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Between Expectations: Lessons from a Pediatric Residency
When Dr. Meghan Weir first dons her scrubs and steps onto the floor of Children’s Hospital Boston as a newly minted resident, her head is packed with medical-school-textbook learning. She knows the ins and outs of the human body, has memorized the correct way to perform hundreds of complicated procedures, and can recite the symptoms of any number of diseases by rote. But none of that has truly prepared her for what she is about to experience.
From the premature infants Dr. Weir is expected to care for on her very first day of residency to the frustrating teenagers who visit the ER at three in the morning for head colds, each day brings with it new challenges and new lessons. Dr. Weir learns that messiness, fear, and uncertainty live beneath the professional exterior of the doctor’s white coat. Yet, in addition to the hardships, the practice of medicine comes with enormous rewards of joy, camaraderie, and the triumph of healing.
The three years of residency—when young doctors who have just graduated from medical school take on their own patients for the first time—are grueling in any specialty. But there is a unique challenge to dealing with patients too young to describe where it hurts, and it is not just having to handle their parents. In Between Lessons from a Pediatric Residency , Dr. Weir takes readers into the nurseries, ICUs, and inpatient rooms of one of the country’s busiest hospitals for children, revealing a world many of us never get to see. With candor and humility, she explores the many humbling lessons that all residents must that restraint is sometimes the right treatment option, no matter how much you want to act; that some patients, even young teenagers, aren’t interested in listening to the good advice that will make their lives easier; that parents ultimately know their own children far better than their doctors ever will.
Dr. Weir’s thoughtful prose reveals how exhaustion and doubt define the residency experience just as much as confidence and action do. Yet the most important lesson that she learns through the months and years of residency is that having a good day on the floor does not always mean that a patient goes home miraculously healed—more often than not, success is about a steady, gradual discovery of strength. By observing the children, the parents, and other hospital staff who painstakingly provide care each day, Dr. Weir finds herself finally developing into the physician (and the parent) she hopes to become. These stories—sometimes funny, sometimes haunting—expose the humanity that is so often obscured by the doctor’s white coat.
From the premature infants Dr. Weir is expected to care for on her very first day of residency to the frustrating teenagers who visit the ER at three in the morning for head colds, each day brings with it new challenges and new lessons. Dr. Weir learns that messiness, fear, and uncertainty live beneath the professional exterior of the doctor’s white coat. Yet, in addition to the hardships, the practice of medicine comes with enormous rewards of joy, camaraderie, and the triumph of healing.
The three years of residency—when young doctors who have just graduated from medical school take on their own patients for the first time—are grueling in any specialty. But there is a unique challenge to dealing with patients too young to describe where it hurts, and it is not just having to handle their parents. In Between Lessons from a Pediatric Residency , Dr. Weir takes readers into the nurseries, ICUs, and inpatient rooms of one of the country’s busiest hospitals for children, revealing a world many of us never get to see. With candor and humility, she explores the many humbling lessons that all residents must that restraint is sometimes the right treatment option, no matter how much you want to act; that some patients, even young teenagers, aren’t interested in listening to the good advice that will make their lives easier; that parents ultimately know their own children far better than their doctors ever will.
Dr. Weir’s thoughtful prose reveals how exhaustion and doubt define the residency experience just as much as confidence and action do. Yet the most important lesson that she learns through the months and years of residency is that having a good day on the floor does not always mean that a patient goes home miraculously healed—more often than not, success is about a steady, gradual discovery of strength. By observing the children, the parents, and other hospital staff who painstakingly provide care each day, Dr. Weir finds herself finally developing into the physician (and the parent) she hopes to become. These stories—sometimes funny, sometimes haunting—expose the humanity that is so often obscured by the doctor’s white coat.
288 pages, Paperback
First published February 18, 2011
21 people are currently reading
998 people want to read
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Displaying 1 - 30 of 45 reviews
December 19, 2015
This is a sad book. Almost all the patients, babies, little children and teenagers, die. Other reviewers have found the author cold and detached. I didn't but I can see why they thought so. The author rotates between different wards and also has an on/off schedule that allows her much time off as she can't cope with the stress and have a life. Because of this, there is little continuity between the cases, the children, she describes. She is involved though, she does go back to check on the little ones who were previously in her care when she is back on duty.
