|
| Final Exam: A Surgeon's Reflections on Mortality (Vintage) | 
 enlarge | Author: Pauline W. Chen
Publisher: Vintage
Category: Book
List Price: $13.95
Buy New: $7.89
You Save: $6.06 (43%)
New (36) Used (18) from $6.24
Avg. Customer Rating:  44 reviews
Sales Rank: 26877
Media: Paperback
Number Of Items: 1
Pages: 288
Shipping Weight (lbs): 0.4
Dimensions (in): 7.9 x 5.1 x 0.7
ISBN: 030727537X
Dewey Decimal Number: 609
EAN: 9780307275370
ASIN: 030727537X
Publication Date: January 8, 2008
Availability: Usually ships in 1-2 business days
Condition: Brand new item. Over 3.5 million customers served. Order now. Selling online since 1995. Order with confidence. Code: B20080904214033T
|
| Also Available In:
|
| Similar Items:
|
| Editorial Reviews:
Product Description
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.
|
| Customer Reviews: Read 39 more reviews...
 a heartfelt account of how medical profession deals with death and dying January 12, 2007
51 out of 53 found this review helpful
I read this book in one sitting! I HIGHLY recommend this fantastic read to anyone considering going to medical school, everyone IN medical school, and middle-aged readers who find themselves faced with the challenge of caring for aging parents.
Chen's stories, told in a humble and genuinely caring voice, reveal the fascinating--and at times disturbing--realm of end of life care in the emergency rooms and operating rooms of American hospitals. Through her heartfelt accounts, beginning with her first dissection of a human cadaver in med school anatomy lab, through her practice at UCLA as one of the nation's top liver transplant surgeons, Chen tackles the difficult issues of caring for the dying candidly and honestly, often citing her own failures as a young doctor before making certain realizations about how to overcome the depersonalization of death required in medical school. There are also exiting scenes, such as her vivid description of tearing down the Californis coast in a helicopter at 3:00 in the morning to harvest a fresh liver from a child just recently run over by his mother's SUV. The stories are gripping and moving, heart-rending yet touching.
Chen's writing is fabulous: caring and empathetic, yet clear and precise. The little book is easy to read. It should be required reading for first year medical students and premeds, since it not only is about death and dying and how to improve end of life care, but also offers a candid look inside med school life and the gritty, messy, day-to-day grind of busy teaching hospitals.
Overall, a solid 5 stars, get this book today.
-Dan
(biology student)
 Caring For the Ill and Personalizing Their Dying March 4, 2007
34 out of 41 found this review helpful
"I think it's like Dr. Courtney M. Townsend, a legend in surgery and a personal hero, recently told me. "We have two jobs as doctors: to heal and to ease suffering. And if we can't do the former, my God we better be doing the latter." Pauline Chen
A few years ago I was part of a poetry group of medical providers. We shared poetry written by or for medical providers that described our work. Most of these poems as it turned it were about the dying, the dead or end-of-life. Our professions had a need to share our profound feelings. Since that time Palliative Care has become a recognized service in many hospitals and communities. Our patients need us and we need each other to share our grief.
Pauline Chen discovered once she was house staff that pronouncing a patient's death was part of her job, the first 'code blue', the first agonizing long death on an intensive care unit, and the day to day life and death of her patients were taking a toll. She was taught it seems to hide her feelings, but then they would not go away and what was she to do? She had an eye-opening experience with a physician who stayed with his patient while he was dying and she realized 'this is what my job is all about." As a transplant physician, Pauline Chen realized that her life and death immersion in very ill patients brought her closer to death than life. As she stated, "zeal to cure is no excuse for failing to communicate prognoses honestly or for sidestepping ongoing dialogue with patients and families as medical events deteriorate." She gives us many examples of her patient experiences and how other physicians reacted to their patient's deaths. As she so eloquently says, " That honor of worrying-of caring, of easing suffering, of being present- may be our most important task, not only as friends but as physicians, too."
"Exercising personal autonomy around one's death is no simple matter today -- especially in settings of ever-more sophisticated and fragmented medical care. As Pauline W. Chen points out in "Final Exam: A Surgeon's Reflections on Mortality," the medical profession bears a good measure of responsibility for this dilemma. But "Final Exam" is neither an angry rant nor a bloodless treatise about medicine's failings. By sharing stories of her own maturation into a healer as well as a technically skilled doctor, Chen in this fresh and honest memoir engages and educates on many levels. At the same time, the author's principal goal -- to hold herself and fellow physicians accountable for providing better end-of-life care -- is ever in view." Claire Dunavan
My role in my profession is to help my patients with their living through their dying. This would not be possible without my team mates and colleagues. My best friend, with whom I share each patient death, found this book and told me about it. Thank you. Pauline Chen has written a book that should be read by all medical providers. It is indeed a good thing to be compassionate and to be there, physically and emotionally with our patients. Highly Recommended. prisrob 3-04-07
Great read January 18, 2007
29 out of 31 found this review helpful
This book is really compelling, Dr. Chen brings you into her world and her work with clarity and a terrific knack for storytelling.
Her love of medicine and her genuine appreciation for her patients as people, not just interesting problems, is extremely touching.
Ultimately, she asks questions that dont just apply to medicine, but to society as a whole. How can our secularized society and our culture do a better job of facing death and caring for the dying?
Humbling! January 25, 2007
29 out of 33 found this review helpful
"Final Exam" is humbling in at least two dimensions - producing greater respect for physicians (their knowledge and skill - both practicing medicine and handling grief and death), and reminding the reader that he/she is not immortal, and has over a 90% chance of dying from a prolonged illness - with plenty of time to reflect.
Care at the end of life provides the theme for "Final Exam," and Dr. Chen takes us through her earliest lessons on death in medical school (her cadaver dissection - imagining the person in real life and covering up emotions with black humor, first resuscitation scene - failed, but wondering if she could do as well, and her first pronouncement of death). Then its on to professional medical practice experiences - eg. evading difficult discussions with patients and family, trying to avoid long-term terminally ill dying on one's shift and incurring subsequent paperwork, seeing the devotion of a spouse to his/her long-term partner, ramping up treatment in terminal cases - even though it made little medical sense (accounts for about 22% of all medical expenditures and usually simply prolonged patient and family suffering; avoiding lawsuits is a major reason, unclarity regarding who is the physician is another). Finally, it's on to Dr. Chen's experiences as a transplant surgeon - removing organs from those declared "brain dead" and then deliberately ending their lives, followed by hopefully bringing life to the donor-organ recipient.
How Many Physicians Would Pass The Exam? February 17, 2007
23 out of 24 found this review helpful
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.
|
|
|
Powered by Associate-O-Matic
| |
