Book Review: The Pen & the Stethoscope
Edited by Leah Kaminsky, Scribe Publications 2010.
I recently received this book as a graduation present from some old friends, and just on reading the cover jacket I was pleasantly surprised to see such an exciting collection of authors, ranging from the multi-award winning Atul Gawande (surgeon and writer for the New Yorker), through household name neurologist Oliver Sacks (author of Awakenings, Seeing Voices, and many other books) to our very own poet Peter Goldsworthy (who received an Order of Australia in 2010 for his services to literature).
Alongside these heavyweight authors there are another 12 highly respected authors whose medical practice varies from General Practice to ENT Surgery, including the editor Leah Kaminsky.
In this collection Kaminsky has divided the writing into fiction and non-fiction categories and starts with Gawande’s essay from The New Yorker “The Checklist”. This essay formed the starting point for his current novel (and New York Times Bestseller) The Checklist Manifesto. As an entry into this collection, which seeks to “look behind the doctor’s mask”, it is a treatise on innovation that looks at the barriers of arrogance and traditional reliance on “expert audacity” in medical practice. Through stories about his own patients and reflections on research both within and outside of medicine, he explores the increasing complexity and responsibilities doctors are dealing with and the difficulty in making systematic changes that are clearly in the best interests of patients.
Other pieces in the non-fiction category give pause for consideration and reflection. For those of us entering the profession Sandeep Jauhar describes the issues faced as an Intern, and Perri Klass encounters the guilt of being responsible for spreading pertussis while continuing to work through sickness. Danielle Ofri writes of her experiences in ICU, probing the pointlessness and waste of resources that can occur with some treatment, while ultimately driving towards the struggles that can overwhelm doctors, with the saddest and most hopeless of consequences.
The non-fiction section gives a human insight into the practice of medicine; of the fallibility, the passion, the hierarchy, the commitment and discipline, and the demands and rewards of being a doctor. It also gives just a small taste of each of the different authors. This is both a strength and a weakness - at times I felt disappointed at the brevity of the texts, yet I was also pleased to be introduced to so many new (to me) authors. Many of the pieces were extracts from longer text, which gave the effect of being slightly out of context. In one, The Nazi Doctors by Robert Jay Lifton, there is such extreme editing and lack of detail that the power of the concepts is lost almost completely.
In contrast, the fiction stories seem to be able to stand well on their own - and most are short, well-formed, complete stories in their own right. These stories forge headstrong into the complexities of the human condition. Dealing with concepts of ageing and sickness, obsession and experimentation, loss and grieving, absurdity and horror, this section of the collection I found emotionally moving numerous times. There is variance in the quality of the writing - all of it is of a high standard, but not all of it communicates with the same strength and clarity. The short format though, is ideal for teasing out an idea and allowing a reader to ponder further about the characters involved. Unlike the non-fiction section, I didn’t find myself wanting more from the fiction stories.
This collection is startling for the high quality authorship, the honesty, the diverse topics, and the insight it provides into the experiences of doctors across a range of fields. It is likely to find an audience in both medical professionals and the general public alike. Indeed, it deserves a wide readership. Personally, I would recommend it to doctors to read as a reminder of the impact of the responsibility they carry each and every day, and of emotional quotient present in every interaction with a patient. There is also the possibility for inspiration, of thinking about better ways to practice and better ways to live. And finally, if nothing else, it may introduce you to a new author whose work resonates with your own thinking.
