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Singular Intimacies: Becoming a Doctor at Bellevue [Hardcover]

Danielle Ofri (Author)
4.7 out of 5 stars  See all reviews (60 customer reviews)


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Book Description

0807072524 978-0807072523 April 15, 2003 1
In the tradition of Abraham Verghese and Atul Gawande, a gripping memoir of learning medicine in the trenches

Singular Intimacies is the story of becoming a doctor by immersion at Bellevue Hospital, the oldest public hospital in the country—and perhaps the most legendary. It is both the classic inner-city hospital and a unique amalgam of history, insanity, beauty, and intellect. When Danielle Ofri enters these 250-year-old doors as a tentative medical student, she is immediately plunged into the teeming world of urban medicine: mysterious illnesses, life-and-death decisions, patients speaking any one of a dozen languages, overworked interns devising creative strategies to cope with the feverish intensity of a big-city hospital.

Yet the emphasis of Singular Intimacies is not so much on the arduous hours in medical training (which certainly exist here), but on the evolution of an instinct for healing. In a hospital without the luxury of private physicians, where patients lack resources both financial and societal, where poverty and social strife are as much a part of the pathology as any microbe, it is the medical students and interns who are thrust into the searing intimacy that is the doctor-patient relationship. In each memorable chapter, Ofri’s progress toward becoming an experienced healer introduces not just a patient in medical crisis, but a human being with an intricate and compelling history. Ofri learns to navigate the tangled vulnerabilities of doctor and patient, not simply battle the disease.

Dr. Danielle Ofri is an attending physician in the medical clinic at Bellevue, with an academic appointment at NYU. She is the co-founder and editor-in-chief of the Bellevue Literary Review, and her essays have been published in over a dozen literary and medical journals; one chapter of this book was selected by Stephen Jay Gould for The Best American Essays of 2002 and received the Missouri Review Editor’s Prize for Nonfiction. She is also associate chief editor of the award-winning textbook The Bellevue Guide to Outpatient Medicine.


Editorial Reviews

From Publishers Weekly

These essays, some previously published, about the author's 10 years as a medical student, intern and resident at the oldest public hospital in the U.S. resonate with insight, intelligence, humor and an extraordinary sensitivity to both the patients she treated in this inner-city facility and the staff she worked with. The cofounder and editor-in-chief of a literary magazine, the Bellevue Review, Ofri is now an attending physician at Bellevue and brings to this memoir a combination of medical information and some very expressive writing. The author acknowledges that when she arrived to work on the wards, she had no idea what her responsibilities were or how to perform typical student tasks like drawing blood. Along with the technical skills she absorbed working overtime in a stressful atmosphere, Ofri also learned to truly care for her cases. In "Finding the Person," she describes, for example, why she continued to speak to and maintain a bedside manner with a comatose woman in front of the dying woman's family. "Intensive Care" recounts the story of Dr. Sitkin, a difficult supervisor who both alienated and won the respect of his medical team, and eventually took his own life. The tragic loss of her close friend Josh, a 27-year-old, who died from a congenital heart condition ("The Burden of Knowledge"), caused her to doubt the foundation of medical training, that knowledge is power. The pieces in this powerful collection are tied together by the struggle of a clearly gifted physician to master the complexities of healing.
Copyright 2003 Reed Business Information, Inc.

