Books that inspired us into Medicine

I recently came across a great post from a now resident, who studied at Stanford medical school.  It reminded me of our 1st year of Copa Book Club, reading “House of God.”  How many times had that book come up in reference, or how many conversations with new attendings had been spirited because of a quick reflection.

The memory made me wonder what other books were were out there acting to bring people in medicine together and I stumbled on Birgisson’s words in her post “Books that made me go to med school.”  Check out the excerpts below as well as a solid list of recommendations for some spring reading!

 

“On the night table was a book left by the last guest, The Soul of Medicine: Tales from the Bedside by Sherwin Nuland, MD, and what I found in his collection of stories was solace, companionship, and hope. It is a compilation of stories, each chapter written by a doctor in a different specialty discussing his or her most memorable patient. If you’re interested in medicine, the reality of it, then I suggest taking Nuland up on his offer to glimpse the mark that medicine leaves on a doctor’s soul.” (1)

– Natalia Birgisson

 

Future reads (pink titles even have Amazon links!) (1):

The Soul of Medicine: Tales from the Bedside by Sherwin Nuland MD

Mountains Beyond Mountains by Tracy Kidder

Blue Collar, Blue Scrubs and Hot Lights, Cold Steel by Michael J Collins MD

Love’s Executioner by Irvin Yalom, MD (a Stanford professor emeritus of psychiatry)

This Won’t Hurt a Bit (and Other White Lies) by Michelle Au, MD

This Side of Doctoring: Reflections from Women in Medicine by Eliza Chin, MDa

Gifted Hands by Ben Carson, MD

To Heaven and Back: A Doctor’s Extraordinary Account of Her Death, Heaven, Angels, and Life Again by Mary Neal, MD

Silence Kills: Speaking Out and Saving Lives by Lee Gutkind

A Not Entirely Benign Procedure: Four Years as a Medical Student by Perri Klass, MD

When the Air Hits Your Brain: Tales from Neurosurgery by Frank Vertosick, MD

Shrink Rap: Three Psychiatrists Explain Their Work by Dinah Miller, MD; Annette Hanson, MD; and Steven Roy Daviss, MD

How We Die: Reflections on Life’s Final Chapter by Sherwin Nuland, MD

Better: A Surgeon’s Note on Performance by Atul Gawande, MD

Cutting for Stone by Stanford physician Abraham Verghese, MD

 

  1. Birgisson, N., Ford, A., & Goldman, B. (2018, March 05). The book that made me go to medical school – and other good reads. Retrieved March 11, 2019, from https://scopeblog.stanford.edu/2014/10/28/the-book-that-made-me-go-to-medical-school-and-other-good-reads/

 

Advertisements

Spring Book Club! March 27th!

Copa Book Club Spring Meeting will be Wednesday March 27th!  Discussion will be held at Casa de McElhinny, (look for email details!) and will feature our Winter book revisited: Cutting for Stone by Abraham Verghese

Below you will find a short clip of the author talking about his inspiration for the book and also how a book brought him to medicine!

 

Bonus!  Below are the books Dr. Verghese mentions in his interview:

Screen Shot 2019-03-11 at 1.07.13 PM.png

Of Human Bondage by W. Somerset Maugham

Screen Shot 2019-03-11 at 1.06.46 PM.png

The Citadel by AJ Cronin

 

Reach Out and Read

Reach Out is a National Program is a “nonprofit organization that gives young children a foundation for success by incorporating books into pediatric care and encouraging families to read aloud together.

(1)

Can you believe “despite all of the benefits of reading aloud, surveys show that only a half of parents read to their young children daily and less than 10 percent read to their children from infancy” ?! “Families living in poverty are significantly less likely to read aloud to their infants and toddlers.”

Maricopa Integrated Health System is a proud sponsor of Reach Out and Read striving to promoting reading aloud to children, with benefits including (2):

  • Builds motivation, curiosity and memory
  • Helps children cope during times of stress or anxiety
  • Take children to places and times they have never been – enlarging and enhancing their worlds
  • Creates a positive association with books and reading

What a great way to address health disparities and build up children and families!