Really it's as much about the author as it is about the patients, it's just that the patients are more interesting and as she writes less about them, it seems she is detached and cold. Those reviewers wanted a different book is all. This is a good read, definitely four stars.
Really it's as much about the author as it is about the patients, it's just that the patients are more interesting and as she writes less about them, it seems she is detached and cold. Those reviewers wanted a different book is all. This is a good read, definitely four stars.
January 29, 2019
I love the inside glimpse of our hallways! Especially her rotations through 7W and Gen Peds! That’s my day, that’s her day and that’s what we do!
The undertones here are that many die... yes that’s so very true but it’s the lessons we take from each child that matter. We can’t save them all, but we sure can fight for them. See ya around DrWeir!
The undertones here are that many die... yes that’s so very true but it’s the lessons we take from each child that matter. We can’t save them all, but we sure can fight for them. See ya around DrWeir!
March 8, 2021
This memoir tells the time when Meghan MacLean Weir started out as a doctor in a children's hospital. It was very interesting but not the slightly cheerful and heartwarming book as I first thought. There is a lot of children patients dying in this book so if it's something that it's hard for you to read, I suggest skipping this. On the page Meghan don't sounds like she is very attached to this patients, but I'm in a minority here and thinks that's it's quite the good thing. A doctor should care for it's patients yes, but to be to attached to them is not always a good thing and can lead to overwhelmeling yourself at work sooner or later. Overall I thought this was a good book.
July 3, 2011
I've read other doctor's memoirs and there was something about Dr. Weir's tone that rubbed me the wrong way and it is hard for me to put my finger on it. Perhaps it was the sense that every child she ever treated died--this can't possibly be the case, but this is what she chose to focus on. Perhaps it is the dismal tone that haunts this book, a reader might think that a healthy child has never been born. An interesting read, however, and worth a look, although I probably wouldn't recommend it to anyone who is expecting a child.
June 3, 2021
I was left speechless by this book. When I finished, I couldn’t bring myself to really move, so I closed the cover, hugged the novel to my chest, and stared out at the night sky in silence for a long time.
This is a novel I’ll surely look back on as I progress through my pediatric nursing education.
Yes, death occurs often in this book. But then again, death often occurs on pediatric oncology wards, in pediatric and neonatal intensive care units, and pediatric ERs. And those spaces are exactly where this book takes place.
If you work the PICU, NICU, or in pediatric oncology—many kids you grow to love will die. It’s not remotely fair or easy to accept, but the presence of their losses doesn’t make this book “negative” or “too harsh” as so many reviewers have stated. Quite the contrary in fact, I found it a tender novel.
As Dr. Maclean Weir states at the beginning, to be allowed to witness is a holy and incredible gift. And that is exactly what she is able to do when her patients’ lives cannot be saved. She bears witness to their last breaths, their battles with diseases with names too long for most of us to pronounce, and all their moments of silent courage in-between.
I’m not quite sure why other reviewers found her tone “cold”.
The fact that she does not gush over each child in the way parents or nurses often do, in no way indicates that she is harsh. This isn’t a book about patient personalities — it’s a book about medicine and how this remarkable woman walks through her development as a physician.
Dr. Maclean Weir’s love for her patients is plainly evident, as is her love for her field of study. All in all, an excellent novel.
This is a novel I’ll surely look back on as I progress through my pediatric nursing education.
Yes, death occurs often in this book. But then again, death often occurs on pediatric oncology wards, in pediatric and neonatal intensive care units, and pediatric ERs. And those spaces are exactly where this book takes place.
If you work the PICU, NICU, or in pediatric oncology—many kids you grow to love will die. It’s not remotely fair or easy to accept, but the presence of their losses doesn’t make this book “negative” or “too harsh” as so many reviewers have stated. Quite the contrary in fact, I found it a tender novel.
As Dr. Maclean Weir states at the beginning, to be allowed to witness is a holy and incredible gift. And that is exactly what she is able to do when her patients’ lives cannot be saved. She bears witness to their last breaths, their battles with diseases with names too long for most of us to pronounce, and all their moments of silent courage in-between.
I’m not quite sure why other reviewers found her tone “cold”.
The fact that she does not gush over each child in the way parents or nurses often do, in no way indicates that she is harsh. This isn’t a book about patient personalities — it’s a book about medicine and how this remarkable woman walks through her development as a physician.
Dr. Maclean Weir’s love for her patients is plainly evident, as is her love for her field of study. All in all, an excellent novel.
