Thursday, March 26, 2009

Free Response! (after Chap. 5 & 6)

What do you like about the book so far? What are your thoughts on the process of going from a freshly minted med school graduate to a full-fledged physician? You can address any aspect you wish - e.g. the book's medical/biological content, the personality or experiences of Dr. Nolen, whether you think you would enjoy working in a hospital, what has interested you most in the reading, etc.

29 comments:

  1. From early childhood, I have always been squeamish about surgery, or any type of skin-piercing anything. I have a profound fear of needles, and cannot bear looking at videos of surgery. In fourth grade, my class dissected a cow heart, while I cowered in the back. I have never found surgery an appealing topic in the slightest.

    Recently, however, I have been reading more books about surgery and clinics. The most recent book I read, The Man Who Mistook His Wife for a Hat, is about abnormal and incredibly rare psychological and physiological abnormalities. I found that book incredibly interesting, and in many ways, I have found this book very similar to it. Both books are written by the main doctor-type person, relating memories of his most important experiences. These types of books are easy reads; they read smoothly and quickly, without complex plot or a multitude of characters.

    As I said above, working in a hospital has never appealed to me. However, I find Dr. Nolen's story captivating. Each patient has his or her particular personality and problem, every patient interesting in his or her own way. Even though some of the content makes me shudder at times (maggots, anyone?) the overall depth of the content is really intriguing. Not only do I admire the content, but Dr. Nolen's personality also serves to bolster the story's appeal, as I find him quite easy to relate to. His decision and actions make perfect sense to me, and he seems amiable enough, at least to the reader.

    So, in conclusion -

    A good read.

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  2. Oh, and here's wikipedia's runthrough of the book I read:

    http://en.wikipedia.org/wiki/The_Man_Who_Mistook_His_Wife_for_a_Hat

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  3. This comment has been removed by the author.

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  4. My favorite part of the book so far is definitely the personal aspect to it. I am not really that interested in the textbook medical stuff (like the size of the patient's ulcer, etc.). However, there are a lot of stories about individual patients that Dr. Nolen has had, or people that he has worked with, that make the book interesting. These short accounts of different people's background seem kind of like adding "characters" to the book, except that they are real. It feels to me like a reminder that this is not what becoming a doctor is exactly like for every person, it is what this one individual person's experience was like. These short stories or character descriptions also tell the reader about what it is like to work in a hospital beyond the actual tasks of treating patients. (For example, the difference between how Jean and some of the other nurses did their jobs.) So overall my favorite part of the book is the details about the people rather than the medical details.

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  5. When someone asks me whether I liked a book, I give a very ambiguous answer. For me, the purpose of a book is not to be liked or disliked, but rather to be understood on whatever level it is understood on. Since all understanding comes from the person him or herself, what is taken from the book is not based on the book but on the person. Saying whether you "like" a book has nothing to do at all with the book, but rather with the preconceived notions you have of a how a book should be. Plus, the person asking the question is not trying to find out what the other person thinks of it, but instead trying to find a validation for their own views of it. Answering the question provides nothing for either party involved, neither the inquirer nor the respondent is really gaining a further understanding of the book. As such, I will not directly answer in any way, both for the aforementioned reasons and because I am a terribly selfish person and do not wish to share my "thoughts" on any subject with others.

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  6. The book is very interesting, but its main character Dr. Nolen really bothers me. Perhaps it is because he experiences hospitals in the 1960s, but he strikes me as very sexist, at times classist and at all times very full of himself. Even in admitting his mistakes, he demonstrates are very pompous attitude. He makes excuses for himself when excuses are unnecessary because they are already understood by the reader. Also, the whole section on nurses struck me as very sexist. I can't really pinpoint exact occurrences, but just the general way with which he discussed the nurses made me uncomfortable. And when he was discussing the male nurses and saying that being a nurse satisfied their homosexual needs I was furious. I'm sorry, but I don't think Dr. Nolen is in any position to make statements like that considering that his opinion stems solely from inference and not from conversations with the male nurses. I guess overall I just get frustrated with Dr. Nolen because he writes in an "I completely understand everything" style that I think is obnoxious and conceited.

