First review for Chronic Patient Book Club is finally here. ::drumroll::

Emily R. Transue, M.D. Patient by Patient: Lessons in Love, Loss, Hope, and Healing from a Doctor’s Perspective. New York: St. Martin’s Griffin, 2008. R154.T673 A3 2008. 610.69’6092

Emily Transue documents her first years as a doctor of internal medicine, living in Seattle and flying back frequently to visit her aging grandparents in New Jersey. She’s honest about the difficulties she faces with the business of being a doctor (coding is a constant nightmare) and the troubles she faces as a daughter and a granddaughter. Her book gives a window into the dual world of a maturing doctor and a maturing adult, considering marriage, the needs of people she barely knows, and the finality of death.

Her first chapter includes that insight we only gain in retrospect:

I had finished the hard years of residency, the hundred-hour weeks and thirty-six hour shifts, the drama of the hospital and the emergency room. I had seen a lot of people die or nearly die in those years, and I thought I knew plenty about grief and loss and healing. I little imagined how much more and how differently I would learn in the coming years. Much of this would come from the patients I would care for, not just in the episodic crises of the hospital but in the slower, richer arc of sickness and health that a primary care doctor sees. In parallel, my first years in practice would be tumultuous ones for the people in the world I loved most, and I would see more than I ever had of medicine from the other side. (5)

It’s interesting as a chronic patient to read something from a physician’s perspective. I always hope to know a little bit more about how doctors think so that I can plan the appropriate strategy for our encounters. But Transue does much more than that. She shows us that doctors know that patients are vulnerable; for a doctor to help, to sympathize, requires as much that the patient come out from behind their hiding place as for a doctor to be willing to listen. For example, she recounts the story of Ellie, an older woman recently widowed, crying and saying, “I just want to die.” Dr. Transue wonders how she’s supposed to treat grief and decides that talking could be as much a comfort as any. When she leaves, she asks that question that so many of us think is empty: “Is there anything else I can do for you?” Ellie’s response impressed me. She asked for a watch because she never knew what time it was. And that became an opening for so much more.

There’s the story that she tells about the Catholic grandmother who insisted about learning all about Transue’s boyfriend and made her promise that they would wait at least another three years before they got married. And another one about some guys who were sharing an id and the confusion that created when one of them turned out to have tuberculosis. Mostly, it’s a different perspective, and it’s helpful to be able to laugh a little bit about the ridiculousness that comes along with any profession, those things that fall by the wayside while we’re focused on the life-threatening stuff.

Overall: Not a profound book, but very true-to-life and funny. Gives a genuine glimpse into a young woman’s life, her journeys as a primary care physician, a daughter, a granddaughter, and a girlfriend.

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