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eBook Final Exam: A Surgeon's Reflections on Mortality download

by Pauline W. Chen

eBook Final Exam: A Surgeon's Reflections on Mortality download ISBN: 030727537X
Author: Pauline W. Chen
Publisher: Vintage; Reprint edition (January 8, 2008)
Language: English
Pages: 267
ePub: 1434 kb
Fb2: 1841 kb
Rating: 4.8
Other formats: doc docx mobi mbr
Category: Medics
Subcategory: Medicine

Chen, a surgeon specializing in liver transplants, is her own patient in Final Exam, a series of thoughtful, moving essays on the troubled relationship between modern medical practice and the emotional events surrounding death.

Chen, a surgeon specializing in liver transplants, is her own patient in Final Exam, a series of thoughtful, moving essays on the troubled relationship between modern medical practice and the emotional events surrounding death. She recalls episodes from her own medical training, and cases in which she was involved, to dramatize her misgivings about the lessons in denial and depersonalization that help doctors achieve a high level of technical competence but can also prevent them from expressing empathy or confronting their own fears about death. In the current system, she writes, few.

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Библиографические данные. Final Exam: A Surgeon's Reflections on Mortality.

Pauline W. Chen attended Harvard University and the Feinberg School of Medicine at Northwestern University and completed her surgical training at Yale University, the National Cancer Institute (National Institutes of Health), and UCLA, where she was most recently a member of the faculty. In 1999, she was named the UCLA Outstanding Physician of the Year. Библиографические данные.

Originally published: New York : Alfred A. Knopf, 2007. Includes bibliographical references (pages 223-268)

Originally published: New York : Alfred A. Includes bibliographical references (pages 223-268). 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 Chen began medical school, 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.

When Pauline Chen began medical school twenty years ago, she dreamed of saving lives

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.

Pauline Chen is a surgeon who does liver transplants. She is also a fine writer as FINAL EXAM - A SURGEON'S REFLECTIONS ON MORTALITY proves so well

Pauline Chen is a surgeon who does liver transplants. She is also a fine writer as FINAL EXAM - A SURGEON'S REFLECTIONS ON MORTALITY proves so well.

Final Exam: A Surgeon's Reflections on Mortality is a 2007 book written by surgeon and liver specialist Pauline Chen. She argues that "medical schools can and should do a much better job of preparing doctors to care for the dying. The patient loses, but the physician loses as well the chance to do- what Chen would call- "something more than cure" and "nurture our best humanistic tendencies.

Final Exam was merged with this page. Chen, a brilliant transplant surgeon, charts her personal and professional rites of passage in dealing with mortality. Focusing on the enormous moral and psychological pressures on doctors, Chen also reports on signs of change within the profession. 11 people like this topic.

Final Exam: A Surgeon's Reflections on Mortality.

In this week's "Doctor and Patient" column, I write about the fascinating results of this study and speak with one of the study authors.

A brilliant transplant surgeon brings compassion and narrative drama to the fearful reality that every doctor must face: the inevitability of mortality.When Pauline Chen began medical school, she dreamed of saving lives. What she could not predict was how much death would be a part of her work. Almost immediately, she 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 and practice as she struggles to reconcile the lessons of her training with her innate sense of empathy and humanity. A superb addition to the best medical literature of our time.
Comments: (7)
Jesmi
Pauline Chen is a surgeon who does liver transplants. She is also a fine writer as FINAL EXAM - A SURGEON'S REFLECTIONS ON MORTALITY proves so well. She writes with both passion and humility about the contradiction she sees in the field of medicine: that doctors, who witness death so often that it should almost become routine essentially are no better at dealing with the end of life than their patients are. (She actually uses the word "dysfunctional" to describe many physicians' attitudes toward death.) She believes there are many reasons for this phenomenon. Doctors are trained to be healers; that is why most of them went to medical school. To lose a patient to death somehow is an admission of failure. Many physicians will continue aggressive but useless therapy for a dying patient to pacify the patient's family. Sometimes they fear litigation or they may continue treatment-- we can only hope occasionally-- for financial gain. But whatever the reasons, they are not good enough. The patient loses, but the physician loses as well the chance to do-- what Chen would call-- "something more than cure" and "nurture our [physicians'] best humanistic tendencies."

