Incidental Findings: Lessons From My Patients In The Art Of Medicine

In Singular Intimacies, which the New England Journal of Medicine said captured the “essence of becoming and being a doctor,” Danielle Ofri led us into the hectic, constantly challenging world of big-city medicine. In Incidental Findings, she’s finished her training and is learning through practice to become a more rounded healer. The book opens with a dramatic tale of the tables being turned on Dr. Ofri: She’s had to shed the precious white coat and credentials she worked so hard to earn and enter her own hospital as a patient. She experiences the real “slight prick and pressure” of a long needle as well as the very real sense of invasion and panic that routinely visits her patients.

These fifteen intertwined tales include “Living Will,” where Dr. Ofri treats a man who has lost the will to live, and she too comes dangerously close to concluding that he has nothing to live for; “Common Ground,” in which a patient’s difficult decision to have an abortion highlights the vulnerabilities of doctor and patient alike; “Acne,” where she is confronted by a patient whose physical and emotional abuse she can’t possibly heal, so she must settle on treating the one thing she can, the least of her patient’s problems; and finally a stunning concluding chapter, “Tools of the Trade,” where Dr. Ofri’s touch is the last in a woman’s long life.

Dr. Danielle Ofri, author of Singular Intimacies (Beacon / 7252-4 / $24.00 hc), is an attending physician at Bellevue and the cofounder and editor-in-chief of the Bellevue Literary Review. She is currently a regular contributor to the Los Angeles Times and the New England Journal of Medicine.

Ofri, an attending physician at New York City's Bellevue Hospital and founder of the Bellevue Literary Review, again displays the same sensitivity and carefully crafted writing that distinguished her first medical memoir (Singular Intimacies). The emphasis in these 14 engrossing pieces is on her determination to learn from those she has treated. Ofri begins by recounting a time when the shoe was on the other foot, when she, as a first-time expectant mother, was the patient. After a sonogram, Ofri and her husband were rather casually told that their baby's umbilical cord was missing one artery. Her disorientation and anxiety that day deepened her ability to empathize with those who are ill. In "A Day in the Clinic," she describes how a language barrier left her unable to effectively comfort an Asian man with a brain tumor. In the especially moving "Terminal Thoughts," Ofri intuits that a woman's signature on a Do Not Resuscitate order and her refusal of dialysis were rooted in depression. Ofri reworks her pain medications and extracts a promise that the patient will stay on dialysis. The patient will not be cured, but Ofri's goal is not to provide happy endings; rather, she aims to wed compassion to medical training and knowledge, to recall her ongoing struggles to understand the sick and to make their lives more bearable. (Apr.) Copyright 2005 Reed Business Information.