A Life in Medicine: A Literary Anthology - Hardcover

Hardcover

ISBN 10: 1565847296 ISBN 13: 9781565847293

Publisher: The New Press, 2002

Synopsis

Short fiction, poetry, and essays by such notable authors as Raymond Carver, Anton Chekhov, Walt Whitman, Hart Crane, Wendell Berry, Robert Coles, Audre Lorde, Lewis Thomas, and Albert Schweitzer explore diverse facets of the medical profession, covering such topics as the nature of compassion, medical ethics, patient advocacy, and life and death.

About this title

About the Author:

Robert Coles is a child psychiatrist, Pulitzer Prize-winning author, and Harvard University professor. For his lifelong work on behalf of children, Coles received the Medal of Freedom from President Clinton. He lives in Concord, Massachusetts. Randy Testa is on the professional development staff at the Ross School in East Hampton, New York. He is at work on a book about preschool teacher Vivian Gussin Paley. He lives on Shelter Island, New York.

From The New England Journal of Medicine:

In their introduction to this anthology of short literary works showing facets of life in medical care, Coles and Testa reflect fears that our medical schools are still not adequately preparing students to "understand and connect [with patients in] heart, mind, and soul." The editors and their three collaborators assembled the anthology with the hope that it might offer readers in the health care professions a fresh perspective on their responses to those they care for each day. The 53 selections are grouped according to four attributes: altruism, knowledge, skill, and duty. These attributes have been specified by the Medical School Objectives Project of the Association of American Medical Colleges as those needed by medical graduates when they enter the world of medicine. Some of the selections are essays; some are poems; and some are very short stories. Some of the authors are widely known -- Anton Chekhov, Walt Whitman, and William Carlos Williams, for example. Some are known mainly within medicine -- Eric J. Cassell, Lewis Thomas, John Stone, and Abraham Verghese. Some are probably known only to their immediate colleagues. The short introduction to each selection defines its place in literature and tells us something about its author. The title of the book, A Life in Medicine, suggests that it is a biography or autobiography. It would have been more informatively cast as Lives in and around Medicine. The voices from those lives differ widely in their identities. Yes, some are the voices of persons directly involved in medicine: a medical student, a nurse, a physician, a resident. Others are the voices of persons whose lives touch medicine in some way: a patient, the family of a patient, a social observer. All these voices are relevant to medicine and how it is practiced. Most of the selections reflect specific episodes: clinical errors, cultural clashes, or interior reflections on clinical encounters. Several of the essays -- notably those by Cassell and Thomas -- are detached analyses of practice in contemporary medicine, but they do serve to support Coles's and Testa's central thesis. Will the works collected here do what the editors hope they will? Will they show health care workers how to see, or see more clearly, the distress, the suffering, and the anguish of patients and their families, even of Ingelfinger's "worried well"? Would other choices have been better? The English-language literature relevant to the editors' aims is enormous. Every reader of this anthology is likely to think of alternatives that might be more effective. For a terse and powerful description of pain I can think of no more relevant work than Emily Dickinson's 1862 poem that opens, "Pain -- has an Element of Blank --." And there is Fanny Burney's wrenching account of undergoing breast surgery without anesthesia in an 1811 letter to her sister. But Coles's and Testa's choices do serve their aim. Some physicians, even if they left medical school poorly educated in seeing patients as persons, come to see the importance of this skill. They will certainly be one of the audiences for this anthology. The other audience members may be readers not working in health care fields but becoming involved in any of them as patients or members of patients' families. For them, the book might simply echo their views of what goes on in doctors' offices and hospitals. Its more valuable effect might be to empower them to ask for, and expect to receive, what seems missing but sorely needed in clinical engagements. A piece such as Anne Fadiman's account of a collision between a Laotian Hmong family and California clinicians is a good example of what may become an increasingly frequent problem in multiethnic America. The "outs" may see in this anthology support for their desire to get better care from the "ins." Such expectations of those who do not feel understood in our health care system can be unnerving to some clinicians who have left medical training with an all-too-common sense of omniscience about all matters medical. This is an aspect of medical education that should change. Patients and their families now search the Internet for clearer answers to their medical questions and what might be done about their concerns. They read accurate medical reporting in the New York Times, Newsweek, and other popular publications. Then they raise questions: "Doctor, what do you think about such-and-such for my condition?" I do not know whether Coles and Testa hoped that this anthology would empower those who have thought of raising such questions, but I think it might. Will this anthology and the many persons in and out of medicine who agree with its central thesis be able to influence our medical schools to prepare their graduates more effectively to see patients as persons? I doubt it. Many schools, perhaps most, are now medical universities: assemblies of research institutes and financially profitable units engrossed in producing technically skillful subspecialists, and not schools focused mainly on training students in the skills central to the practice of medicine, whatever their final choice of specialty. Prestige, reputation, and power hinge on eminence in research and on how many dollars can be squeezed out of the National Institutes of Health or from industrial collaborations, not on the skills of their graduates in patient-physician relations. Edward J. Huth, M.D.
Copyright © 2002 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

About this edition

• Publisher: The New Press
• Publication date: 2002
• ISBN 10: 1565847296
• ISBN 13: 9781565847293
• Binding: Hardcover
• Edition number: 1
• Number of pages: 329
• Editor: Coles Robert, Testa Randy-Michael, D'Donnell M.D. Joseph, Armstrong Penny, Anderson M. Brownell