The incidence of chronic disease is strongly correlated with aging. According to the Information Theory of Aging, aging results from a progressive loss of genetic material due to gradually worsening cellular repair mechanisms. This cellular erosion leads to a nearly interminable list of diseases, including but certainly not limited to cancer, heart disease and neurodegenerative disease.
As a medical student deeply interested in education, books, and writing, I try to read widely, and am always looking for reading material at the intersection of these interests. Thus when a friend of mine described Robert Coles as a gifted writer, one who placed great emphasis on the value of stories to the practicing clinician, he seemed like the perfect fit. I had previously read some of his shorter pieces, but my friend suggested I read The Call of Stories: Teaching and the Moral Imagination.
The field of medical ethics is often ambiguous, esoteric and paradoxically arbitrary. Discussions about ethics during training revolve around case studies of patients without health care proxies and Beauchamp and Childress’s four accepted principles — and stop there.
For most first-and second-year medical students, residency is only in their imagination, and it is not truly until the third and fourth years that it becomes something they can imagine very well. It is the mystical land of having ‘made it’: getting through medical school, having the title MD or DO finally applied to you, and being thrown head first into the clinical world.
Last year, I was struck by the news that Dr. Oliver Sacks had died — I am not sure when I first heard about him and his writings, but I was familiar enough to feel a tinge of sadness at his passing. I’d read a short story or essay here and there, but I realized that I had not read any of his full-length books, and The Man Who Mistook His Wife for a Hat had been sitting on my bookshelf for quite some time. The timing to begin reading it, it turns out, could not have been better: I started it during the last week of my Medical Neuroscience course, and continued it through my next course, The Mind.
Doctored: The Disillusionment of an American Physician is Dr. Sandeep Jauhar’s second book. In keeping with good narrative nonfiction, Jauhar offers a mix of personal stories, thoughtful interludes and an obvious effort to back up claims with facts and statistics. He offers compelling anecdotes, which allow the reader to situate him or herself into the context of health care in New York City. These personal vignettes are especially helpful for highlighting concepts difficult to discuss; an ethical dilemma or complex criticism of the health care system becomes much easier to understand when tied to a tangible person or place.
To most students, physiology is a difficult and mind boggling subject. Thankfully, Dr. Tanaka and Dr. Koyama through Becom Co. Ltd. have poured their love and patience into an illustrated work of organ-based physiology, The Manga Guide to Physiology. Presented in the Japanese graphic novel style of manga, the manga follows nursing student protagonist Kumiko as she prepares for her make-up examination in physiology.
Like many bibliophiles, I keep a running list of books “To Read”, and I have a complicated system for deciding what I will read next; because of this, any new recommendation must go to the end of the queue. Every now and then, though, a book comes along that disrupts my whole system. In this case, I read an excerpt in The New Yorker that moved me: I was struck by the clarity of the writing and finished the excerpt wanting to know more. Over the next week, three different people recommended it and I began seeing it everywhere. Sensing that this book was something important, I bought and immediately began reading When Breath Becomes Air by Dr. Paul Kalanithi.
Few doctors in the modern era have established themselves so securely as both doctor and writer as to be easily recognized in both circles; this is perhaps because of the difficult and time-demanding nature of both careers. One notable exception is Dr. Atul Gawande, a renowned general surgeon in Boston, MA, who also happens to be a widely published and well-known author of several books. In his most recent book, “Being Mortal,” it is clear that he has grown, not only as a writer, but as a doctor and a human being as well – which, after all, is what this book is all about.
It is no great mystery that burnout is prevalent in the field of medicine, and it almost seems as if studies and articles highlighting this sad and disturbing truth are published daily. The reality is that doctors and doctors-in-training often struggle with their profession of choice, citing disillusionment, depression, long hours, exhaustion and lack of empathy as either symptoms or causes of feeling burnt out.
History and the greater emergence of medical presence in popular media have placed physicians on a pedestal where they command significant power and respect. As healers and scholars who are privy to the secrets of the human body, physicians are often expected to shoulder great responsibilities for their fellow human being while still maintaining their own mental well-being.