The Soul of a Doctor: Harvard Medical Students Face Life and Death

by Susan Pories, Sachin H. Jain, Gordon Harper

By the time most of us meet our doctors, they’ve been in practice for a number of years. Often they seem aloof, uncaring, and hurried. Of course, they’re not all like that, and most didn’t start out that way. Here are voices of third-year students just as they begin to take on clinical responsibilities. Their words focus on the odd transition students face when they must deal with real people in real time and in real crises and when they must learn to put aside their emotions to make quick, accurate, and sensitive decisions. Their decisions aren’t always right, and the consequences can be life-altering—for all involved. Moving, disturbing, and candid, their true stories show us a side of the profession that few ever see, or could even imagine. They show, often painfully, how medical students grow up, right at the bedside.

Genres: Medicine, Medical, Nonfiction, Science, Health Care, Memoir, Biography

274 pages, Kindle Edition

First published June 2, 2006

Reviews

[Eileen · Rating 4 out of 5]

My biggest problem with this book is the title. The stories inside are not simply about the "soul" of a doctor, and does it even matter that these are Harvard medical students? But title aside, this collection of stories is a beautiful and oftentimes heartbreaking glimpse of our own humanity and limitations. Each story is written by a different student, with varying length and focus. You really do get to see a whole host of perspectives, which I think is crucial to understanding exactly what it is that goes on in medical training. There is more here than the glorified, "I'm so happy to help people" stories hopeful doctors have told in the past. Perhaps one of my favorite quotes (which I fully came to identify with): "... I also realized that the ICU didn't bother me anymore or fill me with grand spiritual and moral questions. It was a place where sick people were hooked up to machines, and that was that. I was ready to plunk my stethoscope down on the chest of an unconscious man with no preamble, no introducing myself, no ritual of human connection, as if it were perfectly normal for him to be there, and for me to be there too. It was a murmur I was seeking; looking away from the man and toward the monitor, it was a murmur that I heard."

[David Meyer · Rating 3 out of 5]

The book contains a number of essays from Harvard Medical School students about their experiences becoming doctors (primarily their early rotations). I wasn't overly impressed with the writing in most of the essays, and most of them are so short that there isn't a lot of substance. Basically the student explains how they feel using one specific example and concludes the essay without much closure (understandable, as they are still students and don't have any yet, but still feels lacking for the reader). The one thing that is apparent is the honestly that comes through in most of the essays. It brought me back to my days of early rotations, especially in hospital rotations, and of precepting many students over the years, including quite a few med school students. It's a difficult time when students are dealing with all sorts of insecurities and anxieties regarding their future, and that comes across well in most of these essays.

[Aimee · Rating 1 out of 5]

This book was not at all what I expected. I found it to be very dull, tiresome reading--not at all enlightening, intriguing, dramatic, etc. I think part of it has to do with the editing of the student essays, and perhaps the other part from me watching 15 years of ER on TV and reading books like Doctors by Eric Segal. I rarely quit reading a book I have started, but after trudging halfway through this one, I just couldn't stand it anymore. Good boo to put you to sleep at night rather than keeping you up wanting to read more.

[Sally Dershwits · Rating 4 out of 5]

I liked it. Read it the summer before starting medical school. Some Really moving stories

[Roger Liang · Rating 4 out of 5]

4.25/5. As a caveat, I started this book with two strong biases: First, that medical school selects for mediocre writers and second, that medical school selects for rule-followers—people who often fail to question the system that they elect to socialize into. This book pieces together stories by medical students with diverse backgrounds (minus the fact that they’re all at Harvard—a fact that the title does not fail to mention). Sure enough, in this book there are some poorly written essays with corny conclusions, but more often the essays/poems contained beautiful insight and struggle. It is safe to say that this collection has softened my initial biases.
The book was put together in 2006, but many of its topics are just as relevant today. Students write about failures in American healthcare, toxic aspects of hierarchy in medicine, and the struggle to truly care about and for patients when time is constrained. Though it is never outright stated, many of the writers worry about the incentives for doctors and trainees: What happens when a student is given a carrot for a clean full differential but not for displaying genuine compassion?
At the same time, this book covers the beauty of the human body and spirit. Students talk about the satisfaction of listening to patients. They (the students) talk about the excitement of difficult clinical cases. In one poem, Christine Hsu Rohde discusses her thoughts while conducting an autopsy on a female patient. She wonders which words the patient first spoke with her vocal cords, whether the patient's heart “skip[ped] a beat when she [the patient] first saw her husband/Or heard her newborn child.”
In my favorite essay of the collection, Joe Wright explains the connection between cinematography and breathing. It is easy to understand a technique in film, just as it is easy(ish) to understand the physiology of breathing. However, what makes a director “brilliant” is his or her employment of technique. Feeling the synchronous rising and falling of the chest as you hug a loved one is just one example when the breathing becomes so much more than its physiology—when the technique is used brilliantly. Perhaps this was not explained well by me, in which case there is more reason to try the essay out for yourself.
The common thread the essays is a genuine desire and struggle to become a good doctor. These trainees wanted to hold onto their compassion in a system that often makes it hard to do so. Despite being in medical school, I am still on the fence about medicine. I am cautiously excited to be with patients, but I am skeptical about the state of healthcare, the growing power of hospital administration, and the intense hierarchy in medicine. Reading this collection, I felt heard, seen, and reaffirmed in why I am in medical school in the first place. The system is very obviously imperfect, but the good parts—I think—outweigh the bad.

