Patient by Patient

This delightful book covers the years from starting as a full-fledged doctor out of training to becoming comfortable in the role. As with many books about lives in medicine these days, the book reminds us that there is a real person on the other end of the stethoscope -- a person with family, personal tribulations, and emotions about their patients. A person who gets tired at work. While perhaps disconcerting to realize since we all want our doctors undivided attention and a freedom to say anything without judgment, the real story is how hard doctors work to live up to that standard. I would think books like this should be required reading for those in college thinking of careers in medicine. The writing in this book is simply superb. My suspicion is Dr. Transue could write about just about anything and it would be captivating; her description of her grandparents and trips to visit them is as well written as anything I've seen in novels, and her medical stories really convey the feeling of the moment to the layman. Had she not been a MD and become a writer, or should she decide mid-career to change careers, I am sure she'd be successful. Even at this stage, perhaps a column in the New Yorker like Dr. Gawande to reach a broader audience? The only drawback I see in this book, and perhaps its my personal opinion, is over her role in the lives of her patients. Whereas a book such as the ones by Dr. Michael Collins tell you about wrestling with decisions, about whether the pressures the medical setting and doctors bring to bear are really in the patient's best interest, such retrospection is lacking from this book. Dr. Collins is haunted by such events, Dr. Transue narrates them. In closing, after reading this book I feel as if a bright and exceptionally articulate friend in medicine sat down with me and said "this is what its like". The reader comes away from this book with a renewed appreciation for medicine and what doctors do for us.

Dr Transue eloquently lays out the struggle every new physican goes through: how to balance your professional life with your real life. Most, if not all, residents unergo this "shock" when trying to transition from student to doctor. I highly recommend this book to anyone, but especially to those who are progressing through a medical career.

Internist Transue's memoir of her early years in practice begins in trepidation and excitement. In her years of training, there were many diagnoses and decisions, but always a supervisor to pass judgment on her findings. Not any more. "From here on, though I could and often would ask advice of my colleagues, there would be nobody above me. I was on my own. With that first patient, that fact in itself was terrifying." Trained to think in crisis mode in the hospital, she has to adjust to the new rhythm of primary care in which many people are not sick, or not very. But some are. Transue introduces a variety of patients, some old and ill, some young and healthy, some dying. Through it all, her patience and ability to listen characterize a practice that combines compassion with confidence and laughter with tears. Though her days are varied she naturally dwells deepest on those whose days are ending. A terminal diagnosis is only the beginning of their care and Transue involves her patients in decision making, striving to balance longevity, dignity and comfort, no small task in these days of many options. Transue also weaves her own life into the narrative, which provides further depth. Her father, a brain cancer survivor with progressive dementia as a direct result of his treatment, is a heart-wrenching case. As he slips further from her, a new grown-up dynamic develops with her very elderly grandparents. Self-aware but not self-absorbed, Transue matures over the course of her book, learning acceptance and turning it into wisdom. She's funny and outspoken as well as deeply empathetic. Except for time frustrations and health-care bureaucracy issues, she doesn't address any negatives in her practice - no hypochondriacs or personality clashes or patients who won't be helped. Transue, whose first book "On Call," was a memoir of residency, will make many captivated readers wish she was their doctor.

I would not ordinarily comment on-line about books I have read. However, I would love it if every woman out there who is juggling the emotions and logistics of working (at home or outside home), raising children, and especially for anyone who has a parent or loved one with Alzheimers, to read Dr. Transue's book. You know, until you have "been there" there is no way to honestly share and understand. Dr. Transue expresses her experiences with real life so very eloquently in this book. On one page I was laughing hysterically and one page later I was in tears. I have been searching for the words to describe and cope with the realities of being in this "sandwich generation." Dr. Transue has given me those words and strength through her writing. I will be forever grateful as I feel I have been given a huge gift by Dr. Transue. Thank you for allowing me to share. Nancy Lotto

I loved this book! Dr. Transue has a remarkable talent for expressing and integrating her own and her patients' life experiences. I am a 62 year old woman in pastoral ministry and I would use this book as a text for a class in caregiving. The author's ability to listen actively and respond compassionately is better expressed in this book than in many texts designed specifically for that purpose. In addition, Dr. Transue illustrates how she dealt with significant personal experiences in a way that allowed her not to lapse into martydom or exhaustion but rather to use what she learned in life to minister more tenderly to herself, her family and her patients. I read it in one sitting and then read it again.