This book has nothing to do with the practice of medicine but is almost an extended meditation on the trauma doctor's mindset. The style of writing is very variable, and can seem over alliterative, repetitive and incorporating too many tricks taught in creative writing classes. But then it becomes apparent that each style suits each story.
I do not believe the stories are fiction, but that fiction is the literary device by which the author shows us how he dealt mentally and emotionally with that situation. The last story, that of an old woman dying of an abdominal aneurysm is stream-of-consciousness and if the first story was making me think 'dnf', the last one was 10 star brilliant.
The first story was everything we all pick up in one second of seeing someone. Whether it is their expression, how they wear their watch, the relative value of their jewellery, whether their clothes are clean and pressed, and of course their face. It is at this point we all make judgements. And at the end of the story, we see that our judgements can be wrong.
I lived with Caboclo Indians in the Amazon for a while. They lived in floating houses and had school for their kids for only two years, medicine was dispensed by the same person who sold the only consumer goods - alcohol, cheese and crackers. Then there was the medicine man. Life was catching fish every two days and storing them alive in a water-filled pirogue into which inevitably pirana would jump and eat them (you would see fat piranas but nothing to eat). It was picking peppers and cucumbers from little gardens in repurposed leaky canoes. Recreation was crocodile-catching with bare hands (yes I can do it), zagaia fishing with spears (no, I can't) and sailing around the lake, a two hour trip, listening to music from as early as the 60s on an old record player on a Saturday night.
As in the first story in the book, these people seemed completely and utterly different from me. But they weren't. In the book, the doctor shows that it doesn't matter who you are or what your station in life is, at the end patients and family in a trauma room are all exactly the same and the same as the doctor too. In a trauma room, everything is reduced to the basics of life and death.
And in the Amazon, what did these Indians want? The didn't want cars as there are no roads, but wanted outboard engines for their canoes, they wanted better education for their children, they wanted clothes they could choose and not just what the man who made twice-monthly trips in his boat to Manaus brought back, they wanted the opportunity to go to the city and see another life, another culture for themselves, they wanted better health care, and on Saturday night the kids wanted to dance and find someone to fall in love with! How different from us? Not at all.
So a 'dnf' story became a profound introduction to a book that ended with all the thoughts that might go through an old woman's head who is dying and is remembering all her life and who she loved and she wants to be part of that again and leave her inadequate shell of a body behind.
From dnf to 10 star. From what I thought of as dreadful, repetitive writing to an appreciate of the genius of the author to match the style to the subject. But without doubt, it isn't the easiest book to read, it requires real concentration from the reader. But it's definitely worth it.