Judy threw herself into the fascinating world of death investigation, performing autopsies, investigating death scenes, counseling grieving relatives. Working Stiff chronicles Judy's two years of training, taking readers behind the police tape of some of the most harrowing deaths in the Big Apple, including a firsthand account of the events of September 11, the subsequent anthrax bio-terrorism attack, and the disastrous crash of American Airlines flight 587.Lively, action-packed, and loaded with mordant wit, Working Stiff offers a firsthand account of daily life in one of America's most arduous professions, and the unexpected challenges of shuttling between the domains of the living and the dead. The body never lies, and through the murders, accidents, and suicides that land on her table, Dr. Melinek lays bare the truth behind the glamorized depictions of autopsy work on shows like CSI and Law and Order to reveal the secret story of the real morgue.

In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope


Rana Awdish - 2017
    Rana Awdish never imagined that an emergency trip to the hospital would result in hemorrhaging nearly all of her blood volume and losing her unborn first child. But after her first visit, Dr. Awdish spent months fighting for her life, enduring consecutive major surgeries and experiencing multiple overlapping organ failures. At each step of the recovery process, Awdish was faced with something even more unexpected: repeated cavalier behavior from her fellow physicians—indifference following human loss, disregard for anguish and suffering, and an exacting emotional distance.Hauntingly perceptive and beautifully written, In Shock allows the reader to transform alongside Awidsh and watch what she discovers in our carefully-cultivated, yet often misguided, standard of care. Awdish comes to understand the fatal flaws in her profession and in her own past actions as a physician while achieving, through unflinching presence, a crystalline vision of a new and better possibility for us all.As Dr. Awdish finds herself up against the same self-protective partitions she was trained to construct as a medical student and physician, she artfully illuminates the dysfunction of disconnection. Shatteringly personal, and yet wholly universal, she offers a brave road map for anyone navigating illness while presenting physicians with a new paradigm and rationale for embracing the emotional bond between doctor and patient.

On Living


Kerry Egan - 2016
    Instead, she discovered she’d been granted an invaluable chance to witness firsthand what she calls the “spiritual work of dying”—the work of finding or making meaning of one’s life, the experiences it’s contained and the people who have touched it, the betrayals, wounds, unfinished business, and unrealized dreams. Instead of talking, she mainly listened: to stories of hope and regret, shame and pride, mystery and revelation and secrets held too long. Most of all, though, she listened as her patients talked about love—love for their children and partners and friends; love they didn’t know how to offer; love they gave unconditionally; love they, sometimes belatedly, learned to grant themselves. This isn’t a book about dying—it’s a book about living. And Egan isn’t just passively bearing witness to these stories. An emergency procedure during the birth of her first child left her physically whole but emotionally and spiritually adrift. Her work as a hospice chaplain healed her, from a brokenness she came to see we all share. Each of her patients taught her something—how to find courage in the face of fear or the strength to make amends; how to be profoundly compassionate and fiercely empathetic; how to see the world in grays instead of black and white. In this poignant, moving, and beautiful book, she passes along all their precious and necessary gifts.

History of a Suicide: My Sister's Unfinished Life


Jill Bialosky - 2011
    It always gives me a good feeling to see other people happy. . . . It is so easy to achieve.” —Kim’s journal entry, May 3, 1988 On the night of April 15, 1990, Jill Bialosky’s twenty-one-year-old sister Kim came home from a bar in downtown Cleveland. She argued with her boyfriend on the phone. Then she took her mother’s car keys, went into the garage, closed the garage door. She climbed into the car, turned on the ignition, and fell asleep. Her body was found the next morning by the neighborhood boy her mother hired to cut the grass. Those are the simple facts, but the act of suicide is anything but simple. For twenty years, Bialosky has lived with the grief, guilt, questions, and confusion unleashed by Kim’s suicide. Now, in a remarkable work of literary nonfiction, she re-creates with unsparing honesty her sister’s inner life, the events and emotions that led her to take her life on this particular night. In doing so, she opens a window on the nature of suicide itself, our own reactions and responses to it—especially the impact a suicide has on those who remain behind. Combining Kim’s diaries with family history and memoir, drawing on the works of doctors and psychologists as well as writers from Melville and Dickinson to Sylvia Plath and Wallace Stevens, Bialosky gives us a stunning exploration of human fragility and strength. She juxtaposes the story of Kim’s death with the challenges of becoming a mother and her own exuberant experience of raising a son. This is a book that explores all aspects of our familial relationships—between mothers and sons, fathers and daughters—but particularly the tender and enduring bonds between sisters. History of a Suicide brings a crucial and all too rarely discussed subject out of the shadows, and in doing so gives readers the courage to face their own losses, no matter what those may be. This searing and compassionate work reminds us of the preciousness of life and of the ways in which those we love are inextricably bound to us.

No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America


Ron Powers - 2017
    Braided with that history is the moving story of Powers's beloved son Kevin--spirited, endearing, and gifted--who triumphed even while suffering from schizophrenia until finally he did not, and the story of his courageous surviving son Dean, who is also schizophrenic.A blend of history, biography, memoir, and current affairs ending with a consideration of where we might go from here, this is a thought-provoking look at a dreaded illness that has long been misunderstood.

Committed: Dispatches from a Psychiatrist in Training


Adam Stern - 2021
    His new and initially intimidating classmates were high achievers from the Ivy League and other elite universities around the nation. Stern pulls back the curtain on the intense and emotionally challenging lessons he and his fellow doctors learned while studying the human condition, and ultimately, the value of connection. The narrative focuses on these residents, their growth as doctors, and the life choices they make as they try to survive their grueling four-year residency. Most importantly, as they study how to help distressed patients in search of a better life, they discover the meaning of failure and the preciousness of success.

With the End in Mind: Dying, Death, and Wisdom in an Age of Denial


Kathryn Mannix - 2017
    Kathryn Mannix has studied and practiced palliative care for thirty years. In With the End in Mind , she shares beautifully crafted stories from a lifetime of caring for the dying, and makes a case for the therapeutic power of approaching death not with trepidation, but with openness, clarity, and understanding. Weaving the details of her own experiences as a caregiver through stories of her patients, their families, and their distinctive lives, Dr. Mannix discusses the universal, but deeply personal, process of dying. With meditations on life, death, and the space between them, With the End in Mind describes the possibility of meeting death gently, with forethought and preparation, and shows the unexpected beauty, dignity, and profound humanity of life coming to an end.