March 12, 2011
I am strangely fascinated by these type of books by medical professionals (and almost as equally addicted to shows like ER, House and Private Practice). Between Expectations is Meghan Weir's story of her residency in Paediatrics, her struggle with the losses and triumphs as she cares for sick newborns and dying children.
Modern medicine is a miracle but still there is so much that cannot be answered or treated, where death or survival defies explanation. I think that in the Paedatrics ward that endless struggle between despair and hope must be amplified. Meghan shares the stories of some of her patients and their families. These tales are heartbreaking if you imagine a tunour wrapping around your childs heart, or the joy of a remission from cancer only for an unrelated infection to steal their mind. In those cases Meghan's shares of recovery the outcomes are usually ambiguous, the victories are small and quiet.
I think perhaps the book lacks some warmth, Meghan's tone tends to be more clinical than compassionate. I wonder how the birth of her own child will affect the relationships she builds with parents and her patients. I imagine that from Meghan's perspective tragedy is far more common that joy but I, particularly as a parent reading the book, would like at least one story of unbridled triumph, a miracle of sorts. Unrealistic perhaps, but I want to believe the possibility exists.
The training for residents is punishing and the ridiculous demands made on medical trainees in this day and age is clearly illustrated. I can see no reason for requiring 30 hour shifts in a field where a moment of inattention due to fatigue could kill someone. I cannot understand, nor condone, any justification for those conditions. Meghan's story emphasises the disconnect that results from such a consuming schedule, from patients, partners and family and even herself.
Between Expectations is an intriguing memoir, it has none of the glamour of Grey's Anatomy, but is a very personal and raw exploration of the personal and professional commitment required to become a doctor. While it lacks a spirit of optimism, it is reassuring in its way, that should you find yourself in a paedeatrics ward with your child, that everyone will be doing all they can.
Modern medicine is a miracle but still there is so much that cannot be answered or treated, where death or survival defies explanation. I think that in the Paedatrics ward that endless struggle between despair and hope must be amplified. Meghan shares the stories of some of her patients and their families. These tales are heartbreaking if you imagine a tunour wrapping around your childs heart, or the joy of a remission from cancer only for an unrelated infection to steal their mind. In those cases Meghan's shares of recovery the outcomes are usually ambiguous, the victories are small and quiet.
I think perhaps the book lacks some warmth, Meghan's tone tends to be more clinical than compassionate. I wonder how the birth of her own child will affect the relationships she builds with parents and her patients. I imagine that from Meghan's perspective tragedy is far more common that joy but I, particularly as a parent reading the book, would like at least one story of unbridled triumph, a miracle of sorts. Unrealistic perhaps, but I want to believe the possibility exists.
The training for residents is punishing and the ridiculous demands made on medical trainees in this day and age is clearly illustrated. I can see no reason for requiring 30 hour shifts in a field where a moment of inattention due to fatigue could kill someone. I cannot understand, nor condone, any justification for those conditions. Meghan's story emphasises the disconnect that results from such a consuming schedule, from patients, partners and family and even herself.
Between Expectations is an intriguing memoir, it has none of the glamour of Grey's Anatomy, but is a very personal and raw exploration of the personal and professional commitment required to become a doctor. While it lacks a spirit of optimism, it is reassuring in its way, that should you find yourself in a paedeatrics ward with your child, that everyone will be doing all they can.
September 26, 2012
It's rare these days to find a first person account of a doctor's practice without a whole lot of philosophical fluff and filler on how things used to be, so Weir's novel was refreshing in that way. Judging by the prologue, this book was actually a vital part of her training in that she extended her residency by a year in order to keep from going out of her mind and used the downtime to write and have an outlet to the frustrations she'd been feeling to that point. Weir is blunt in saying that she hated her training, not because she had a change of heart while constantly surrounded by sick and dying kids, but because she battled complete exhaustion 100% of the time and didn't feel like she was giving the children her best. Her experience was not unique though, and given that this book was based on training in the early 2000s, I feel it is likely an accurate portrayal of programs across the nation.