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  7. I find this book to be a fairly easy and good read, even though I have little to no interest in the medical field. I actually kind of disagree with Alice: Dr. Nolen's tone strikes me more as reflective on the past, and it shows how much he knows he has progressed since he began his career at Bellevue. I don't perceive his tone as arrogant, but that's just my personal reaction to the book. I think Dr. Nolen is easy to relate to, because he has prejudices, and he makes mistakes, etc. I find that whenever Dr. Nolen learns a lesson, it's actually satisfying for me as a reader to experience a little of his personal journey to become a great surgeon. I think this book is important and enjoyable because the lessons Nolen learns are applicable to anybody's life, so this book can help anyone, even someone who is not a doctor, understand life and its problems a little better.

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  8. When reading this book it is clear that to pursue a medical career requires accepting that you will make mistakes. I have considered medicine and I think working in an emergency room would be quite interesting. I think it would be interesting trying to figure out what is wrong with a patient, as Dr. Nolen often does. I have also been very interested in all the factors which complicate surgery. It is not merely a matter of performing a certain operation. Dr. Nolen made such an error when he removed the stomach of a seventy-year old woman who died after surgery. While this operation was the most direct way to treat the patient's ulcer, it was not appropriate given the age of the patient. This demonstrates how surgeons cannot take a strictly "by the book approach" because they must not ignore critical human factors. Dr. Nolen hilights this point when he calls surgery "this all too human profession" meaning that even surgeons must accept that their mistakes, even if they result in a loss of life.

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  9. I've never wanted to be a doctor because I can't imagine potentially working as a person under whom people die. And in a way reading this book has cemented these kinds of fears; but Dr. Nolen talks about them in a rather light-hearted way so that you almost feel that it's possible to come out with your person intact even after watching people die because of your fallibility or stupidity.

    About what Lena and Alice were saying- I completely agree with what Alice was saying about the homosexual nurses- he should keep what he was saying to himself and those types of statements are simply not necessary. But at the same time, I think Dr. Nolen was simply writing to a different audience- I'm not sure that he was thinking of 16-year-old high school students who go to school in Oakland. And yet what Lena says is true: you do still like Dr. Nolen because he makes mistakes and seems all the more human. This might be off topic, but the reason that this book is all the more interesting and easy-to-relate to is because he has faults. It's just like Art Speigelman's graphic novel Maus- why do the majority still identify with Vladek Speigelman even though he's blatantly racist, paranoid, and at some points pretty horrible? Well, it's because he's a real man, and even though he went through something as horrendous as the Holocaust, he still is him. You really can't compare Dr. Nolen's and Vladek's experiences at all, but I think that the fact that they are fallible makes them all the more easy to identify with.

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  10. What really draws me to "Making of a Surgeon" is Dr. Nolen's tenacity and personality. Since the beginning of the book when he decided to take on the monumental challenge of working at Bellevue instead of a white-tower hospital, I have been fascinated in his perspective and outlook. I am especially impressed with his honesty and directness. He admits that as a doctor he sees great inequalities in health care access and quality, but even he has lost his patience and taken out his frustrations with his indigent patients. His blunt approach at discussing the social problems in health care gives me hope that there are other leaders who will have the same courage to be truthful and open to actively improving the system.

    Another aspect of the book that I love is Dr. Nolen's intimate discussions of his surgeries. It is really interesting to learn about the ways that his thinking process and methodology work together. The huge burden that he has as a doctor, however, is taking responsibility for the lives of his patients. Again, he is rather direct in his discussion of the flaws of human medicine and the great risks that caring for patients involve, which constantly reminds me of the limitations that even modern medicine have.

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  11. So far, I am enjoying this book quite a bit. The informative and slightly comical style of Dr. Nolen's Making of a Surgeon creates quite an interesting read. Yet while his book is a good read, I have no interest at all in pursuing a medical career. The part of this book that was hardest for me to get through was his graphical description of needles and the unsanitary way Bellevue patients used them.
    I also would have to disagree with Alice regarding his sexist tone. I didn't get that at all. I thought he was simply saying that Bellevue was a great place for nurses to work because they wouldn't be limited on what they could do. Whatever they could contribute would be appreciated by everyone. And with the male nurses, I don't think he was saying at all that they received sexual satisfaction from being nurses, in fact he explicitly says he didn't think that. He was just pointing out that they were good workers.

