On Call: A Doctor's Days and Nights in Residency


Emily R. Transue - 2004
    Having studied at Yale and Dartmouth, Dr. Emily Transue arrives in Seattle to start her internship in Internal Medicine just after graduating from medical school. This series of loosely interconnected scenes from the author's medical training concludes her residency three years later.During her first week as a student on the medical wards, Dr. Transue watched someone come into the emergency room in cardiac arrest and die. Nothing like this had ever happened to her before-it was a long way from books and labs. So she began to record her experiences as she gained confidence putting her book knowledge to work.The stories focus on the patients Dr. Transue encountered in the hospital, ER and clinic; some are funny and others tragic. They range in scope from brief interactions in the clinic to prolonged relationships during hospitalization. There is a man newly diagnosed with lung cancer who is lyrical about his life on a sunny island far away, and a woman, just released from a breathing machine after nearly dying, who sits up and demands a cup of coffee.Though the book has a great deal of medical content, the focus is more on the stories of the patients' lives and illnesses and the relationships that developed between the patients and the author, and the way both parties grew in the course of these experiences.Along the way, the book describes the life of a resident physician and reflects on the way the medical system treats both its patients and doctors. On Call provides a window into the experience of patients at critical junctures in life and into the author's own experience as a new member of the medical profession.

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.

Intern


Sandeep Jauhar - 2007
    Residency--and especially the first year, called internship--is legendary for its brutality. Working eighty hours or more per week, most new doctors spend their first year asking themselves why they wanted to be doctors in the first place.Jauhar's internship was even more harrowing than most: he switched from physics to medicine in order to follow a more humane calling--only to find that medicine put patients' concerns last. He struggled to find a place among squadrons of cocky residents and doctors. He challenged the practices of the internship in The New York Times, attracting the suspicions of the medical bureaucracy. Then, suddenly stricken, he became a patient himself--and came to see that today's high-tech, high-pressure medicine can be a humane science after all.Now a thriving cardiologist, Jauhar has all the qualities you'd want in your own doctor: expertise, insight, a feel for the human factor, a sense of humor, and a keen awareness of the worries that we all have in common. His beautifully written memoir explains the inner workings of modern medicine with rare candor and insight. "In Jauhar's wise memoir of his two-year ordeal of doubt and sleep deprivation at a New York hospital, he takes readers to the heart of every young physician's hardest test: to become a doctor yet remain a human being." ― Time

Hot Lights, Cold Steel: Life, Death and Sleepless Nights in a Surgeon's First Years


Michael J. Collins - 2005
    A natural overachiever, Collins' success, in college and medical school led to a surgical residency at one of the most respected medical centers in the world, the famed Mayo Clinic. But compared to his fellow residents Collins feels inadequate and unprepared. All too soon, the euphoria of beginning his career as an orthopedic resident gives way to the feeling he is a counterfeit, an imposter who has infiltrated a society of brilliant surgeons.This story of Collins' four-year surgical residency traces his rise from an eager but clueless first-year resident to accomplished Chief Resident in his final year. With unparalleled humor, he recounts the disparity between people's perceptions of a doctor's glamorous life and the real thing: a succession of run down cars that are towed to the junk yard, long weekends moonlighting at rural hospitals, a family that grows larger every year, and a laughable income.Collins' good nature helps him over some of the rough spots but cannot spare him the harsh reality of a doctor's life. Every day he is confronted with decisions that will change people's lives-or end them-forever. A young boy's leg is mangled by a tractor: risk the boy's life to save his leg, or amputate immediately? A woman diagnosed with bone cancer injures her hip: go through a painful hip operation even though she has only months to live? Like a jolt to the system, he is faced with the reality of suffering and death as he struggles to reconcile his idealism and aspiration to heal with the recognition of his own limitations and imperfections.Unflinching and deeply engaging, Hot Lights, Cold Steel is a humane and passionate reminder that doctors are people too. This is a gripping memoir, at times devastating, others triumphant, but always compulsively readable.

Complications: A Surgeon's Notes on an Imperfect Science


Atul Gawande - 2002
    Complications lays bare a science not in its idealized form but as it actually is--uncertain, perplexing, and profoundly human.Complications is a 2002 National Book Award Finalist for Nonfiction.

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.

Internal Medicine: A Doctor's Stories


Terrence Holt - 2014
    Personal, poignant, and meticulously precise, these stories evoke Chekhov, Maugham, and William Carlos Williams, admitting readers to the beating heart of medicine. Internal Medicine is an account of what it means to be a doctor, to be mortal, and to be human.

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.

Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis


Lisa Sanders - 2009
    Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D.The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it–on some level–restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer.A healthy young man suddenly loses his memory–making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment–only to have their symptoms mysteriously return. A young woman lies dying in the ICU–bleeding, jaundiced, incoherent–and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis.Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness–the diagnosis–revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.

