A Cure for What Ails Doctors Today

By PAULINE W CHEN

By Pauline W. Chen

The Washington Post

Every medical specialty in every hospital has its “professor.” Often the oldest and usually the most experienced, the professor is the doctor you call when trouble breaks. The professor is the doctor’s doctor, the go-to person and, when out of earshot, “Mom” or “Dad.”

In the world of medical writing, Sherwin Nuland is one of those professors. A National Book Award winner, he has tackled every conceivable life enigma in his writing, death and aging among them. It would stand to reason, then, that this professor’s take on his 40- year career in medicine would be quite the read.

It is. Insightful and profoundly humane, “The Uncertain Art” stands solidly among Nuland’s better works. This collection of essays, many of which appeared in the American Scholar, is our chance to sit at the feet of the professor.

Nuland is an intellectual omnivore, and so it is hardly surprising that his thoughts on a medical career extend to Thomas Eakins, Sept. 11, acupuncture and the future of medicine, among other things. But he begins the book with a literary dissection of an aphorism attributed to the original professor: Hippocrates. “Life is short, and the Art is long; the occasion fleeting; experience fallacious, and judgment difficult.”

Nuland peels away the historical layers of meaning encasing Hippocrates’ words until at last his own interpretation comes into relief. “We can deepen our understanding of ourselves, and in this way deepen our ability to help our patients, and add breadth to the value of our days.” This appeal for greater reflection is Nuland’s clarion call not only for the book but for medicine in general.

Nuland looks critically, for example, at medical education. He describes the historical roots of American medical pedagogy that created “one of the most remarkable phenomena in the history of science and education,” a medical system of worldwide pre-eminence. He asserts, however, that in its development academic medicine also lost sight of its primary goal, “to teach individual students how to care for the sick.”

Nuland’s prescription, then? To arm young doctors “with a liberal education and a background in humanistic thought.” He writes, “The wisdom of any of us is circumscribed by our relatively limited experience of life. We expand it by studying literature, history, philosophy, and the evolution and beliefs of societies not our own.”

As in previous books, he offers fascinating deconstructions of esoteric medical terms, and he deftly weaves multiple lines of thought into delicately balanced sentences. But occasionally the literary filigree becomes too ornamental, and you wonder if the professor has turned misty-eyed.

But these overwrought passages are few. What fills the pages are Nuland’s hopes for medicine. At the end of the book, he writes of his friend George Leyden, a heart transplant candidate, and traits that shine through: his deep belief and indefatigable optimism in the potential of humanity.

Which are also precisely what put this book, and this professor, a step above.

Pauline W. Chen is the author of “Final Exam: A Surgeon’s Reflections on Mortality.”

“THE UNCERTAIN ART: Thoughts on a Life in Medicine”

Sherwin B. Nuland

Random House. 198 pp. $25.

Originally published by BY PAULINE W. CHEN.

(c) 2008 Virginian – Pilot. Provided by ProQuest Information and Learning. All rights Reserved.