Book Review
Book Learning
The poems and essays in this third volume of On Being a Doctor capture the spirit of medicine.
Reviewed by Charles R. Meyer, M.D.
In 35 years, my medical reading has undergone a meandering evolution. In medical school, aside from textbooks, I explored an eclectic array of journals, from Science to JAMA. During my training, I sifted the collection some, but when I entered practice, I still subscribed to 10 journals. As the realities of practicing hit, my textbooks gathered dust, and I gradually dropped journals, whittling my regular reading down to a core of five publications and paring down what I read in each one. My compulsive cover-to-cover approach soon ceded to educated selectivity, flying by the case studies of rare genetic diseases to land on clinically relevant scientific articles and reviews. In recent years, although I still read significant clinical articles, I have found myself turning first to the essays and poems that appear in JAMA and the Annals of Internal Medicine. Maybe my aging mind has lost a bit of its scientific rigor or maybe I’ve adopted the reader’s version of “Life is short, so eat dessert first,” but in these pieces, I find a refreshing, different sort of truth than results on the latest medicated stent.
In On Being a Doctor 3, editors Christine Laine, M.D., M.P.H., and Michael LaCombe, M.D., have put together 363 pages of dessert, compiling works that first appeared in the Annals of Internal Medicine. In bite-sized one-page poems or three-page essays, the soul and the spirit of the practice of medicine unfolds, offering revelations that physicians will find enlightening and enlivening.
Many of the pieces highlight that universal of medical training and practice, insecurity. In “A Little Confidence,” first-year student Alain Le struggles with his lack of confidence and meager medical knowledge as he interviews his first patient and nearly turns apoplectic when the patient says “One more question” as Le is leaving the room, only to be asked merely to turn on the television. Jordan Grumet’s poem “Fake” scathingly describes a fraudulent doctor only to reveal in the last stanza that the author is looking in the mirror.
We see doctors enmeshed in the social and political world in “To Be a Doctor in Jerusalem,” written by Yishai Offran, a Jewish physician, and Shaden Salameh Giryes, an Arab doctor, working in a hospital that serves both Arabs and Jews, or in Ronald Carson’s “Emergency,” which poignantly depicts the different ER experiences of haves and have-nots. In the essay “Sabir, Patient 4914,” military internist Jason Stamm reflects on the consumption of resources in the Iraqi war and the bleak outlook for patients in the Iraqi medical system and concludes: “I have learned that in this war zone medicine for our Iraqi patients is most safely practiced as a myope, well-intentioned but short-sighted, a person who concentrates on the surgery and the medication but remains blind to the context of his efforts.”
And we see doctors as patients, having their own encounters with the medical system—the homosexual male physician agonizing as he waits for the result of his annual HIV test or the female physician enduring an HIV needle stick protocol and wrestling with the potential impact on her children and her family if she is HIV positive.
As a faithful reader of the Annals, I was surprised that I didn’t remember many of these essays and poems. But one that stuck with me was “Blue Light and Milk” by David Morowitz. Now 60 years old, Morowitz recollects a night after call 30 years before when he sat at 3 a.m. with his 5-month-old son, restless, crying, and wet: “We sat there, loving parent and attentive, wordless child, young father and younger son, mutually enchanted, I hypnotized by the vision of his bright new eyes searching my face, pulling who knows how many signals about me into that acquisitive, unfettered intelligence.” He then outlines his current, close relationship with that son, now 30: “But feeling the warmth of his voice or his broad, reassuring man’s hand on my shoulder, I travel by reflex back half my lifetime and nearly all of his, when the links of love and comfort were forged in the resolute watchfulness of a father by his infant son, a nocturne of blue light and milk, the mysterious beginnings of love.” That sentence alone is enough to keep me coming back to this book. MM
Charles Meyer is editor in chief of Minnesota Medicine.