The Soul of Medicine & The Real Life of an Internist

Nursing Book Club

The Soul of Medicine & The Real Life of an Internist

Two books that delve into the mind of a physician

By Sherwin B. Nuland & Mark D. Tyler-Lloyd, M.D.
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Reviewed By Christine Contillo, RN, BSN

I love real medicine stories. I’m interested in how clinicians feel about their patients, how their patients feel about them, and how that bond develops to the advantage of both. I wonder why some doctors are intuitive about illness, and if that’s a skill that can be enhanced. Mostly, I love to read about the lives of medical providers, how they reach a diagnosis, and how it impacts on everyone involved.

This year, two books gave me ample opportunity to become absorbed in these kinds of stories. The Soul of Medicine by Sherwin Nuland is the modern day equivalent of Chaucer’s Canterbury Tales. Nuland was the 1994 National Book Award winner for How We Die, a fascinating account of the effects of terminal illness. In the prologue to his most recent book he states that in 30 years of practice he has collected stories, case narratives and personal recollections that go “far beyond mere factual descriptions to teach lessons.” He addresses the issues of confidentiality and ethics, and the way that “certain technological changes and patient advocacy groups have affected them or may affect them in the future.” The specialists telling their stories to him include a surgeon, family physician, internist, cardiologist and geriatrician — all clinicians whose competencies are changing at a dizzying rate, as are our expectations of them. Some stories have commentary by Nuland when he thinks he needs to add explanation. Some storytellers are arrogant, some thoughtful, but all have a lesson worth learning if we have the time to listen.

The second book is The Real Life of an Internist, a compilation of stories edited by Mark Tyler-Lloyd. M.D. It is the first in a series to be published by Kaplan Publishing. These physicians deal with chronic illness and noncompliant patients, families in denial and overwhelming circumstances. We travel with them as they reveal that they don’t always know how to present bad results, they’re unsure about how to manage difficult patients, they often feel that they don’t get the respect they should, they wish they had more time to spend on patient education, they take their worries about their patients home with them, and they have clinical near-misses that give them nightmares. In short, they are just like us; they have many of the same problems, but on a different scale with a different set of responsibilities.

A chapter at the end of the book reveals additional information about the identity of each writer, including training and length of service. This serves to place much of the writing into perspective. Hopefully by now the physician unsure of himself has gained more confidence, and the arrogant doctor has encountered a nurse who has set him in his place.  

Christine Contillo, RN, BSN, has worked as a nurse since 1979 and has written extensively for various nursing publications, as well as The New York Times.

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