Of all the cringeworthy episodes of Curb Your Enthusiasm, for me the cringeworthiest includes the scene where Larry David, stuck waiting in an exam room, uses the doctor’s phone to call a friend. The doctor finally enters the room, catches Larry in the act, and scolds him at length for using the doctor’s phone because… it’s the doctor’s phone. This scene makes me cringe because it lays bare the absurdity of the power gap between doctors and patients—and the ways doctors maintain that gap by subjecting patients to confusing medical jargon, humiliating hospital gowns, and, yes, by making patients wait.
Mostly, it makes me cringe because I’m a doctor.
There are, fortunately, many works of fiction, nonfiction, poetry, and memoir that bridge the distance between doctors and patients by offering an inside view of doctors’ doubts, faults, foibles, frustrations, and joys—works in which we see doctors for what we are: human beings. The following is just a small sample of the rich body of literature by physicians. Due to space limitations I’ve excluded many excellent titles as well as fine books by nurses and other healthcare workers (and by patients). No doubt COVID-19 will inspire many more accounts of illness and caregiving, just as AIDS, the 1918 influenza pandemic, and other health crises going back to antiquity did. Storytelling, it seems, is essential to healing for clinicians and patients alike.
***
In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope by Rana Awdish
The doctor-becomes-patient narrative takes on a new dimension in this 2017 memoir. Awdish, an ICU physician in Detroit, was hospitalized in her own ICU after a massive hemorrhage during pregnancy. The shock she experienced resulted not only from loss of blood, but from the patient’s-eye view she received of her colleagues’ insensitivity. The worst example: a resident asked Awdish to teach him how to confirm the death of her own fetus on ultrasound. In the years since this trauma Awdish has become a prolific speaker and writer, persuasively arguing that clinicians should receive training in empathy no less than in other aspects of medicine.
Comfort Measures Only: New and Selected Poems, 1994-2016 by Rafael Campo
Campo, an internist and HIV physician in Boston, often speaks of the many identities he brings to his writing; he’s a doctor, a poet, a Latino, and a gay man. Many of the poems in his most recent collection center on medicine, but always obliquely. The “I,” often a doctor, seems determined to view his medical work through a non-medical lens. In the title poem, for example:
I’m really not obsessed with how we die.
I checked the chemistries, I weighed the salts:
Pretending we’re immortal, we don’t crywhen inpatients still refuse to defy
the odds. The clock still ticks, the flowers wilt.
I’m really not obsessed with how we die—
Chekhov’s Doctors: A Collection of Chekhov’s Medical Tales by Anton Chekhov, edited by Jack Coulehan
Chekhov once claimed: “Medicine is my lawful wedded wife and literature is my mistress.” Still, his two professions overlapped in a series of sixteen short stories featuring doctors and collected in this edition. In some of these stories, such as “Ward Six,” the tables are turned and a doctor becomes a patient. In “A Doctor’s Visit,” a young physician wonders about the limits of his professional role when called to the home of an heiress who seems to be suffering more from loneliness than illness. In “A Boring Story,” an aging professor of medicine approaches the end of his career with regret and dread. And in “Enemies,” a young doctor struggles to empathize with a patient in the face of his own grief.
Complications: Notes on an Imperfect Science by Atul Gawande
Years before he’d become a MacArthur Genius awardee, a New Yorker staff writer, and a renowned surgeon, researcher, and policy advisor, Atul Gawande began writing essays during his residency. He wrote, mostly, about his profession’s flaws: about missed diagnoses, treatments gone wrong, and gaps in medical training, Several of these essays appeared in a then-new online publication—Slate—and still more appeared in the New Yorker. His first book, Complications, is a collection of those early essays, published in 2004. Gawande’s storytelling skills and his willingness to address uncomfortable issues were fully apparent even then.
The Beauty in Breaking: A Memoir by Michele Harper
Last summer, when COVID deaths were rising and residents of New York and other cities banged pots at 7 p.m. every night in appreciation for health care workers, Michele Harper, an emergency medicine physician in Philadelphia, published a memoir in which she acknowledges often feeling less than heroic. Coming to medicine after an often-violent childhood, Harper encounters racism, sexism, and tragedy—but also deep satisfaction in connecting with her patients.
Doctored: The Disillusionment of an American Physician by Sandeep Jauhar
We hear that burnout is rampant among doctors and nurses, but what does that mean? In this 2014 memoir, Jauhar, a cardiologist and New York Times contributor, explores a major cause of burnout: the pernicious and relentless influence of money on medical practice. Jauhar tells how during his first decade in the profession, rushed visits, shady billing practices, and unnecessary referrals and tests made him feel alienated and depressed. His recovery—the cure for burnout—involved returning to the values that inspired him to become a doctor in the first place.