If you’re “Marie-Kondoing” the heck out of your abode (definitely read that book recently :)) check out the link below for an opportunity to donate books to MIHS Clinics.

http://www.reachoutandread.org/contact/?sid=40&type=donate

 

  1. PBS. Reach Out and Read on PBS News Hour. YouTube. https://youtu.be/Umzgxw8OXl0. Published January 16, 2013. Accessed February 15, 2019.
  2. Reach Out and Read. Importance of Reading Aloud. Importance of Reading Aloud | Reach Out and Read. http://www.reachoutandread.org/our-story/importance-of-reading-aloud/. Accessed February 15, 2019.

Read Across America

Continuing on the theme of encouraging young people to read, check out this super cool monthly selection that the National Education Association puts on every month!  Its even being featured at MIHS clinics in the month of March to encourage our patients and their families to read together!   (1)

Screen Shot 2019-02-14 at 3.44.52 PM.png

The selection of books includes a diverse range of topics and characters. This month’s selection is Malala’s Magic Pencil, a story that encourages children to find their own voice and features Nobel Prize winner and Pakistani Activist Malala Yousefzei! (2)Screen Shot 2019-02-14 at 3.44.01 PM.png

Some days you might find yourself in Malala’s shoes, working your way through the daily grind, trying to find your voice as a resident or new attending or in a new leadership position. Maybe take a crack at this illustrated narrative, children’s books really do have the most heartfelt and enduring messages!

 

  1. Maricopa Integrated Health System — Read Across America. Facebook. https://www.facebook.com/mihs.az/photos/a.176365405095/10161547611305096/?type=3&theater. Accessed February 14, 2019.
  2. National Education Association. “Malala’s Magic Pencil” – NEA Read Across America Official Selection. Read Across America: an NEA project. https://www.readacrossamerica.org/finding-your-voice/. Accessed February 14, 2019.

The Childhood Joy of Reading

Nothing beats sharing a book with a kiddo.  And to boot, reading at a young age has been demonstrated to directly impact health out comes for young patients (2). Just think, something so precious and so simple, could help your family AND your patient’s grow and learn into healthy adulthood.  And as far as children’s books go, you really can’t go wrong with the beautiful illustrations and the imaginative stories.

Time Magazine has come up with its list of the top 100 children’s books, I’ve highlighted the first three below.  Please scroll through a few on amazon or stop by your local library, just remember, you’re never too old to appreciate a children’s book.

Screen Shot 2019-01-20 at 8.14.17 PM.png

Where the Wild Things Are, By Maurice Sendak

The adventure that has inspired generations of children to let out their inner monsters, showing how imagination allows for an escape from life’s doldrums. Its also a moving testament to family love: when young Max returns from his reverie, his mother has saved him a hot dinner. (1)

Screen Shot 2019-01-20 at 8.17.15 PM.png

The Snowy Day, Ezra Jack Keats

The journey of Peter through a snowbound New York City made for a milestone: as a successful children’s story focused on a black protagonist, it broke down barriers many white editors may have never noticed. But Keats’ Book is memorable too for the sheer beauty of its collage illustrations. (1)

Screen Shot 2019-01-20 at 8.24.06 PM.png

Goodnight Moon, By Margaret Wise Brown, illustrations by Clement Hurd

Somewhere a child is being put to sleep right now to Brown’s soothing, repetitive cadences. While the lines may be etched in every parents memory, Hurd’s illustrations, with their quirky hidden jokes, provide amusement on the thousandth reading.  (1)

 

  1. The 100 Best Children’s Books of All Time. (n.d.). Retrieved January 20, 2019, from http://time.com/100-best-childrens-books/
  2. Dewalt, D. A., & Hink, A. (2009). Health Literacy and Child Health Outcomes: A Systematic Review of the Literature. Pediatrics,124(Supplement 3). doi:10.1542/peds.2009-1162b

A resolution to share books!

