Incidental Findings: Lessons from My Patients in the Art of Medicine

This is not only a compelling read, but a telling read. Should be read by all those who are caregivers for others. Well worth reading D.Ofri's other work as well.

Dr. Ofri is an amazing writer. She is able to turn her most intimate interactions with patients into chapters that make the reader think and learn. She is able to share all aspects of medicine, not only the rewarding experiences, but also the stresses associated with her career. By reading her writings, one can begin to understand what is necessary to be a successful doctor, a strong doctor-patient relationship.

Dr. Ofri's first book of essays, "Singular Intimacies," was a soul-searching, thought-provoking self-portrait of becoming a doctor at a busy, inner-city hospital, New York's Bellevue. Ofri is still at Bellevue as an attending physician and editor of the Bellevue Literary Review. This second reflective and graceful book of essays ranges over her experiences since - from far-flung temp positions during a post-qualifying travel break to her own rude awakening as a patient during her first pregnancy. But the bulk of the book revolves around Bellevue; the month-long rotations on hospital wards and the ongoing clinic practice which is her base. In the hospital rotations her interaction with a patient is intense, but finite. She prefers the clinic where the people are less sick, but the relationship is ongoing. The book opens with Ofri's first experience as a patient dismayed by a busy doctor's delivery of fear-inducing news, the intimidation inherent in the relationship, and the medical professional's casual use of jolting jargon, like "high risk." In one of the last essays, she delivers her baby and discovers the reality of being an ordinary patient: "I had no idea how much shame and humiliation are part of the experience: from the horrid gowns that never cover enough, to the exposure of some of the most private and embarrassing bodily functions, to the smells and sights which one is forced to wallow in, to the helplessness and inability to assert one's control." Ofri does get to exert control though, when eventually she succumbs to the temptation to throw her weight around - "I am an attending physician on faculty here" - and service improves dramatically. She describes an ordinary chaotic day in the clinic, capped with anguish when she discovers an elderly Chinese man has a brain tumor and the language barrier prevents her from offering comfort or even information. There's lots of that - the problems of communicating in a place that encompasses so many immigrants. Communications problems do not always stem only from the lack of language interpreters, but also from cultural gulfs. Ofri is no saint and she's often driven to the edge by frustration - too little time, too many demands, unsympathetic patients. One woman, always accompanied by her young daughter as translator, is a non-compliant, depressed hypochondriac whose arrival fills Ofri with teeth-gritting dread. Until a simple query from the daughter opens her eyes to the real pain that reverberates through the woman's family. Ofri's treatments often stray outside medical boundaries. She negotiates ways for immigrant children to stay in school rather than accompany non-English speaking parents to the clinic; tutors a boy for the SAT test because her best recommendation for his long-term health was "to take the SAT and get into college." Issues of poverty, helplessness, dignity and medical ethics dominate. A number of essays deal with terminal issues, two at length. In the first, "Living Wi

Recently I had finished reading SINGULAR INTIMACIES by Ofri and I was so disappointed that the book had to end. When I found out that she had written a new book, I picked it up right away. INCIDENTAL FINDINGS is an easier read in some ways because Ofri is now an attending physician at Bellevue. Her first book was a graphic depiction of a young doctor's education. Both books are exquisitely written, and I look forward to Ofri's third book (hopefully there will be one). I recommend her books to anyone who ever considered medicine as a profession, anyone who has considered any of the healing professions.