The Earth in the Attic by Fady Joudah
In this volume of poetry, for which he won the Yale Younger Poets award in 2008, Joudah, an internal medicine physician in Houston, often injects medical language into political and other contexts. In “Pulse,” for example:
Wadis fill with water
And fill the jaundiced earth green,
Green like autumn
A woman told me when I asked what color
Her diarrhea was… autumn
Is for chill metamorphosis.
Louise Glück writes in her forward to the collection that Joudah’s poems “…resemble scientific proofs, but proofs written in an utterly direct and human language…” I interviewed Joudah for The Rumpus in 2013 and discussed with him the ways in which his medical experiences infused his poetry.
When Breath Becomes Air by Paul Kalanithi
Written while Kalanithi, a neurosurgical resident at Stanford, was dying of lung cancer and published posthumously, When Breath Becomes Air is a lyrical meditation not only on the passage from sick to well and life to death but from doctor to patient. Kalanithi confronts the painful irony that during his long and grueling medical training he deferred gratification and neglected relationships only to find that the future would never arrive.
Memoirs of a Woman Doctor by Nawal El Saadawi
This 1988 novel narrated by an Egyptian female physician closely follows the life of its author. It opens: “The conflict between me and my femininity began early on…” Saadawi writes of the sexism professional woman faced in the 1950s and ’60s and how women in that era so often had to choose between work and family. For Saadawi, who died at ninety last month, the injustice she experienced herself fueled a lifelong activism. She advocated against genital mutilation and cofounded the Arab Association for Human Rights.
A Leg to Stand On by Oliver Sacks
It’s hard to choose just one book by Sacks (he wrote a dozen) but my own favorite is this lesser-known memoir about a severe leg injury the neurologist sustained while hiking in his forties. The long journey toward “reconnecting,” as he puts it, not only his body but his spirit is beautifully wrought. When I interviewed Sacks in 2013 for The Rumpus on the occasion of his eightieth birthday, he was pleased and surprised that I requested he sign a copy of A Leg to Stand On rather than one of his most popular books, such as Awakenings or The Man Who Mistook His Wife for a Hat. He inscribed it: Thank you for liking this.
Black Man in a White Coat by Damon Tweedy
The effect of structural racism on the health of people of color received renewed attention this past year when COVID-19 sickened and killed Black and Latinx people disproportionately. In 2015, Duke psychiatrist Damon Tweedy explored the effect of racism on both patients and healthcare workers—including himself. Mistaken for a janitor by one of his medical school professors who asked him to fix the lights in the lecture hall, Tweedy wonders if he’s really cut out to be a doctor. His experience illustrates powerfully how “imposter syndrome” is so often really internalized prejudice.
Mortal Lessons: Notes on the Art of Surgery by Richard Selzer
At age fifty-eight, Selzer gave up surgery and began to write full-time, practicing at first by composing horror stories. His short stories and lyrical essays, such as those contained in his first collection Mortal Lessons, published in 1976, extract poetry out of the most prosaic clinical scenarios.
My Own Country: A Doctor’s Story by Abraham Verghese
This Stanford physician’s best known book is his novel, Cutting for Stone, but his first book, a memoir, is my favorite. Verghese arrived in Johnson City, Tennessee in the early 1980s at the beginning of the AIDS epidemic. A recent immigrant to the US, born in Ethiopia to Indian parents, Verghese saw in the closeted gay men he encountered in the rural South echoes of his own dislocation.
The Doctor Stories by William Carlos Williams
Like Chekhov, Williams wrote mostly not about medicine, but this compilation of elegant and sometimes brutal vignettes offers a window into his inner life as a pediatrician and OB-GYN in Rutherford, NJ in the early twentieth century. The most famous of these, “The Use of Force,” tells of a doctor—Williams himself—paying a house call on a young girl during a deadly outbreak of diphtheria. Unable to convince the girl to open her mouth so he can inspect her throat the doctor is overcome with an almost murderous rage. “I could have torn the child apart in my own fury and enjoyed it,” Williams admits.
And to close out this wonderful list, we just had to include Suzanne’s new book, Letter to a Young Female Physician: Notes from a Medical Life, out May 4 from W. W. Norton & Company! – Ed.
Letter to a Young Female Physician: Notes from a Medical Life by Suzanne Koven
In 2017, Dr. Suzanne Koven published an essay describing the challenges faced by female physicians, including her own personal struggle with “imposter syndrome”—a long-held secret belief that she was not smart enough or good enough to be a “real” doctor. Accessed by thousands of readers around the world, Koven’s “Letter to a Young Female Physician” has evolved into a deeply felt reflection on her career in medicine. Koven tells candid and illuminating stories about her pregnancy during a grueling residency in the AIDS era; the illnesses of her child and aging parents during which her roles as a doctor, mother, and daughter converged, and sometimes collided; the sexism, pay inequity, and harassment that women in medicine encounter; and the twilight of her career during the COVID-19 pandemic. As she traces the arc of her life, Koven finds inspiration in literature and faces the near-universal challenges of burnout, body image, and balancing work with marriage and parenthood.