Body of Work: Meditations on Mortality from the Human Anatomy Lab


Christine Montross - 2007
    Entering a room with stainless-steel tables topped by corpses in body bags is shocking no matter how long you've prepared yourself, but a strange thing happened when Montross met her cadaver. Instead of being disgusted by her, she was utterly intrigued-intrigued by the person the woman once was, humbled by the sacrifice she had made in donating her body to science, fascinated by the strange, unsettling beauty of the human form. They called her Eve. This is the story of Montross and Eve-the student and the subject-and the surprising relationship that grew between them. Body of Work is a mesmerizing, rarely seen glimpse into the day-to-day life of a medical student-yet one that follows naturally in the footsteps of recent highly successful literary renderings of the mysteries of medicine such as Atul Gawande's Complications: A Surgeon's Notes on an Imperfect Science. Christine Montross was a poet long before she became a doctor and brings an uncommon perspective to the emotional difficulty of the first year of medical school-the dispiriting task of remaining clinical and detached while in the anatomy lab and the struggle with the line you've crossed by violating another's body once you leave it. Montross was so affected by her experience with Eve that she undertook to learn more about the history of cadavers and the study of anatomy. She visited an autopsy lab in Ireland and the University of Padua in Italy where Vesalius, a forefather of anatomy, once studied; she learned about body snatchers and grave-robbers and anatomists who practiced their work on live criminals. Her disturbing, often entertaining anecdotes enrich this exquisitely crafted memoir, endowing an eerie beauty to the world of a doctor-in-training. Body of Work is an unforgettable examination of the mysteries of the human body and a remarkable look at our relationship with both the living and the dead.

The Intern Blues: The Timeless Classic About the Making of a Doctor


Robert Marion - 1989
    Robert Marion asked three of them to keep a careful diary over the course of a year. Andy, Mark, and Amy vividly describe their real-life lessons in treating very sick children; confronting child abuse and the awful human impact of the AIDS epidemic; skirting the indifference of the hospital bureaucracy; and overcoming their own fears, insecurities, and constant fatigue. Their stories are harrowing and often funny; their personal triumph is unforgettable.This updated edition of The Intern Blues includes a new preface from the author discussing the status of medical training in America today and a new afterword updating the reader on the lives of the three young interns who first shared their stories with readers more than a decade ago.

Another Day in the Frontal Lobe: A Brain Surgeon Exposes Life on the Inside


Katrina Firlik - 2006
    She is also a superbly gifted writer–witty, insightful, at once deeply humane and refreshingly wry. In Another Day in the Frontal Lobe, Dr. Firlik draws on this rare combination to create a neurosurgeon’s Kitchen Confidential–a unique insider’s memoir of a fascinating profession.Neurosurgeons are renowned for their big egos and aggressive self-confidence, and Dr. Firlik confirms that timidity is indeed rare in the field. “They’re the kids who never lost at musical chairs,” she writes. A brain surgeon is not only a highly trained scientist and clinician but also a mechanic who of necessity develops an intimate, hands-on familiarity with the gray matter inside our skulls. It’s the balance between cutting-edge medical technology and manual dexterity, between instinct and expertise, that Firlik finds so appealing–and so difficult to master. Firlik recounts how her background as a surgeon’s daughter with a strong stomach and a keen interest in the brain led her to this rarefied specialty, and she describes her challenging, atypical trek from medical student to fully qualified surgeon. Among Firlik’s more memorable cases: a young roofer who walked into the hospital with a three-inch-long barbed nail driven into his forehead, the result of an accident with his partner’s nail gun, and a sweet little seven-year-old boy whose untreated earache had become a raging, potentially fatal infection of the brain lining. From OR theatrics to thorny ethical questions, from the surprisingly primitive tools in a neurosurgeon’s kit to glimpses of future techniques like the “brain lift,” Firlik cracks open medicine’s most prestigious and secretive specialty. Candid, smart, clear-eyed, and unfailingly engaging, Another Day in the Frontal Lobe is a mesmerizing behind-the-scenes glimpse into a world of incredible competition and incalculable rewards.From the Hardcover edition.

How Doctors Think


Jerome Groopman - 2007
    In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong -- with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can -- with our help -- avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track.Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems.How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.

Confessions of a Surgeon: The Good, the Bad, and the Complicated...Life Behind the O.R. Doors


Paul A. Ruggieri - 2012
    Paul A. Ruggieri has seen the good, the bad, and the ugly of his profession. In Confessions of a Surgeon, he pushes open the doors of the O.R. and reveals the inscrutable place where lives are improved, saved, and sometimes lost. He shares the successes, failures, remarkable advances, and camaraderie that make it exciting. He uncovers the truth about the abusive, exhaustive training and the arduous devotion of his old-school education. He explores the twenty-four-hour challenges that come from patients and their loved ones; the ethics of saving the lives of repugnant criminals; the hot-button issues of healthcare, lawsuits, and reimbursements; and the true cost of running a private practice. And he explains the influence of the white coat code of silence and why patients may never know what really transpires during surgery. Ultimately, Dr. Ruggieri lays bare an occupation that to most is as mysterious and unfamiliar as it is misunderstood. His account is passionate, illuminating, and often shocking-an eye-opening, never- before-seen look at real life, and death, in the O.R.

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.