Happy (belated) New Years!

Any chance your New Year’s resolution was to read more? Maybe you resolved to bring a friend to the next book club? The 2nd week of March 2019 will bring the next occasion up for a spirited gathering with great people and delicious food! Our book for discussion will be a continuation of the winter choice Cutting for Stone by Abraham Verghese.

In the spirit of bringing the joy of reading to those who don’t typically partake, please share your favorite book (and why you love the book) in the comments below. I hope to highlight a few all-time favorites for enjoying in the beautiful winter weather or curled up in a cozy chair. Below is my favorite!

Screen Shot 2019-01-13 at 8.22.01 PM.png

Book Title: Bridge to Terabithia

Author: Katherine Patterson

Synopsis:

Bridge to Terabithia is a work of children’s literature about two lonely children who create a magical forest kingdom in their imaginations. It was written by Katherine Paterson and was published in 1977 by Thomas Crowell. The novel tells the story of fifth grader Jesse Aarons, who becomes friends with his new neighbor, Leslie Burke, after he loses a footrace to her at school. She is a smart, talented, outgoing tomboy from a wealthy family, and he thinks highly of her. He is an artistic boy from a poorer family who, in the beginning, is fearful, angry, and depressed. After meeting Leslie, his life is transformed. He becomes courageous and learns to let go of his frustration. They create a kingdom for themselves, which Leslie names “Terabithia.”

Why I love this book: It combines the privileged imagination of childhood against the heart wrenching realities of life through the innocent child’s eye.

Book Feature: Dreamland

51x56REyXrL.jpg

 

At a recent CME event for opioid prescribing, this book has come up yet again as both a non-fiction and a fascinating look at the history and progression of opioid misuse in southern California.  With echos of Arizona, consider taking a deep dive into the heroin trade all the way to big pharma with Sam Quinones’ and Dreamland.

Quinones is a veteran journalist and expert storyteller long steeped in the demi-monde of Mexican-American bordercrossings. Dreamland: The True Tale of America’s Opiate Epidemic is an intricate jigsaw puzzle piecing together his findings from intensive investigation of the unprecedented spread of heroin addiction throughout the United States over the past two decades.

Through participant-observation involving interviews with addicts and their relatives, Mexican farm boys turned entrepreneurs, narco-bosses, lawmen, pioneering drug researchers, doctors, and other public health personnel, Quinones weaves together a haunting account of how the underground drug culture of addiction surged like wildfire with the complicity of the medical profession and Big Pharma. (1)

  1. Gates, M. (2015, April 21). Dreamland: The True Tale of America’s Opiate Epidemic. Retrieved December 2, 2018, from https://www.nyjournalofbooks.com/book-review/dreamland

Book Feature: Complications

Complications, written by well known author Atul Gawande describes the gritty parts of Dr. Gawande’s surgical training which comes across as a series of gracefully complied short stories.  If your looking a new perspective on the razor edge of medical reason and instinct, consider Complications and a cozy cup of cocoa this winter!

For a quick preview, check out this excerpt from The Guardian:

It begins with a bullet wound in a young man’s buttock and ends with a woman whose leg is almost destroyed by flesh-eating bacteria. It documents messy tracheotomies, a stomach-stapling operation on an obese man and a surgical procedure to help a woman who cannot stop blushing. Atul Gawande’s account of a trainee surgeon’s career has been a bestseller in the US, but Dr Finlay’s Casebook it certainly is not.

One of the most striking features of Complications is the unsparing detail about what happens in the operating theatre. The book is also about split second decisions that could mean life or death and the limits – often unsuspected by the patient – of both doctors and medical science. There is the surgeon who left a large metal instrument in a patient’s abdomen, where it tore through the bowel and the bladder wall. There is the doctor who biopsied the wrong section of a woman’s breast, delaying a diagnosis of cancer for months. Mistakes are sometimes solved by surprisingly low-tech solutions, such as marking the patient’s leg with felt-tip to ensure that the correct limb is operated on.