In terms of the structure of the book, most patients and experiences are summarized in one section and do not reappear later on, though some of her chronically ill patients return to the hospital and others get recalled when Weir encounters a similar situation and explains how learning from the first patient helped her to treat the next one better. What I didn't get from the book was a delineation of her years of training. Late in the book, she mentions supervising others who were in the same year of training as she was at the beginning of the book, but the book wasn't broken into Year 1, Year 2, Year 3, etc. Therefore, I was never entirely sure what the 'expectations' referred to in the book title were of Weiar at any given time. Other than the chapter where she writes of supervising the next generation of physicians, including one who isn't pulling her weight, and a later one where she travels to Africa to work in a clinic, I generally felt that Weir's role in treating her patients didn't evolve throughout the book. She alluded to finding zebras, yet in most cases, she was just following plans of care for patients already diagnosed, and wasn't doing much diagnosing herself.
Overall, I enjoyed the book, I was just left wanting a little more. She wrote of her time in the NICU, the Peds ICU, the cancer ward, and the chronic care service but again, those were all places where she largely inherited a group of patients and just tried to keep them alive until she passed them off to the next resident. Sure, writing about working in a clinic diagnosing colds, asthma attacks, diaper rash, etc would make for a boring book, but including work she did with acutely ill patients instead of the chronically ill would have added the variety I think was missing until her work in the African clinic at the end of the book.
In terms of the structure of the book, most patients and experiences are summarized in one section and do not reappear later on, though some of her chronically ill patients return to the hospital and others get recalled when Weir encounters a similar situation and explains how learning from the first patient helped her to treat the next one better. What I didn't get from the book was a delineation of her years of training. Late in the book, she mentions supervising others who were in the same year of training as she was at the beginning of the book, but the book wasn't broken into Year 1, Year 2, Year 3, etc. Therefore, I was never entirely sure what the 'expectations' referred to in the book title were of Weiar at any given time. Other than the chapter where she writes of supervising the next generation of physicians, including one who isn't pulling her weight, and a later one where she travels to Africa to work in a clinic, I generally felt that Weir's role in treating her patients didn't evolve throughout the book. She alluded to finding zebras, yet in most cases, she was just following plans of care for patients already diagnosed, and wasn't doing much diagnosing herself.
Overall, I enjoyed the book, I was just left wanting a little more. She wrote of her time in the NICU, the Peds ICU, the cancer ward, and the chronic care service but again, those were all places where she largely inherited a group of patients and just tried to keep them alive until she passed them off to the next resident. Sure, writing about working in a clinic diagnosing colds, asthma attacks, diaper rash, etc would make for a boring book, but including work she did with acutely ill patients instead of the chronically ill would have added the variety I think was missing until her work in the African clinic at the end of the book.
March 29, 2025
Take aways: I truly believe peds is such a beautiful field, the relationship with patients and families is something I cherish so deeply. I enjoyed her stories of patients both happy and sad and how they had a profound impact on her residency journey and how she practiced medicine going forward.
Cons: I found her writing style at times was all over the place, and she sometimes did not finish the stories she started. I also wish she would have had one or two more chapters at the end really wrapping up her journey and what changed her the most in residency.
Cons: I found her writing style at times was all over the place, and she sometimes did not finish the stories she started. I also wish she would have had one or two more chapters at the end really wrapping up her journey and what changed her the most in residency.
August 1, 2011
“Between Expectations: Lessons from a Pediatric Residency” by Meghan MacLean Weir, M.D...
Category – Medical/History
This book should be read by anyone in or interested in pediatrics, this includes Doctors, Nurses, and anyone who works in the field, or is thinking of working in the field of pediatrics. It is also a wonderful read for the casual reader, or those just interested in the medical profession.
Meghan is doing her residency in pediatrics and her first rotation is in NICU (neonatal intensive care unit). It is here that she is faced with the problems faced in the care of premature babies and their parents. Not only is she faced with dealing with the care of the infant but she must also inform the parents of their child’s condition. The conditions could range anywhere from very good to the devastating possibility that the child may be severely handicapped for life and the possibility of death.
Her second rotation is an area that she calls, “women troubles”. Here she finds herself dealing with young girls who have become sexually active. She deals with the possibility of these girls having gonorrhea, Chlamydia, syphilis, or AIDS.
In some cases these young girls do not even know what these diseases are, or that there are ways to prevent them.
Her third rotation is in MSICU, (medical surgical intensive care unit). This is an area where children are cared for who have lived longer than they ever have before but where doctors and nurses are fighting an almost impossible battle against certain death. The parents as well as the hospital staff know this and walk a thin line in keeping hope alive where there is no hope.
