A Life in Medicine: A Literary Anthology [Hardcover]

Robert Coles (Author), Randy Testa (Author), Joseph D'Donnell (Author)

Book Description

ISBN-10: 1565847296 | ISBN-13: 978-1565847293 | Publication Date: June 1, 2002 | Edition: 1

A stirring collection of stories, poems, and essays on all aspects of the medical profession, from the Pulitzer Prize-winning author of the "Children of Crisis" series. A century of unprecedented scientific advances has left the medical profession facing profound ethical and procedural crises, as doctors, nurses, hospice workers, psychiatrists, and others involved in the healing arts struggle to keep up with the science while staying true to the humanitarian goals at the heart of their work. A Life in Medicine explores questions such as, "What is a 'small, good thing' in medicine?" "Can patients be instruments of grace?" and "How does one muster one's compassion for (so-called) 'difficult' patients?," bringing together provocative and moving writing on the moral and ethical lives of physicians, nurses, and psychiatrists, and injecting a dose of contemporary reality into a centuries-old discussion. The book is organized around the central themes of altruism, knowledge, skill, and duty, and contributors include well-known writers, doctors, nurses, practitioners, and patients, who address life and death, cancer and AIDS, seizures and psychosis, advocacy and anatomy, from both ends of the stethoscope.

With stories by: Raymond Carver • Anton Chekhov • Shusaku Endo • Anne Fadiman • Laurie Moore • William Carlos Williams

Poems by: • Hart Crane • Walt Whitman • Raymond Carver

And essays by: • Wendell Berry • Robert Coles • Robert Jay Lifton • Sara Lawrence Lightfoot • Audre Lorde • Lewis Thomas • Albert Schweitzer • Terry Tempest Williams

and others.

Editorial Reviews

From Library Journal

This compilation of essays, poems, short stories, memoirs, and a play excerpt, edited by child psychiatrist Coles (Harvard Medical Sch.; Spiritual Life of Children) and literature and ethics professor Testa (Harvard and Dartmouth), reflects on the human side of medicine. The book includes pieces by famous writers (Raymond Carver, Hart Crane, Anton Chekhov, Mikhail Bulgakov, William Carlos Williams, etc.) as well as by the lesser known, most of whom are surgeons, psychiatrists, nurses, and midwives. The book is divided into four sections, with each part focusing on a particular quality that a physician must have (altruism, knowledge, skill, and a sense of duty). All of the selections reflect a concern for the human aspects of medicine and espouse the rights of the patient over the rigidity of the medical establishment. This anthology will be most useful for colleges that have medical ethics courses; the general reader will likely be less interested in such readings, excellent though they are. Recommended primarily for university libraries that support medical curricula. Morris Hounion, New York City Technical Coll. Lib., Brooklyn
Copyright 2002 Cahners Business Information, Inc.

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.

See all Editorial Reviews

Product Details

• Hardcover: 329 pages
• Publisher: New Press, The; 1 edition (June 1, 2002)
• Language: English
• ISBN-10: 1565847296
• ISBN-13: 978-1565847293
• Product Dimensions: 9.1 x 6.1 x 1.4 inches
• Shipping Weight: 1.4 pounds
• Average Customer Review: 5.0 out of 5 stars  See all reviews (4 customer reviews)
• Amazon Best Sellers Rank: #242,604 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

21 of 23 people found the following review helpful:

5.0 out of 5 stars A literary look at the human side of medicine, December 3, 2002

By 

Matthew J. Lambert "Writer" (River Forest, IL USA) - See all my reviews
(REAL NAME)   

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This review is from: A Life in Medicine: A Literary Anthology (Hardcover)

Whenever I see a book with Robert Coles name on it I know it will be worthwhile to read. Coles served as one of several editors of A Life in Medicine: A Literary Anthology and the selections within are outstanding. They include poems, essays, short stories, and excerpts from longer works. The authors range from those working in the field (nurses, medical students, midwives, and physicians) to those not commonly associated with the field (e.g., Raymond Carver).

The book is thought provoking and emphasizes how we are all connected to the process of life and death. As a physician (with writing as an avocation) I thought it offered a wonderful look at the many facets of medical care and those that deliver it.

This book would be a wonderful gift for anyone in the profession but can be enjoyed by anyone with an interest in the human condition.

5 of 5 people found the following review helpful:

5.0 out of 5 stars A Candid Look at Medicine, April 4, 2006

By 

J. Marren "jtm497" (Glen Ridge, NJ USA) - See all my reviews
(VINE VOICE)    (REAL NAME)   

This review is from: A Life in Medicine: A Literary Anthology

My rather on-and-off-again interest in medical and health issues prompted me to pick this up when I saw it in the library. It's a wonderful collection of essays, poetry and stories by professionals and "laymen" alike, on the mysteries and challenges of medicine. I especially enjoyed the fiction selections, from the story of a woman who hypnotizes the doctor after a dehumanizing and personal exam, from the terror of the doctor who gets stuck with an AIDS patient's needle, to the perversion of all medical ideals in the euthanasia programs of WWII, I found the stories and essays fascinating and almost disturbingly real. You can pick and choose what you like--I'm not much for poetry, but lingered over "The Good Doctor," about the seamier side of the long-standing hierarchical structure in medicine. I highly recommend this anthology.

2 of 2 people found the following review helpful:

5.0 out of 5 stars Another Five-Star Vote, June 2, 2008

By 

Brad4d "bb" (United States) - See all my reviews
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This review is from: A Life in Medicine: A Literary Anthology (Hardcover)

-Just wanted to add another five-star vote for this excellent anthology.

-The NEJM review from 2002 does a fine job of summarizing the text so I won't add much here. My perspective is as a clinician for 25 years.

-I found the book was realistic, knowledgeable, and often solidly humorous, and often found myself thinking I had experienced something very similar to what the authors were reporting. THis is the kind of book that gives a "booster shot" to your determination to try to be a decent clinician -- similar to that given by people such as Rachel Remen, who remind you of the sacredness of your profession not because it is perfect, but because it is an attempt to do some good in a world where so much suffering exists.