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  12. So far, I think the making of a surgeon is a very interesting book. What I find most interesting are the ways in which his personal life in the hospital works with his professional life, and how they conflict. The whole dynamic of the hospital and all the various characters is interesting, and he manages to paint a good picture of his various experiences. I enjoy reading about all the different quirky characters. Though the different problems with the patients are very interesting, the book seems to keep repeating itself. In each chapter Nolen talks about a certain issue and his personal experiance with it and the times that he has gone wrong. Overall though, I am enjoying this book a lot.

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  13. I am enjoying The Making of a Surgeon and find it quite interesting to read. I like the personal feel and the insight into his feelings and thoughts concerning the situations he was in and the conditions he worked around. I enjoy his descriptions of certain situations and his daily schedule around the hospital because it gives the reader a good sense of what he experiences every day. One can relate to him better because of the personal feel and comical parts, but at the same time, the book is informing the reader about the difficulties of being a surgeon in a hospital like Bellevue. Personally, I have no intention of pursuing surgery as a career, but I have not yet ruled out all medical professions as potential career options. I think I would not like to work at a hospital, especially one like Bellevue, at first because of the intensity and urgency of emergencies. I would constantly feel pressured and rushed to do everything correctly but as fast as possible. After gaining more experience, however, I think it would be interesting to work at a hospital.

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  14. "The Making of a Surgeon" is a pretty good book because it shows aspects and details of being a doctor that people don't usually think about. Although I wouldn't want to be put in the situation of doing surgeries or using needles, it is interesting finding out how things work in the medical world. One aspect of the book that I really like is that it describes the whole scene of the hospital. The book describes the different types of nurses and doctors. It also describes the methods and tools used in the hospital. All of these things combined make the book seem alive in my mind. I can visualize everything easily. It reminds me of shows like Grey's Anatomy and ER. The cases that Dr Nolan takes on really intrigue me and make me wonder how things work and operate. I am encouraged to figure out what is happening to the patients before they are treated.

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  15. The aspect of Making of a Surgeon that I really enjoy most are the great anecdotes and misadventures Dr Nolen treats us with. The whole book is like a long episode of House, minus the annoying interpersonal relationships. I really enjoy reading about Dr Nolen's failures (in a totally non-sadistic way). It’s an interesting insight to see all of the struggles doctors go through in performing even the most mundane operation. It’s also completely terrifying. Dr Nolen seems like an excellent doctor; I must wonder what horrible mistakes less proficient doctors must make on their unsuspecting patients. I don’t particularly enjoy hearing about all of the inner workings of the hospital, nor the differing personalities of specific nurses, but I do like hearing about the various patients and their ailments. I like the surgery narrations as well; though I don’t know most of the anatomy, the writing style leads to a suspenseful read the likes of which we don’t often get to enjoy at CPS. All in all, the book is pretty low-key, but is a nice change of pace from the more hardcore reading we tend to get.

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  16. What do I like about the book so far? Not much. For starters I hate reading. I feel like there are better ways to learn or be entertained. This book does not entertain me in any way, which is what I want out of it, but it has taught me some of the ins and outs and difficulties of the medical field. As for the story, it is interesting how personal and detailed it gets, but that doesn't make me like the book much more. Dr. Nolen particularly aggravates me. As Lena and others were saying, it is easy to compare oneself to him because of his faults and realness. I find that if I'm reading a book I don't want to relate myself to someone with such faults and immoralities. I find pleasure in relating myself to the interesting, and flawless characters that are still similar to me. I see no reason why comparing myself to someone I hate would be justification for this being a good book. All in all I find this book hard to read because of all the gore, different cultural aspects and Dr. Nolen.

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  17. I think his process shows what is common for almost everyone. AS you leave your comfort zone, reality starts to set in. There are things that one never knew existed or only had a faint idea of. An example in Dr. Nollen's case is his difficulty with his appendectomy. He went in so confident, and he realized that there was still a lot he had to learn before he could successfully do an operation on his own. His experience is to be expected because any transition from the theoretical to the practice of anything, especially something that is as exact as surgery, can have several bumps on the way.

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  18. So far, I’d say that The Making of a Surgeon is ok… not my favorite read. One thing I do like about the book is that Nolen keeps the reader interested my telling various short anecdotes. I don’t think I could bear reading a book that only talked about the logistics of medicine. On the other hand, I don’t like the fact that Dr Nolen is the only character in the book that the reader gets to really know. The story never focuses on any other characters, so the reader is only left with Dr Nolen. I would have like the book to go a bit more in depth about other people working at Bellevue.