Her fourth rotation is in the children’s cancer ward. Here Meghan is able to see the ravages of cancer but she can also see that many of these children are cured and go on to live healthy and productive lives.
“Between Expectations” is an exceptional read and has a little something for everybody, and a lot more for most of us.
Category – Medical/History
This book should be read by anyone in or interested in pediatrics, this includes Doctors, Nurses, and anyone who works in the field, or is thinking of working in the field of pediatrics. It is also a wonderful read for the casual reader, or those just interested in the medical profession.
Meghan is doing her residency in pediatrics and her first rotation is in NICU (neonatal intensive care unit). It is here that she is faced with the problems faced in the care of premature babies and their parents. Not only is she faced with dealing with the care of the infant but she must also inform the parents of their child’s condition. The conditions could range anywhere from very good to the devastating possibility that the child may be severely handicapped for life and the possibility of death.
Her second rotation is an area that she calls, “women troubles”. Here she finds herself dealing with young girls who have become sexually active. She deals with the possibility of these girls having gonorrhea, Chlamydia, syphilis, or AIDS.
In some cases these young girls do not even know what these diseases are, or that there are ways to prevent them.
Her third rotation is in MSICU, (medical surgical intensive care unit). This is an area where children are cared for who have lived longer than they ever have before but where doctors and nurses are fighting an almost impossible battle against certain death. The parents as well as the hospital staff know this and walk a thin line in keeping hope alive where there is no hope.
Her fourth rotation is in the children’s cancer ward. Here Meghan is able to see the ravages of cancer but she can also see that many of these children are cured and go on to live healthy and productive lives.
“Between Expectations” is an exceptional read and has a little something for everybody, and a lot more for most of us.
December 30, 2012
just what it sounds like. essays that basically comprise a memoir about one doctor's experience as a pediatric resident. it started off awfully depressing, as the author is called to attend to the birth a very premature baby. the parents, naturally, request that everything possible be done to save the baby, & the doctors acquiesce, but the author reflects that in cases like this, it may be more humane to let the baby die, because such a premature infant faces so many health problems & can be affected by life-long disabilities. while this may be true, it's also kind of hard to fathom new parents being like, "yeah, let our baby die." & i read this even before i gave birth to my own premature infant (33 weeks, & pretty healthy for her gestational age--she was delivered for my health, not her own).
this book was definitely interesting, but more because of the subject matter & less because of the author. her writing style was surprisingly unengaging. i wonder what i would thin of it now that i have gone through having my baby in the NICU for a month?
this book was definitely interesting, but more because of the subject matter & less because of the author. her writing style was surprisingly unengaging. i wonder what i would thin of it now that i have gone through having my baby in the NICU for a month?
February 12, 2017
I wanted and expected to like this book. It's well enough written, has the right balance of stories, introspection, and looking at a broader view. But something about how the author thinks puts me off. I mean, the title itself seems oddly removed from just experiencing life. She does have some happy moments, along with plenty of dissatisfaction, but it all seemed kind of indirect. She also rubbed me the wrong way in the beginning chapters with her outlook on childbirth. Yes, she saw all the high-risk situations and the worst outcomes. But, a healthy just-born baby actually doesn't have to cry or be handled roughly. And I hate it when doctors call the laboring woman or new mother "mom." Save that for your own mother. Oh, and writing in present tense can be awkward. I'm sure she and the editors carefully considered exactly in which sentences/paragraphs to use past tense, but I guess I disagree with their choices.
April 25, 2015
I have mixed feelings about the book. I love medical memoirs/autobiographies, and a personal connection to books about babies born premature. This book ticks those two boxes.
However, as others remarked, the author is at times very clinical, and I didn't really feel the emotional attachment while reading about her patients. Yet chapters later, she would reference those very same patients, and would bring up how important a certain patient was to her. I would find myself asking "which one is that?"
I'm sure that as a doctor or anyone who cares for people, especially babies, you do need to separate emotionally from them, so you can be able to do your job. I guess I just feel like the emotions are as important as the medical details when you write a memoir.
However, as others remarked, the author is at times very clinical, and I didn't really feel the emotional attachment while reading about her patients. Yet chapters later, she would reference those very same patients, and would bring up how important a certain patient was to her. I would find myself asking "which one is that?"