The first time Gawande is called on to make an incision, the senior surgeon draws a six-inch line on a sleeping patient’s abdomen and hands him a knife. Human skin, he discovers, is thick and springy and he has to make two attempts to get through. ‘The experience was odd and addictive,’ Gawande admits, ‘mixing exhilaration from the calculated violence of the act, anxiety about getting it right, and a righteous faith that it was somehow good for the person.’

This sentence touches on the paradox at the heart of the surgeon’s profession, which requires him or her to perform acts that would, in another context, constitute an assault. What are the psychological effects of cutting open the unconscious bodies of patients you have talked to and in some cases come to like? Although Gawande has a philosophical turn of mind – he studied PPE as a Rhodes Scholar at Oxford before training as a surgeon at Harvard – these are not questions he chooses to pursue. (1)

  1. Smith, J. (2002, November 17). Observer review: Complications by Atul Gawande. Retrieved December 2, 2018, from https://www.theguardian.com/books/2002/nov/17/biography.scienceandnature

Winter Book Discussion, a Summary

Our 2018 Winter Book discussion will take place next Monday November 26th!  Come enjoy a lovely (warm and filling) lasagna with veggie options including gnocchi with white sauce with Cesar salad!

Our selection was a long one this quarter, so please join us even if you haven’t had time to finish– a plot summary is included below!

“The story is told by the protagonist, Marion Stone. He and his conjoined twin Shiva are born at Mission Hospital (called “Missing” in accordance with the local pronunciation), Addis Ababa, in September 1954. Their mother, Sister Mary Joseph Praise, an Indian Carmelite nun, dies during childbirth. Their father, Thomas Stone, the English surgeon of Missing, abandons them and disappears. Orphaned at birth, the pair grow up in the household of two physicians of Missing, both from Madras, the obstetrician Kalpana Hemlatha (Hema) and Abhi Ghosh, who fall in love while caring for the infants. Hema names them Marion (after J. Marion Sims) and Shiva (after the Hindu deity). Ghosh teaches himself surgery to replace Stone. The tissue link between the twins has been separated at birth and the two grow up together being very close initially. Both are exposed to the changing political environment in Ethiopia. There is an unsuccessful rebellion by Haile Selassie’s bodyguard, General Mebratu. Ghosh is imprisoned, then released, in the aftermath of the coup, due to his friendship with Mebratu. Through their parents, both boys are exposed to medicine and taught at the hospital. Over time, though, individual differences begin to become pronounced. When entering puberty their relationship to Genet, the daughter of Rosina, a domestic help, finally tears them apart. Marion is in love with Genet and intends to marry her, but it is Shiva who, interested in sexual pursuits, deflowers her. Marion feels betrayed. Rosina forces Genet to submit to female genital mutilation and commits suicide shortly thereafter. Genet will later join the Eritrean liberation movement. While Marion goes to medical school, his brother stays at Missing. Focused on the repair of birth-related fistulas, he takes up his surgical training with Hema eschewing a formal medical education. On his death bed, Ghosh has three wishes for Marion – to get the best medical education, to find Stone, and to forgive his brother.

