1 comments about The Making of a Nurse.

1. The Making of a Nurse is the true-life story of author Tilda Shalof, a caregiver all her life, and an Intensive Care Unit nurse with twenty-five years of experience in Israel, New York, and Canada. She tells stories of overprotective "helicopter parents", so named for their tendency to hover over their children; dealing with patients ranging from gracious to delusional or even violent; to the virtual war between the mother and a girlfriend of a dying hospital patient over his comatose form. An absorbing and revealing look into the day-to-day life of a nurse, as well as the personal travails - including a stint of life on the streets - that beset the author. Highly recommended.

5 comments about Complications: A Surgeon's Notes on an Imperfect Science.

1. I find this book which has gotten such rave reviews disappointing. Dr. Gawande addresses a number of issues which are pertinent to surgical practice. However,I found the book to be superficial and lacking of "heart".
   
   I will elicudate. Dr. Gawande states frequently that surgeons slash their way into a patient.I suspect that this is for dramatic effect.There are other examples of this such as the description of an autopsy.He tones it down later.He treds lightly on the fact that doctors don't want to own their mistakes which is why there is no improvement in medical care over 20 years ago despite huge advances in both technology and costs.
   
   The only Surgeon I have ever known who "slashed" his way into a patient ended up losing his privileges...thank God but it took many years and a yeoman's effort and those who spoke up were alienated and shunned. It was not as simple as is portrayed in this book.I do laud him for bringing up the "good doctors going bad" issue. It is a huge problem and bad doctors are often covered for years and years while patients are repetitively injured. It is also very harmful to the doctor who is creating the problem. The cost of this problem to patients, hospitals and society is staggering.
   
   I looked up the reference that computers were better than doctors at diagnosis. It is not about medical diagnosis, it was about psychologists' diagnosis. The second article was from 1954...A bit dated. before the computer era.
   
   I laud him for the courage in mentioning his screwed up tracheostomy attempt. There are numerous methods for both intubation and percutanous guided tracheostomy techniques that have been available for 20 years. I have to wonder why he was unaware of these. The technique that he describes for subclavian vein cathethers is also not as safe as other methods which use a small guage finding needle. I have to wonder why 20-30 years after these problems were identified that this young doctor was not being instructed in these techniques.
   
   His chapter on bariatric surgery is notable for his mentioning of the commercialization of medicine an increasingly dangerous trend is appropriate. At this point bariatric surgery has been shown to be helpful for a large number of patients, but without question medicine has been commercialized.
   
   His section on uncertainty is the best part of this book. He saved the best for last.
   
   Nonetheless, I find his "laissez-faire" attitude to these problems even more worrisome.I find little actual feeling that he cared about his patients in this book. This is not surprising as it pervades medicine today.
   
   I haven't found this book to be a thriller.It lacks depth of character. If he had connected with us and his patients emotionally I believe that it would have been a much more powerful work.



2. An amazing thriller...
   
   Dr.Atul's superb portrayal of finest qualities of a doctor, yet the limitations of an individual, their weekness,strengths, system flaws etc with vivid examples of real life cases makes "Complications" the best medical book I'v ever read.It's not the content of the book alone that deserves appreciation, it's also the flow of words that blend with the topic.
   
   Certainly the pinnacle of the book is the story of Joseph Lazaroff, Atul's Anguish depicting the finest of human character and also the professionalism of a doctor, also his questions behind the ethics of "absolute insane rights of patient's expression". I felt a pain in the heart for that "unknown soul" ( a gist of that chapter is below)
   
   Chapter : Whose body is it Anyway :
   ...I turned the ventilator off, and the suddenly the room was quiet .His breathing slowed ...Joseph Lazaroff had died.But Knowing how much Lazaroff had dreaded dying the way he died....
   
   Chapter : Education of a Knife:
   I said to the patient that there were "slight risks" involved.And the disasters weighed on my mind: the woman who had died from massive bleeding, the man who had to have a chest opened, the man who had a cardiac arrests.I said nothing of such things when I asked my patient's permission to do this
   
   Chapter : When Doctors Make Mistakes:
   At 2 A.M on a crisp friday in winter a few years agao, I was in sterile gown , pulling a teenage knifing victim's abdomen open, when my pager sounded "code trauma, three minutes"
   
   Chapter : When Good doctor's Go bad:
   Before the license of Dr.Goodman was taken away, he was a highly respected and sought after surgeon...he could do some of the best, most brilliant work around....In one case , he put the wrong-size screw into a patient's ankle,another case when he refused to do hip replacement. For the last several years, he was the defendent of a stream of malpractice suits.
   
   Chapter : The Man Who Cannot stop Eating :
   ...He had to let his legs apart to let his abdomen sag between them. He cannot lie down and breath properly because of excess fat in the tongue and upper airway. He had to sleep in the recliner and every thirty minutes or so , he would wake up asphyxating, He could no longer stand up to urinate, he had to shower after moving his bowels to get clean
   
   A Must Read book...Afterall, someday you might be an example in his future books!



3. I just couldn't finish this book! I thought it would be better--but as I am reading the words they are more and more unfamiliar. I don't want to read a book where you spend more than 3/4 of the time looking up the words!