I'm sure that as a doctor or anyone who cares for people, especially babies, you do need to separate emotionally from them, so you can be able to do your job. I guess I just feel like the emotions are as important as the medical details when you write a memoir.
April 11, 2014
I really enjoyed this book. I like personal experiences and the author's writing improved as the book went along. Overall, she is a darn good writer. Also, she must be multi-talented as she accomplished so much in her life, leading up to being a doctor and a writer. I'm amazed she could find the time to do so much, and to do such a good job at each, when both are time-consuming careers. The sad part of the book was when she was in Liberia and how there were so many shortages in supplies/equipment the doctors there needed to save peoples' lives. Here in the US, we have so much in the way of good health care even if it is way more expensive than it ever should be.
March 7, 2011
There are so many sad realities that make up this young pediatrician's life. She describes her work so honestly and in such detail that not enough of her warmth and compassion shine through. I would welcome the chance to read this same book written when the author is 10 years into her career.
April 6, 2014
I think this author did a great job with this book - I'm not sure why others complain it lacks warmth & compassion. For me, the author's despair at the unsolvable problems she encountered is itself proof of her compassion.
April 4, 2019
Wow ... so many good lessons from this book and so many things that hit home for me ... perfect book to prepare me for my pediatric residency starting this summer ... thank you, Dr. Weir for your honest, funny, and mind-challenging book ... although I could sense the angry and cynical tone sometimes, I understand that our mind tends to focus on negativity for survival & so that we can also appreciate the positivity ... pediatricians, in general, are the ones who try to help the most vulnerable; and when the system, the parents, or the circumstances do not allow children to grow up healthy, we get angry.
These quotes are my favorite parts of the book and probably sum up the message of who pediatricians are in general:
“They say that the first thing you must learn in residency is how to walk into a room and recognize whether a child is sick or not sick, whether you have time to think him over or if you need to run ...”
“... and although each child’s parents and their wishes are important, they cannot be allowed to become more important than the child herself.”
“I am angry because you need a license to drive a car and own a gun and sell alcohol but not to have or raise a child. I am angry that I live in a country that cares so much for the rights of unborn children but gives so few resources for the stewardship of those children after they are delivered. I am angry about many things and wish I had the energy to see my way forward to someday making changes, even little ones, but at the end of the day, it is hard enough to stay awake.”
“The hospital is the place where you must keep moving, always learning, the place that drives you forward to keep working no matter how little sleep you’ve had.”
“This is what they talk about, those physicians who have come to the end of their careers, when they say that it has been fulfilling in a way that no other job can ever be.”
These quotes are my favorite parts of the book and probably sum up the message of who pediatricians are in general:
“They say that the first thing you must learn in residency is how to walk into a room and recognize whether a child is sick or not sick, whether you have time to think him over or if you need to run ...”
“... and although each child’s parents and their wishes are important, they cannot be allowed to become more important than the child herself.”
“I am angry because you need a license to drive a car and own a gun and sell alcohol but not to have or raise a child. I am angry that I live in a country that cares so much for the rights of unborn children but gives so few resources for the stewardship of those children after they are delivered. I am angry about many things and wish I had the energy to see my way forward to someday making changes, even little ones, but at the end of the day, it is hard enough to stay awake.”
“The hospital is the place where you must keep moving, always learning, the place that drives you forward to keep working no matter how little sleep you’ve had.”
“This is what they talk about, those physicians who have come to the end of their careers, when they say that it has been fulfilling in a way that no other job can ever be.”
January 30, 2022
I do like a doctor-memoir, and it's intriguing to me that Between Expectations is so different from The Book of Essie. It doesn't sound like Weir particularly enjoyed residency (quite possibly true of most doctors!), but I do wonder just how different it felt to be practicing medicine when past residency and on a more sustainable schedule.
I've put this on my 'Africa' shelf because Weir spent a brief amount of time in Liberia, but I question that section's placement in the book—putting it all the way at the end lends it more weight than strictly necessary (it's not the point of the book), though in a lot of ways it does seem to sum up Weir's feelings about doctoring: throwing starfish into the sea, only to realise that this particular sea doesn't even have the right salt for half the starfish she manages to throw, and she as an individual will never be able to source the right salt. (I could probably find a better analogy here, but...) So many of the stories she highlights (both in Liberia and in Boston) seem to have unhappy endings, and I'm not sure if that's because that was the balance of the work she was doing at the time (a higher proportion of unhappy endings seems likely when you're working with, e.g., micro-preemies than when you're working with full-term labour!) and how much those are just the stories that stuck with her.
