A Not Entirely Benign Procedure

During her four years at Harvard Medical School, Perri Klass wrote articles for The New York Times and also managed to have a baby. Her unusual experiences, combined with an insightful, witty prose style, create a fresh and compelling account of the making of a doctor.

In a literary tapestry of the beauties and terrors of family life, Klass--a five-time O. Henry Award winner--explores the lives of parents, doctors, patients, friends, and lovers who encounter one another in sickness and in health, for better or for worse.

A group of vivid, first-person stories of medical students who don't "fit the mold" and have had challenges completing conventional medical training.

When Dr. Meghan Weir first dons her scrubs and steps onto the floor of Children’s Hospital Boston as a newly minted resident, her head is packed with medical-school-textbook learning. She knows the ins and outs of the human body, has memorized the correct way to perform hundreds of complicated procedures, and can recite the symptoms of any number of diseases by rote. But none of that has truly prepared her for what she is about to experience. From the premature infants Dr. Weir is expected to care for on her very first day of residency to the frustrating teenagers who visit the ER at three in the morning for head colds, each day brings with it new challenges and new lessons. Dr. Weir learns that messiness, fear, and uncertainty live beneath the professional exterior of the doctor’s white coat. Yet, in addition to the hardships, the practice of medicine comes with enormous rewards of joy, camaraderie, and the triumph of healing. The three years of residency—when young doctors who have just graduated from medical school take on their own patients for the first time—are grueling in any specialty. But there is a unique challenge to dealing with patients too young to describe where it hurts, and it is not just having to handle their parents. In Between Expectations: Lessons from a Pediatric Residency, Dr. Weir takes readers into the nurseries, ICUs, and inpatient rooms of one of the country’s busiest hospitals for children, revealing a world many of us never get to see. With candor and humility, she explores the many humbling lessons that all residents must learn: that restraint is sometimes the right treatment option, no matter how much you want to act; that some patients, even young teenagers, aren’t interested in listening to the good advice that will make their lives easier; that parents ultimately know their own children far better than their doctors ever will. Dr. Weir’s thoughtful prose reveals how exhaustion and doubt define the residency experience just as much as confidence and action do. Yet the most important lesson that she learns through the months and years of residency is that having a good day on the floor does not always mean that a patient goes home miraculously healed—more often than not, success is about a steady, gradual discovery of strength. By observing the children, the parents, and other hospital staff who painstakingly provide care each day, Dr. Weir finds herself finally developing into the physician (and the parent) she hopes to become. These stories—sometimes funny, sometimes haunting—expose the humanity that is so often obscured by the doctor’s white coat.

Medical mistakes are more pervasive than we think. How can we improve outcomes? An acclaimed MD’s rich stories and research explore patient safety. Patients enter the medical system with faith that they will receive the best care possible, so when things go wrong, it’s a profound and painful breach. Medical science has made enormous strides in decreasing mortality and suffering, but there’s no doubt that treatment can also cause harm, a significant portion of which is preventable. In When We Do Harm, practicing physician and acclaimed author Danielle Ofri places the issues of medical error and patient safety front and center in our national healthcare conversation. Drawing on current research, professional experience, and extensive interviews with nurses, physicians, administrators, researchers, patients, and families, Dr. Ofri explores the diagnostic, systemic, and cognitive causes of medical error. She advocates for strategic use of concrete safety interventions such as checklists and improvements to the electronic medical record, but focuses on the full-scale cultural and cognitive shifts required to make a meaningful dent in medical error. Woven throughout the book are the powerfully human stories that Dr. Ofri is renowned for. The errors she dissects range from the hardly noticeable missteps to the harrowing medical cataclysms. While our healthcare system is—and always will be—imperfect, Dr. Ofri argues that it is possible to minimize preventable harms, and that this should be the galvanizing issue of current medical discourse.

Although there are many books on the mechanics of doctor-patient interaction, none has previously confronted the philosophical and psychological issues of power and trust that bind these figures. One consequence of their changed relationship, Furst asserts, has been the decrease of interest in patients as individuals. In this time of impersonal HMOs and spiraling health-care costs, she hopes that doctors and patients can learn from the past and eventually find a mutually beneficial balance of power that will see medicine as both a science and an art and will recognize human understanding as an integral element of healing.

Debra Jarvis works as a chaplain supporting patients at Seattle’s Cancer Care Alliance (the clinic founded by the world-famous Fred Hutchinson Cancer Research Institute). In that capacity she meets daily with patients in at many points along the path of living with cancer, from diagnosis to treatment to recovery and facing death. So in one of those ironic twists of fate, Jarvis was diagnosed with breast cancer herself. It’s Not About the Hair is the account of her time with cancer. As she says, the first thing people ask when they learn you have cancer is whether you are going to lose your hair. But what they really mean to ask is whether you are going to lose your life. Debra Jarvis is able to write honestly and humorously about her experience with cancer because she has had the unique experience of having witnessed and having guided so many cases of cancer. And she brings all of that perspective and context and wisdom to the story of her own breast cancer. As an ordained minister she considers her voice to be a combination of Mr. Miyagi from The Karate Kid" and Martha Stewart (pre-felon, that is), a persona she labels Mr. Martha Miyagi. It’s mystical and practical. Debra Jarvis manages to channel a humor that is reminiscent of Nora Ephron. This is a cancer story that won’t give you the creeps, but it will guide you to think deeply about the serious stuff like ingrained views on health and disease, life and death, the time we have and how we want to live it.