Clinical Emotion General Humour Lifestyle Literature Medical Humanities Narrative Reflection

On Playing Doctor

An excerpt from “Playing Doctor: Part Two: Residency”

By: John Lawrence, MD

As was her habit, she [the surgical chief resident] had called to check in with a surgical nurse to see how each of her patients was doing. They were discussing each patient when the nurse stopped to mention that there was a code team outside a room on the sixth floor with a collapsed patient.

My girlfriend quickly realized that it was one of her patient’s rooms, then raced back to the hospital, sprinted up six flights of stairs, and dashed onto the sixth floor, where she encountered a chaotic group of people surrounding one of her patients lying unconscious in the hallway.

The internal medicine residents and attending physician running the code were about to shock the unconscious patient because he had no pulse. As we’ve discussed previously, no pulse is bad.

Suddenly, in the middle of their efforts, and much to everybody’s surprise, the 5’1” surgery chief ran up, injected herself into their midst, ordered them to stop, and demanded a pair of scissors.

Nobody moved. The internal medicine attending exploded, wondering who the hell she was and what she was doing. It was his medicine team in charge of the code, and this patient had no pulse. Protocol was shouting for an immediate electric shock to the stalled heart.

Paying little or no attention to his barrage of questions, she grabbed a pair of scissors and now, to everyone’s complete and utter shock, cut open the patient right through the surgery wound on his abdomen.

Let me recap in case you don’t quite appreciate what’s going on: she cut open a person’s abdomen in the middle of the hospital hallway—and then stuck her hand inside the patient!

When the chairman of surgery came racing down the hall, he found his chief resident on the floor wearing a full-length skirt, with her arm deep inside an unconscious patient, asking, “Is there a pulse yet?”

The furious medical attending was shouting, “What are you doing? Are you crazy? What are you doing?”

And she kept calmly asking the nurse, over the barrage of shouts and chaos, “Do you have a pulse yet?”

Suddenly the nurse announced, “We’re getting a pulse!”

Which immediately quieted everyone.

Being an astute surgeon, she remembered thinking that the patient’s splenic artery had appeared weak when they operated on him. She correctly guessed that the weakened artery had started bleeding, and that his collapsing in the hallway was due to his rapidly losing blood internally. She had clamped the patient’s aorta against his spine with her hand to stop any further blood loss.

From the sixth-floor hallway the patient was rushed to the O.R. with my girlfriend riding on top of the gurney, pressing her hand against his aorta, keeping the guy from bleeding to death.

She then performed the surgery to complete saving his life.

The guy took a while to recover. Being deprived of blood to the brain had its detriments; when he awoke, he was convinced the 5’1” blond surgeon in the room was his daughter. When he was informed that no, she wasn’t his daughter, he apologized, “Sorry, you must be my nurse.” That comment, one she heard all too frequently, did not go over well.

To put this somewhat crazy event into perspective, within a day or two, the story became the stuff of legends told throughout surgical residencies across the country—and this was before social media sites existed to virally immortalize kitten videos.

Opening a patient in the hallway and using her hands inside the guy to save his life? This feat, treated by her as nothing more than a routine surgical moment, was akin to knocking a grand slam homerun in the ninth inning of the World Series in game seven to win the game—well, something like that. It’s what little kid wannabe surgeons would dream of if they cultivated a sense of creativity.

And to be fair, I thought it was an exciting episode, but she was always running off to save lives as a surgeon. The moment however, that finally put this accomplishment into perspective for me occurred when I was having dinner with her brother, the ace of aces surgeon, along with several other all-star surgical resident friends. This was a few weeks later, and without her present.

Eventually their surgery discussions (because that is pretty much all that this group of surgeons discuss when stuck together: surgery, ultra-marathon running, and more surgery) turned to loudly bantering back and forth about the whole event.

They boisterously argued about how much better they would have handled the whole situation, and wished they had been there to save the day instead of her:

“You dream of something like that going down.”

“Can you imagine being that lucky?”

“Should have been me.”

“Oh man, I would pay to have something like that happen.”

All the young surgeons agreed that this was their medical wet dream, being the rebellious action hero, on center stage, in such a grand case, in the middle of the hospital, no less, calmly saving a life in front of everyone with attending physicians yelling at you.