4. The first part of the book is the typical medical error conversation - the system needs changes, but, instead, the last doctor to touch a patient is always ultimately responsible. The last two sections of the book are full of interesting patient stories and antecdotes, leaving the reader with a sense of "why do I pay so much for services that are not consistent and not scientifically proven?" Gawande does an excellent job pointing out some of the uncertaintaties of medicine and some of the major health disparities and inequalities - the poor are usually the ones that are used as training tools for interns and residents, and receive subpar-care compared to the well-insured.
   
   A very easy and quick read.



5. Atul Gawande gratefully takes the reader to the back of the OR, a place open for a few, yet intriguing for many. Dr. Gawande is extremely frank and poignant, as he describes actual cases from his own surgical practice. He admits that cutting someone open for the first time is hell, praises surgery which gives chance to obese people, wonders about doctor's intuition, and remains human in every case.
   
   As always, Atul Gawande is not just writing about medicine; this book reaches far beyond the realm of the operating room. He touches on the most complicated ethical questions of medicine and society as a whole. Gawande speaks of mistakes and our imperfect judgment; tackling the questions of good doctors gone bad along with malpractice claims and punishments. He makes the case for autopsy as a means of learning. He admits that medical students must practice on cadavers or animals in order to cut people open; all ethical questions are answered by means of vivid examples.
   
   For instance, in the 1980s the death rate from a particular surgery would be about 10%. When the new surgical treatment of heart pathology arose, surgeons started trying the novice. At that training period, the rate of children death from this particular intervention increased to 25% of cases. Sounds horrible? Yes, but after surgeons learned, the rate fell down to just a couple percent. Was it worth it? Sure, granted the number of lives saved in the long run. Never, granted now many kids died just due to surgeons' learning. Would any doctor let anyone practice on his own kid? Never. At the same time, learning is a necessary part of medical progress.
   
   Those questions dominate the book; Gawande ponders at the patient's right to choose, reminds us that doctors are human and prone to mistakes, reveals mysteries of complications, which are usually open only during the M&M - Mortality and Morbidity Conference behind the closed door. Gawande is not afraid to open the doors. Moreover, he is confident that openness is the only way to reduce the complications.
   
   I almost wanted to say the book is too idealistic, except it's written by a person whose profession is to think realistically. Great book!

2 comments about La Escafandra y La Mariposa/ The Diving Bell and the Butterfly: Un Sobrecogedor Testimonio Sobre Los Limites De La Naturaleza Humana.

1. This book is captivating and touching in both English and Spanish. Knowing that each and every letter of every word written was such an effort and struggle to write...makes the experience of reading this novel that much more powerful. This book is truly eloquent and thoughtful, as well as inspiring and beautiful. The reader will close this book with a greater appreciation of what they have now.



2. Un relato realmente conmovedor acerca de lo grandioso del espiritu humano y su fortaleza ante las adversidades. Es una historia real que nos obliga a reflexionar sobre el verdadero proposito y sentido de la vida.

5 comments about Reasonable People: A Memoir of Autism and Adoption: On the Meaning of Family and the Politics of Neurological Difference.

1. This book will bring tears of acknowledgement and smiles of joy for those families who grapple with some of the these same issues. I truly believe the universe brings certain people together......Ralph, Emily, and DJ are three of those. It is time the world changes the perception of competence and what can be accomplished in believing that, right from the beginning. Ralph is a talented, thoughtful writer, and our family thanks him, and all the Savarese family for opening their lives up for this incredible story.



2. This is a brilliant, moving memoir that I would recommend to any reader. Despite the seriousness of its topics, this is a page-turner that you will not be able to put down (I read it non-stop in two days, as did my mother!). As someone with no experience or knowledge of autism, I found Savarese's book to be incredibly informative on many levels and lucidly written. But more than that, Reasonable People asks provocative questions about how we define family, community, and inclusion.
   
   A must read!



3. Savarese's book on autism is a paradigm-altering read. In this memoir he recalls all that went through the transition of his young adopted boy as a noncumunicative "thing" (as seen by society), to a poetic activist. This book is more than a history of one family, it is also a commentary on our foster care system, how we treat those with disabilities and our education system. It also discusses the difficulty in changing scientific paradigms.
   
   Although Savarese's prose and simile often get in the way - making the reading more difficult as you try to decipher some of the esoteric analogies - they are often very humorous, in a story filled with the tragedy of a boy tossed into society's dumpster. It is a story of sexual abuse, physical abuse and neglect. It is the story of a child abandoned and mistreated that is then rescued by his loving, adoptive parents. What I found very interesting about Savarese's far left agenda, is that he recognizes the problems that we have had in addressing how to care for orphaned children and that neither the left nor the right have any really good solutions. The solutions are found in the path that the Savarese's took - personal involvement and dedication to the weakest in our society.
   
   Unfortunately, after reading of the untold sacrifices made by the Savarese's, I would come to question whether any of us have the charity and strength to do what they have done.
   