    One thing that I find unique in this book is that it talks about the mistakes that doctors make. Society doesn’t usually like to point out the mistakes that are made, especially when they are made in fatal situation such as operating on patients. I haven’t decided whether I like this aspect of the book or not. On one hand, I think it’s cool that Dr Nolen can admit the faults of doctors like himself; but on the other hand it makes me partially afraid of doctors. As if I didn’t have enough weird little phobias (spiders, piranhas, heights, hippos…), now I’m partially afraid of doctors. I don’t want to go to a doctor for help and have him screw up the problem even worse.

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  19. As of now, I really like The Making of a Surgeon. It has kind of surprised me, in that I was expecting a larger focus on the specifics of medicine, and I have enjoyed how Dr. Nolen instead also dedicates a significant amount of the text to the emotional factors in being a doctor. It makes the whole story easier to read, and a lot more interesting. I had expected not to like the book too much, because being a doctor was never of interest to me, but now I have a newfound interest in the topic and the profession.

    While I would say that I like the book as a whole, I do find myself a little squeamish at times while I am reading the story. It does get too detailed for my taste, for example I could have gone without reading about the doctors using maggots. In addition, as Helen said, it is frightening to have the notion of error introduced into the story. To have the doctor’s errors so openly acknowledged is unusual to me, and I agree does make going to the hospital even less appealing than before. But looking beyond these two aspects of the book, I have so far found the book very informative. It’s a good read.

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  20. The most interesting section for me thus far in MOAS as been the chapter about blood. While I am not sure whether the things he talked about still have relevance today, it was interesting to see how important something basic like blood was to their everyday operations. It certainly makes me rethink the idea that hospitals contain the capacity to treat as many health issues as is being demanded. It also gives me more appreciation for Red Cross blood banks and those who donate. Other than this chapter I have found that my enjoyment of this book has significantly decreased after the first few chapters. While it was interesting to learn about the environment and inner-workings of Bellevue hospital for a number of pages, I find now that many of Nolen's anecdotes seem rather repetitive of stories he has already told. I think it would be rather hard to enjoy working in a hospital like Bellevue, but at the same time it could be rather satisfying to do such vital work and know that you are making a large in difference in the lives of the patients there. Personally, I would not choose to have such an experience that to me would seem futile since the same problems continue to arise and seemingly very little improvements are made to fix the problems causing the health issues that the hospital tries desperately to keep under control.

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  21. “The Making of a Surgeon” certainly has its interesting parts, but I would not call it great. While I find Dr. Nolen’s stories remarkable in their diversity, I do not really appreciate the way that Dr. Nolen tells his various stories. He often tells personal anecdotes than are not really related to his surgical work, and I find these stories irrelevant especially as a biology student who is not reading the novel for pleasure. However, besides the failed attempts to be entertaining, I do find interest in each specific case. I had never really experienced (or read) a graphic account of an operation and while it is sometimes nauseating, I have learned certain things from reading this book. I think I have a greater appreciation for a surgeon’s work, especially for the work done at the Bellevue hospital. I definitely think that the story is enhanced by the fact that Dr. Nolen chose to work at such a place, because that difficult environment fostered a greater diversity in the patients and their cases. Dr. Nolen’s frequent rants do, however, take away from the interesting stories of the patients, I believe.

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  22. I really enjoy reading "The Making of a Surgeon." I think the stories he tells are very interesting and I think Dr. Nolen is very interesting over all. While I think being a Doctor would be very interesting I don't think I would like. The long hours and the constant worrying about if you have done something right are wrong is too much for me. Working in any hospital, not just Bellevue, would be hard also. You are constantly surrounded by sick people and I cant see how that wouldnt be depressing or just hard to deal with. Also, the fact that not everyone can be saved seems very hard to deal with. If someone dies on your watch, even is you couldnt do anything to stop it, you would still feel bad and I dont understand how Doctor deal with that. That's one reason why I like Dr. Nolen. He is able to work in such horrid conditions and still be a good doctor.

