The scholarship is exemplary, the work impressive, and the sum total made me want to rummage around for my old picket sign. It is scholarly and immensely readable, inclusive and critical. Poirier has written a book that will appeal to a wider audience curious about medical writing and a text that will speak to the heart of what medical education struggles with today. I will rejoice in being able to use it and refer to it in my teaching and writing.
Women Write Their Bodies. Suzanne Poirier is professor emerita of literature and medical education at the University of Illinois College of Medicine, Chicago. Language, Literature, and Analysis.
Doctors in the Making: Memoirs and Medical Education
Would you like to tell us about a lower price? If you are a seller for this product, would you like to suggest updates through seller support? Recent surveys of medical students reveal stark conditions: Compounded by long hours of intellectually challenging, physically taxing, and emotionally exhausting work, medical school has been called one of the most harrowing experiences a student can encounter.
Although most students emerge from medical education as well-trained, well-prepared professionals, few of them will claim that they survived the process unscathed. The authors of these accounts document—for better or for worse—the ways in which they have been changed.
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The book is based on diaries he kept while he was a junior doctor, and he thinks he may have overrepresented the comic incidents because he used to write about them to ease the sense of pressure he felt. Kay is at his most vivid as a writer when describing what that pressure involved. And whereas he has to cancel holidays, wedding invitations and much else besides to fit in with changing rotas, one of his consultants takes two weeks of compassionate leave when her dog dies, while other consultants are almost strangers to their wards.
He says now that he was probably suffering from undiagnosed post traumatic stress disorder, and that little understanding was shown by the medical authorities. He believes that in such circumstances, doctors should immediately be offered a week off work if they want it. He was in a state of depression for about a year, not going out, not seeing anyone, and losing a great deal of weight. Kay had enjoyed a longstanding interest in comedy, performing in medical student revues, and later in corporate gigs for pharmaceutical companies. Although he has forged a successful new career, it would be wrong to say he never looked back.
And he maintains a great respect for those who do the job he once did. But junior doctors disagreed and the BMA then supported strike action. Kay believes the doctors were portrayed as money-grabbing and irresponsible when, he argues, precisely the opposite is true. The system is one that never had a lot of slack in it but is now stretched to absolute breaking point. At the conclusion of the book, Kay writes an open letter to Jeremy Hunt in which he suggests he should have to work shifts alongside junior doctors, so that their motivation was never again questioned.
This message has obviously worked with readers. At book signings Kay says he has often been asked to sign an extra copy that people then send on to Hunt. Whether or not it was receiving these books that did it, Hunt asked to see Kay a few weeks ago. Buses and taxicabs were letting people off in front of the hospital. An ambulance whizzed by on the main thoroughfare, sirens blaring, lights flashing.
The noise fed my sense of wonder. I had grown up in a quiet Southern California suburb, craving the excitement of a big city. Louis had their pockets of vitality, but nothing like this. Even the smell of the neighborhood—a mix of pizza, garbage, cigarette smoke, and fragrant fruit—was rich and seasoned, like wisdom wafting through the air. I had only arrived in Manhattan a few days earlier, moving into a one-bedroom apartment about a block away from the hospital. On the plane flight in from St. Louis, the pilot took a detour because of airspace congestion, he told us, flying into LaGuardia from the south, not the usual flight pattern.
As we passed over the World Trade Center and then soared low over the city, I craned my neck to look down at the broad swath of Central Park. The brown buildings on its outskirts were arrayed like divers ready to jump into a pool. The first time I had been to New York was the summer before medical school, when I spent a couple of weeks with my brother and his wife in their tiny one-bedroom apartment across the street from the hospital, where he had just begun his fellowship. I wandered around the city, going on walking tours of Harlem, joyriding on the subway, chatting with bartenders late into the night.
Like many visitors to Manhattan, I was swept away. The delicatessens, the dry cleaners, the corner convenience stores and smoke shops. There was magic in the movement on the streets. So much was happening, and I could watch it all and remain a shadow. That was the wonderful paradox of Manhattan: Back on the sidewalk, I felt a light spray from air-conditioning units outside the apartment windows above me.
