Editor’s Notebook: Summer Reading

September / October 2009

Editor’s Notebook

Summer Reading

Staying current on developments in patient safety and quality improvement allows me to indulge my eclectic taste in reading. Looking back at what I’ve read this summer, I see a wide range of topics and a couple of books in particular that I’d like to recommend.

Technology always takes a good share of my reading time. In addition to the usual fare — electronic medical records (EMRs), clinical decision support, medical devices — the federal government’s HITECH funding for EMRs has added personal health records, “meaningful use,” and HIT certification to the mix. Healthcare reform has added economics, comparative effectiveness, and various perspectives on health policy.

I’ve particularly enjoyed two books this summer that balance the technology focus and policy debates: Every Patient Tells a Story by Lisa Sanders (2009, Broadway Books) and Body of Work by Christine Montross (2007, Penguin Books). I’ve been interested in the unique experience and outlook that medical training seems to create. Sanders and Montross vividly convey different aspects of that experience.

In addition to being an internist on the faculty of the Yale University School of Medicine, Sanders is a technical advisor to the television series, House, M.D., and author of a monthly column for The New York Times Magazine on the topic described by her book’s subtitle: Medical Mysteries and the Art of Diagnosis. She believes that the process of making a diagnosis is central to being a physician but “remains mostly hidden, often misunderstood, and sometimes mistrusted.” In one story, she describes a 23-year-old woman who is dying from an illness that remains undiagnosed despite days of hospital examination and testing. Unable to solve the mystery with technology, her perplexed doctors reach out to colleagues, “using those irreplaceable tools, a phone and a friend.” One of those friends—head of the hospital’s Department of Medicine and known for his sensitivity and diligence—makes the correct diagnosis and saves the patient’s life.

In Body of Work, Montross takes the reader deeply through her experience of human anatomy lab as a first-year medical student. Now a psychiatrist, Montross entered medical school as a teacher of writing and published poet, and the quality of observation, personal reflection, and language in Body of Work represent artistic accomplishment as well as riveting storytelling. Montross describes the experience as a crucible, pivotal to the personal transformation that was part of her medical school experience. “My classmates and I are undeniably new to doctoring, but the lessons that the body teaches us are profound and resonant, and they begin to change us.”

My non-medical summer reading has taken me to Pakistan and Afghanistan, courtesy of Three Cups of Tea by Greg Mortenson and David Oliver Relin (2006, Penguin Books). The book begins with Mortenson’s failed ascent of K2, the second highest peak in the world, and follows his efforts to build schools for poor villages in Pakistan. It’s taking me a long time to finish Three Cups, but it’s been a pleasure to slowly savor this evocative and thrilling story.