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Book Review
Final Exam 
The highest praise I can give this book is to tell that my wife Marian, married to a doctor for 56 years, picked this book up and could not put it down. She found the details of education and the revulsion at certain aspects of surgery so honest, that I earnestly recommend this book to just about everyone interested in what doctors do. After all, Marian is long accustomed to my stories – and to those of many surgical and medical friends. If she can find something so intriguing in Pauline Chen’s account of her life in medicine and in transplant surgery, you will too! The book should be required reading for all medical students early in their career. Pauline Chen is a friend, and she was once a resident in the surgical program here at Yale, where for 15 years I made weekly bedside rounds on the surgical service with our late friend and my colleague Elton Cahow. In those old days, we would spar, ultimately to agree, about patients, rejoicing in the attention of residents like Pauline. What Marian found so lovely about this book is the sensitivity and empathy that Dr. Chen exhibits throughout. Indeed, my wife wondered whether she was too sensitive to endure the triumphs and tragedies of transplant surgery. And Marian is right, as usual. The author identifies with her patients, even the living bodies of those labeled “dead” and “donors” from whom she must extract organs which will save the lives of strangers. Her poignantly honest description of how she felt taking out the liver of a young woman of Asian descent is breathtaking: “For a moment I saw a reflection of my own life and I felt as if I were pulling apart my own flesh … I could not bear to think of herself – myself – as dead …” A few short sentences later, we read of the “stone- cold body” of the girl, once the “warm sponginess” of organs had been removed. How can anyone not a robot contemplate, whether with regret or gratitude, what had to be done? Her candid accounts give a valuable -- no, an essential -- description of what goes on in the mind of a young surgeon with imagination and sensitivity to all things human. She rejects the notion of equanimity so praised by Osler for physicians, and preserved by necessity for surgeons. She wrestles with the prescribed denial learned by first-year medical students, but her book brings new vistas to share the suffering that medical students and physicians must know. And so I wonder, can a soul so attuned to humanity endure a life in surgery? After all, Richard Selzer also glimpsed heaven and hell in his work as a surgeon and left off operating to teach his readers about life. Regardless of what she does -- and I hope she will continue in medical practice to find other lessons for those of us less sensitive -- Pauline Chen will easily prove Selzer’s heir. I hope that her writings will turn all the medical students who read them into the “true healers” that we physicians yearn to be. Published: March 22, 2007 |
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