Book Review: Final Exam

I have to admit, physicians are a bit larger than life to me.

I get medical school, years of learning, tons of debt, putting your pants on one leg at a time. . .  yada, yada, yada. Still, there is something about the white coat, the bedside manner, the potential of another person being able to heal what ails me that draws my attention. Was it this, my biology background, my position in a medical center, or something else that made me pick up, put down and ultimately use my Barnes and Noble 15% off coupon and membership discount on a book about mortality written by a surgeon?

Final Exam is a compelling read that captures a struggle of the human condition (my new favorite phrase.) Vintage introduces the book and begins their reader's guide in this fashion, "In Final Exam, Pauline Chen tells the story of her own medical education and the many crucial experiences with patients that lead her to become a more empathic, more compassionate and more patient oriented doctor. 'I never intended, ' Chen writes, 'to make my living among the dying.' She began her medical career with dreams of saving lives but found very quickly that death would be a constant, though largely unacknowledged companion."

Did you know that one-quarter of oncologists failed to tell their patients that they had incurable cancer, that they deny the reality of the condition, that they are not ok "doing nothing," even in the face of something that is absolutely, no doubt about it, beyond their control? They are not bad people, bad physicians, bad surgeons. As a matter of fact, they are some of the best, the brightest and the most compassionate professionals in health care who may not be fully aware that their detailed plans, multi-leveled algorithms and myriad of medical rituals they begin to learn from Day 1 of medical school may not fully prepare them for complex realities of what they will encounter.

Chen's stories and personal accounts provided me with a glimpse into a world I would not ordinarily see and that was very interesting. That, however, was not what kept me turning the pages. It was Pauline's honesty, her insights into both the benefits and limitations of rituals and more than anything, her willingness to look beyond the institution, to question what was right for her and ultimately, to follow her heart.

At the very end of Final Exam, Chen writes, “I had comforted my patient and his family. I had eased their suffering. I had been present for them during life and despite death. I had caught a glimpse of the doctor I could become.” 

She had me from very beginning and I could not let go until the very end.