From the author: Bone cancer in my cheek ended my career as an opera singer and brought me face to face with mortality, disfigurement, the meaning and uses of beauty—and a lot of left over pieces.
Read moreShark Heart: A Love Story by Emily Habeck
When I learned of an upcoming book about a man who turns into a great white shark, I thought this was another example of our need to tame a dangerous wild animal into something suitable for a child’s tee shirt. Shark Heart, A Love Story, Emily Habeck’s first novel (Simon & Schuster, 2023) is not that at all, but much more: a love story about newlyweds Lewis and Wren, a meditation on our relationship with the animal world, and an exploration of illness and caregiving. Shark Heart explores the characteristics we share with other species and the question of what makes humans unique, while it also considers how health and illness affect our relationships with other people.
Read moreWhat We Bring to the Practice of Medicine: Perspectives from Women Physicians. Editors: Kimberly Greene-Liebowitz and Dana Corriel
In 1960, women comprised 6.7% of practicing physicians; today, that number is 37%. Women often face different difficulties from their male counterparts; even today, misogyny, discrimination and societal expectations affect training, health, specialty selection and academic progress.
In What We Bring to the Practice of Medicine, a collection of essays published by Kent State University Press, women share stories from their careers that altered how they saw themselves and their patients. These authors have no fear of vulnerability; they recognize their emotional responses as not only acceptable, but necessary for them to be the physician they want to be.
Read moreBeautiful Trauma: An Explosion, An Obsession and A New Lease on Life by Rebeca Fogg
Rebecca Fogg notes that there are innumerable responses to recovery, and she wisely avoids turning this story into a “how-to-survive-a-trauma” manual. This is no misery memoir, one that concentrates on the vulnerability and suffering of the survivor. She does describe the intense pain of the injury, however, in the objective, almost detached manner required of a scientist. She has a relationship with her hand as an object of concentrated study.
Read moreUncaring: How The Culture of Medicine Kills Doctors and Patients by Robert Pearl
In Uncaring: How the Culture of Medicine Kills Doctors & Patients (published by Public Affairs), Dr. Robert Pearl, a Stanford professor, plastic surgeon, and former chief operating officer of Kaiser Permanente, writes a well-documented panoramic narrative and insider view that demystifies the complicated healthcare system. His book offers a disturbing look at healthcare system that has lost its purpose. Pearl relates inefficiencies and slow changes, as patient centric views held by physicians and systems that have failed to adapt, both to cultural and individual principles, held so dearly for decades.
Read moreThe Song of Our Scars: The Untold Story of Pain by Haider Warraich
Almost everything we know about pain and how to treat it is wrong, Haider Warraich says in his insightful book The Song of Our Scars: The Untold Story of Pain, published earlier this year by Basic Books. The physician and assistant professor at Harvard Medical School claims that there are dire misunderstandings between patients who feel pain, the clinicians who address it, and the researchers who study it. Worst of all, he says, pain has transformed from a symptom into a disease.
One in five American adults—an estimated sixty-six million in total—experience chronic pain, resulting in billions of dollars in direct medical costs and lost productivity. Lower back pain is the leading cause of disability in the United States, followed by migraine headaches, neck pain and conditions like osteo and rheumatoid arthritis. And Americans are most likely to use opioids to help alleviate their pain. Yet, as Warraich points out, opioids provide little to no benefit for chronic non-cancer pain, and can even make it worse.
Pain’s storied complexity is multifaceted and multilayered. Its treatment, in Warraich’s view, requires empathic holistic care that considers how pain is racialized, gendered and personal. Pain is subjective. You can have pain without suffering. There is no single dedicated pain center in the brain. The pain of Black people remains both under-recognized and under-treated. Women are more likely to feel pain, but their pain is also more likely to be dismissed. Simply assessing pain on a numeric scale doubles the risk of opioid overdoses in hospital. And exercise is a vital part of any multidisciplinary approach to managing chronic pain.