[Saloni (earnestlyeccentric) · Rating 3 out of 5]

The Soul of a Doctor was what cemented the decision to go to medical school way back in tenth grade. I didn't fully digest what I had read but I could totally imagine myself walking around the wards, helping sick patients. I wanted to be like the students. I needed a reminder of why I had pursued medicine which was why I picked this book up again. I didn't enjoy it as much the second time around.


Most of the essays followed a similar format. The author would write about a patient and how they weren't able to help them get better. There would be a line or two of criticism about modern medicine. Some essays felt inconclusive and ended abruptly. Some were written as poems which I didn't enjoy. However, I love how candid the authors were. They expressed their feelings raw. Even though I may not have enjoyed a few of the essays, I could tell how much thought had gone into articulating their thoughts. 

I particularly enjoyed the essays written by Joe Wright. The first one was about taking a patient's history and how he was just scribbling as much as possible on paper rather than really listening. We're learning how to take a patient's history and I remember the first time I was chosen, I was hastily writing too, trying to keep track of all the patient had said. I had remembered this story from the first time so I tried not to but it was so hard. It was nice to reread the essay and really understand how Wright felt. I also loved his essay on respiration and how beautiful it is that our organs just function so well. I'm always filled with awe when I learn the mechanics behind physiology (the rare times I properly understand it). 

There were a few essays on racism which I could really relate to as well. My medical school seems to have a LOT of white professors. I always get very excited to see someone of colour leading a tutorial or giving a lecture. I especially love when they're an Indian because it makes me feel like I can do it too. I've been subject to quite a bit of casual racism but unlike one of the students, I didn't really stand up for myself until much later in the year. I wish I had done so earlier. 

One essay that also resonated with me was about raincoats and how medical students have to wear one to shield themselves from all the criticism and mean comments they will receive. The student talks about the competition and perpetual imposter syndrome and all I could do while reading the essay was nod and mutter, "SAME," under my breath.

While The Soul of a Doctor didn't impact me as much as I hoped, I did still like that I could understand more of the medical jargon and relate to the students. It's definitely still a book I would recommend to other medical students.

[EThayer3 · Rating 3 out of 5]

I read this a bit ago and forgot to review it. As I remember I found it rather depressing. Seems most of the stories were about patients that died. I would have loved to see more with happy endings. Another take away was that medical students appear to be much more caring and into helping a patient than doctors with many years experience. It’s too bad most of them lose that special touch after a few years.

[Naz Z · Rating 4 out of 5]

Realistically this would be a 3.5, but anyways I really liked this collection of essays! Some were not as good as others, but big takeaways were working with difficult patients and hoping to understand them (long term support), a lack of a cure does not mean failure, family’s may want doctor’s kindness more, honesty with patients, letting patients speak during interviews, active listening, and issues with hospital care. Perfect read as I work on applications.

[Sarah Freudson · Rating 3 out of 5]

This was a fast read filled with small essays from mostly Harvard med doctors in training. It felt sterile in the way in which you would expect a book filled with accounts from the same type of person, ie the person who gets into Harvard med. I would’ve found it more enjoyable if there was more accounts of diversity in the book as I believe there were only 2 or 3. I do recommend this book because it humanizes the doctors we all inevitably interact with

[Adria · Rating 5 out of 5]

A book every aspiring or graduating physician should read. It’s a powerful reminder that doctors are human too—people with emotions who can feel overwhelmed by the privilege of holding the knowledge to heal others. It shows how important it is to see patients not just as a set of symptoms, but as scared individuals who need empathy as much as treatment. Medicine isn’t only about long nights studying cases; it’s also about learning to care for someone else, sometimes even more than for yourself.

[Casey Salandra · Rating 3 out of 5]

There are some very heartwarming and thought provoking stories but many of stories have no real conclusion. They all seem to be conveying something meaningful about their experiences but in the majority of cases they don’t really get to that point and fall short. Still would recommend to anyone in medical school looking to explore the emotional side of medicine

[Zach Christensen · Rating 3 out of 5]

3/5, would recommend.