   This book was difficult to put down and hard to pick up to read. The pain suffered by DJ (their autistic boy) made it difficult to pick up while the odyssey of DJ from a "non-person" to a powerful and strong advocate-kid via facilitated communication is amazing. I often felt like I was reading about an alien that had visited the earth.



4. This is a very interesting read. I am a mother of 5 children 2 of whome have autism and I have read many books on the subject. This story was like none that I have ever read before. I would have to say that the author and his wife have done the most amazing job of parenting this little boy and they must be truly wonderful people. Emily, DJ's mother must be so knowledgeable and so kind and patient. She is such an inspiration. DJ's father also impressed me, with his determination to give DJ the life he is entitled to. It is a wonderful story which touches on so many interesting and rarely spoken about topics in regard to disabilites. I was delighted to reach the end of the book and see just how much DJ had improved, and to know that the outcome of a little boy's life has been changed so dramatically for the better thanks to the kindness of two very special people.
   
   I did how ever find some of this book very hard to read, the shocking abuse that DJ suffered in foster care, before his wonderful parents adopted him - I found this very disturbing and distressing. I also felt that the author goes off on a few tangents about his theories and quotes several other authors in great detail which I found a bit boring and hard to read.
   
   Overall it was an amazing book.



5. To be sure, this book is a compelling and engaging story and you feel tremendous admiration for Savarese and his wife, in their attempts to connect with their adopted son, DJ, who is profoundly autistic. However, there is so much more in the book than just that story, and I thought much of it was distracting. The poetry quotations, the interjections about Savarese's terrible relationship with his pompous and autocratic father, the recaps of the back-and-forth exchanges with DJ's biological father and his new wife (who Savarese despises), etc. etc. I enjoyed reading this book but all in all, I felt there was just too MUCH here. It read more like a stream-of-consciousness emotional outpouring by the author than a story with an organized and compact narrative. Savarese is a brilliant man and a talented author, no doubt, but a deft editing hand was needed here, and that didn't happen. Quite a bit of the extraneous information was marginally relevant to the story, but the narrative would have been stronger without all the other "stuff" thrown in. There are amazing, poignant moments in this book - the subplot about baby Charlie just broke my heart, as a mother - but I think DJ's story would have been better served by tighter storytelling and less interjection of Saverese's own editorial opinion and personal history. Still very much worth reading, and ultimately an amazing story. I did appreciate Savarese's discussions of the frustrations and exasperations of living with DJ, alongside the discussions of the triumphs. Savarese and his wife are truly amazing individuals who could teach us all a few lessons about love and acceptance.

5 comments about The Anatomist: A True Story of Gray's Anatomy.

1. The Anatomist is another winner from Bill Hayes. The book tells the story of Gray's Anatomy, the definitive anatomy text that was first published 150 years ago this year. Most likely your doctor has come into contact with the text somewhere in their training or career. Until The Anatomist, very little has been written about the two others of Gray's Anatomy. Yes, there are two authors. While the book is named after Henry Gray who wrote the text, there was another author/artist who drew the meticulous, detailed drawings of the human body. As a matter of fact, it could be argued that the book is most well known for the drawings by Henry Vandyke Carter who has mostly been uncredited since the early editions. The story of the book is fascinating. After copious research very little is known about Henry Gray. I won't give away why. But in his research on Gray, Hayes stumbled upon Carter's journals which are filled with details about his life during those times. The journals provide a fascinating glimpse into the troubled life of Carter who is tortured by the religious doctrines of the time and his burgeoning sexuality. Of course scandal ensues for Carter and I also want give that away. The book is also a fascinating examination of the practice of journaling. Hayes himself is journal keeper and finds many similarities in the practice of keeping a journal with Carter who lived 150 years earlier. If you keep a journal, you must read this book. Hayes also includes side by side with the story of Gray and Carter his own experiences in the gross anatomy lab learning about the human body through dissection. Hayes is a beautiful writer. His choice of words and his descriptions of the human body are eloquent and strangely beautiful even when he is describing something that most would want to turn their gaze from. His sentences flow with grace and he seamlessly mixes all of the different elements of the story with his own memoir. Like his other two books, Hayes has a unique gift of combining traditional memoir with science. I can't recommend this book more highly.



2. Author Bill Hayes pursues parallel stories:
   * The back story on that medical reference icon, "Gray's Anatomy"
   * His own anatomical education in exploring dissection of the human body with classes of pharmacy, physical therapy and medical students
   
   He deftly shifts back and forth between the two narratives. He finds that he cannot do justice to Gray's Anatomy without chronicling the life not only of Henry Gray but also the book's illustrator, H.V. Carter. With the patience of a skilled investigator and historical sleuth, Hayes unearths a fascinating narrative of how Grays Anatomy came into being, a tale befitting the 150th anniversary of the book's publication.
   
   Hayes also touches on some interesting points regarding current medical student education, where hands-on dissection may be reduced if not supplants by CD-ROMS and computer-aided tutorials. Do fledgling doctors get the same benefit from that approach or is The Old Way the best?
   
