On Doctoring

Maybe it's my unhealthy obsession with reruns of House, MD, but as of late, I have taken an interest in all things medical. Of course, I do not care for anything remotely technical or sciencey (read: challenging), but I do like reading all the gory, salacious details of surgery, medical conditions, and anything generally disgusting or unpleasant relating to the bodies we occupy every day. So, hoping for some short stories that encompass the above, I picked up a copy of On Doctoring: Stories, Poems, Essays edited by Richard Reynolds, MD and John Stone MD. If medical students get big pimped-out Oscar-style gift baskets their first day of school full of the things a med student would need -- My First Stethoscope; bottles of No-Doz; the obligatory white jacket; piles of tongue depressors; a box of latex gloves -- this would be included as the medical equivalent of Chicken Soup for the Medical Student's Soul. Aside from the preface, the book is arranged chronologically, beginning with some verses from the Bible and ending with a story written in the 1980s. About half the pieces are written by doctors, the rest were composed by regular folks who just happened to have a particularly memorable experience with a doctor.

Not suprisingly, the stories by doctors tend to have more interest for those who actually know a little bit about medicine because they are full of the day to day minutiae of the job, but -- perhaps by design -- they have a common theme: patients will die in your care. The most harrowing of these stories was one by Dr. David Hilfiker who told the tale of a doctor's tragic diagnostic mistake with a pregnant woman. This is a part of the job, so you had better get used to it.

While dealing with the stress of remaining objective and removed enough from the patient to plan the best course of treatment after the diagnosis has been established, each and every 20th century account bemoans the evolution of a health care system that slowly strips the doctor of his decision making abilities while simultaneously endeavoring to make him more businessman than healer. Of course, all of our jobs are in a constant state of flux and evolution, but the doctors describe a system that is stealthily robbing them of their core impulse: to eliminate suffering for the patient. I don't go to work one day a pilot and wake up the next morning an accounts payable clerk; this is the type of radical shift these men and women describe. Hopefully these tales won't scare off a young potential doctor, but the narratives are harrowing enough for me -- an outsider -- whose abbreviated treatments represent nothing more than a potential profit increase for the insurance company.

While the doctors tend to describe medicine from their perspective, the non-medical writers are presenting tales from the view of patient. Have a shot of bourbon (or a take your favorite narcotic) and have a go at Kafka's "A Country Doctor." It's typical Kafka: ghost horses; people walking around naked; rape; angry, torch-bearing mobs; etc. As is typical of Kafka, it's a narcisstic reflection of himself, but there is a surreal tale of a doctor woven through the strangeness. Though many of the stories are good, the poems produced the most powerful physical reactions. L.E. Sissman's haunting account of each and every biological detail of his impending death from Hodgkin's disease made a lump in my throat. Maya Angelou's description of growing old and giving up on life caused my heart to ache. The Bible's short admission, "Death is better than a miserable life/and eternal rest than chronic sickness," (Ecclesiasticus 30:17) made me reconsider religion and its stance on euthanasia, thus hurting my head.

Though I didn't get many medical details, I was satisfied with the book. As with all decent tomes, it gave me a different perspective on the subject, and I really couldn't ask for more. Because they are grappling with death and the progression of disease and age, doctors easily have the most difficult job in the world. They look potential death in the face every day and I am grateful there are people up to that task. If I want dramatic fiction, I'll stick to House. On Doctoring taught me that real life is way more gory and traumatic.