I've put this on my 'Africa' shelf because Weir spent a brief amount of time in Liberia, but I question that section's placement in the book—putting it all the way at the end lends it more weight than strictly necessary (it's not the point of the book), though in a lot of ways it does seem to sum up Weir's feelings about doctoring: throwing starfish into the sea, only to realise that this particular sea doesn't even have the right salt for half the starfish she manages to throw, and she as an individual will never be able to source the right salt. (I could probably find a better analogy here, but...) So many of the stories she highlights (both in Liberia and in Boston) seem to have unhappy endings, and I'm not sure if that's because that was the balance of the work she was doing at the time (a higher proportion of unhappy endings seems likely when you're working with, e.g., micro-preemies than when you're working with full-term labour!) and how much those are just the stories that stuck with her.
January 18, 2023
While not the most well written memoir I've ever read, it is valuable for the peek into the NICU (neonatal intensive care unit) that it offers. I have some idea of what goes on there since, as a pediatric occupational therapist, I see the preemies that survive it two or three years down the road. Still, even I cringed at the painful procedures visited on tiny infants unlikely to survive them, and even more unlikely to survive them without massive disabilities. It's fair to ask, as the author does, is it always worth it?
The author also does a good job of describing the emotional toll that caring for very ill children takes on young doctors who enter practice with all of their ideals intact but leave with few of them still in place. Especially poignant was the comment of one young intern during a feedback session intended to find out how the residency program at the children's hospital could be improved. She stated simply, "You could have warned us that, no matter what we did, nearly all of these children would die." Practicing medicine is not for the faint of heart.
The author also does a good job of describing the emotional toll that caring for very ill children takes on young doctors who enter practice with all of their ideals intact but leave with few of them still in place. Especially poignant was the comment of one young intern during a feedback session intended to find out how the residency program at the children's hospital could be improved. She stated simply, "You could have warned us that, no matter what we did, nearly all of these children would die." Practicing medicine is not for the faint of heart.
August 16, 2020
As a medical student planning to apply to combined internal med and pediatric programs, this was an excellent book. I can understand how some people may find it detached—there is a lot of technical language—or overly sad—there is a great deal if focus on patients who do not make it. But as a medical student, technical language does not feel as cold to me. In a way it is a as colorful as any descriptive adjectives that might be used to describe how a child is doing in the present moment. And talking about death, well that is just something that is important to do. Yes, of course, there are so many stories if children overcoming an illness that could have surely been discussed. But the way that she discussed death honestly and fully, it felt very compassionate to me and has given me a lot to think about.
October 11, 2025
I genuinely think this is one of the better written and crafted medical nonfiction books I’ve ever read. Dr Maclean-Weir’s prose is almost poetic at various points and there’s a great balance between autobiographical experience and medical stories. I think actually this is punished by publisher/marketing. The cover does not match the tone of the book at all and imo the subtitle is poor. This is very much not a light book about pediatric residency it’s about the struggles of balancing residency with life and the pain and suffering of chronically ill kids and the impact it has on their families and care teams.
January 20, 2022
I stumbled on this memoir after reading a work of fiction from the same author which was nothing at all like this book but great as well. I love medical books and enjoyed learning more about paediatric residency. The story is well written and shows both the highs and lows, the opportunities and challenges of residency and the signs that this career, while worthwhile, isn’t for everyone! Luckily for this author, her second career path is clearly a great option for her! Great book!
January 8, 2018
Great insight into the world of pediatric care. I don't think one ever really thinks of the amount of work and sacrifice doctors go through and this book only talks about the beginning of that journey. It was tough reading about families painful visit to the NICU, ICU, and oncology units, but their stories added to the learning experience of this doctor. Good read.
November 10, 2017
It was well written in terms of language but I felt the author was already jaded and condescending to some of her patients, which turned me off to her writing. I also thought it ended kind of abruptly.
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June 16, 2019i found it interesting that many of the cases she talks about in this were children that died - maybe because that is when doctor's feel the most helpless? it was stark and vulnerable in many places; but you could feel her hope at becoming a good doctor
October 15, 2019
Fantastic!! Extremely well written and the stories are touching. Please write us more, Meghan MacLean Weir.
