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Loading... Final Exam: A Surgeon's Reflections on Mortality (Vintage)by Pauline W. Chen
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will love Sign up for LibraryThing to find out whether you'll like this book. A fascinating look at how doctors deal with death and dying, from the first cadaver they dissect, to the patients that they are unable to save. Dr. Chen proposes that doctors need to take a more intimate and caring role in dealing with dying patients and their families. (  ) apartmentcarpet | Aug 5, 2008 |  First off, let me say this: I love a book with a good bibliography. It makes me feel like I am in knowledgable hands. No, that was not a surgeon joke. Because of this exhaustive bibliography I want to subscribe to all these medical journals. I know Dr. Chen reads them to stay up on her field, but I would just love to see her filing system. It must be stupendous. Either that, or she's got a wicked e-subscription file. A close family member died recently, and this book is exceptional in explaining what was happening. Not from a biological system standpoint, but from a medical system standpoint. Dr. Chen delves deeply into the reflexive reaction a physician has to the process of dying. They were taught to fix problems. When the problems are no longer fixable, then things become much more personal. Our family member died at home, surrounded by those she loved. She was not given false hope, and she was not subjected to the "full court press" in her final days. Reading this book made me glad that was the case, and made me much more conscious of the decisions there are to be made within the bounds of medicine. ( ) jonesjohnson | Aug 5, 2008 | I found this one through a book review by Atul Gawande, and there are a lot of similarities in style -- more-or-less discrete essays that employ a mix of personal reflections and historical context, each rooted in the experience of being a surgeon and yet still of broad societal interest. Unlike Gawande's books, however, Chen's book has a strong theme: dealing with death. Chen details her first encounter with death as a medical student dissecting a cadaver in anatomy lab, then progresses through her first official pronouncement of death, her inculturation as a resident to ignore dying patients, the first patient she killed through error, the sense of false immortality that she developed as a transplant surgeon, her creeping sense of sometimes doing harm by trying too hard to prevent a patient's death, and eventually culminating in learning a little of how to be helpful when a patient and his family is facing the patient's impending death. It's an emotionally honest and compelling read. It would be a lie to say that parts of the book aren't upsetting---death isn't a particularly pleasant subject anyhow, and she's cringingly honest about her reactions. Yet, there is something that can be comforting about looking at death head-on, and that comes through clearly here. 1  sanguinity | Jan 19, 2008 | Behind the glamour of surgery lies heartache for patients and surgeons. muir | Nov 9, 2007 | Final Exam: A Surgeon’s Reflections on Mortality by Pauline W. Chen is outstanding on many levels. Its purpose is to reveal what is wrong with the medical profession’s attitude toward the treatment of terminally ill and dying patients. But don’t expect an academic discussion; Chen makes this issue very personal. The book is a recounting of the many experiences in her own medical career—from medical student to transplant surgeon—that shaped and later changed her attitude toward care of patients at the end of life. I had no particular reason to read this book—I am not a doctor, the parent of a doctor, or involved in any way with the medical profession. I just saw this book on the New Books shelf in my local library and checked it out. What is amazing is that I could not put this book down—I know that sounds so trite, but it’s true. What grabbed me first was the wholly unexpected openness and honesty of the author. What grabbed me next was the beautiful clear prose. Here was a brilliant woman doctor telling me all about the many experiences in her medical career that shaped her current convictions about medical care at the end of life. But she was not just telling me about these medical experiences, she was turning herself inside out to reveal how she actually felt about each experience. How many doctors have you ever heard talk to you about their feelings? This author brought me close to her heart—I felt like a sister or a dear friend. I came away from this book with a far greater respect for physicians; especially all they have to deal with, physically and mentally, throughout their long years of training and practice. I also come away with a far greater appreciation for the human frailty of physicians, particularly when dealing with-end of-life issues. This is a profession that has to deal with far more than a normally allotted human share of agony, grief, and soul-searching. (  )1 msbaba | Jul 7, 2007 |  no reviews | add a review
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A brilliant young transplant surgeon brings moral intensity and narrative drama to the most powerful and vexing questions of medicine and the human condition.
When Pauline Chen began medical school twenty years ago, she dreamed of saving lives. What she did not count on was how much death would be a part of her work. Almost immediately, Chen found herself wrestling with medicine’s most profound paradox, that a profession premised on caring for the ill also systematically depersonalizes dying. Final Exam follows Chen over the course of her education, training, and practice as she grapples at strikingly close range with the problem of mortality, and struggles to reconcile the lessons of her training with her innate knowledge of shared humanity, and to separate her ideas about healing from her fierce desire to cure.
From her first dissection of a cadaver in gross anatomy to the moment she first puts a scalpel to a living person; from the first time she witnesses someone flatlining in the emergency room to the first time she pronounces a patient dead, Chen is struck by her own mortal fears: there was a dying friend she could not call; a young patient’s tortured death she could not forget; even the sense of shared kinship with a corpse she could not cast aside when asked to saw its pelvis in two. Gradually, as she confronts the ways in which her fears have incapacitated her, she begins to reject what she has been taught about suppressing her feelings for her patients, and she begins to carve out a new role for herself as a physician and as human being. Chen’s transfixing and beautiful rumination on how doctors negotiate the ineluctable fact of death becomes, in the end, a brilliant questioning of how we should live.
Moving and provocative, motored equally by clinical expertise and extraordinary personal grace, this is a piercing and compassionate journey into the heart of a world that is hidden and yet touches all of our lives. A superb addition to the best medical literature of our time.
(retrieved from Amazon Fri, 24 Apr 2009 07:58:11 -0400)
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