   This is a good book but is somewhat marred by the distraction of Hayes' insistence that all the readers know he is gay. He inserts references to his "partner" Steve, how he got into body-building as a youth to attract the boys, etc. With a clicking sound in his jaw, Hayes suffers apparently not only from TMJ but TMI - Too Much Information! This undercurrent in the book adds little or nothing to the book's narrative thread. OK, we get it. You're gay. Move on! For the medical laity he insists on flaunting his gaiety.
   
   Despite this quibble, "The Anatomist" is a good book that will especially (though not exclusively) appeal to those interested in medicine, health and medical education.



3. Very interesting book with a different perspective of being a biography
   with a personal story of the author. Lots of background on everybody
   concerned. Its not just Gray's Anatomy but the collaboration of Gray and
   Carter. Not too technical but informative.



4. The Anatomist. Bill Hayes. New York: Ballentine Press, 2008. Pp. 250
   
   For those who do not know, Gray's Anatomy is not the television series, Grey's Anatomy, it is the medical school anatomy textbook after which the series is named. The Anatomist is a nonfiction book about the author and the illustrator of this famous textbook which was written 150 years ago and is it in its 39th edition. Physicians all over the world use it in dissecting cadavers and learning human anatomy. Additional stories that Bill Hayes skillfully weaves into the main story are his own experiences participating in anatomy classes with doctors, physical therapists, and pharmacists, and the story of working with his partner sifting through books, manuals, catalogs, diaries, and letters in libraries and archives in England and India as they uncover the story of the lives of these two men, both named Henry, Henry Gray, M.D. and Henry or H.C. Cartwright, M.D., Illustrator.
   Henry Gray is a man driven by ambition, fame, status, and money and is the principle force behind the writing of a concise and inclusive manual of anatomy to be used as a guide to dissection of the human body. He does achieve his goal but meets an early painful demise at the peak of a successful career. H.V. Carter, the illustrator, is the coauthor but was not given credit in name or financially to the degree that Dr. Gray was. He is a complicated, driven, obsessive, self deprecating man with strong Christian beliefs whose motivations regarding the book are to make the world a better place and live a life commensurate with his religious values. He pursues it with little regard for status, fame and fortune. His life is productive but tortured, and his career takes him to India studying and writing about tropical diseases. He has a scandalous marriage in India that leaves his wife and himself leading separate lives, he living in India, she in Europe with an occasional rendezvous when he is able to take a break from his work in India. She dies at an early age. He eventually acquires stature and fortune in the British government Indian Medical Service and remarries. At the age of 50, he presents his research on tropical diseases to peers such as Louis Pasteur, Robert Koch, and Joseph Lister. I will leave the rest for the reader to discover. It is an interesting tale.
   To research the book the author, Bill Hayes, participates in anatomy classes and cadaver dissections with medical students, pharmacists, and physical therapists. Interwoven in the story of the two authors is a tour of the human body and the process of learning anatomy through dissection of human cadavers. It involves teamwork and getting to know the different types of people and their feelings of awe as they visualize, touch and feel the parts and understand the workings of the human body. It is an anatomy education for the lay person as well as some insight into the personalities of the different professionals. The other part of researching the book involved working with his partner who assists with the research by sifting through letters, diaries, notes, medical research papers, anatomy manuals, etc. both in Great Britain and in India. The materials are 150 years old and frequently illegible or very difficult to read. Of interest also are the authors' experiences gaining access to archives and dealing with various archivists. There is a much unexpected ending to the book that I will leave the readers to find.
   Personally, as a Physician, I have read Gray's Anatomy and used it in my dissection of a cadaver. That experience made the reading of this book particularly appealing. The book is of educational value to those without a medical background. It also gives insight into the personality types of the different professionals that the author worked with. The three stories of Dr. Gray and Dr. Cartwright, the anatomy classes, and Bill Hayes and his partner's research experiences were cleverly interwoven. The only negative I would say about the book is that the descriptions of Bill Hayes' experiences in anatomy class occasionally became a little long to sustain interest. The stories were fascinating, and I would rate the book as excellent. It was well researched, well written, and very interesting reading. I would recommend it to anyone. It is not a book with the gay theme but has a gay author. It is not written for the gay reader only but is a mainstream book.



5. The Anatomist is a delightfully told story about Henry Gray and Henry (HV) Carter, the author and the illustrator, of the landmark and still in use monumental tome, Gray's "Anatomy, Descriptive and Surgical".
   
   I was first introduced to "Gray's Anatomy" while taking Human Anatomy in College on my way to degrees in the psychological sciences. That was many years ago. Years later, my interest in anatomy was again piqued while studying the life and works of Leonardo Da Vinci whom many consider the father of medical illustration.
   
   So it was that when I came upon a copy of "The Anatomist" I grabbed it, sight unseen as it were.
   
   It proved a good read, interesting, full of the history of the study of human anatomy, and as the title purports, Gray's Anatomy in particular. It is largely seen through the eyes of H.V. Carter the illustrator. The historical tract for Carter is extensive. That for Gray himself has been lost.
   
   Hayes takes one not only through the history of anatomy, but manages with some skill to take the reader right into the dissection room where the wonders of the unveiled human body are revealed. Tastefully done this short work is well work reading.

5 comments about Broken Justice.

