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Between Expectations: Lessons from a Pediatric Residency Hardcover – March 1, 2011

4.1 out of 5 stars 19 customer reviews

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Editorial Reviews

From Publishers Weekly

It's a given that doctors-in-training will suffer through sleep deprivation and stress, but pediatrician Weir brings something more heartfelt—and joyful—to this achingly personal chronicle of her residency at Children's Hospital Boston and Boston Medical Center. Weir's grim introduction to Connor, a fragile preemie, forces her to wonder whether "the ends will justif even the most agonizing means." There is her anger at baby Myranda's drug-addicted mother, her panic over blue-baby Briony, her struggles to tell 19-year-old Harry's father that his son has a brain tumor, and her realization that when you don't know what to do, you should know whom to call. The most memorable parts of Weir's grueling training are the complicated kids and families, the hope she inspires in them—and the hope they give her in turn. Yet, she shows, doctors working with very sick children must know when they're offering families too much hope, or not enough, and that there's a cost to everything they do. Here's a white coat insider's account with better writing and more soul than most medical dramas. (Mar.)
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From Booklist

Among the lessons Weir recounts in this somewhat uneven memoir of her residency at Boston Children�s Hospital is the fact that sometimes parents of seriously ill children are more resilient than one might expect and that, as a physician, one can only do what one can do. When she needed to take a break early in her internship due to job-related stress, Weir fretted over the decision but took it nonetheless. Upon her return, she realized it was the best thing she could do, both for herself and for the children in her care. Additionally, a brief stint at a disastrously underequipped and understaffed hospital in Monrovia, Liberia, revealed that medical priorities must be adapted to the reality of one�s situation. Finally, by following her early patients and their families over the span of her residency, she discovered that sometimes the advice she might have given parents as a new intern was best left unsaid. Aside from its unusual pediatric perspective, Weir�s medical residency memoir is a consistently modest addition to the physician-in-training genre. --Donna Chavez
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Product Details

  • Hardcover: 288 pages
  • Publisher: Free Press; 1 edition (March 1, 2011)
  • Language: English
  • ISBN-10: 1439189072
  • ISBN-13: 978-1439189078
  • Product Dimensions: 6 x 1.1 x 9 inches
  • Shipping Weight: 14.9 ounces
  • Average Customer Review: 4.1 out of 5 stars  See all reviews (19 customer reviews)
  • Amazon Best Sellers Rank: #760,762 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

By Brent Ragar on March 3, 2011
Format: Hardcover
I will admit up front that I am biased - I remember first hearing about this book years ago on call over subsidized cafeteria food when Dr. Weir was an intern and I was finishing residency. But just because I like Meghan and have enjoyed her updates as she submitted her manuscript and chose titles and covers doesn't mean that the book will be good. That's why I'm relieved that I really loved her accounts of her experiences as she grows to be a better doctor.

There is a lot to love here. First and foremost are the patients - even though she claims not to tell their stories, she does so quite well. Her blend of compassion, rectitude, and practicality make sure that we realize that we are seeing patients through her eyes and not necessarily as others would see them. However, I think that many patients, families, and doctors would benefit from such an honest assessment of the patient-doctor relationship -- especially when it pertains to students, residents, and fellows who are still learning the art of medicine. She is to be commended for putting forth her own insecurities and for constantly seeking to improve herself by revisiting old encounters and examining them in the light of subsequent events. Such a view of the human nature of doctors can only improve the shared decision-making needed between doctors and patients.

Another aspect of the book which I found special was the juxtaposition of her time in various hospitals - from Children's Hospital to Boston Medical Center to JFK in Liberia. Realizing what it would take to give everyone the kind of care they need and deserve is a central part of the narrative and the depressing effects of war, poverty, and rampant disease are important reminders that it's easy to lose sight of how much is needed in this world. Whether it's education or basic human rights there is much work to be done.
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Format: Hardcover Verified Purchase
I will admit to being a sucker for the medical trainee memoir. From my first encounters with Perri Klass, I've been hooked. And with the proliferation of the genre since Klass' "A Not Entirely Benign Procedure," there has been no shortage of fuel for my addiction. I've been waiting to read Meghan Weir's "Between Expectations" for some time now - and it's a nice addition to this collection of writing about medical training. But what does she add to the genre?

Her writing has some insightful moments for sure. She bears witness to the painful suffering of children and their families that goes on in our hospitals all over the country. She gives voice to the trainee who too often just plugs away at the machine that is medical training without the space for self-reflection that she fought for in her own training program. But she did fight for this opportunity to write about her training, and I wonder, by the end of the book, what she accomplished beyond catharsis by writing this collection of stories. Many times by the end of a chapter I found myself wishing that I were able to ask her "OK, THEN what?" Not about what happened to the patient, or what she did next, necessarily, but who cares? Why did you write this? What did this change about who you decided to be as a pediatrician? How did this experience affect what you decided to do with your next patient? Or did it?

But while I find myself wanting more, my medical memoir fix has definitely been met by this book. It's very readable; the framing of the collection with her first patient in the NICU and the "NICU grad" at the end adds a nice structure; and maybe that's enough.
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Format: Kindle Edition Verified Purchase
it's been 30 years since i finished my residency; so i was looking forward to maybe reliving that experience and learning about some of the things that have changed since then. the book is well written and obviously interesting to a former resident, but honestly, i thought it was way too morbid, with too much emphasis on the children that don't get well and almost making it sound like a fruitless exercise to get admitted to a tertiary care children's hospital where you are really only delaying the inevitable. my experience was totally different; i do remember some of the futile attempt to prolong life and some of the failures, but i remember many successes, even whole ones, and i thought the book should have lent more balance to its portrayal of the residency experience. of course, i can't argue with the authors' experience and her personal perception of it; but it was not the same as mine.
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Format: Hardcover
The author is an excellent writer, and tells numerous stories about her time in pediatric medicine. Her writing brings vivid mental pictures, but medical memoirs can be very heavy (I know, I have read a ton of them), and the author does little to help with this.

For example, Michael Collin's Hot Lights, Cold Steel uses wry humor and self-deprecating stories about his poverty and many children (as well as the occasional fish-hook-up-the-nose story) to allow a respite from what can be a series of difficult tales. Tilda Shalof, a nurse, finds that real human connection to each of the patients she discusses, so that in each story, we find a greater meaning to connect to our own lives.

But this book, while beautifully written, is basically a skilled retelling of facts, with little of the synthesis that makes this genre of book something most people can connect to and gain insights from. Writing a book is more than a beautiful retelling; I also want the author to have something of her own to SAY. And this book just doesn't have enough of the author's unique perspective in it to make me fall in love with it, however clearly and engagingly-written it is. The insights here are simple and straightforward.

If you're addicted to these medical memoirs, this book is probably worth reading and getting because it is fast-paced and written smoothly. But if you're the average nonfiction reader just looking for a unique perspective, try either of the authors I mentioned previously first.
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