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Thursday, 11 January 2007

Pauline W. Chen, "a surgeon specializing in liver transplants" and "[t]he daughter of immigrants from Taiwan", has written a book about her experiences in the operating theatre, which is reviewed by William Grimes in The New York Times. Knopf Publishing Group has released Final Exam: A Surgeon’s Reflections on Mortality in the U.S. and it's available online, but my local independent doesn't yet carry it.

Medical essays can be very rewarding. The first one that I read, during one of my courses last year, was by Atul Gawande, titled 'Education of a Knife', which appeared in his 2002 collection Complications: A Surgeon's Notes on an Imperfect Science. It brought home to me that surgery is an inexact science where the practitioner may not be as experienced as we might wish. It's a salutory lesson, and the quality of Gawande's writing ensures that it is taken lightly.

Chen's focus, in her new book, appears to be the fact of mortality itself.

She ... laments the lack of training in talking to patients, especially about death. Doctors, like everyone else, avoid the topic. Institutionally, discussions of death are limited to formal inquiries known as morbidity and mortality conferences, in which surgeons analyze recent deaths on the operating table in the hope of learning from them.

Outside the conferences, death is the unwelcome, awkward visitor who stops conversation. Dr. Chen cites a survey showing that one-quarter of oncologists failed to tell their patients that they were suffering from an incurable disease.

It's interesting to note that Gawande is also the child of immigrants, in his case from India. Do Asian genes somehow convey adeptness with words?

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