World Famous Comics: Final Exam: A Surgeon's Reflections on Mortality (Vintage)
Final Exam: A Surgeon's Reflections on Mortality (Vintage)
By: Pauline W. Chen Publisher: Vintage Average Rating: Binding: Paperback Label: Vintage Number of Items: 1 Number of Pages: 288 Publication Date: January 08, 2008 Release Date: January 08, 2008
Product Description: A brilliant transplant surgeon brings compassion and narrative drama to the fearful reality that every doctor must face: the inevitability of mortality.
When Pauline Chen began medical school, she dreamed of saving lives. What she could not predict was how much death would be a part of her work. Almost immediately, she found herself wrestling with medicine’s most profound paradox–that a profession premised on caring for the ill also systematically depersonalizes dying. Final Exam follows Chen over the course of her education and practice as she struggles to reconcile the lessons of her training with her innate sense of empathy and humanity. A superb addition to the best medical literature of our time.
Three weeks ago, we marked the fourth anniversary of my son's death. In a week, we will remember him on what would have been his thirteenth birthday.
I found Andrew having seizures and called the paramedics. After seven hours of surgery, the neurosurgeon could not find a way to tell me that Andrew had died. Instead, he described in horrible, excruciating detail what he had done to try to save my son and what we could expect if Andrew survived. I have only been able to repeat his words to others twice since that night, but they have been repeated in my mind many times. I could tell myself that he had been physically and emotionally exhausted by his night in the OR, but I still felt angry that he had used that level of detail.
Eight months later, I was helping my mother through the last stages of her cancer when she fell at home and her neighbor called me to tell me that she had been taken to the hospital by ambulance. At that point she had lost about a third of her normal weight. When I got to the hospital, she was in pain and seemed different in her behavior. It took a day for me to realize that she had no short-term memory. If I was not in the room and the nurses asked about me, she would tell them that I lived too far away and could not come. Every time that I entered the room, she greeted me like she had not seen me for a long time. My sister-in-law believes that she had a minor stroke. Within a day, it was obvious to me that she was failing. I called my sister to tell her to come now. My mother's oncologist saw her in the hospital, and then started calling me to make appointments to start a new course of chemotherapy. I finally told him that she would no longer need his services. He could not seem to understand. My mother died four days after her fall, the day after I dismissed her oncologist. I was baffled by his attitude to her care.
Pauline Chen's book has helped me to understand and appreciate how both doctors responded to these deaths. I have found a new peace with two men who had to face the fact that they could not save everyone. I am grateful to her for helping me to find a new perspective.
My only quibble with her book is the use of the word "harvest" to describe the collection of organs for transplant. We donated Andrew's organs and I now volunteer for our transplant organization. Many donor families dislike that word and the California Transplant Donor Network does not use it.
Her writing style drew me into what she experienced. Sometimes, I could visualize what she was seeing as if I was there. I sometimes found her descriptions of liver surgeries difficult, as we have met our liver recipient. Some reviewers have disliked the graphic style of her writing, but I believe that it is important to help us see the emotional turbulence that medical students and practitioners go through just to do their work day after day.
I cannot say enough good things about how organ donation has helped our family. Meeting one of our recipients and his family has been a special gift that came from Andrew's death. They have become part of our family. Please go to donatelife.org, find the donor registry in your state, and sign up.
We live in a lucky time and place when many people do not see the immediacy of death on a regular basis. Reading this book is an important reminder that this is an everyday occurrence and that those who have to see it everyday pay a deep price.
Lovely reading Autobiographical, well written and organized, sensitive and upbeat, Dr. Chen shares with us her experiences as a medical student and as a doctor. I enjoyed the chapter on dissection of the human body and the stories of patients. It reads as if one were talking to a friend. Thanks for the lovely book.
Final Exam This book is an excellent resource for caregivers who work with terminally-ill people: clergy, social workers, hospice volunteers, family members, etc. It provides a clear picture of the daily world of professional medical personnel, offering a rare insight into the personal dilemmas and struggles they encounter, but which are not shared with others.
Final Exam Very moving at times. The medical profession is a world of its own. Power is too concentrated. The education process is to dehumanizing. It's difficult for human beings to emerge from the process.
A Courageous Book This book is a call for doctors to provide comfort to patients when cures are no longer viable. She urges doctors to engage with persons as a complex, integrated whole rather than as an impersonal clinical case. The book is a heart felt philosophical argument against medical deconstructivism that illicits almost knee-jerk "do something" responds to illnesses. Complicated ritualistic processes or treatment algorithms focus on the disease rather than the person who suffers. Dr. Chen is amazingly courageous in writing this much needed book and she openly questions herself as well as the medical culture and educative process that "made her."
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