February 27, 2017
I am a paramedic....not nearly as knowledgeable as a physician but I know enough to be dangerous. Becoming a doctor was my dream when I was younger, I was so set on it that any other outcome was utter failure. I adore being a medic, with someone giving a differential diagnosis on gut instinct and talking. I am not always right, and sometimes I can't do anything to make the situation better but ask my partner to drive faster.
This book was beyond profound. Death is the end to all of our stories. The wonder that is the human body leaves me in awe daily. Yet most people don't think about the large amount of children each day that are dying because their body wasn't made right. Their bodies are compatible with life. These stories will stay with me forever. My least favorite part of my job is to prolong someone's life who is in pain and no longer living the life they want. I can't imagine how horrible that is to witness in children. Death really isn't the worst thing that can happen to us, too much love and ill fated interventions are. I don't want to bring someone in this world for them to only experience suffering. I don't want to define someone else's life either but what I consider suffering. As humans we are all in life together. We are our own salvation and our own curse.
I am envious of all the doctors out there but I have one thing up on them....I get to go into someone's house and make them feel safe before leaving that house to go to the hospital. I am a part of that moment where a little relief sets in when they know that they are no longer alone in their emergency. Even if I can't do anything but drive them there, I get to be a part of their lives in some of the scariest moments. Healthcare is amazing but it should be more person care focused. If you're not happy, getting your liver fixed isn't going to suddenly make you happy.
I am grateful for the Healthcare access that we have in the US. The author traveling to Liberia was eye opening and gut wrenching. Everyone should lose sleep over innocent children dying merely because they were born in a poor country. It is a tragedy beyond words.
This book was beyond profound. Death is the end to all of our stories. The wonder that is the human body leaves me in awe daily. Yet most people don't think about the large amount of children each day that are dying because their body wasn't made right. Their bodies are compatible with life. These stories will stay with me forever. My least favorite part of my job is to prolong someone's life who is in pain and no longer living the life they want. I can't imagine how horrible that is to witness in children. Death really isn't the worst thing that can happen to us, too much love and ill fated interventions are. I don't want to bring someone in this world for them to only experience suffering. I don't want to define someone else's life either but what I consider suffering. As humans we are all in life together. We are our own salvation and our own curse.
I am envious of all the doctors out there but I have one thing up on them....I get to go into someone's house and make them feel safe before leaving that house to go to the hospital. I am a part of that moment where a little relief sets in when they know that they are no longer alone in their emergency. Even if I can't do anything but drive them there, I get to be a part of their lives in some of the scariest moments. Healthcare is amazing but it should be more person care focused. If you're not happy, getting your liver fixed isn't going to suddenly make you happy.
I am grateful for the Healthcare access that we have in the US. The author traveling to Liberia was eye opening and gut wrenching. Everyone should lose sleep over innocent children dying merely because they were born in a poor country. It is a tragedy beyond words.
October 22, 2011
I found this rather disappointing. I generally love medical books, finding them fascinating but this one just didn't deliver. I suppose the main reason is that the majority of the cases Weir chose to highlight did not involve diseases which intrigue me (how morbid is that?) She seemed to select the most extreme and fatal cases, perhaps for the shock value, rather than tell the stories of triumph and recovery.
July 14, 2014
One of my reading priorities for this year was read books that would allow me to see the world through new eyes. This book definitely fell into that goal. Weir shares stories of patients she cared for throughout her three-year pediatric residency. She shares what she learned from her patients and what she learned about herself. From sleep deprivation to patients who don't necessarily recover, this poignant read taught me about a world I will likely never experience first hand.
October 8, 2012
I really wanted to like this book, but the author made it very hard to do so. On several occasions she came off as judgmental at best, unsympathetic & cold at worst. I'm surprised she continued on as a pediatrician since she is clearly unhappy with her job. I expected there to be at least one anecdote that was heartwarming, but I was wrong. Very disappointed. I appreciate her honesty & her sharing of even the most heartbreaking cases.
December 29, 2012
I picked this up after one too many late night reruns of early-season Scrubs. It more or less gave me what I was going for (a peek into doctors' rounds from a current young doctor's perspective, largely unencumbered by anecdotes from non-work life), but there was also something lacking. The writing was simultaneously too dreamy and too clinical, making it hard to form even a short term investment in any patients besides Max. It has a super cute cover, though. Worth my $1 investment.
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