Warraich himself has chronic back pain due to a sports injury that happened many years ago when he was a medical student in Pakistan—around the time when he felt confirmed in his vocation to be a doctor. Just when he felt like he had fallen in love with medicine, he broke his back.
Now an insightful, wounded healer, Warraich draws from his own experience of how disruptive chronic pain can be—how it “disrupts the way a person moves through their life, the narrative they define themselves by, the arc of their stories.”
The Song of Our Scars is filled with research findings, clinical vignettes, historical details and sociopolitical commentary. Yet the story Warraich tells is so broad and at times surprisingly sequenced—jumping from the mythological Greek world, to the history of opium, to the American Civil War—that it can sound like listening to the radio while scanning the channels, catching snippets of newscasts in search of a good song. We as readers want to hear more of Warraich’s own personal self-reflections, which would help focus his narrative by giving voice to his song, and deepen its impact on readers, his listeners.
Perhaps most helpful is Warraich’s concern for the origins of the opioid addiction crisis in America. The story of the opioid crisis continues to unfold in the United States, and recently came into the headlines in the documentary “All the Beauty and the Bloodshed,”directed by award-winning director Laura Poitras about artist Nan Goldin’s life and chronicles her addiction and activism that led to major museums such as the National Portrait Gallery in Washington, DC, the Guggenheim, the Tate and others to stop taking donations from the Sackler family and removing the Sackler name from the walls of their institutions. The documentary won the prestigious Golden Lion at the Venice Film Festival in September.
In The Song of Our Scars, Warraich highlights how Cicely Saunders’s revolutionary approach to pain management in hospice care was “hijacked” into a business strategy by the pharmaceutical industry, whose goal, he says, “was to take Saunders’s approach toward total pain experienced by people at the end of life and apply it to people in every phase of life, treating routine medical conditions as if they were terminal illnesses.” Saunders, who started her clinical practice as a nurse and became a doctor, is credited with founding the first modern hospice and establishing the discipline and the culture of palliative care in the late 1950s.
In terms of narrative care, Warraich brings to mind, but does not reference, other prominent physicians and scholars who describe and advocate also for such empathic patient-centered care, including Rita Charon, Victoria Sweet, Arthur Frank and William Randall.
What are the songs of our scars? What type, form and shape do they take? There are love songs, ballads, laments and anthems, to name an obvious few. How do they help us? Do they capture our hearts and move our spirits? Warraich hopes so. As patients tell us their tales of pain, he knows how important it is to listen to them. And he wants healthcare providers to learn how to listen more fully, deeply and more compassionately in clinical practice. Empathy is what makes a good doctor, he says—empathy and kindness.
“As we look to the future and take stock of all that we know about chronic pain,” he says, “we find that the most promising treatment approaches don’t involve any chemical inebriation or procedural manipulation. They involve one human being talking to another, helping them realize that the path to relief was within them all along.”—Robert Mundle
Robert Mundle is a graduate of Yale Divinity School and a palliative care chaplain in Kingston, Ontario. He is the author of How to Be an Even Better Listener: A Practical Guide for Hospice and Palliative Care Volunteers (JKP 2018).
A History of Present Illness by Anna DeForest
The narrator of A History of Present Illness is a young doctor going through the daily initiation of learning her vocation. In the story, the narrator subverts the fabled tradition of medical education through her position as an outsider on the inside. We discover her history in increments: She grew up in an unstable home with a mother who drank too much. In her adolescence, she walks in to see her pregnant mother sitting on the kitchen floor shooting staples into her arm. Financial instability is a way of life, as is self-injury: The narrator cuts lines into the creases of her hands, to manage the suffering and hide her scars.
Read moreOrdinary Deaths: Stories From Memory by Samuel LeBaron
Psychologist Samuel LeBaron’s book, “Ordinary Deaths” was recently published by the University of Alberta Press and in it, he examines the following truth without the drama often accompanying such writing: Death is not a heroic journey, a metaphorical “war” against fatal illness. It is, as the title states, ordinary.