When Genet and her comrades hijack an Ethiopian Airlines airplane in 1979, Marion is on a list of her connections. To avoid arrest he flees the country overnight to Kenya. He goes to New York City where he finds a position at Our Lady of Perpetual Succour, a hospital in the Bronx. There, he enters a surgical residency. One day, assisting his senior in a complicated trauma operation, an unknown surgeon enters looking them over the shoulder. It is Thomas Stone, by now a well-renowned liver surgeon from Boston. Marion’s encounter with his biological father redirects his life leading to a painful reconciliation and reunion with his estranged brother.” (1)

 

  1. Wikipedia. (2018, March 03). Cutting for Stone. Retrieved from https://en.wikipedia.org/wiki/Cutting_for_Stone

 

Parenthood and Emergency Medicine

Hema’s transition into motherhood, her revelations on a crashing plane and in a hopeless OR really spoke to an ongoing discussion in medicine regarding parenthood and career balance. This practice of pushing aside, or putting off parenthood, ‘just till I start my career,’ or ‘ after I finish my training,’ etc is something I’m sure is not unique to medicine.  Interestingly that tension was exemplified by a series of articles published in Emergency Medicine News not too long ago in mid 2017.

The first commentary was printed in July 2017 describing the balance between treating patients and being present for family medical emergencies.  Dr. Sandra Scott Simmons describes her experience:

The conflict between our core values as parents and as EPs creates significant cognitive dissonance. Receiving a text with a photo of an ankle looking like Cole’s looked that night would make most people drop everything to be with him in the ED, but I still showed up to work. I’ve never felt so much inner turmoil during a shift. Parenting may be first on our priority list, but our careers don’t always allow us to realize that ideal. Physicians valiantly do what it takes to meet the high expectations placed upon us, but we’re far from invincible. The cognitive dissonance produced by choices we are forced to make will ultimately affect all of us and our families.” (1)

In a letter to the editor, Dr. Geoffrey Martin offers his response on this long debated balance:

Certainly many families feel the pain of mothers trying to fulfill both roles with equal expertise while suffering terrible “mommy guilt” when significant events occur in their families’ lives. In the end, it’s a choice. Those natural mothering tendencies don’t have to disappear when you become a physician, but you can plan a little differently so that you can experience the richness and fulfillment of both. While you can’t reasonably expect everything simultaneously, with planning and pragmatism you can have both, in their season at their time.

If you’re planning to tilt your lance at a windmill, maybe take on the lie that women should be everything all the time to everyone. Be a mom, be a wife, be a doctor, but each in its season. Don’t expect to do them all simultaneously with expert ability and no pain. It’s in very few women’s nature, and there’s almost always pain.” (2)

And again, Drs. Tintinalli, Kass and Wolfe Respond to ‘Parenthood and Medicine, Each in its Season’ in Emergency Physicians Monthly.  Tintinalli’s commentary concludes:

Does a Dad feel any different than a Mom in a situation like this? No way. The seasons change with age – your age, your children’s ages, your parents ages – but the tender feelings never go away.

Dr. Geoff Martin seems like a fine guy (based on a video on vitals.com). He seems proud to be an emergency physician. He gives food for thought when he writes “you can plan a little differently so that you can experience the richness and fulfillment [of both].” But change the words “women” or “moms” to “men” or “dads,” and you get the same angst. 

We all make choices. When we realize the pressures and choices become unbearable, time to re-calibrate. Emergency medicine provides us with a world of professional choices:  full-time, part-time, hardly-any-time, high-intensity, low-intensity. We are lucky. We are doctors. We are parents, sons, daughters, friends. We do the very best we can.” (3)

What has been your experience?  How do your priorities, family or otherwise, balance your sense of responsibility to your career?  Does it take a crashing plane and a medical disaster, like in the story of Hema to take a fresh perspective on the debate?

  1. Simons, S. S. (2017). ER Goddess. Emergency Medicine News,39(9), 6. doi:10.1097/01.eem.0000524788.36561.5f
  2. Martin, G. (2017). Letter to the Editor: Parenthood and Medicine, Each in Its Season. Emergency Medicine News,39(8), 21. doi:10.1097/01.eem.0000522233.73773.41
  3. Tintinalli, J. (2017, August 22). Drs. Tintinalli, Kass and Wolfe Respond to ‘Parenthood and Medicine, Each in its Season’. Retrieved from http://epmonthly.com/article/three-women-respond-parenthood-medicine-season/; Emergency Physician Monthly