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The Finest Traditions of My Calling: One Physician’s Search for the Renewal of Medicine
Patients and doctors alike are keenly aware that the medical world is in the midst of great change. We live in an era of continuous healthcare reforms, many of which focus on high volume, efficiency, and cost-effectiveness. This compelling, thoughtful book is the response of a practicing physician who explains how population-based reforms have diminished the relationship between doctors and patients, to the detriment of both. As an antidote to failed reforms and an alternative to stubbornly held traditions, Dr. Abraham M. Nussbaum suggests ways that doctors and patients can learn what it means to be ill and to seek medical assistance.
Using a variety of riveting stories from his own and others' experiences, the author develops a series of metaphors to explore a doctor's role in different healthcare reform scientist, technician, author, gardener, teacher, servant, and witness. Each role influences what a physician sees when examining a person as a patient. Dr. Nussbaum cautions that true healthcare reform can happen only when those who practice medicine can see, and be seen by, their patients as fellow creatures. His memoir makes a hopeful appeal for change, and his insights reveal the direction that change must take.
Using a variety of riveting stories from his own and others' experiences, the author develops a series of metaphors to explore a doctor's role in different healthcare reform scientist, technician, author, gardener, teacher, servant, and witness. Each role influences what a physician sees when examining a person as a patient. Dr. Nussbaum cautions that true healthcare reform can happen only when those who practice medicine can see, and be seen by, their patients as fellow creatures. His memoir makes a hopeful appeal for change, and his insights reveal the direction that change must take.
320 pages, Hardcover
First published March 22, 2016
20 people are currently reading
324 people want to read
About the author
Abraham M. Nussbaum
18 books13 followersAbraham M. Nussbaum, M.D., is Director of the Denver Health Adult Inpatient Psychiatry Service, and Assistant Professor in the Department of Psychiatry at the University of Colorado School of Medicine.
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Displaying 1 - 24 of 24 reviews
May 31, 2016
I found this book a real grind. I think I understand what the author is trying to say about the current state of medicine, but his style of writing and eliciting authors and texts that I hadn't heard about did not make for engaging reading at my end.
January 6, 2020
Abraham Nussbaum is director of inpatient psychiatry at Denver Health and lives in my neighborhood. I read this book awhile ago but found it very honest about the evolution of American medicine towards a factory mentality. He compares it to the Cheesecake Factory. He stresses the importance of the therapeutic alliance between doctor and patient. He discusses the beginning of evidence based medicine with interesting background on Archibald leman Cochrane (Cochrane Library) and WWII...and the problems with evidence based medicine being the end all.
Refreshing perspective.
Refreshing perspective.
July 25, 2023
Thankful to have stumbled across this book with such perfect timing. Lots of ideas that I bet I’ll be thinking about for the next many years!
May 16, 2017
I tend to reserve 5-star ratings for books that truly deserve them, and this one does. Nussbaum explores the reality of modern medicine, governed by life-saving but ultimately automating evidence-based guidelines and algorithms, and how he, his colleagues, and future colleagues might return to or rediscover the finest traditions of their callings. He advocates for going a step or two beyond algorithms and becoming wise physicians: physicians who can effectively navigate difficult relationships with patients therapeutically, and still stay afloat among the myriad other responsibilities doctors today have.
As a medical student, this book was inspiring and I hope to be even nearly as wise and discerning as Nussbaum demonstrates he is (though doesn't boast about). I also appreciated references to some of my favorite scholars (which shows how nerdy I really am) such as Stanley Hauerwas, William Osler, Abraham Verghese, Atul Gawande, and even Hildegaard of Bingen!
Certainly don't read this if you're not interested in an insightful physician's honest take on medicine in the US. But if you are, you should read it.
As a medical student, this book was inspiring and I hope to be even nearly as wise and discerning as Nussbaum demonstrates he is (though doesn't boast about). I also appreciated references to some of my favorite scholars (which shows how nerdy I really am) such as Stanley Hauerwas, William Osler, Abraham Verghese, Atul Gawande, and even Hildegaard of Bingen!
Certainly don't read this if you're not interested in an insightful physician's honest take on medicine in the US. But if you are, you should read it.
July 5, 2022
An awesome book!
I picked up this book for a class, but finished reading it because of Dr. Nussbaum’s writing and stories. This book reminds me of Being Mortal by Atul Gawande, another mind-opening and inspiring book.
