The Very Human Heart Behind the Bedside Manner
Most of the 100 essays in this volume give doctors the chance to express their humanity. In short and very personal pieces, they air feelings they usually stifle, such as frustration in seeing a child in pain, grief in losing a patient, guilt at not being able to do more, powerlessness in facing their own mortality. The remaining essays are reflections from other health-care workers--and a few patients.
For two decades, the popular feature “A Piece of My Mind” has appeared in each issue of the weekly Journal of the American Medical Assn., bringing readers inside the minds of those working to battle diseases, save lives, maybe make death a little gentler when it comes. In this collection, the second taken from more than 800 pieces published over the years, Young has brought together some of the best, illustrating funny, unexpected and poignant encounters between doctors and patients. She’s organized it into five sections: doctors’ education, patients’ families, violence, patients who have shaped doctors’ lives, and, finally, reflections from patients, their families and friends.
In reading the essays, however, you wish Young had included some biographical information on the writers, identified only by name and professional degree. You’re left to wonder, for example, if the third-year medical student who recounted his first day left the profession, as suggested by the lack of an M.D. after his name.
These writers--whoever they are--share many intimate moments.
The passage from arrogance to maturity is beautifully told in “Watchers,” a piece by Dr. L. Stewart Massad. As a hotshot young intern, he was about to walk away from a delivery when an ob-gyn nurse said to him repeatedly: “Stay and watch.” Over time, the nurse became his best teacher: “She taught me to be a physician, taught me to see, to feel, to listen, to touch, to speak, to understand.” And years later, when she came to him with cervical cancer that both knew would kill her, he gave something back in her dying moments: “I stayed. I watched.”
Dr. Daniel J. Waters shows that sometimes doctors can step back and appreciate the organs they deal with as more than that, as wondrous machines. He writes about what it means to hold a human heart in his hands. “To hold the heart of another human being is among the rarest of privileges. Those so favored should never lose sight of the inherent mystery and wonder of the experience.”
In “My Heroes,” Dr. Nina K. Regevik describes a mother dying of AIDS and the attentive and loving 10-year-old son who demonstrates preternatural maturity. She tells how the child ran up to her at the funeral and said: “Thank you, Dr. Nina, for taking care of my mommy.” That moment clarifies for the doctor why she continues doing what she does.
Sometimes a doctor describes the need to put up a shell and withdraw emotionally from a patient. In “Jailhouse Blues,” a patient with AIDS asks the prison doctor what he thinks about the diagnosis. Knowing the reality of AIDS in prison, Dr. Joseph E. Paris can feel how he’s putting distance between himself and this man: “My voice sounds hollow, but I can’t afford to get involved. There is too much to be done, for him and for the others.” It’s an admission at once stirring and distressing.
In many cases, doctors admit that they often suppress words--or actions--for the sake of their own salvation or some sense of propriety. In “Cristina,” Dr. Peggy Hansen watches helplessly as even advanced medicine has no more to offer a 40-year-old woman succumbing to advanced cervical cancer. Hansen admits that she wants to grab women in the street and tell them to get their Pap smears, or shake their husbands or boyfriends into some sort of recognition. But she never does, she admits, because “such passion scares us. There is something frightening about zealotry.”
At a time when doctors are too often perceived as mere cogs in a wheel, giving a patient too little time in an over-scheduled day, this book helps restore faith and dignity to the healers by showing their internal struggles, how they wrestle with overwhelming need and how, somehow, they manage to keep going. It may remind others why they went into the profession in the first place.