Read moreIn Love: A Memoir of Love and Loss by Amy Bloom
Amy Bloom’s moving memoir, In Love: A Memoir of Love and Loss, is a love story about an idyllic marriage shattered when Bloom’s 60-year-old husband Brian’s forgetfulness takes over their lives. His personality changes, and he becomes distant and indifferent. “Names disappearing, repetition, information turned upside down, appointments and medications scrambled. Suddenly it seemed we argued endlessly about everything,” Bloom laments.
Read moreWords We Cannot Say by Sita Romero
Sita Romero’s debut novel Words We Cannot Say offers a true and unflinching look at pregnancy and hardship. The story is told through the lives of three different women as they navigate the struggles of friendship, motherhood, pregnancy and loss. Though the women seem to be entirely different, their lives connect in organic and often overlooked ways.
Read moreHEALING: When a Nurse Becomes a Patient by Theresa Brown, RN
Theresa Brown’s 2015 book The Shift explored the question of what it means to care for others. In her new memoir, Healing: When a Nurse Becomes a Patient (Algonquin Books), Brown chronicles her experience with breast cancer from diagnosis through treatment and deepens that question into: How can we make the healthcare system more compassionate?
Read moreWhat Cannot Be Undone: True Stories of a Life in Medicine by Walter M. Robinson
Our training as physicians teaches us to bury our emotions, to remain objective and detached, and it has become clear that patients can perceive doctors as lacking empathy by hiding this aspect of themselves. The complexities of this dynamic are explored in Walter M. Robinson’s What Cannot Be Undone: True Stories of a Life in Medicine, a collection of essays examining the self-destructive results of detachment from the physician’s emotional responses, published recently by the University of New Mexico Press. When physicians cannot tolerate the pain and suffering of their inner life, compassion-fatigue, burnout, substance abuse and suicide are possibilities.
Read moreLetter to a Young Female Physician: Notes from a Medical Life by Suzanne Koven
Letter to a Young Female Physician: Notes from a Medical Life by Suzanne Koven, MD is both instructive and empowering for a professional audience. The “young female physician” is Koven herself 30 years ago, and the memoir’s title comes from a New England Journal of Medicine op-ed she wrote that brought to light Imposter Syndrome (a perceived and misplaced self-doubt that high-achievers are unworthy of the confidence others place in them and that soon enough they will be found-out as imposters). A primary care physician, Koven creates a narrative that addresses issues facing women in medicine such as pay iniquity, harassment and sexism. While all of the above is plenty to keep readers in the clinical world engaged, the book’s success resides in something else—the way Koven approaches universal truths by examining and honoring the specific experience of her life as a woman and as a doctor. Going beyond the halls of the hospital and the titular “young female physician,” she creates a narrative sure to resonate with many.
Read moreAt Peace: Choosing a Good Death After a Long Life by Samuel Harrington MD
At Peace: Choosing a Good Death After a Long Life is a book that should be studied by students preparing themselves for careers in medicine, by those taking care of aging patients, by family members who don’t want their loved ones to suffer, and by everyone who desires for their life to end in peace with a good death.
Read moreThe War for Gloria by Atticus Lish
Fiction has the ability to bring a world to life, to offer other viewpoints and ways of looking at the world, and it also has the ability to put us in another body in order to give us the experience of a disease or condition. In Atticus Lish’s excellent new novel The War for Gloria (Knopf, 2021), the disease is amyotrophic lateral sclerosis, ALS or Lou Gehrig’s disease. The story is told from the perspectives of Gloria and her son Corey, who is a young teenager when Gloria is diagnosed with ALS. Lish, whose novel Preparation for the Next Life won the 2015 Pen/Faulkner Award, brings to life the world of working class Boston suburbs.