On Call : A Doctor's Days and Nights in Residency

Rating:
Summary: A Poignant Portrayal
Review: Dr. Transue's book is captivating as it leads the reader through the emotional ups and downs of this segment of medical training. Her sensitivity and humor bring us to a greater awareness of the humanity of both doctor and patient. Occasionally, one finds an author wise beyond her years. So it is with Dr. Transue. It is good to know that at 58 I can still learn from one so young.

Rating:
Summary: Beautifully expressed
Review: I read the book in one sitting -- it was that easy to become absorbed in the stories. Dr. Transue writes extremely well, both in describing the medical details (some gory, some extremely technical, but without being condescending or gross for the sake of grossness), and in capturing the emotions she felt and those she perceived in her patients.
I hate tear-jerkers -- those maudlin stories where you know the writer is just going for effect. I cried reading parts of this book, but it is in no way a tear-jerker. I felt like I was a silent observer of the real dramas of medicine, guided by a narrator I could trust: one who saw clearly and honestly, and whose reactions and thoughts make me feel more hopeful about the promises of modern medicine.
Dr. Transue's patients are lucky to have her care.

Rating:
Summary: Today's Resident: Smart, Female and Very Tired
Review: I've always been fascinated by careers and career choices, so I read about occupations from veterinary medicine to military service. Women write many of these books because, for a long time, the novelty of being female in those occupations would get the book published.

We've seen many books by women doctors, including Perri Klass, Frances Conley and Elizabeth Morgan. So what's remarkable in this book is the complete absence of any references to gender and gender issues. One older woman says she'd rather have a woman doctor and the author says sure, she would too. Big deal. Transue writes about "the neurology resident" and then uses "he" or "she" with no comment. Both male and female attendings -- senior physicians -- can be heroic or deficient.

Almost as surprising, Transue portrays herself as polite and caring. I must admit I've stayed far from doctors and hospitals throughout my life, but the few I've met were nothing like Transue. She actually apologizes for bothering people. In fact, I suspect she set a world record for a doctor saying, "I'm sorry."

Most doctors I've met were arrogant, even rude, but Transue doesn't report a single instance of arrogance. An attending is "distant" and another unsure of herself. But when a patient's relative demands to speak to an attending, and orders Transue to make the call, she complies.

On Call deserves five stars because it's well written, almost a page-turner. Transue manages to make a collection of essays hold our interest, even when we rarely learn the ending. For instance, we learn that a man has been estranged from his family, but never why.

Most chapters are based on actual patient encounters. Transue helps us understand what's going on but doesn't get bogged down in the (literally) gory details. She describes her own fatigue without whining or pity. She doesn't seem to wonder if things could be changed.

And, in what appears to be a teaching hospital, there's little concern with changes in medicine and managed care. In one scene a patient must decide if he'll pay for a no-smoking patch or wait six weeks to begin a no-smoking campaign. Isn't there an irony here worth noting?

This non-judgmental style is both the strength and the weakness of On Call. Transue examines her own experience with, well, clinical detachment. She marvels that she could break down crying one day and be a model resident the next. She doesn't share details of her life, so we don't know what gave her the strength to keep her perspective. She went sailing with friends; she baked a blackberry pie; she lifted weights with another resident who became a gym buddy. She alludes to a loyal and loving family and she had a superb education.

But we don't know where she lived during residency or what sustained her during the tough times. Perhaps the combination of these factors helped her become such a successful resident.

As a career consultant who has studied life transitions, I was fascinated by her final chapter: a realization that the major changes in our lives often are not marked by ceremony. Going from residency to medicine was more important than graduating from medical, but marked only by a brunch and a certificate.

Transue concludes she's grateful for those years but wouldn't ever want t do it again. Paying dues is always hard but usually worth the effort. Transue was lucky to pay hers when she was very young and to end with something that was worth the price.


Rating:
Summary: Must Read For Anyone Interested In Medicine
Review: I've always been fascinated with medicine and at one time toyed with the idea of becoming a nurse. However, my aversion to blood and gore go the best of me but I never lost my interest. Dr. Emily R. Transue tells an enlightening story of her residency and introduces the reader to some of the interesting people she treated during that time. Unlike other doctors, Dr. Transue actually has a conscience and a heart. Some of her stories are heartbreaking and some are joyous but they all are interesting and worth reading. I finished this book in about six hours.