1. Aside from being an amazing story, told in an emotionally-stirring fashion, this book truly has an impact on the reader. For my generation, this point in history is often glossed over, whether because it's too controversial or because so much time is spent each year on earlier points in American history. This book shed a light on the years surrounding Roe v. Wade and the subject was swimming around my head all day.
   
   Even if you're not as fascinated by history as I am, it pulls you in and shows you bits and pieces of Boston in the 70's, while remaining focused on the issue of abortion. An excellent read and a reminder that we must preserve the right to choose.



2. EXCELLENT BOOK, DEFINATELY A TRUE REPRESENTATION OF THE 70'S IN BOSTON AND ONE BLACK MAN'S STRUGGLE TO MAKE A DIFFERENCE



3. I have known Dr. Edelin for a number of years and always have found him to be an engaging speaker and a great storyteller. This book did not disappoint. It is amazing to imagine one person going through what he went through....the turn of events was such that I couldn't believe that it was a non-fiction book!
   
   This is an important book on the subject of Roe vs Wade and the parallels to a John Grisham novel in describing the court room scenes are accurate. I felt the energy of the 70's and his experiences as a young man faced with such a frightening indictment. Where it differs from John Grisham novels that I have read is that this was the first book I had where someone had gone in-depth into the medical profession and explained it in a way that made sense to a non-doctor. He makes the medical world accessible and interesting in the same way that Grisham and Turow have made the legal world accessible and interesting.
   
   Overall this is a great read and one that I have already recommended to many others.



4. Broken Justice captures its reader's attention from the very first page. This book is not only a story of a young Black doctor fighting for his rights in racist Boston, but fighting for the rights of all Women, in Boston and through out this country. It is hard at times to turn the page because of the injustice that keeps emerging on each page, but at the same time it is hard not to keep going so as to find out how this young doctor continued to survive through this treacherous time in his life, because the book grips you and forces you to continue.
   
   This book is a must read for people of all ages, genders and races. If we are to unite as a country, it is pertinent for all of us to understand everyone's struggle. Dr. Edelin fought for himself, but more importantly he selflessly fought for others. And 30 plus years after his trial he still fights and believes in the same rights as he did then. Thank you for giving this book to us!



5. I have met Dr Edelin in 1975 and have known him during the post trial years. His motivation for the work he has done is nothing but honorable .. a man following his beliefs for the good and welfare of people. This book demonstrates, once again, the broken legal system, with all of its prejudice in a very polarized city,not unlike many tainted trials. In Ken's instance, it is shameful of our legal system to have put this esteemed and caring doctor through the ringer for selfish and biased reasons. Once I began this book, I couldn't put it down.

5 comments about Married to a Bedouin.

1. This New Zealand-born woman with her Dutch ancestry talks about how she wasn't brave or didn't do anything extraordinary: she merely fell in love with a wonderful, decent, funny, charming and intelligent guy -- who happened to be Bedouin and live in a cave in Petra. I met them in the teahouse across from the amphitheater in the spring of 1989 when Salwa was a little girl and the boys were toddlers. Marg and Mo became our lifeline there and secured one of the new government houses in Umm Sehun for us to rent -- with a hot shower and all. We returned in the fall for three more months, learning so much from Marguerite: how to weave a tent from goat hair, to make margluba in one pot and attend a wedding. Each year for the next 10 years (until 2000), we remet and rekindled our friendship, having incredible fun with my own bint (daughter). Now, reading her book, I cherish each page, understanding even more about their special lives and what it means to be part of a Beduoin family.
   It is a book that is so pertinent today in understanding another culture and how our American government is clueless about that part of the world and the vastly different outlook, superstitions, meanings, approach to everyday living that the local people have. Bravo Marguerite.



2. Read this book right after touring Petra. It enhanced my feelings and memories if the place immensely. Well written. It gives a very good sense of what life was like in a Petra cave and being married to a very creative Bedouin man and his very large extended clan. Recommended highly, although I'm not sure how much I would have comprehended without having been there myself.



3. If you want to understand Arab culture no better place than to start here. You get a two for one. Petra is one of the great places on the globe and the people there are very special. Marguerite writes a cogent and charming account of her life from New Zealand to Jordan and her family in Petra.



4. Having been to Jordan several times and hoping to go back (I am totally in love with the country) I picked up this book at the airport for an in-flight reading.
   
   I thought it would be just another account of a western person whining about the ''wrongs'' of Muslim life but I was so pleasantly surprised that I couldn't put this book down.
   
   Margaruite's story is a matter of fact account and no preaching. She writes it as she experienced it and offers us facts which we can then make into whatever we want. She offers no criticism of the lifestyle nor does she compare it to the western lifestyle as many of the similar accounts are written nowadays. She also isn't a ''hippie gone native'' as she says many people used to see her as.:)) She simply fell in love with a man and adapted to live her life in his culture. You will enjoy the funny details, and I especially liked her account of the trip back to New Zealand with her Bedouin Husband.
   
