The Soul of Medicine: Tales from the Bedside

Having previously purchased five of Nuland's books, I almost didn't buy this one. However, I found it quite enjoyable and quite different. The "Tales" of the various "memorable cases" from many specialists were quite interesting, and the "narrator's" commentaries on most of them were interesting as well. It is fortuitous, perhaps, that I read this book just as the National debate on health care reform is reaching rather absurd dimensions, and if nothing else, it gave me some perspective and in some cases comedy relief. I believe that writing like Nuland's can really shed important light on some of the core issues of health and healing, for those who want to gain wisdom and not just add to the chaos and confusion.

In "The Soul of Medicine," Dr. Sherwin Nuland has collected reminiscences from a variety of doctors, offering "a sort of Canterbury Tales of medicine." Each chapter is written in the first person by a particular specialist in such fields as neurology, nephrology, pediatrics, and anesthesiology. In some cases, Nuland follows up with a commentary of his own. Some of the stories are tragic and others comical, but all are thought-provoking. Certain facts have been altered to disguise the identity of the people involved. However, the author assures us that the cases and medical details are accurate. This is fascinating overview of the significant changes that have revolutionized the practice of medicine in the last half century. With MRIs, PET and CAT scans, and other advanced tools at their disposal, physicians are better equipped to make diagnoses that in the past might have eluded them. Of course, conscientious practitioners still take careful medical histories and conduct thorough physical examinations. In addition, they try to keep in mind the crucial role of communication and mutual respect between healer and patient. The anecdotes in this book demonstrate that, although most doctors are hard-working and dedicated people who take their awesome responsibilities seriously, they are also flawed human beings who, at times, make costly mistakes. The best among them, on the other hand, heroically fight to restore their patients to good health. Nuland adds that, in the last three decades or so, an ever increasing number of women have been entering medical school. We no longer hear that it is futile to educate female physicians who will inevitably drop out to have a family. Whether his or her patient has an advanced malignancy, a chronic medical condition, or unexplained symptoms, each doctor/narrator reminds us that life is finite and unpredictable and that to awaken healthy each day is a gift not be taken lightly. As Dr. Nuland states in his epilogue, even with the sophisticated machinery and cutting-edge techniques that are now commonplace in major hospitals, "judgment will always be the most difficult aspect of the art of medicine." Sometimes, in spite of a dedicated practitioner's best efforts, a patient's condition will worsen. "The Soul of Medicine" is a poignant and informative work and a worthy addition to Dr. Nuland's well-received chronicles about how we confront disease, aging, and death.

Having read Dr. Sherwin B. Nuland's outstanding book "How We Die" I was naturally interested when I heard that he had published another book related to his medical interests. I have spent the better part of my life in medical related careers where it is common practice to discuss the unusual events of the day precisely to keep them unusual. Now in "The Soul of Medicine," Dr. Nuland is simply including us in the "surgical grand rounds" and sharing with us some of what has made his life exciting. For some unknown reason, Nuland has fashioned his book roughly on the model of Chaucer's Canterbury Tales so that the 20 plus tales that are told have 20 "different" tale tellers. You'll read the Surgeon's Tale, the Urologist's Tale, the Cardiologist's Tale, etc. I was unable to discern any order based on the tellers specialty nor for that matter was every tale related to its teller. Hence the puzzlement over the Chaucer analogy. I was also somewhat confused as to whether he was telling each story in the actual words of the specialist from who he heard the story or whether he had put his story in the mouth of a specialist who might have had reason to hear or participate in the creation of the story. The stories themselves are delightful. You'll find yourself turning pages way too quickly so that the 20 tales and the 207 pages are soon behind you. You find yourself wishing there were 5 or 10 more stories or wondering why the author stopped so soon. There is nothing in the book that requires the reader to have a medical education. Just the normal brush with medical and nursing care. Nuland's stories remind me a little of the gynecologist who worked in my hospital. He carried around with him a standard vaginal speculum somewhat like other doctors carry a stethoscope. The shock was supposed to amuse you and remind you that he (the gynecologist) was not a normal person. So Nuland's stories have a little shock value to remind us that we're not dealing with normal people in normal jobs. For example in the first tale a patient is discovered to have a chest cavity filled with feces. Normal people would find that only mildly alarming given that there's intestines & all in that general area so Nuland has to explain why that is not an expected condition. Some stories are heart warming, some are inane, some are just quirky. It is the package of the whole that makes it "The Soul of Medicine." Lastly, one minor complaint on the parchment-like jacket cover - it doesn't hold up well and it isn't transparent enough to show the illustration on the hard cover.

The author has made his twenty year writing career by telling tales of medicine practiced and how the body works in clear layman's terms (see "How We Live" and "How We Die"). This latest work tells how old time medicine worked with all its arrogance, errors, and healing. The first story describes in full gory detail the operation on teenager Jimmy who had fecal matter leak into his chest. They operated without reviewing his chart and possibly without legal consent. The writing is entertaining and the author lets the reader make their own judgment.

From: www.BasilAndSpice.com Author & Book Views On A Healthy Life! A FirstLook Book Review: The Soul of Medicine: Tales from the Bedside (Kaplan/ Apr 2009) by Sherwin B. Nuland In a twist on his usual style, Sherwin Nuland has penned a rather unusual collection of medical stories. Gathered during his thirty years in practice, and presented in the fashion of Chaucer's Canterbury Tales, Nuland takes readers inside the hospitals of our country, exploring poignant memories from his own and his esteemed colleagues' recollections. The accounts are sometimes gruesome, light-hearted, and all are memorable. Various doctors from Nuland's past were interviewed --ranging from a chest surgeon, an anesthesiologist, and an obstetrician, to the gastroenterologist, and a cardiologist--19 tales in all. Some are told in the first-person narrative and others have a commentary added to a tale. (Identities of physicians and patients have been hidden.) Most of the physicians who related their stories are past the end of their careers, enabling them to give detail and experienced perspective. "By and large, they deal with a period that drew to a close in the 1970s, when the bionic wonders of ultramodern medicine began ..." The first narrative, a surgeon's, begins with a hardened street-wise teenager with a chest full of "pus," from which the origin was unknown. Not a minor problem, in this instance it was an anomaly in the medical world; its diagnosis and elimination were fascinating reading. As in the many situations relayed in the book, the patient, because of his particular illness or disease, had become the teacher of the doctor. These narratives are "lessons of humanity itself" Nuland writes, "with all its wondrous gifts and its failings." Medical doctors, being both professionals and people, are viewed in the book as multi-sided individuals, with real fears, friends, and faults, just as we all have. The relationship between physician and patient, as illustrated in The Soul of Medicine, hits the heart of the matter when Nuland clearly shows that a "transaction between doctor and patient is a transaction in personal and professional ethics." What can be learned from this? Doctors must still rely on their own sound judgment. The Soul of Medicine is a compelling and classic book, suitable for both the physician and the public. 5 Stars