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Check It Out

Courier Article by Lucy Clem
Sunday, August 26, 2007

Doctors Explore Science, Humanity of Medicine


Some people think they're gods, to be followed without question because of their superior intellect and education. Others think doctors' opinions are just that, rendered by ordinary mortals.

To bridge that gap, there's a growing body of excellent writing from doctors talking about what they do and how it's done.

They are articulate, sometimes lyrical, always frank about the way doctors' work changes both patient and those who care for them. The following books are as fascinating as they are informative, and offer a very personal look at a profession with huge demands and great rewards.

Better: A Surgeon's Notes on Performance, by Atul Gawande (Metropolitan, 2007).

Gawande, staff writer for The New Yorker and assistant professor at Harvard Medical School and the Harvard School of Public Health, has a gift for cutting to the heart of a story. Whether he's chronicling the fight to wipe out polio one Indian village at a time, a painful malpractice suit, or the intensity of treating a child with recurring cancer, he focuses on the mental and emotional challenges doctors face.

More than that, he brings out the humanity of the profession: Doctors feel the same pain, fear and sadness that affects their patients.

Gawande graphically demonstrates that a good doctor feels an obligation to learn from his mistakes. Unfortunately, those mistakes sometimes result in death, but that makes them all the easier to remember and to avoid.

Treatment Kind and Fair: Letters to a Young Doctor, by Perri Klass, M.D. (Basic Books, 2007).

Klass, an award-winning writer of fiction and nonfiction, has taken an interesting route with this work. It's a series of letters to her son upon his acceptance to medical school, in which she outlines the course of his education while gently offering advice.

She gives insights into the sleep-deprived life of a doctor-in-training, describes the frustration of not knowing enough - yet imparts the almost holy relationship of doctor to body.

Klass does a superb job of expressing the reverence for life and the awareness of its fragility that are a daily part of a good doctor's experience. She has a gift for seeing material in her daily work. Joining the tenderness of a mother's advice with the stark reality of life, sickness, and death, Klass lets you see inside a doctor's life in a unique and moving way.

How Doctors Think, by Jerome Groopman, M.D. (Houghton Mifflin, 2007).

If you're a fan of the TV series "House," you know that thinking out of the box can be a life-and-death matter in medicine. Groopman talks about the way doctors are taught to approach diagnosis and treatment, and why Dr. House is unusual in the profession.

Like all scientists, doctors learn to quantify results, to structure the approach to diagnosis and treatment, to make rules. Unfortunately, the human body doesn't always fit these rules. The author does an excellent job of explaining why doctors expect symptoms and disease to behave in a specific way, and how some gifted individuals can look beyond these expectations to solve a medical puzzle.

A fascinating look at medical detective work, this book also gives us insight into standard medical thought and offers ways we as patients can direct our medical treatment.

These books and others like them ought to comfort us with the realization that our doctors, while human, are doing the best they can to fix us. At the same time, they show substandard medical care for what it is, and teach us to expect better.

At the very least, we should learn from them to ask questions, to listen to the answers, and to understand that good doctors want the best for us, and from themselves.

Lucy Young Clem is the Tech Center Supervisor at Central Library, where she sandwiches reading book reviews between computer training sessions.