From The New England Journal of Medicine

Bellevue Hospital, probably the oldest hospital in America, began to serve George II's New York subjects in 1736 as a Public Workhouse and House of Correction with six beds for the sick. Included in the cost of construction were 50 gallons of rum. Forced by an epidemic of yellow fever to escape the filth of central Manhattan in 1794, the almshouse-prison-hospital complex found a haven at Belle Vue, an estate overlooking the East River. Bellevue became a teaching hospital, first by shedding its poorhouse and penitentiary and then, in 1847, by opening its doors to medical students. The horse-drawn wagons of the world's first hospital-based ambulance service began to clatter out of Bellevue in 1869, and four years later the hospital opened America's first nursing school. Over the ensuing years, Bellevue evolved into a behemoth built of bricks the color of dried blood, one side facing the East River, the other looming over First Avenue and 27th Street (Figure). In the 1950s, New York University medical students, of which I was one, thought it was the greatest hospital in the world's greatest city. The Old Bellevue is now a worn-out hulk occupied mainly by administrators. Its clinical services were transferred to the New Bellevue in 1973, and a part of the former poorhouse is undergoing conversion into a center for biomedical research. Now, 30 years after the Old Bellevue closed its doors to the sick, Danielle Ofri recounts in Singular Intimacies how it was to be a medical student and resident at the New Bellevue and how it is to serve the grande dame of New York medicine as an attending physician. Ofri is a gifted writer. Her vignettes ring with truth, and for any physician or patient who knows the dramas of a big-city hospital they will evoke tears, laughter, and memories. Indeed, any reader, physician or not, will find in Singular Intimacies the essence of becoming and being a doctor. Ofri's prologue tells the story of a 62-year-old French woman with lung cancer who, gasping for breath, gives the intensive care unit (ICU) team her final orders through an oxygen mask. "Air France," she says. "No other airline. My body must fly to Paris via Air France. . . . No ceremony before the interment . . . just a burial at Rue de la Colonnade." Ofri writes, "We file out of the room . . . our hands dangling awkward and useless, our tears threatening to give way." Ofri's epilogue reveals that after a week in the ICU, her French patient's pulmonary infiltrates and hypoxia gave way to antibiotics. "There was no sweeter music than that silvery Parisian accent floating into my ears. . . . The arc of her words shimmered in the air and her history settled softly into mine." Little wonder that Danielle Ofri is editor-in-chief of the Bellevue Literary Revue. Then there is "The Professor of Denial," a psychiatrist who is clearly in the terminal stages of an intraabdominal cancer but does not have a tissue diagnosis. The psychiatrist insists to the end that he has viral hepatitis. Despite obvious signs of his patient's impending death, Dr. Gursky, the attending physician, demands one invasive diagnostic procedure after another, including a laparotomy, to get the answer. All to no avail. Ofri's anguish at having to carry out Gursky's orders is the only point of clarity in this story. One wonders who was in denial -- the patient or Dr. Gursky. Ofri writes about Mrs. Whitney from South Carolina, whose brain lost its cortical function after she collapsed from cardiac arrest while visiting her daughter in New York. All the frustrations of caring for a patient in a vegetative state in the cardiac care unit of Bellevue Hospital and dealing with her family are examined. "It's just a coincidence that her eyes sometimes move toward you when you speak. But her cortex can't process anything they're seeing. I . . . I'm sorry." The arresting aspect of the story is Ofri's respect for the unseeing, unfeeling Mrs. Whitney and her hope that the staff that will continue Mrs. Whitney's care will "find the person within the patient." In these and 13 other stories, Ofri distills the terrors, frustrations, and joys of her life as a student and physician at Bellevue. Above all, Ofri has the precious gift of humility. It is this quality that graces her prose, transforming it from mere storytelling into memorable parables. Robert S. Schwartz, M.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Product Details

  • Hardcover: 240 pages
  • Publisher: Beacon Press; 1 edition (April 15, 2003)
  • Language: English
  • ISBN-10: 0807072524
  • ISBN-13: 978-0807072523
  • Product Dimensions: 8.8 x 5.8 x 1 inches
  • Shipping Weight: 15.7 ounces
  • Average Customer Review: 4.7 out of 5 stars  See all reviews (60 customer reviews)
  • Amazon Best Sellers Rank: #659,860 in Books (See Top 100 in Books)

More About the Author

When I started medical school, I had no idea that I would become a writer. I'd completed a PhD in the biochemistry of endorphin receptors, and planned to become a bench scientist with a once-a-week clinic to see patients.

But during residency, I fell in love with patient-care, and realized that I'd have to put bench research aside. After three years of training, I took off some time to travel. I spent 18 months on the road, working occasional medical temp-jobs to earn money, and then exploring Latin America for as long as my money would last.

It was during these travels, during this first true break from medicine, that I started writing down the stories of my medical training at Bellevue Hospital. I had no intentions about a book, or publishing at all, but I just needed to unload some of the stories that had built up over the years.

When I came back to medical practice, writing kept itself going in my life. Then I helped found the Bellevue Literary Review, which was another way to incorporate literature into medicine. Now, my time is split between clinical medicine, teaching, writing, editing, my newest hobby--cello, (and of course my three wonderful children!).


Official Bio

Danielle Ofri's newest book is Medicine in Translation: Journeys with my Patients (Beacon, 2010), which examines the challenges that immigrants face in the American health-care system, as well as her own experience as a patient in a foreign country.

She is the author of two collections of essays about life in medicine: Incidental Findings: Lessons from my Patients in the Art of Medicine and Singular Intimacies: Becoming a Doctor at Bellevue. Most recently, she and the editors of the BLR published the anthology, The Best of the Bellevue Literary Review.

Danielle Ofri's writings have appeared in the New York Times, the Los Angeles Times, the New England Journal of Medicine, the Lancet, and on National Public Radio. She is the recipient of the Missouri Review Editor's Prize for her essay Merced, which was selected by Stephen Jay Gould for Best American Essays 2002. Her essay Common Ground was selected by Oliver Sacks for Best American Science Writing 2003. A third essay, Living Will, was selected by Susan Orlean for Best American Essays 2005. She is the recipient of the 2005 John P. McGovern Award, given annually by the American Medical Writers Association for "preeminent contributions to medical communication." Danielle Ofri was Associate Chief Editor of The Bellevue Guide to Outpatient Medicine, which was awarded Best Medical Textbook of 2001 by the American Medical Writers Association.