In Finest Traditions of My Calling, Dr. Nussbaum talks about ways that his patients and experiences as a physician have shaped him, and seeks renewal and change in medicine that would help everybody, not just the wealthy. His stories are sometimes hilarious and sometimes really sad, but he always learns from them and draws a lesson.
I hope I’ll get to meet this man! His book truly changed my perspective of medicine and what it means to help someone. I wish they had this book in Spanish, because I would love for my mom (a physician too) to read it.
I picked up this book for a class, but finished reading it because of Dr. Nussbaum’s writing and stories. This book reminds me of Being Mortal by Atul Gawande, another mind-opening and inspiring book.
In Finest Traditions of My Calling, Dr. Nussbaum talks about ways that his patients and experiences as a physician have shaped him, and seeks renewal and change in medicine that would help everybody, not just the wealthy. His stories are sometimes hilarious and sometimes really sad, but he always learns from them and draws a lesson.
I hope I’ll get to meet this man! His book truly changed my perspective of medicine and what it means to help someone. I wish they had this book in Spanish, because I would love for my mom (a physician too) to read it.
August 13, 2016
Thoughtful and interesting read though at times I was confused as to who the target audience was. If you're already fearful of the healthcare system, this won't help. ;-)
May 26, 2016
didn't live up to the hype
December 31, 2024
It's the last day of 2024 so I've gotta log all the books I read this year but never reviewed (even though I shall still fall short of my goal alas). I put off reviewing this book because it was so good that I wanted to deeply reflect and summarize, but alas again, I finished this book in April and have since forgotten most of the details (as I do). But I retain a strong impression that Nussbaum is (1) an incredible writer and (2) a profoundly humane physician. By exploring various roles the doctor might inhabit (gardener, teacher, coach, etc.), Nussbaum presents a level of care and intention that begins to restore my faith in health care, at least on an individual practitioner level. Thanks, Dr. Whitt, for all the discussions and reflections!
December 13, 2017
I wish this book were required reading for all medical residents. I wish that all physicians were as thoughtful and self-analytic as Dr. Nussbaum. As health care becomes more and more driven by efficiency, it is losing the most critical aspect of caring for the patient – the relationship between the physician and the patient as a person. The author examines this issue with strong self-criticism and obvious heartfelt care. It renews my hope for medicine.
I need to note that I know/knew Dr. Nussbaum. He was a medical student at UNC and interested in the history of health care. He was a delight as a student and I am not surprised that he has written a book of such depth and importance.
I need to note that I know/knew Dr. Nussbaum. He was a medical student at UNC and interested in the history of health care. He was a delight as a student and I am not surprised that he has written a book of such depth and importance.
January 13, 2018
Intriguing account of one man's journey from medical student to seasoned psychiatrist. Dr. Nussbaum intersperses some history in the medical field and its approach to training physicians with personal anecdotes of clinical encounters with patients. Disenchanted with modern medicine's view of a human as collection of mechanical parts and hospitals push to achieve efficiencies by grafting organizational reforms from factories and the military, Dr. Nussbaum seeks to renew a human approach to medicine.
His accounts of working with mentally ill patients alternate between funny and moving, uplifting and heart-breaking.
Full disclosure: the author is my brother-in-law.
His accounts of working with mentally ill patients alternate between funny and moving, uplifting and heart-breaking.
Full disclosure: the author is my brother-in-law.
December 14, 2021
Reaction: finally something different from the mundane, but well-written narratives by healthcare providers lamenting the problems, wistful optimisms, etc
Writing Style: retrospective, well-cited across modern and ancient traditions, thinkers, and ideas
Argumentation: we lost the patient-provider relationship, and it’s up to physicians to do something about it to regain our true calling and contribute to society in the way we know best
Commendation: fun anecdotes with a touching narrative that follows the events and lessons
Critique: much psychiatry bias, which isn’t really common
Writing Style: retrospective, well-cited across modern and ancient traditions, thinkers, and ideas
Argumentation: we lost the patient-provider relationship, and it’s up to physicians to do something about it to regain our true calling and contribute to society in the way we know best
Commendation: fun anecdotes with a touching narrative that follows the events and lessons
Critique: much psychiatry bias, which isn’t really common
November 8, 2023
This book was hard to get started, but it grew on me as I read it. I think the author makes some valuable points about what the practice of modern medicine has become. He helped me reflect on how medical training often centers on seeing people as parts and problems instead of setting them as people. I think sometimes his writing was a bit long-winded for my brain to follow. Despite that difficulty, I found a lot of inspiration and hope to be a little better as a doctor as a result of reading this.
