Final Exam: A Surgeon’s Reflections on Mortality by Pauline W. Chen

final exam

 

Final Exam was a book I picked up myself from the library. It was on my own personal reading list, which I haven’t been really able to get to these days. This is not a new book; it was published in 2007, but the ideas that Dr Chen speaks of should be relevant and in use today.

The mission of all doctors is to maintain life–by performing surgery, by prescribing medication, by encouraging life changes such as dieting or quitting smoking. But–everyone eventually dies, no matter how brilliant the surgeon was, or how much weight a patient lost. Many doctors gloss over this fact and prefer to focus on living and making a better quality of life.

Who will champion a better quality of death? No, Dr Chen is not  going to talk about euthanasia, or discuss funeral services. She is going to bring to the forefront a subject that has been assiduously avoided in human medicine for a long time: death is very much a part of life, and it should not be spoken of in hushed tones or pushed to the back of one’s mind. To truly care for your patients, you must realize that death is truly part of life.

No one wants to consider their own mortality, especially someone who is going to the hospital for an operation.  Dr Chen postulates that all doctors can give better care by embracing their own personal feelings and fears about death, and listening to what their patients are telling them, either with words or what their body is saying.

There is a great deal of explicit description in Final Exam:  of medical procedures and people struggling to die, those with sickness or those who have developed complications after surgery. Dr Chen starts out with her own personal experience with a cadaver in medical school and brings us all the way to her visceral reaction when a good friend of hers dies.

This book’s message is a powerful one, and not for the faint of heart. I thoroughly applaud Dr Chen for suggesting that doctors make themselves more emotionally available and vulnerable. Too often a patient’s death is couched in a sense of failure, of medicine gone wrong. A delicate balance needs to be attained, and I hope Dr Chen has started a dialogue by writing this book.

I loved this. You can pick up your own copy here.

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