   I admire her story, not just for the story itself but for the way it was written.
   Although I have been to Petra several times, after having read this book I went again to experience it in a totally different way, not stopping to admire the ancient Nabataean city but the people who live there and around at the moment. And the experience was unforgettable. We do tend to forget observing the people when doing the ''touristy'' thing at the historical sites. And ashamed, I must admit that the first couple of times around I was annoyed by the ''Bedouins'' trying to get me to buy the ''ancient'' items - but this time around I had a wonderful experience enjoying their spirit.
   
   I don't want to give away too much.
   Read the book. You will not regret it!
   
   Hope it will get you to plan your next holiday to Jordan!



5. I've only heard rave reviews of this book and was strongly encouraged to read it since I would be spending an extended period in Jordan. I think my expectations were too great. I had hoped to learn more about Bedouin traditions and culture and how a Westerner became a part of the society. I'm not a scholar of the Middle East, Arab, or Bedouin historty/tradition, but there was little information that was new for me. I found the book to be poorly organized, lacking of structure, and repetitive. Except for a few "chapters" when the author truly opened up to the reader, I felt as if I were reading a list of items from a day planner. From the anecdotes, it's clear Ms. Van Geldermalsen (Umm Salwa wa Umm Raami) led a rich life and experienced much that most of us will never know. I simply wish she had a better editor.

5 comments about What Patients Taught Me: A Medical Student's Journey.

1. When one conceives of the typical American medical school student's training one usually envisions students learning core clinical sciences the first two years and then proceeding on to rotations in major, large intercity hospitals. Yet, a quick glance at the inside jacket of this personal narrative mentions places like Bethel, Alaska and South Africa - not typical locales where one would expect to see a budding young physician. The singular uniqueness of the experience initially captures one's attention and then the succinct, yet poignant prologue fully captivates one's curiosity. Audrey Young brings a clairvoyant quality to her writing and seems to realize her own experience's importance in the midst of the vastness of modern medicine. She has found one thing that unifies medicine - the patient's story - and simultaneously is cognizant of its decline. Young best describes what attracts readers to the book by saying, "Patients teach things that the wisest and most revered physicians cannot, and their lessons are in this book." (x) These lessons are the defining topics of Dr. Young's personal memoir, What Patients Taught Me.
   Audrey Young describes her experiences as a developing physician enrolled at University of Washington Medical School. In preparation for medical school and the goal of becoming a practicing physician in the future, Young envisions herself as an urban doctor working in a clinic to provide much needed medical assistance to the indigent and underprivileged. After trudging through her first year of medical school, settling "into the idea that doctoring meant fixing bodies with science", and considering going to practice rural medicine, Young finally enrolls into a summer experience in the WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) program. (10) The maturing medical student ventures first to Bethel, Alaska where she learns from the Yupik people the value of doctoring as caring for one's patients and living alongside one's patients as not only caretakers but neighbors as well. It is in Bethel that Young first realizes that "telling the story was the crucial first step in taking care of a patient" - a lesson that motivates all subsequent interactions and provides the framework for her memoir. (29) She concludes her experience in Bethel without knowing the outcome of a patient suspected to have either curable tuberculosis or malignant cancer - she never finds out.
   Upon return returning to embark upon her second year of medical school, Young "gradually...began to function like a classroom student again and devolved into a primitive machine that ate textbooks and syllabi and spit out answers on multiple-choice exams." (39) Such harsh criticism of the traditional, rigid educational structure of lecture pervades Dr. Young's book, and instructs the reader of the dangers of making medicine simply an inhuman science without a personal component to the learning. In Spokane, she returns to a different type of classroom where her patients established the syllabi and constantly made additions and revisions. On her obstetrics rotations, Audrey Young witnesses difficult labors, complicated pregnancies, and tragic endings with one baby dying immediately after the mother held the baby born without a fully developed nervous system. Young learns to overcome her feelings of judgment of pregnant teenagers and renews her duty to care for those in need in spite of witnessing how not even the best doctors could always convince their patients to help themselves.
   In the next chapter of Dr. Young's seemingly unending journey, she endeavors to Pocatello, Idaho where she completes her pediatrics rotation. In this segment of her training, Young finds herself persistently in doubt - of her motivations, her capabilities, and her desire to become a physician - but she is able to find consolation in the example set by one caring resident, Jon. Of him she writes, "I felt a surge of gratitude again for how much he'd contributed towards my clinical skills and for the glimpse he'd given me into a young physician's soul. We had been through a chapter together." (110-111) In Missoula, Montana on her next rotation these clinical skills would prove defenseless against "the capricious powers of the human body to act as it wished, regardless of what the mind hoped for." (125) Martha, a patient who had previously recovered well enough to be taken off a ventilator, quickly sinks into a coma after being resuscitated and then dies almost too quickly for any of her relatives to bid her farewell. John, another of Young's patients, decides to live a fuller life without chemotherapy, spending his time riding on top of horses instead of gurneys.
   It is here where she learns from her patients valuable lessons such as the difficulty involved in adhering to an extensive drug regimen, the suffering of being misdiagnosed and treated improperly, and the vulnerability of making such important decisions as a physician. Young learns from her own inadequacy on a standardized test that she herself may make many mistakes, and that someday others might not be able to prevent her mistakes from harming her patients.
   Dr. Young's next journey leads her to practice medicine in Swaziland in South Africa in an impoverished community health clinic. Here in Africa Young witnesses the inadequacy of her clinic; this clinic is a healthcare facility that does not even have penicillin to treat simple infections. In spite of a close-call with an accidental needle-stick after taking abdominal fluid from an HIV-infected patient, Audrey Young still renews her devotion to medicine and carries on by taking care of patients and working through difficult circumstances. Young recalls, "I convinced myself that to feel and to act could be entirely unrelated things, but I decided that a doctor who sees suffering must act, rejecting the choice of not acting, even when futility and risk run high." (193) The time spent in Africa, while a vastly divergent setting, still provides Young and the reader with fundamental lessons about the devoted care that an exemplary physician must impart upon his or her patients.
   After returning to the United States, she continues her commitment to rural medicine by pursuing a rural internal medicine residency. She finds her niche practicing in a Seattle clinic for the indigent and teaching medical students how to interact with patients. From her writings, one can learn numerous valuable lessons from her diverse experiences. Dr. Young promotes an awareness of a different type of medicine - the type of medicine that the reader witnesses in Young's travels is not the dramatic, exciting medicine that one might see on television. It is also not the technology-driven medicine that one might envision as the future of medicine. What the reader finds in Young's account is simple patient and physician interaction. Young conveys this important message by reiterating, "I admired many of my teaching physicians as brilliant scientists and intellectuals, and for a time fancied myself in that vein. But WWAMI had imprinted upon me that doctors take care of patients, and in the end, I could not imagine a lifetime of doctoring without patients at the center." (208, emphasis added)
   Dr. Young weaves an elaborate tapestry out her patients' colorful stories - they are stories of nothing short of what it means to be human. The author does not veil the patients' suffering in medical terminology or vapid euphemisms; the reader instead discovers a potent, passionate account of what physicians might be missing by not listening to patients' stories beyond the clinical manifestations of disease. The first, primary lesson of this narrative informs the reader that "almost everything important comes from the patient's story." (212) The reader witnesses the consequences of failure to take note of the patient's story in the case of Carla, whose first doctor missed the diagnosis of Crohn's disease. From this encompassing lesson, the reader also learns that medicine and health should not simply concern itself with simple clinical symptoms and treatments, but should include consideration of the patient's and the family's more fundamental needs as emotional beings. John's decision to end chemotherapy to live out his last remaining days happily and the physician's respect of this decision eloquently demonstrates the importance of medicine extending beyond physiological considerations.
   Moreover, one of the perhaps more important messages that the reader can derive from Dr. Young's What Patients Taught Me is that medicine is fallible and that physicians cannot completely conquer human suffering. It is this humanly flawed aspect of medicine that makes it such an emotional experience to be a physician - to have the power to make a positive impact many times, but to lack any power against disease and illness at other times. Young concludes this statement best when she writes, "Sometimes I enter a story and find I can bring a little light and relief to human suffering." (214)



