Monday, June 25, 2007

Book #26 Final Exam: A Surgeon's Reflections on Mortality by Pauline Chen

This book was a lot tougher to read than I thought it would be. I finished it today and it only added to the emotion I'm carrying with the death of my friend Tricia's mom. Chen started with medical school and gross anatomy, then went on to her residency and finally to her thoughts and reflections on the role of medicine in end-of-life care.

Throughout the book I was struck by Chen's writing ability, so I was not surprised when she talked about an urge she had to write stories and take writing classes. Her writing is pure prose, even though her subject was science. She talked in graphic detail about her first cadaver and about her first patient she was "responsible for killing," something a fellow doctor told her every surgeon goes through. She talked about harvesting organs for transplant from a woman whose breasts, skin, and hands resembled her own. She talked about her discovery to accepting her own mortality, something that was very difficult for her to do.

She balanced scientific data with personal stories and I found myself in tears several times over the relationships that she developed with her patients, only to have them pass away from terminal illness. I had never given thought to becoming a doctor, but I know now that if I had I would have failed miserably. It is not in me to be a caregiver of that magnitude.

Everyone who knows me well knows about my interest...okay, unhealthy obsession...with death. Pauline Chen's book was a feast for me--true knowledge of illness, death, and all the steps inbetween, from someone who didn't leave anything a mystery. She didn't protect readers from the truth: the death rattle, the smells, how the body becomes septic and turns in on itself. Because of that I found this truly one of the most educational and satisfying books I've ever read.

Like Bracco's memoir, Pauline Chen's book is not for everyone. It has, combined with other events, resulted in a pretty significant depression for me. I will chew on this book for a long time, and I'll probably read it again. It's compelling in its truth, and reading the words and seeing what truly happens to terminal patients has forced me into a place where I need to look at my own thoughts on mortality and see where I stand.

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