The subtitle of this book is Lessons in Love, Loss, Hope and Healing from a Doctor’s Perspective. It is written by a general internist in Seattle who has authored a previous book,
On Call. It is obvious from her writing that she takes a personal interest in her patients, something that is unfortunately not all that common among medical people. She is also a poet.
Referring to that annoying matter of “coding and compliance,” Transue states that “Seeing patients was easy to get used to, but the financial and administrative side of medicine was considerably more challenging.” One often suspects that it is this “elephant in the waiting room” that discourages patients as well as medical professionals, creating mistrust unnecessarily. The constant tension between insurance companies, doctors and sick people is a strain that needs to be relieved, and Transue concludes, “the message seemed to be, there is no way to do it right.”
In the realm of patient care, the doctor may feel discouraged at times, but she does not lose her compassion as she describes, for example, the older couple, both alcoholics, who must face the death of one and the permanent hospitalization of the other. There’s a woman in her seventies who works as a volunteer with children who have AIDS – she just needs something to help her sleep sometimes. Or the annoying Willard, the man no one wants to see coming through the door, whose obituary reveals a war hero, a widower, a worker for human rights.
Caring for the aged and dying, Transue’s thoughts turn to her grandparents, already in their eighties when she begins her practice. She reveres them but feels guilt at not being able to stay in touch, to fulfill their dreams for her in the way they imagined she could. She sees that old age is complicated, and just as she tries to spend time with her grandparents, she tries to do small things for her elderly patients on the brink of the end – bring them some chocolate or a notebook. She shares the poignant though painful moment when a woman realizes she is definitely going to die and then asks, “Will everyone please let me stop suffering now?”
She allows herself a smile when a priest says that one his charges had received Last Rites before she passed away and so was “good to go.”
It is not hard to predict that Transue’s grandmother will pass away by the end of this book despite its message of hope and healing. We all must die, and if we are lucky, we can figure out how best to do that. Her grandmother died peacefully in her sleep, as she had wished. Her grandfather must piece together a life for himself after this loss: “He’s lonely, of course. Lonely without her and without all the connections she had so carefully cultivated.” But he must start a new journey, living despite his grief.
Transue, who must constantly change roles from professional to personal, says “My office continues to be well stocked with tissues.” We sense that the tissues are for her as well as for the people whose lives intersect her hers.