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Book ReviewThe Art of Medicine: What Every Doctor and Patient Should Know The evolution of a naive medical student into a competent, caring physician is a transformation that is unequaled within the entire sphere of education. The vast majority of medical students begin their medical careers with only a rudimentary understanding of what medicine really is, and absolutely no understanding of the metamorphosis that will occur within them as they progress toward their goal of becoming the best possible physician they can be. Although the words are different, the message that these students portray on their medical school applications is always the same. They attest that they are bright, dedicated, hard working, and want to do "good for mankind." Their characterizations of themselves are appropriate, but to attain the tools to do "good for mankind," they must undergo a substantial metamorphosis. In his book, What Every Doctor and Patient Should Know, Dr. Kevin Joseph Soden reconstructs certain aspects of this dynamic time in a medical student's life in a truly wonderful way as he portrays and then plays out the roles of the Advisor and the Student. Soden draws on a rich personal experience of being a nationally recognized athlete serving, among other things, as the goalie on our Pan American Soccer Team and performing as a truly outstanding collegiate baseball player. He also draws upon his experiences in medical school and beyond. He completed his training in Family Medicine with a focus on emergency medicine. In mid-career he became the Senior Medical Officer for one of the largest international chemical companies [in the US] and then served as a consultant to the NBC "Today Show." He often appears on camera to serve as a resource to the public on various medical problems. Soden has dissected the maturation of the Student—from a somewhat capricious, opinionated young individual who has already decided that he wishes to go into interventional radiology because "that's where the money is"—to a much more sensitive individual who has accepted the mantle of a true physician. The book is staged in a rather unusual fashion. The story begins with a third-year medical student who is treated in a busy emergency room for an injured ankle and overhears comments about his chosen profession. Later, as he starts on his ward rotations, he has been assigned a mentor. This mentor/mentee relationship is scorned by the student, but to complete the obligations of the first clinical year, he must abide by the rules and participate. The mentor turns out to be a surgeon. Not only that, but a general surgeon who is the head of a large surgical department. The Student expects the surgeon to be opinionated, brusk, and to exhibit all of those prototypical characteristics that medical students have been conditioned to expect of a surgeon. Surprisingly, he finds something entirely different. The relationship that develops between the Student and the Advisor is, at times, strained, but develops in a positive direction as the book progresses. Short vignettes about the Student's experiences begin each chapter as the Student progresses through the clinical year. These literary sketches are then punctuated with commentary from the author that extract the salient points of the Student experience and explore the ethical and moral issues, as well as the subtleties that exist between the student, his patients, and his teachers. Using this methodology, Soden covers an enormous amount of material. He truly touches on the highlights of any student's experience as he or she goes from the pragmatic black-and-white world of physiology, pathology, and biochemistry, to the world of pastels and shades of gray that make the management of an individual patient so difficult and yet so rewarding. Soden masterfully explores the conflicts that every student feels as he or she matures through participation in the clinical experience and approaches the decision of how he or she will spend the rest of one's professional life in medicine. He also shatters many of the myths characterizing physicians in various specialties and sets some wonderful guidelines for the relationship between the mentor and his advisee. Along the way, Soden punctuates his points by identifying individuals who have had an impact on his academic life, sometimes by name and at other times by innuendo. This is truly a remarkable work and one that should be read with equal fervor by students (for whom it was constructed) and for anyone in a mentoring capacity (for whom it probably carries an even stronger message). The book is an intriguing reading selection for patients so that they can better understand the physicians in whose hands they have placed their most precious commodity, their health, if not their very lives. Review by
Online March 25, 2003
by the American College of Surgeons, Chicago, IL 60611-3211 |