2. It was very thoughtfully written.
   
   It was a topic of great interest to me.
   
   The evolution of her insight into her patients was craftfully presented.
   
   My only negative comment concerns the less than excellent level of literary skill.



3. After reading the author's accounts of rural medicine, I've begun to strongly consider applying for a rural-based residency upon completion of medical school.
   
   Her tone isn't as pompous as some other similar books I've read. She's very down to earth, and doesn't try to make herself sound impressive by using jargon and fancy words. I've already recommended it for friends who are looking into going into medicine. A friend gave this book to me as a gift after reading it, and I plan on doing the same!



4. If you are in the medical field you need to read this book. It's great to see someone who is in the medical field for the people and not the money.
   
   If you don't pick something up from this book as to how to handle your patients, I'd be real surprised.



5. In "What Patients Taught Me," author Audrey Young, M.D. describes her path in the study of medicine. Growing up in a comfortable Seattle household, she became interested in socioeconomic justice. As an undergrad at Berkeley she "wanted to be an urban doctor for neglected populations."
   
   She chose the University of Washington Medical School, an institution with a " ... dispersed ... program to train medical students from the Pacific Northwest to practice as rural doctors." Under this program, called WWAMI for its presence in Washington, Wyoming, Alaska, Montana and Idaho, Young's medical school rotations provided an unusual amount of patient contact and responsibility.
   
   It was her choice to spend the first year in a Seattle rotation, where she had limited patient contact while taking a heavy academic load. The following summer she began her rural training in a family practice clinic in Bethel, Alaska, where huge distances and inaccessibility of care often led to delayed treatment.
   
   Here on the tundra, as Young learned to present a case in pertinent bullet points, she began to see the context in which patients live their lives. From a healthy youngster with a cold, to a mother with a fulminating post-partum infection, to a forty-year-old mechanic with tuberculosis, each patient was so much more than symptoms and test results.
   
   After Alaska, Young's rotations were a mix of urban and rural. Seattle for surgery and psychiatry; Spokane for obstetrics; Pocatello, Idaho for pediatrics; back to Seattle for internal medicine where she began to long for the autonomy and open spaces of more rural rotations.
   