Danielle Ofri is currently working on a set of essays about medicine, while several unfinished novels in various states of disrepair gather prime New-York-City dust under her bed. Ofri lives with her husband, three children, cello, and black-lab mutt in a singularly intimate Manhattan-sized apartment



 

Customer Reviews

60 Reviews
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Average Customer Review
4.7 out of 5 stars (60 customer reviews)
 
 
 
 
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Most Helpful Customer Reviews

13 of 13 people found the following review helpful:
5.0 out of 5 stars Writing from Bellevue, August 26, 2003
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This review is from: Singular Intimacies: Becoming a Doctor at Bellevue (Hardcover)
Danielle Ofri is the type of doctor you would be lucky to find, should you need one. This book is an extremeley intelligent and sensitive document of the interaction between doctor and patient, health and sickness, and the nature and limits of healing. It's also a hands-on, first person account of what it's like to work in one of the biggest and busiest hospitals in the country. Her essay, "Merced," on a patient who continuted to suffer from a mysterious and unknowable ailment, is a wrenching tale of a doctor who can't help her patient, despite incredible efforts and every modern mechanism. The fate of that patient is gripping and chilling, and she stays with me some three months after reading the book. Finally, for a doctor -- for anyone, in fact -- Danielle Ofri writes like a dream.
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11 of 11 people found the following review helpful:
5.0 out of 5 stars From the heart and from the mind, May 5, 2004
By 
Sarah Bain (Spokane, WA United States) - See all my reviews
(REAL NAME)   
This is not a book to take lightly. This is a book about real people, with real problems. This is a book written by a doctor who takes nothing about what she does lightly.
Dr. Ofri takes the sacred--a person and his/her life--and offers us a glimpse into the patient's world and the doctor's world in a poetic, gorgeous book that offers us both rare insight about ourselves and insight about human beings in general.
Each essay describes a moment in time, a look at Dr. Ofri's residency at Bellevue Hospital, a glimpse of one or more of her patients, and a glance toward the human condition and how it can be both transformational and devasting.
Dr. Ofri takes the mundane--an alcoholic arriving in the ER from too much imbibing--and transforms the story into one that will stay with you for the rest of your life.
I am not a doctor, I am not a scientist. I am an ordinary person who will never again look ordinarily at any person whether I see them in a hospital bed or posted as a missing person on a flyer.
Perhaps what sets Dr. Ofri apart is that she is a doctor, a wife, a mother. But I hope not. I hope that every doctor could aspire to having access to both sides of his/her brain, to show emotion and to offer solace in a way that Dr. Ofri has.
This is a must read for anyone in the medical field and a must read for anyone who aspires to have a deeper connection in any relationship with any person.
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11 of 11 people found the following review helpful:
5.0 out of 5 stars Touching, September 4, 2003
This review is from: Singular Intimacies: Becoming a Doctor at Bellevue (Hardcover)
I am currently an intern in my first year of training at Bellevue. This book was given to me as a present upon my recent graduation from medical school. Although internship does not provide much time for pleasure reading, I am very glad I stayed up at night to read this book. Dr. Ofri is wise and caring. Her willingness to share her insecurities and imperfections is rare in the world of medicine where admissions of weakness are rare. Unlike a number of other senior and jaded doctors I have met, Dr. Ofri has not lost the caring and excitement for medicine everyone has when they begin medical school. Anyone involved in the medical profession will immediately relate to these aspects of the book.

For readers not involved in medicine, the book will still be wonderful to read. It is beautifully written, and all readers will be able to relate to the human drama Dr. Ofri presents. Although I have yet to meet Dr. Ofri in person, I hope that when I am done with my training at Bellevue, I will have a fraction of her passion and compassion.

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First Sentence:
"AIR FRANCE," she says. Read the first page
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developer fluid, lung markings, blood tubes, esophageal rupture, breathing tube
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Adrienne Berneau, Carnegie Hall, Herbert Ziff, New York City, East River, Mary Lou, Beth Israel, Eileen O'Neil, First Avenue, New York Times, South Carolina, University Hospital, Zalman Wiszhinsky, Angeline Burton, Danielle Ofri, Department of Medicine, Elba Rodriguez, Friday Mercedes, Second Avenue, United States, Hey Doc, Joseph Sitkin, Leo Teitelbaum, New England Journal of Medicine
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