I harbor a secret obsession with medical books for laypeople. I absolutely love the feeling of insider knowledge about what doctors do all day. And I especially love when all this is presented in clear, interesting, unlabored prose.
Final Exam, by Pauline Chen, explores how doctors are (not) trained to deal with the death of their patients. In it, Dr. Chen uses anecdotes from her own medical/surgical training and practice to highlight the gaping hole in medical education that is “How to Manage Patient Death.” It is thoughtful, honest, sad, and a lovely read. It is also a bubble-wrapped softball thrown at the center of that gaping hole. Somehow, after reading this book, I didn’t feel so bad about doctors who can’t acknowledge death. Maybe because the doctor who wrote the book had clearly learned so much.
Back out here in the real world, though, I’m stuck looking at medical professionals who daily fight to beat back any shadow of patient death. And I admire them for it — especially when our most recent losses are of patients who are so young. It’s such a strange balance, which The Professor brought into crystal clear focus in a 30-second exchange today:
“Is there a reason why you can’t massage my abdomen?”
“Well, in this medical setting, I need to take extreme care with what I do so that I don’t tax your body, but rather support it through your treatment. ‘Do no harm’ applies to me as well.”
“And yet the doctors who ‘Do no harm’ are the ones ordering noxious chemicals for me to take.”
The Professor, restarting his treatment after a particularly nasty go-round with side effects, had a point. But he wanted his doctors to do this calculated harm, for now. When he stops wanting it, though, how hard will it be for his doctors to accept? And how hard will they fight to convince him not to die?