   At the end of her third year Young took a difficult rotation in Swaziland, in eastern Africa. This third-world country was overrun with HIV and suffered acutely from interruptions to the supply chain due to war, poverty and political ideology.
   
   What Patients Taught Me: A Medical Student's Journey is illustrated with story after story of patients and their diseases and social context. This is the lesson Audrey Young shares with us -- "that a doctor should understand how people live." She tells her own story beautifully, and it's an inspiring story regardless of the reader's field of interest. I would paraphrase her life lesson and say that in all our interactions, any person should strive for that same understanding.
   
   There is a lot of medical detail in this memoir, but if that field is within your area of competency as a reader, I recommend this book to you.
   
   Linda Bulger, 2008

5 comments about What I Learned in Medical School: Personal Stories of Young Doctors.

1. This book was brilliant, amazing, and modern. It told the stories of untraditional medical school students. Medical school isn't just for middle-to-upper class white males anymore. That's a thing of the past. Now it is becoming more common to see females, minorities, and other groups of individuals in medical school.
   
   There were 22 stories in this book, written by doctors who do not fit the middle-to-upper class white male profile. Stories by parents, alcoholics, homosexuals, women, minorities, and more. My favorite one is the closing story, the graduation speech. It's a medical school graduation speech that was never actually chosen to be read. It scared me so much...but at the same time, it challenged me, it made me want to be a doctor even more, to get through all of the obstacles that all the doctors before me have.



2. I have read many books of this genre (medical school memoirs), and this is by far the worst. Kevin Takakuwa,listed as the main editor, uses this book as a forum to make a littany of excuses for his failure to pass medical school, and his inability to develop social connections and relationships while there. The remainder of the stories are more about how individuals coped with being a minority, either through race, religion, or disability. If you are looking for stories about surviving medical school, don't bother reading this one.



3. Not just for minorities or those who have faced hardships on the road to becoming a doctor, this book paints a very realistic and (often) terrifying tales of students' worst experiences in medical school.
   
   While it may seem intuitive that medical school is easier if you have financial support as well as a healthy personal and family life, not all of us are so lucky. This is a collection of stories from those who have found themselves in an unlucky position at one time or another. While most of them faced prejudices, the culture at medical schools has become more accepting; however, many challenges still remain. The most important part of the book is towards the end where a list of problems plaguing our medical school is outlined in a concise, clear manner. These issues are important whatever your race, creed or gender.
   
   The face of healthcare is changing and our medical schools must change with it. The obstacles created by academic beaurocracy and an unforgiving system apply to all of us. I would heavily recommend this to anyone apply for or already in medical school.



4. Not the best book I have read of this type, but interesting. Some of the writers come across as a little too self-involved (woe is me stories are not my favorite) and I skipped the poetry sections. Keven Takakuma's story made the whole purchase worth while, in my opinion.
   I imagine if you are a minority going into med school, you could relate very well to the stories of the struggles and concerns of these students.



5. I believe this was a great book. It was interesting and certain things they mention I can relate. My mentor let me borrow the book and it really motivated me to continue on the path of medicine.

5 comments about I'll Carry the Fork! Recovering a Life After Brain Injury.

1. I never fully understood my dad's head injury, but after reading this humorous story of Kara it made me realize the frustrating effects of brain injury. Just a great book over-all and written on the level of a sixth grader, so it makes it an easy read.



2. A delightful book which takes the author from a tragedy and life change to making her new life the best it can be. A wonderful message for those of us having a family member who is a recent traumatic brain injury survivor. It is written with humor but with a valuable message. The chapters are short and written in a manner our TBI survivor is able to read and comprehend it. Thank you for this book.



3. A delightful book which takes the author from a tragedy and life change to making her new life the best it can be. A wonderful message for those of us having a family member who is a recent traumatic brain injury survivor. It is written with humor but with a valuable message. The chapters are short and written in a manner our TBI survivor is able to read and comprehend it. Thank you for this book.



4. A great read for a survivor or family member of TBI. Slightly larger print and easy to follow story line. This book puts you in touch with the TRUELY important things in life. Showing some of possitive and humorious bumps in her new learning curve keeps this book from reading like a text book. Wow does it feel better knowing that others share similar experincies.
   I have purchased several of these, one for my daughter, and a couple for friends to help them understand me now.
   If you ever get the chance to meet Kara DO IT, she is uplifting to speak with.



5. My son received a severe brain injury in a car accident almost two years ago. He has made a remarkable recovery. However although I ask him how he feels he can't always tell me, says " I just want to be back to normal" I have really wanted to know exactly what goes on in their brain during the recovery -which of course is on going. This book was just delightful. I loved Kara's honest comments and the way she expressed her feelings. My son does not want to read it but my daughter-in-law does.
   I have to say though, for all of you parents out there who's child has been diagnosed with a severe brain injury, don't despair, Kara's mild brain injury seems a lot more severe in her recovery than my son's!
   Thank you Kara for a wonderful insight into the feelings of a brain injured person. Best of luck for a continued recovery.
   Judy Knott
   Auckland
   New Zealand