February 23, 2021
Dr. Nussbaum takes you on an elaborate and well articulated journey, through the hoops and ladders associated with becoming a Physician. I especially enjoyed the story about Beaumont the surgeon under William Osler, and his interest with the injured fur trapper.
August 26, 2021
Was fine, a little dull, most sections are things that have been said before. Can read the chapters “Doctors without Silver”, “Witness”, and “Hope” which were worthwhile and I think could stand alone.
April 24, 2025
Really well written. Millions of metaphors - and overall a digestible read as he walks us into modern healthcare. Continued need for virtue, particularly Christian virtues, within the field. Disheartening at moments, so glad I read this and honestly would reread
April 6, 2016
[ARC courtesy Amazon Vine program]
Abraham Nussbaum has done a brave thing in writing "The Finest Traditions of My Calling." Tucked within its pages are very personal vignettes of his journey from eager student to sleep-deprived resident to ethicist who honors the tradition of his profession even as he acknowledges its weaknesses.
He freely describes his own mistakes – such as spending the last hours of a terminal patient’s life down the hall from that man, writing up a flaw-free description of his patient’s body rather than being with the person who occupies that ebbing body.
The intertwined strength and challenge of this book as Nussbaum has structured it is that he means it as a discussion, but unless you are used to viewing a book as a writer’s wish to have a conversation with you, it can be hard to realize why a writer is offering a series of perspectives and explorations in the way he has.
Running like a bright thread throughout this book is Nussbaum’s concern with “seeing much” and “seeing wisely.” One of the modern lions of medicine views these concepts as needing to be bound together, while Nussbaum spends much of his medical career perceiving them as somewhat independent. There is value, he says, in “seeing much” – in building up a body of knowledge – through learning, as well as through caring for countless patients. But there is also merit in seeing the individualities of the person – the soul, if you will, although he does not use that term – who occupies the body.
“Seeing wisely” for Nussbaum, then, is understanding more than the physical and mental issues that have led someone to need care. It is doing your best to comprehend that person’s background and ethos, and building a bond with him or her. Psychologists and psychiatrists (Nussbaum is the latter) describe this favorable tie as a “therapeutic alliance,” but it seems much more the norm for these specialties than others, especially in today’s ever-more-specialized style of medical care. In simpler terms, though, it is an acknowledgment that a person is more than an organism in need of a differential diagnosis and a treatment plan. He or she is a distillation of culture and space and place, all filtered through a singular awareness.
This book is not meant to be read straight through. Because it is a discussion, it is best taken a chapter at a time, with generous spaces in between for reflection. Because working through this book calls for a personal investment (shades of therapeutic alliance?) I will share the perspective I brought to these pages. I come to this subject from a family tradition of healthcare, with at least one member per generation wearing a long white coat, or providing support services, or conducting lab experiments aimed at understanding disease. Although I do not live their frustrations, I have been a sounding board for their eagerness and their doubts.
I also advocated for a loved one during terminal care, in search of physical comfort and emotional peace both for the loved one and those left behind. During that wrenching time, I saw flashes of the husbandry approach Nussbaum discusses. They were too infrequent, but they sustained me, and have helped me be a better advocate since then for other family members and for myself.
Abraham Nussbaum has done a brave thing in writing "The Finest Traditions of My Calling." Tucked within its pages are very personal vignettes of his journey from eager student to sleep-deprived resident to ethicist who honors the tradition of his profession even as he acknowledges its weaknesses.
He freely describes his own mistakes – such as spending the last hours of a terminal patient’s life down the hall from that man, writing up a flaw-free description of his patient’s body rather than being with the person who occupies that ebbing body.
The intertwined strength and challenge of this book as Nussbaum has structured it is that he means it as a discussion, but unless you are used to viewing a book as a writer’s wish to have a conversation with you, it can be hard to realize why a writer is offering a series of perspectives and explorations in the way he has.
Running like a bright thread throughout this book is Nussbaum’s concern with “seeing much” and “seeing wisely.” One of the modern lions of medicine views these concepts as needing to be bound together, while Nussbaum spends much of his medical career perceiving them as somewhat independent. There is value, he says, in “seeing much” – in building up a body of knowledge – through learning, as well as through caring for countless patients. But there is also merit in seeing the individualities of the person – the soul, if you will, although he does not use that term – who occupies the body.
