Writer, M.D. (eBook)

Forewordby Jerome Groopman


A physician works at the border between science and the soul. Schooled in physiology and pharmacology, the molecular workings of genes and proteins, the biochemistry of health and disease, a doctor brings to care a diverse body of expert knowledge. That knowledge is rapidly expanding with the use of sophisticated technologies such as genomics that map mutations in our DNA, and MRI scans that reveal millimetre abnormalities in our inner organs. This wealth of information has changed the nature of diagnosis and treatment, bringing many maladies under the bright light of science, illuminating their genesis, and providing a rational basis for their remedy.

But what has not changed over the millennia is the human soul. The role of the physician as healer has not been fundamentally altered by his burgeoning knowledge. Greater knowledge does not necessarily translate into greater wisdom. Wisdom requires melding information with judgement and values. The wise doctor probes not only the organs of his patient but also his feelings and emotions, his fears and his hopes, his regrets and his goals. And to accomplish that most important task of applying wisdom, the physician also needs to take his own emotional temperature, to realise how his own beliefs and biases may be brought to bear in his efforts to secure a better future for his patient.

This remarkable collection melds science and the soul, logic with feeling, knowledge with wisdom. The voices that the reader hears are among the most prominent in the constellation of physician--writers. What makes these writers so compelling is not only the fluidity of their prose and the intensity of their focus, not only their literary and narrative skills, but also their remarkable degree of self-awareness. A physician is trained in medical school and residency to hide his feelings and filter his thoughts. This training is required in order to effectively deliver care in an environment that is often chaotic and unnerving. The doctor needs to present himself to the patient as a safe harbour of stability in the midst of the tempest of illness. But when that doctor has moved from the clinic to the page, the mask drops, and we see the turmoil and tribulations in his heart and mind. The humanity of both patient and physician is what makes the stories that follow so rich and so fulfilling.


Introduction
by Leah Kaminsky

When I first became a medical student, many years ago, I developed a condition I call Tunnel Vision of the Soul. It is a crippling ailment in which you see only things that are straight in front of you. You focus on the sickness, and don't see the sick person. Your peripheral vision is blurred, so that you don't notice your surroundings, with all their inherent colours, nuances, and possibilities, unless you deliberately turn your head to look. The onset can be insidious, the symptoms barely perceptible at first.

Spending lunchtimes in the anatomy museum, surrounded by dissections under glass, it never occurred to me that what lay exposed was the pelvis of someone's mother, or the foot of somebody's brother. I munched on chicken sandwiches, busily memorising mnemonics: Swiftly Lower Tilley's Pants To Try Coitus There, for the bones of the wrist, Grandpa Shagging Grandma's Love Child, for the top layers of the skin.

After six years as a medical student, practising rectal examinations on old men who had become paralysed following a stroke, performing bone-marrow biopsies on dying little old ladies, and shoving needles into the spines of crying babies, I emerged almost totally desensitised to human pain and suffering....