Heavy construction was going on in a lot nearby; large bulldozers were exhuming a deep hole, as if for a tomb, their blades ravenously picking up mouthfuls of yellowish dirt. I passed by an old church and stopped at a fruit stand to buy a nectarine. Then I ambled back to orientation munching on it. A plane flew overhead. My bags were packed, the bills paid, the car loaded.
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Most of my possessions had been sold, save for some clothes and a few boxes of books, which I forced into the trunk and backseat. After a week of sleepless nights, I had turned in my Ph. I had even found someone to take over my apartment. Now all I had to do was leave. It was late in the afternoon on Tuesday—August —and the sky over the shimmering San Francisco Bay had turned a smoky orange.
Medical school orientation was starting tomorrow.
I would be in a Honda Civic somewhere in the Rocky Mountains. After explaining to the dean that I was delayed finishing my physics thesis, she had urged me to at least try to make it to St. Louis by Friday morning for the white-coat ceremony and the recitation of the Hippocratic oath. After speaking with her, I looked it up: To please no one will I prescribe a deadly drug, nor give advice which may cause his death.
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Nor will I give a woman a pessary to procure abortion. Perhaps that could be my first contribution to my medical education. The air was warm, still, vaguely welcoming. The fraying eucalyptus trees in the backyard gave off a pungent fragrance. Taking a long drag, I felt buzzed, even a bit dizzy.
For the first time in months, I was in the moment. But the carefree feeling quickly dissipated as the thought—the same thought that had plagued me for months—reentered my mind, even as I tried hard to resist it: What the hell are you doing? I pulled out of the driveway and headed south toward the Berkeley campus one last time.
Ice plant still lined the side of the road, and the landscaping was still immaculate, just as it had been a decade ago. Freshman year, I remembered, I had planned to major in history or political science, but Victor, my randy Russian roommate, had deterred me. He was a double major in math and physics. He put a mattress in our walk-in closet. Every night, moans from one of his girlfriends titillated me as I fell asleep. He lent me books on abstract algebra. He told me about Ramanujan, the Indian mathematical prodigy who claimed that the Hindu goddess Namakkal whispered theorems about prime numbers to him in dreams.
In freshman chemistry, when I had to memorize the rules for how electrons occupy atomic orbitals, Victor taught me where those rules came from, in a quantum-mechanical language that was both beautiful and inscrutable.
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The exactness, the inaccessibility, of quantitative science intoxicated me. In the social group I eventually joined, math and physics had prestige, a sort of intellectual exclusivity that was deeply appealing.
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The spectrum of talent in these subjects was so broad, much broader than in the social sciences or humanities or even the biological sciences, where it seemed that with enough study even the grade-conscious premeds could master the concepts. What separated me from the rest of the pack was what separated Victor from me, and what separated my friend Mike from Victor, and what separated the genius student David Moulton from Mike, and what separated the weird, stinky math professor who ambled around campus mumbling to himself from David Moulton, and probably what separated Einstein from the weird, stinky math professor.
The brain function required was so specialized that math and physics seemed to me the truest tests of intelligence. So, by the end of my freshman year, my major had changed to physics, and my intellectual heroes had changed from Churchill and Gandhi to Einstein, Heisenberg, and Feynman, men who changed the world through the power of mathematics. But by senior year it had become clear to me that theoretical physics, at least at the level I wanted to pursue it, was beyond my capabilities.
Trial law had always interested me; in high school I often fantasized about leading a courtroom charge like Atticus Finch in To Kill a Mockingbird. Law school, I hoped, would allow me to broach the big questions of ethics, philosophy, and politics that had always interested me. I got into the top schools and even deferred my admission for a year, but in the end I decided to stay at Berkeley for the graduate program in physics. One thing I never thought seriously about was becoming a doctor.
