The Soul of Medicine (2009)

by Sherwin Nuland
In his essay Nurse and Patient, Osler wrote "To talk of disease is an Arabian Nights' entertainment." While, this book is not exactly a pathography, many of you will want to spend some time with it, since it's a great read and gives insight to both the illness experience and the mind-set of doctors.

For "The Soul of Medicine," Nuland has asked 16 physicians to tell the story of their most memorable patient and, with two of his own additions, cobbled them together into a modern-day version of "The Canterbury Tales." Here, Canterbury is the fictionalized name of the prestigious medical institution where our storytellers' practices intersect, and the tales themselves are delivered by specialty: The Urologist's Tale, The Pediatrician's Tale and so on.

The Soul of Medicine is comprised of 21 short "Illness Narratives," each told in the voice of a different medical specialist. Most are fascinating (at least to other physicians). One wonders if a similar book with chapters told by patients with different disorders might even be better. One thinks of Mandel and Spiro's When Doctors Get Sick (a memorable compendium) in this context.

When Doctors Get Sick: Henry Mandel and Howard Spiro (1987)

This book is a minor classic. In an essay in the Annals of Internal Medicine, Harvey Mandell writes: Storytelling has gained prominence in medicine, where the tales of the sick are medicalized as "pathography." Interest in "narrative," as it is called in academic circles, is equally widespread in history, where stories based on facts and re-created with imagination bring other times to life more dramatically than the dry data of economics and biography. If we physicians read more accounts of our patients' travails and, better still, talked about them with each other, we might improve the humane qualities of medical care. The chiaroscuro of conversation and narrative can so highlight the social, emotional, and economic origins of many complaints that it might even help to make medical practice more cost-effective.

We review here what the two of us learned from the stories about sick doctors that we collected a decade ago. These narratives illuminate the dilemma of impaired physicians-or wounded healers, as they have been called-that our profession must examine before others do it for us.

I read this when it came out, and it remains a favorite of mine. There are 52 short vignettes, almost all of them memorable.

The can be difficult to find. There was one copy on ABE Books for ~ $2.00 but the rest were way too expensive.