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  23. I like the book so far, it is pretty interesting and gives a lot of insight into the medical world. This book is pretty fascinating because it shows how challenging it is to become a doctor. I like how the book explains the different medical terms, while Nolen explains a procedure. The book is also interesting because it explains the different medical slang and actions used by doctors in the medical world. It seems like being a doctor is one of the hardest professions a person could choose to be in. The pressure as well as intense situations seem so powerful and mind numbing that these situations could permenantly change a doctor's perspective on life. Such as Nolen's discovery of patient treatment with books and in the real world, along with the countless mistakes and near misses that he has encountered. It seems to me that in order to be a doctor, you have to possess a very short lived memory and be totally dedicated to the practice. This book has really interested me so far, and with some of my family members in the medical field, it is eye-opening to see how there career paths might have started.

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  24. So far the book, The Making of a Surgeon, has been about as enjoyable for me as any other book I was forced to read. This is not to say it is not a good book, it is. Rather, that with any book I am forced to read I am more likely to have a naturally negative bias against it. Dr. Nolan is a fascinating charecter nad the book is very good about explaining the difficulties of becoming someone who works in the medical profession; however, it is just not "my cup of tea."

    I have never considered myself a squeamish person; whenever we have had to dissects things in previous science classes, I have always volunteered to do the cutting. However, I would not like to be a doctor, or work in a hospital, I am just more interested in other fields. (no fault of the book)

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  25. Quite frankly, I am loving this book. I appreciate how it does not try to sugar coat the realities of hospital life in order to appeal to any audience in particular. It simply tells you "The Way It Is." As stated by Alice (Per. 3) there are times when the book can be classist and sexist among other things. Although these may not be pleasant subjects, they are REALITY. That is what I appreciate most about this book so far. There are no theories or hypothetical situations. It is real life... real life that is filled with flaws, mistakes, shortcomings, errors, insults, etc... These are things that best help a doctor become the best he/she can be. The world we live in is NOT perfect, therefore, to me, it seems more beneficial to be exposed to both the good and the bad aspects of the world we live in. (This is not in contradiction to Alice's blog, I just wanted to bring up what she adressed)
    -Talon

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  26. I love this book. I think it portrays the hospital in a different light than in House and Scrubs. It shows the trials that medicine brings on everyone.
    The interesting thing is that many mistakes are often portrayed as near misses. You don't often see any real cases that he loses a patient because of any arrogance or mistake. I feel like they have been kind of sugar coating all the examples.
    The story is really enthralling though. Even though I know that he saves most of the people every time but it is told in such a way that has a real struggle to it. There is a real story there and the nice endings where they get through is good.
    I think it is just a really good book. I might have read it on my own if they chance had been given to me. I would highly recommend it to people as a real view into the medical system.

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  27. I think The Making of a Surgeon is a pretty good book so far. Although it may not be the most entertaining of books, it's definitely very informative about medicine and hospitals and it shows how hard it really is to work in the medical division. It's a good book with some captivating stories, but medicine is something that I just don't take that much interest in. I still think it's a good book, as it does a good job at explaining things and telling Dr. Nolen's story, but I would rather not read about medicine and hospitals.

    sorry this is late :(

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  28. What has interested me the most so far about this book is the lifestyle that surgeons, doctors and other hospital staff grow accustomed to in their work at Bellevue. It interests me, but I feel I haven't seen a whole lot about the period of adjustment for Dr. Nolen after the first two chapters. The the first two made the hospital seem like a daunting, scary place, but really by chapter three, even while he's still an intern, Nolen writes about life in the hospital as if it was not a major issue for him. It seems like a very "before and after" situation for him, like before his disastorus (like my spelling of that word) first apendectomy he was lost, and afterwards things were easier for him.
    (I, like Nathan, am sorry this is late)

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  29. I like the book!

    It does make me squeamish to read about the specifics of Nolen's craft, but the book is well-written and shines light on a seldom-addressed aspect of the hospital experience. Now, all this may be old hat to many people, who are accustomed to hospital dramas on the television; but I never watched any of those, so it gives me a warm happy feeling to read about the vagaries of daily business in a frantic hospital like Bellevue. One of the parts I enjoyed most was the logistics of obtaining and apportioning blood. It makes those nurses and doctors seem like valiant heroes! Which of course they are.

    On the other hand, the book is very dated; lots of fifty-year-old sexist remarks and silly slang. But everything is a product of its times, so that did not bother me too much.

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