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.

Intensive Care: The Story of a Nurse


Echo Heron - 1987
    Dedicated to healing and helping in the harshest environments, she spent ten years in emergency rooms and intensive care units. Her story is unique, penetrating, and unforgettable. Her story is real."Compelling reading."NEW YORK DAILY NEWS

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.

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 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.

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.

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

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.

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 Language of Kindness: A Nurse's Story


Christie Watson - 2018
    She takes us by her side down hospital corridors to visit the wards and meet her unforgettable patients.In the neonatal unit, premature babies fight for their lives, hovering at the very edge of survival, like tiny Emmanuel, wrapped up in a sandwich bag. On the cancer wards, the nurses administer chemotherapy and, long after the medicine stops working, something more important--which Watson learns to recognize when her own father is dying of cancer. In the pediatric intensive care unit, the nurses wash the hair of a little girl to remove the smell of smoke from the house fire. The emergency room is overcrowded as ever, with waves of alcohol and drug addicted patients as well as patients like Betty, a widow suffering chest pain, frail and alone. And the stories of the geriatric ward--Gladys and older patients like her--show the plight of the most vulnerable members of our society.

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.

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.

The Real Doctor Will See You Shortly: A Physician's First Year


Matt McCarthy - 2015
    But when a new admission to the critical care unit almost died his first night on call, he found himself scrambling. Visions of mastery quickly gave way to hopes of simply surviving hospital life, where confidence was hard to come by and no amount of med school training could dispel the terror of facing actual patients.This funny, candid memoir of McCarthy’s intern year at a New York hospital provides a scorchingly frank look at how doctors are made, taking readers into patients’ rooms and doctors’ conferences to witness a physician's journey from ineptitude to competence. McCarthy's one stroke of luck paired him with a brilliant second-year adviser he called “Baio” (owing to his resemblance to the Charles in Charge star), who proved to be a remarkable teacher with a wicked sense of humor. McCarthy would learn even more from the people he cared for, including a man named Benny, who was living in the hospital for months at a time awaiting a heart transplant. But no teacher could help McCarthy when an accident put his own health at risk, and showed him all too painfully the thin line between doctor and patient.The Real Doctor Will See You Shortly offers a window on to hospital life that dispenses with sanctimony and self-seriousness while emphasizing the black-comic paradox of becoming a doctor: How do you learn to save lives in a job where there is no practice?

Your Life in My Hands: A Junior Doctor's Story


Rachel Clarke - 2017
    It is 4 a.m. I have run arrest calls, treated life-threatening bleeding, held the hand of a young woman dying of cancer, scuttled down miles of dim corridors wanting to sob with sheer exhaustion, forgotten to eat, forgotten to drink, drawn on every fibre of strength that I possess to keep my patients safe from harm.'How does it feel to be spat out of medical school into a world of pain, loss and trauma that you feel wholly ill-equipped to handle? To be a medical novice who makes decisions which - if you get them wrong - might forever alter, or end, a person's life?In 'Your Life in My Hands', television journalist turned junior doctor Rachel Clarke captures the extraordinary realities of life on the NHS frontline. During last year's historic junior doctor strikes, Rachel was at the forefront of the campaign against the government's imposed contract upon young doctors. Her heartfelt, deeply personal account of life as a junior doctor in today's NHS is both a powerful polemic on the degradation of Britain's most vital public institution and a love letter of optimism and hope to that same health service.

When Death Becomes Life: Notes from a Transplant Surgeon


Joshua D. Mezrich - 2019
    Joshua Mezrich creates life from loss, transplanting organs from one body to another. In this intimate, profoundly moving work, he illuminates the extraordinary field of transplantation that enables this kind of miracle to happen every day.When Death Becomes Life is a thrilling look at how science advances on a grand scale to improve human lives. Mezrich examines more than one hundred years of remarkable medical breakthroughs, connecting this fascinating history with the inspiring and heartbreaking stories of his transplant patients. Combining gentle sensitivity with scientific clarity, Mezrich reflects on his calling as a doctor and introduces the modern pioneers who made transplantation a reality—maverick surgeons whose feats of imagination, bold vision, and daring risk taking generated techniques and practices that save millions of lives around the world.Mezrich takes us inside the operating room and unlocks the wondrous process of transplant surgery, a delicate, intense ballet requiring precise timing, breathtaking skill, and at times, creative improvisation. In illuminating this work, Mezrich touches the essence of existence and what it means to be alive. Most physicians fight death, but in transplantation, doctors take from death. Mezrich shares his gratitude and awe for the privilege of being part of this transformative exchange as the dead give their last breath of life to the living. After all, the donors are his patients, too.When Death Becomes Life also engages in fascinating ethical and philosophical debates: How much risk should a healthy person be allowed to take to save someone she loves? Should a patient suffering from alcoholism receive a healthy liver? What defines death, and what role did organ transplantation play in that definition? The human story behind the most exceptional medicine of our time, Mezrich’s riveting book is a beautiful, poignant reminder that a life lost can also offer the hope of a new beginning.