In fact, for most of my life, medicine was the last thing I wanted to do. My maternal grandfather had been an army doctor in India before he went into private practice. As a boy in India, before we moved to America, I used to watch him at work in his iodine-stained clinic on the ground floor of his palatial flat in an upper-crusty neighborhood of New Delhi.
It was fine, noble work—or so I was told—but it never caught my fancy. To me, even as a boy, medicine was a cookbook craft, with little room for creativity. My family immigrated to the United States in , when I was eight we lived in Kentucky for two years, before moving to Southern California. Whenever the subject of lifework came up, I told my parents that I would never become a doctor.
Unlike my brother Rajiv, who somehow always knew he wanted a career in medicine, I was more interested in books, literature, philosophy, the big questions of human existence, about which medicine apparently had nothing to say. Even when I experienced a flash of medical curiosity—say, when the pope got sick or a Soviet leader mysteriously disappeared for a few days—it would quickly dissipate or be subsumed by my interest in the politics of the event. I wanted to be a historian or a high-ranking government official or a famous lawyer or actor or a private investigator, something romantic, with character and flair.
Medicine was so bourgeois! My father admonished me for being impractical. He wanted me to become a neurosurgeon—one trained at Stanford, no less. To him, that was the apogee of professional attainment. He understood well the privileges of being a doctor. Whenever he was on the phone with the airlines or with the bank, he always identified himself as Dr.
My mother, too, wished for me to become a doctor. For her, medicine represented an honorable path to influence, power, and wealth—all the things that had eluded my talented father. In immigrant Indian culture, youthful rebellion is saying no to a career in medicine.
I find that the harder I work, the more I have of it. He felt an overwhelming urge to keep my brother, Rajiv, my sister, Suneeta, and me from repeating his mistakes. When I was in middle school in Riverside, California, a medium-size suburb of tract housing and strip malls tucked away in the smog-ridden Inland Empire, my parents invited a veterinarian over to the house for tea. He too had emigrated from India, a lanky man in his forties with a curly mustache, a Nehru jacket, and baggy brown pants that looked like they needed washing.
He and my father talked about the evils of Reaganism, but the conversation quickly turned to medicine. Then he retold a story I had heard many times. My paternal grandfather had died when my father was only thirteen. After his death, the family spiraled into poverty. My father, an able and devoted student, was forced to read his schoolbooks under streetlamps because there was no electricity in the house.
For an indigent boy growing up in rural Kanpur, medical school became an impossible dream. My father flirted with the idea when we first came to the United States, but by then he was thirty-seven, with a wife and three young children, and it no longer seemed practical. I desired the academic, retiring life of my father. The vet turned to me. She was a typical Indian mother, loving, caring, committed, but small-minded, too, in that only-concerned-with-my-own-backyard way. She had struggled alongside my father, raising the three of us kids, working full-time as a lab tech, making do with much less than she was accustomed to having, sacrificing so my father could write his academic textbooks, which sold a few dozen copies a year.
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She always said that nothing good or substantial would come of writing books. We lived hand to mouth in a house sparsely furnished with lawn furniture, kitsch, little tchotchkes and cheap knickknacks my parents picked up from garage sales. When you walk into the room, people will stand. At the university you may get nothing for your hard work. Where are the human rights in this country? They will always hire a white American if they can.
You have to be three times as good as them to get the same recognition. If I could start a practice, I would kick them. I would tell them to go to hell. The irony of all this was that my father hated doctors. He thought they were all crooks. He always said scientists like him, Ph. I had heard the stories growing up: Gokhale, our family doctor, had bungled the stitches I needed after a dirt-biking accident, incorrectly diagnosed my brother with water on the knee, and almost killed my grandmother by giving her a drug for a blood disorder she did not have.
My parents had a running joke between them about how much Rajiv was going to charge them for medical care in their old age. The clear if unintended message was that doctors were money-grubbers, distinguished from shopkeepers only by their higher education. I too resented doctors for their money, their airs. At Indian social functions, the doctors would drive up in their fancy cars as we were getting out of our dilapidated old Buick.