“Seeing wisely” for Nussbaum, then, is understanding more than the physical and mental issues that have led someone to need care. It is doing your best to comprehend that person’s background and ethos, and building a bond with him or her. Psychologists and psychiatrists (Nussbaum is the latter) describe this favorable tie as a “therapeutic alliance,” but it seems much more the norm for these specialties than others, especially in today’s ever-more-specialized style of medical care. In simpler terms, though, it is an acknowledgment that a person is more than an organism in need of a differential diagnosis and a treatment plan. He or she is a distillation of culture and space and place, all filtered through a singular awareness.
This book is not meant to be read straight through. Because it is a discussion, it is best taken a chapter at a time, with generous spaces in between for reflection. Because working through this book calls for a personal investment (shades of therapeutic alliance?) I will share the perspective I brought to these pages. I come to this subject from a family tradition of healthcare, with at least one member per generation wearing a long white coat, or providing support services, or conducting lab experiments aimed at understanding disease. Although I do not live their frustrations, I have been a sounding board for their eagerness and their doubts.
I also advocated for a loved one during terminal care, in search of physical comfort and emotional peace both for the loved one and those left behind. During that wrenching time, I saw flashes of the husbandry approach Nussbaum discusses. They were too infrequent, but they sustained me, and have helped me be a better advocate since then for other family members and for myself.
July 8, 2016
Pondering the profound questions of becoming a physician and what has become of the profession of medicine, Dr. Nussbaum balances observations in health-care evolution to an "evidence-based" practice of groups rather than individuals with the cost of neglecting the therapeutic relationship with the individual patient, and necessary individual medical management. His journey parallels many of our journeys. We train for years with time-bound traditions of our calling to discover that the world changed, priorities changed, treatment changed in ways incongruent with our understanding of healing. Nussbaum draws from history, medicine, religion, humanities, psychiatry and more to explicate questions that need answering. How do we care for patients individually when we are checking off lists? How do we treat patients with care in 10-minute office visits, and then view the experiences as various billing codes? How does one not become burned-out, disillusioned, losing meaning in work? Despite the daunting questions asked, the book tells stories of people, patients Dr. Nussbaum feels he treated well or not as well as he could. In summary, a well-written, engrossing read with issues I will continue to ponder as I teach medical residents to better communicate with patients, and each other.
May 17, 2016
This is a physician's history of the philosophy of medical care interspersed with anecdotes from his personal experiences in becoming a doctor and practicing medicine as a psychiatrist. Some of those experiences are sad, others hilarious--like when, for two years after taking a new position, he gave out business cards giving his title as "Director of Impatient Psychiatry" until a friend pointed out the typo. The author offers his timely views on medicine's direction and where he believes it should best be heading--informative; interesting; and, at times, entertaining.
April 13, 2016
Dr. Nussbaum makes a persuasive argument for "renewing" medicine by focusing more on the patient as a person. Weaving his own experiences as a medical student, intern, and resident with a broader view of medical history and contemporary practice, Dr. Nussbaum presents a readable and very human look at the strengths and failings of his profession.
July 6, 2022
a lot of the things in this book have stuck with me, especially involving physician burnout/the role of spirituality in healthcare, and i would recommend to any pre health students
May 1, 2016
An important point of view.
Well worth the time to read. I particularly like the author's style and ability to ask probing and powerful questions about his chosen field.
Well worth the time to read. I particularly like the author's style and ability to ask probing and powerful questions about his chosen field.
October 14, 2016
Absolutely superb!
July 25, 2023
I was fascinated by this young doctors experience of his medical school experience. His ideas on healthcare reform were refreshing.
April 20, 2017
In his latest book, “The Finest Traditions of My Calling: One Physician’s Search for the Renewal of Medicine,” Abraham M. Nussbaum pleads with readers to help him find the best way to reimagine his role as a physician and remind him of why he sought out this profession in the first place. Director of the Adult Inpatient Psychiatry unit at Denver Health, Nussbaum joins the ranks of the growing number of physicians telling stories about the goings-on in their exam rooms. However, he takes his book a step further, extending its reach to comment on one of the larger questions for the profession in our time: how can we recharge medicine with the humanism it seems to have lost?