Several of the essays were excellent, with thought-provoking stories and dichotomies that accurately reflect my first three years of medical school. What a frustrating and beautiful art.

[Tracey Lindeman · Rating 3 out of 5]

Read during med school.

[Karnola · Rating 5 out of 5]

I've written a blog post about this book; read further for some insight:

https://www.howpithy.com/the-soul-of-...

[Rasa Valiauga · Rating 4 out of 5]

An enlightening collection of essays of what it is like to be a medical students faced with real patients on rotations.

[Jose Almeida · Rating 5 out of 5]

A must read book for all medicine practioner and other... It covers the complexity of many ethycal dilemas in a very fresh and vivid manner.

[Erin Eickholt · Rating 2 out of 5]

Short collection of essays from Harvard medical students. Underwhelming. Some were insightful, others entitled.

[Patrick · Rating 2 out of 5]

Interesting story on the process of becoming a doctor in medical school.

1) How does one handle someone who is in denial on their medical condition? In this case, a mother who denies end-of-life care since she has two small children @ home while her husband will be deployed to Afghanistan soon.

2) EM residents being overworked with an increasing workload, stresses efficiency over compassion in communicating towards their patients.

3) JM was relieved when the diagnosis of ALS was given to him since it confirmed to him what he had and thus alleviated all guess work for them.

4) The importance of listening to ward off malpractice suits is emphasized

5) I like the story of the African student whom the US made the all African's minus the usual African ethno-religious rivalries.

6) Interesting story on how an intra-abdominal fetus was terminated b/c of the risk to the mother and the risk to viable fetus.

7) Dr. Casillas realizes we are only human. That our innate desire to heal whatever the cost is to the patient also is our weakness especially if the patient is an old woman who wants to die in peace but in our haste to practice on a patient we make them suffer our incompetence. "The most interesting cases are often the most devastating for the patients." Pikeman's observation is a good one. That is, how as doctors can we be both objective about the needs of the patient as far as technique goes but @ the same time subjectively care for them?

8) It is interesting how Raj Shah learned about anxiety from Mrs. Longwood that it is a real disease. It is through his personal relationship with Mrs. Longwood that he was able to convince her to have her leg amputated to save her life from the dreaded osteosarcoma.

9) Again the medical student is faced with the dilemma in which the intellectual fascination of zebras is wrapped around real human suffering.

10) Joan understand the limitation of surgery that it is not a cure all. While Feldman begins to accept that is ultimately up to the patients to decide whether their life is worth living or not. The surgeons role is to fix the problem but not heal the person. Balboni learned the unexpected beauty that can come from someone who is resigned to their fate of death despite the pain that comes with it.

11) Joan realizes the limitations of medicine as a panacea even though the family tells the team that they represent God's hands on earth so they cannot give up their father. The father's case also represents why the patients wishes should be spelled out in writing b/c family and medical establishment will always err on saving the life patient over their implied wishes. Even as some patients cannot not face their own mortality, medical students can be the bridge to bring them toward that realization and thus perhaps heal
their soul if not their body.

12) Kurt Smith has a lack of trust in medical knowledge in answering medical question that should be answered.

13) Dr. Henry has the lack of identifiable role models as holding her back. In a place where white people predominate, it is good when a person of color can be a role model. Lam was offended by the off-color remark of his race by a Radiologist who appreciated his candor.

14) Jain rightly acknowledges the complex relationships b/w hospitalist and primary care and as patients in hospitals we do not understand where one jurisdiction ends where the other begins.

15) Harper states the process of self-reflection is necessary to provide for patient safety in the future. It takes physicians awhile to develop and the aura of clinical binocularity in which the physician both empathize with the patient but @ the same time have clinical detachment necessary to do their job right.

[Madi Swegle · Rating 3 out of 5]

The Soul of A Doctor, compiled of many 2-5 page essays is not a page-turner by any means. In fact, I found myself having to take breaks in my reading after 3 or 4 essays to collect my thoughts and absorb the content. I found myself trudging through many sub-par essays fishing for the next well-crafted piece. Some, in my opinion, were brilliant and insightful. Others, however, were boring and half-hearted.

One of the reasons I chose to read this book was to view medicine from the perspective of a Harvard medical student. Some of these essays could have easily been high school papers-- definitely not what I would have anticipated from Harvard students.

Furthermore, it was discouraging to hear so many negatives about the learning environment Harvard provides. Of course, becoming a doctor requires a certain amount of tough love from mentors, but reading stories about racism and sexism in the learning environment was nothing short of disheartening. In fact, one student alluded that Harvard had sent her into a spiral of depression and personal psychological trips.

I don't regret reading this book, and I did finish it within 6 days, but it wasn't what I expected. It would be a nice book to keep on your nightstand or coffee table to read every once in a while.

