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Summary
Summary
In medical charts, the term "N.A.D." (No Apparent Distress) is used for patients who appear stable. The phrase also aptly describes America's medical system when it comes to treating the underprivileged. Medical students learn on the bodies of the poor--and the poor suffer from their mistakes.
Rachel Pearson confronted these harsh realities when she started medical school in Galveston, Texas. Pearson, herself from a working-class background, remains haunted by the suicide of a close friend, experiences firsthand the heartbreak of her own errors in a patient's care, and witnesses the ruinous effects of a hurricane on a Texas town's medical system. In a free clinic where the motto is "All Are Welcome Here," she learns how to practice medicine with love and tenacity amidst the raging injustices of a system that favors the rich and the white. No Apparent Distress is at once an indictment of American health care and a deeply moving tale of one doctor's coming-of-age.
Author Notes
Rachel Pearson , MD, PhD, is a resident physician who also holds a PhD from the Institute for the Medical Humanities. Her writing has appeared in Scientific American, the Guardian, the Texas Observer, and the New York Times Book Review.
Reviews (4)
Kirkus Review
A sensitive doctor describes her beginnings navigating the unpredictable, woolly world of modern American health care.Pearson's inspired collective of illuminating clinical episodes immediately sparks to life with anecdotes from her early work in a female-owned and -operated abortion clinic in her 20s. Her experience there as a young, bilingual patient advocate counseling Spanish-speaking women greatly broadened her perspective on women's issues, "the suffering that women go through," and it solidified her decision to pursue a career in medicine. Because many of the artfully and creatively compressed stories she shares are so personal and admittedly "hard to tell," the book takes on an intimate tone, even while the details veer toward the gruesome or the emotionally raw. Intensive medical school classes on Galveston Island led to hospital and family medicine rotations, and all of the experiences exposed the author to the trauma and heartbreak of pain, cancer, and disease and the frustrations of age and deathbut also the sincere appreciation from those she was fortunate enough to assist in creating wellness. Pearson's history as a poet and a fiction writer aids with the flow and the tone of her memoir. Eloquently and briskly written, the narrative is moving and will be inspirational and particularly enlightening for pre-med students eager to discover and explore the real insider details found both in and out of school. The author offers a helpful, pragmatic perspective on how the American health care system operates, how and who it helps, and what it has become hobbled by, though, disappointingly, only a few closing pages are devoted to these thoughts. On the whole, Pearson's well-balanced book provides a smooth combination of personal history and patient care cases. Educative and thoughtfulimportant reading for patients and fellow medical professionals alike. Copyright Kirkus Reviews, used with permission.
Booklist Review
Pearson's emotional medical-school memoir commences with her confessing a mistake and concludes with her continued haunting by that error and failure to make it right. In between, she describes working in an anatomy lab, volunteering at a free medical clinic, practicing on standardized patients (actors with scripted illnesses), learning how to do genital and breast exams, clinical rotations (family medicine, surgery, internal medicine), and hospital training. She also chronicles plenty of pressure, grief, and sacrifice. Pearson can be blunt, as in her account of cadaver dissections: We sawed off an areola, sliced through an eyeball, cut penises in half to see the chambers of flesh inside. But more often, her writing is passionate, as in her repulsion from hurting other living beings in my process of learning. Pearson shares anecdotes about especially memorable and challenging patients, working in an abortion clinic, depression, and outrage over how poor people are treated by the medical system. Lots of vulnerability the author's own and that of poverty-stricken patients is bared here in what is one of the better current doctor-in-training books.--Miksanek, Tony Copyright 2017 Booklist
New York Review of Books Review
NO APPARENT DISTRESS: A Doctor's Comingof-Age on the Front Lines of American Medicine, by Rachel Pearson. (Norton, $16.95.) On the heels of Hurricane Ike, in 2008, Pearson headed to Galveston, Tex., for medical school, where she witnessed firsthand how health care consistently fails lower-income patients. A huge segment of society has been cast aside by medical providers, she writes, and not by accident. THE DESTROYERS, by Christopher Bollen. (Harper Perennial, $16.99.) In this crisp, taut thriller centered on a Greek island, the heir to a construction fortune goes missing. Bollen pairs all the pleasures of a literary thriller (dazzling coves, a string of murders, champagne on yachts) with uneasy moral questions. Our reviewer, Thad Ziólkowski, praised the novel's "seductive mood of longing mixed with regret." THE ENDS OF THE WORLD: Volcanic Apocalypses, Lethal Oceans, and Our Quest to Understand Earth's Past Mass Extinctions, by Peter Brannen. (Ecco/HarperCollins, $16.) The earth has undergone five mass extinctions in the history of the planet, and Brannen, a science journalist, explains them all in gruesome detail. A glimmer of bright news? The extinction rate we've seen in the past 400 years doesn't come close to rivaling the Big Five - at least not yet. THE DARK NET, by Benjamin Percy. (Mariner, $14.99.) A gang of misfits in Portland, Ore. - a disgruntled journalist, his blind niece, a former child evangelist, a homeless man and others - must band together against satanic online groups from the darkest corners of the internet. Percy's thrilling story delivers on the setup's promise for action and horror: As our reviewer, Terrence Rafferty, put it, "It's one of the best Stephen King novels not written by the master himself." THE BOY WHO LOVED TOO MUCH: A True Story of Pathological Friendliness, by Jennifer Latson. (Simon & Schuster, $16.) Roughly one in 10,000 people have Williams syndrome, a genetic condition that wipes out the skepticism and social caution that seem hard-wired into most other humans. Latson follows one, 12year-old Eli, and his mother's attempts to shield him from the disease's most wrenching side effects. STAY WITH ME, by Ayobami Adebayo. (Vintage, $16.) It's 1980s Nigeria, and the childless marriage between Yejide and her husband, Akin, is unraveling, as his secrets and betrayals come to light. This heartbreaking debut novel considers questions of fidelity and commitment; the tensions between tradition and modernity; and the break between society's expectations and a woman's own.
Library Journal Review
Writer, MD, and PhD student (Inst. for the Medical Humanities, Galveston) Pearson writes movingly about American medicine and medical education from the perspective of a working-class student who comes to realize that her medical education (and that of many) is based on learning from the poor and uninsured. The author spent years practicing at the St. Vincent Student Run Free Clinic, learning that treatments for diseases are not always available to patients, even under the Affordable Care Act and with heroic efforts by health professionals. She discovers the extent of bias in medical care, including in herself. "No apparent distress" is used in medical charts for patients who appear stable. -Pearson also considers the American medical system of treating the underprivileged, who provide critical experience for medical students to learn from their mistakes on these patients. VERDICT With similarities to Victoria Sweet's God's Hotel, this timely, highly recommended title is for readers interested in medicine, public health, disparities in treatment, and the complicated politics of health care and poverty.-Mary Chitty, Cambridge Healthtech, Needham, MA © Copyright 2017. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.