Nussbaum writes, “We need to see wisely … the solution for medicine’s ails is not rigid standardization, but the renewal of wisdom and the communities that cultivate wisdom.” Patients and doctors alike “want virtuous physicians” but the medical community “does not actively cultivate them.” Instead, physicians now are “encouraged to count something rather than see someone.” Nussbaum believes that “the best hope for medicine lies in physicians seeing patients as particular, unique individuals,” inspired by Abraham Verghese’s writing imploring physicians to approach patients almost as they would a text they needed to close-read, implementing the literary tools of narrative, character, and metaphor to better understand their patients.
Nussbaum writes chapter after chapter, drawing from an almost overwhelming (but necessary given the breadth of his book) number references to former and contemporary thinkers including Aristotle, Foucault, our own Arnold and Sandra Gold, Hildegard, and Osler to name just a few. Spurred by Gawande and Sweet’s likening of the physician to line-chef and gardener respectively, Nussbaum reimagines the role of the physician in other professions from artisan to witness as he searches for renewed inspiration.
One reimagining that Nussbaum is critical of is the physician-technician. He writes, “We often conceive of medicine as controlling the body, which is why analogies to industrial engineering, where a worker is responsible for the inanimate object he or she manipulates, carry such currency in contemporary medicine. We compare physicians to airplane pilots, implicitly likening our bodies to airplanes, machines controlled by physicians. An airplane pilot is responsible for flying a plane, but patients and practitioners have a mutual responsibility to care for a body.”
Perhaps a better analogy is physician as teacher, helping “patients make changes they could not achieve on their own” or a coach “motivating a patient to change.” However, Nussbaum recognizes the limitations of these analogies, and recognizes the unique place of the physician. “Coaches can use techniques like motivational interviewing to kindle and encourage patients and students, but profound illness incapacitates self-motivation.”
Nussbaum’s book is at once a humanist’s account of the state of healthcare today and a call to action for medical professionals to take up humanistic practice. Nussbaum leaves readers with his dream of what medicine could be, imagining “a medicine where physicians and other practitioners could get to know people intimately, bear witness to the social injustices they suffer, and accompany them to health and justice.”
-Molly Olmsted, APGF Intern
Nussbaum writes, “We need to see wisely … the solution for medicine’s ails is not rigid standardization, but the renewal of wisdom and the communities that cultivate wisdom.” Patients and doctors alike “want virtuous physicians” but the medical community “does not actively cultivate them.” Instead, physicians now are “encouraged to count something rather than see someone.” Nussbaum believes that “the best hope for medicine lies in physicians seeing patients as particular, unique individuals,” inspired by Abraham Verghese’s writing imploring physicians to approach patients almost as they would a text they needed to close-read, implementing the literary tools of narrative, character, and metaphor to better understand their patients.
Nussbaum writes chapter after chapter, drawing from an almost overwhelming (but necessary given the breadth of his book) number references to former and contemporary thinkers including Aristotle, Foucault, our own Arnold and Sandra Gold, Hildegard, and Osler to name just a few. Spurred by Gawande and Sweet’s likening of the physician to line-chef and gardener respectively, Nussbaum reimagines the role of the physician in other professions from artisan to witness as he searches for renewed inspiration.
One reimagining that Nussbaum is critical of is the physician-technician. He writes, “We often conceive of medicine as controlling the body, which is why analogies to industrial engineering, where a worker is responsible for the inanimate object he or she manipulates, carry such currency in contemporary medicine. We compare physicians to airplane pilots, implicitly likening our bodies to airplanes, machines controlled by physicians. An airplane pilot is responsible for flying a plane, but patients and practitioners have a mutual responsibility to care for a body.”
Perhaps a better analogy is physician as teacher, helping “patients make changes they could not achieve on their own” or a coach “motivating a patient to change.” However, Nussbaum recognizes the limitations of these analogies, and recognizes the unique place of the physician. “Coaches can use techniques like motivational interviewing to kindle and encourage patients and students, but profound illness incapacitates self-motivation.”
Nussbaum’s book is at once a humanist’s account of the state of healthcare today and a call to action for medical professionals to take up humanistic practice. Nussbaum leaves readers with his dream of what medicine could be, imagining “a medicine where physicians and other practitioners could get to know people intimately, bear witness to the social injustices they suffer, and accompany them to health and justice.”
-Molly Olmsted, APGF Intern
Displaying 1 - 24 of 24 reviews