Dr. Chen discusses candidly her first experience with death, when she was a sophomore in college, of her maternal grandfaather. Then in medical school she spent 12 weeks with a cadaver: "My very first patient had beeen dead for over a year before I laid hands on her." She writes about her first patient to die and her inability to contact a dying friend. She confronts her fears about her own mortality when she is about to harvest organs (a procedure she had done eighty-two times previously) from an automobile accident victim and discovers that the donor is a brain-dead thirty-five-year old Asian American woman: "For a moment I saw a reflection of my own life and I felt as if I were pulling apart my own flesh."

This beautifully written book reminded me of another fine book by another physician, Abraham Verghese's MY OWN COUNTRY, an account of his treating the first patients-- most of whom would certainly die horrible deaths-- with HIV/AIDS at the local VA hospital in Johnson City, Tennessee in the 1980's. Both these books should be required reading for medical students.

When I finished Dr. Chen's "reflections," I thought of (1) how fortunate her patients are to have a surgeon so sensitive and so human and (2) wondered how many physicians would take time out from their busy schedules to read her wise words.
Morlurne
I highly recommend this book! Dr. Chen's authentic writing, part memior and part thesis, explains the training medical students undergo. She discusses how this training, the culture of medicine and other factors have failed to prepare doctors to communicate with patients and family members about death and dying.

Dr. Chen's book reminded me of the doctor who told a friend to 'put your affairs in order' when she woke up after surgery. That surgeon's total failure to convey news that an expected benign tumor was advanced stage cancer emotionally gutted his groggy patient. Final Exam sheds light on how this highly recommended surgeon could so spectacularly fail to communicate with compassion.

This book is well written and an easy read for the layman. As I finished this book, I recalled the debates about what 'the doctor said' whenever my family had dealt with a terminal diagnosis. I had chalked it up to a mix of stress and different communication styles yet Dr. Chen reminds us that the doctor's ability to communicate is essential.
Bandiri
I am one of those people who is always the patient ... and I am one of those complicated patients where things don't typically go as planned. I am probably not one of a surgeon's easiest patients as I tend to test their mettle. That being said, I have had surgeries where surgeons have removed various organs from my neck (thyroid) down to my abdomen (gallbladder and hyster.) All of them have been complicated by one thing or another.

I have asked myself more than once: "How do surgeon's do it?" How do they get to that almost God-like place where they hold life in the balance for a period of time and we, the patient, put our utmost trust in them? It's quite amazing if you think about it.

The one aspect that is not often addressed or talked about is that of death. How does a doctor distance themselves enough emotionally so that they can continue to do their job? How do they get through the first time that they are actually responsible for a patient's death? These are tough questions that require a special journey for doctors. Dr. Chen's book outlines this journey from med student to a fully-fledged practicing physician specialist. She shares the shift that has taken place in medical studies that teach young doctors how to deal with death in a healthy way that includes palliative care. The journey is fascinating and touching.

As a patient, I always wonder. This book helped to pull the curtain back just a little bit more. Thank you Dr. Chen!
Enone
It was a good read, overall. I was never bored with the book, and it was written well. There were some parts that were amusing, other parts that were morbid but thought-provoking.

The parts that stood out to me most, however, were the ones that dealt with the emotions of the surgeons. It seems sometimes that to the public, surgeons are emotionless beings that serve only to cut someone up and move on to the next patient - but surgeons are people too, despite their apparent need to suppress their emotions while performing their jobs. But when does a patient become more than a patient, but a living piece of work that no matter how tired you are, you keep perfecting? When is it time to let that patient go?