Goodreads author Carolyn Jourdan is one of my longest-standing Goodreads friends; but back in 2007, when this book first came out and before I'd ever heard of Goodreads, I'd read a review of it in Library Journal or Booklist (maybe both) and been intrigued by it. I usually don't read memoirs, except for James Herriot's books, but this one caught my interest. So, when I had a chance to snag a copy on BookMooch awhile ago, I grabbed it up. I'm really glad I finally made time to read it!
The Goodreads description actually gives a good sketch of the situation that confronted Carolyn during the year that this book covers, and the decision that emerged from it. What it may not fully convey is the flavor of the book. It's not a bit pat or treacly; the author doesn't try to portray herself as a saint, and her struggle with the idea of giving up a $100,000-a-year job as a Senate committee counsel, and a lifestyle she liked, in order to opt for a much less heralded and lucrative place of service is portrayed with unflinching honesty. That makes her decision all the more powerful in the end; it wasn't something she effortlessly fell into, but a conscious, deliberate choice of the kind of things that matter most in life. Along the way, she provides us as readers with a wonderful ride.
Appalachia is where I've lived for more than 20 years, so I could relate to the setting here. She doesn't romanticize it, though she makes it clear that it's a place of great natural beauty, a place where communities of friends and family who actually help each other can still be found, and a place with a cultural ethos that's not wholly homogenized by modernity. But it's also a place of widespread poverty, ravaged by prescription drug addiction, and not immune to the social dysfunctions of modern life. Above, I mentioned James Herriot's books as memoirs I liked. Some reviewers have actually compared this book to his work; and allowing for the differences in time and place, there are similarities in the rural setting, the tone, and the fascinating character portrayals of the patients --which here even include some animals; Dr. Jourdan wasn't a veterinarian, but he saw a few four-legged patients nonetheless. (The goat on the cover of the edition I read came in for an X-ray. :-) ) There's abundant humor in these pages; I laughed out loud several times. But humor sometimes serves to hold back tears, because medical practice necessarily involves its tragedies, too; patients die, and they're not always the patients we think are "ready" to die. And there's a goodly share of wisdom, too, homespun or hard-won; and ultimate triumph that makes the spirit soar. It's no secret that I tend to prefer fiction over nonfiction in my reads, but this is nonfiction that's as readable as a novel --a high-quality, serious novel that has something worthwhile to say (as opposed to what passes for a modern "literary" novel).
I'm trying not to make this review too long; but one point that cries out to be made, and that the reader can't help but take from the book, is the contrast between the older personal, service-oriented kind of medicine exemplified in this book by Dr. Jourdan (a doctor, for instance, who still made housecalls, and didn't charge indigent patients), and the modern bureaucratic, profit-driven model we're told we have to settle for now. We all know the former is better, but we've gotten accustomed to wringing our hands and bewailing its loss. This book shows us that we don't have to do that; that human-scaled medicine is a viable option for the present, given people determined to make it work.
Very strict Christian readers may be put off by the fact that Carolyn and her family and friends don't totally eschew a certain amount of bad language of the d-, h- and s-word sort at times, and she faithfully reproduces that dialogue as it was. And a couple of conversations involve theological speculations that aren't strictly orthodox. For my part, I honestly wasn't bothered by either factor here. (As far as theology goes, I'd rather see people take God seriously enough to think about him, even in ways I don't agree with, than to ignore Him; and the latter is something our author doesn't do.)
While the author doesn't try to make herself a plaster saint on a pedestal here, and laughs at her own foibles as much as at anybody's, the personality that's revealed here is a really likeable one: kind, smart, caring (and at times a little zany :-) ). I'm proud to say that we're "friends" (even in the limited sense that word sometimes bears on Goodreads); and getting to know her, even through the medium of a book, is one of the best treats this read has to offer.
Note: in the back, the edition I read has a short but interesting "Conversation With the Author," and even some discussion questions for book clubs who want to do this book as a read. I'm not sure if all the editions have these; but I highly recommend the book in any edition!