[Kim · Rating 4 out of 5]

Of course this is from the medical student's point of view. It highlights the shortcomings in our current medical system, which are getting worse each day. Too little staff with too little time to do what they know is the right thing; but, they cannot as the " protocol" does not allow it. This makes me so sad for medicine. The ideal that brought me into this profession no longer exists. On the other hand, I am encouraged that there is still a hint of humans with a belief in God left out there. I wish people in this profession would be nicer to each other and give and accept the necessary pointing out of mistakes as a way to learn and grow rather than to give it and receive it as a personal cut on the individual. We all need to understand that we are human beings who can only do so much in a shift. Overwork is a danger to caregivers and patients; yet, this is what medicine has become: a driving of the too few to do too much at the expense of safe, compassionate care for the patients. Add to that the protocols that dehumanize patients and caregivers.....

[Brittany · Rating 3 out of 5]

As a paraprofessional on the fringes of the medical field, as well as a frequent patient nowadays, it was refreshing to read of the humanity in doctors. I know it seems strange to say that, but from the patient's perspective, we can become disillusioned and believe that doctors simply are desensitized.

This is a collection of essays by third year medical students at Harvard Medical School. Most are heart-wrenching, while others offer a bit of humor and grace. Some even think outside the box of how to change small things in the medical field considering patient care. As we all know, there are too many hoops to jump through, even if you have health insurance.

I would imagine that these essays would be a great reminder to current physicians of where they once were, how far they've come, and of their idealism as they entered the medical world.

A fast read. Excellent for patients, med students, and MDs alike.

[Jessica Gibbins · Rating 5 out of 5]

From a viewpoint of someone not in the medical field, I really loved this book. It was one of the best nonfiction books that I have ever read and was very enjoyable. The book is comprised of short stories and poems from Harvard Medical Students. Each student talks about experiences they have gone through working in the hospitals and studying patients. The stories made laugh, cry, and were surprisingly really good. I couldn't put the book down and was so touched by some of the stories. I thought it was a very good read and definitely recommend it to everyone, even people that don't usually like nonfiction.

[Ali · Rating 4 out of 5]

This is an incredible work that manages to translate the process of transforming from a medical student into a physician in a legible manner. The topics of the essays and the words used could be well understood by someone outside the field of medicine. I enjoyed this book immensely and would recommend it to anyone as a good look into medicine and the way physicians learn to treat and address their patients while coping with the jarring experience of relating difficult test results, being with patients in their last moments, and the ethics of medicine.

[Allyson Dyar · Rating 4 out of 5]

I had mixed feelings about this book. On one hand, these were medical students who were being faced with the realities of medicine. And secondly, the writings were wildly uneven.

I didn’t find many of the essays to be that engaging, in fact, many times, I felt that I was left hanging, asking myself, “and then what happened?”

Still, this book is probably well-worth reading. I can’t say that it’s an enjoyable read, but still, it’s enlightening to read what our future doctors are thinking and feeling.

3.5/5

[Pcomlibrary · Rating 4 out of 5]

One of the best nonfiction books that I have ever read and was very enjoyable. The book is comprised of short stories and poems from Harvard Medical Students. Each student talks about experiences they have gone through working in the hospitals and studying patients. “You’re in a hospital trying for the first time to be a doctor. No more textbook diagrams and classroom cadavers; this is the real thing, in real time."

[Zahra · Rating 5 out of 5]

Ahh, yes I read this over the summer. I truly enjoyed viewing the experiences of medical students and what they have trug their way though. The essays really took you to their "souls." Title was very appropriate for the novel and its content. I recommend it to anyone going into the medical field, brings a new light to your eyes.

[Karan · Rating 4 out of 5]

typically not a fan of disconnected sets of essays (which this sort of was), but this gets a 4 because of the time it popped into my life---right before starting med school. it felt like i was hearing from an entire class full of third-years about their experiences, and got me simultaneously amped and shit-scared to begin the journey on my own. also, the epilogue by gordon harper is superb.

[The Rose · Rating 4 out of 5]

Many of the stories really struck a cord, possibly because I have seen or heard about similar cases. I was also often impressed by the quality of the writing and the insight of these medical students. Highly recommended for incoming and current medical students. Glad I read this early in my career in medicine.

[Danusia · Rating 5 out of 5]

This book is a very quick read. I may be biased, since I'm in medicine, but I found the commentaries of the student doctors very insightful. It reminded me of the reasons I chose to become a doctor. I would recommend this to doctors and pts alike.

[Susan · Rating 4 out of 5]

This is a collection of poems or essays written by medical students. It is interesting to get a glimpse into their thought process, but in the end, it left me wondering about what the answers are to some of the questions they raised.