Then there was a moment of silence, total quiet as everyone reflected on the event…

“But you know what?” her brother finally said, looking around at everyone, then shaking his head and chuckling, “I never would have had the balls to do it.”

And every single surgeon around the table slowly nodded their head in agreement—they wouldn’t have either.

True hero.

Playing Doctor: Part Two: Residency is a medical memoir full of laugh-out-loud tales, born from chaotic, disjointed, and frightening nights on hospital wards during John Lawrence’s medical training and time as a junior doctor. Equal parts heartfelt, self-deprecating humor, and irreverent storytelling, John takes us along for the ride as he tracks his transformation from uncertain, head injured, liberal-arts student to intern, resident and then medical doctor.

Emotion General Literature Palliative Care Poetry Reflection Spirituality

Smiling Rust

Smiling Rust
By Janie Cao
Edited by Mary Abramczuk
My grandpa used to be a particular quirky smile.

He was once a certain amused sigh.

But nowadays, at visits I pay

He’s a bag of dust— hidden behind marble and rust.

On those days, I am truly glad

That I believe in more than what passes the eye.

Photo credit:lavagirl66
Emotion Empathy General Humanistic Psychology Literature Opinion Patient-Centered Care Psychiatry Psychology Public Health Reflection

Book Review: Loose Girl by Kerry Cohen

Hi MSPress Blog Readers!
We didn’t have a blog post scheduled for this week, so here’s a book review instead 🙂 I read this book last week for my Adolescent Sexual Health MPH course and enjoyed it.There’s a lot of interesting tidbits on sexual health issues. I mention two.
Even if you don’t agree with everything the author says, I think memoirs can be helpful in showing you unique life perspectives based on true experiences that you may never have experienced yourself. Furthermore, reading memoirs can get you acquainted with potential resources to help others. Ever heard of bibliotherapy, anyone? 🙂
Your Blog Associate Editor,
Janie Cao

General Literature

Frankenstein: A tale for the Modern Age

“I succeeded in discovering the cause of generation and life; nay, more, I became myself capable of bestowing animation up on lifeless matter.”
– Dr Victor Frankenstein, Frankenstein (2)

Frankenstein is a science fiction novel published by British author Mary Shelley in 1818 that has become an integral part of modern day culture. It follows a Swiss scientist named Dr Victor Frankenstein who becomes obsessed with alchemy and the idea of creating life. His indelible curiosity gradually leads him down the path towards atrocious experiments in the name of science, to the point where he creates a creature – a ‘monster.’

This novel, which has captured our imaginations since its release almost two centuries ago, has led to several famous film adaptations and has become one of the cornerstones of the Horror genre even to the present day.

The inspiration for this novel came from the early 1800s when scientists awed audiences with their ability to use electricity to stimulate the nerves of dead animals, a process called galvanism (1). In 1803 the body of murderer George Foster was attached to a large battery, and witnesses tell us that ‘the adjoining muscles were horribly contorted, and the left eye actually opened’ (3).  It was during this era that science started to take over the reins, stepping onto its pedestal as the fountain of knowledge.

Interestingly, the subtitle of Frankenstein is ‘Modern Prometheus’ (3). Prometheus is the Greek God who brought knowledge to humanity, and later paid for his ‘crime’ through eternal torment. In a similar fashion, Victor Frankenstein brings further knowledge to humanity through his obsession with the life sciences, leading to his creation of a ‘monster’ that ultimately torments him to his dying day. The novel, despite being written at a time when science was just learning to walk, is as relevant today as it was when first published. Yes, it may just be a work of fiction, but the deeper warnings contained within its fine pages speak to us in a way that no scientific journal can.

Frankenstein reminds us that the humanities are the seat belt for the sciences. They have been there to remind us of our morals when all we want to indulge in is our supreme power as human beings. They remind us to stay humble, to think and to question, and not merely to set fire to everything that surrounds us.

History is littered with examples of how scientific discoveries can lead us astray. From the splitting of the atom, which led to the creation of nuclear weapons, to the rise of technology, which has led to the dehumanization of everyday life. But of course, this is a simplification. Science has also given us so much that we now take for granted: organ transplants, heating, the latest iPhone, the very roof over our heads. Science has given us our healthy years, filled with food, shelter, safety and comfort. What Frankenstein highlights is our human desire to go further; to extend our years beyond our imagination, so that not only do we never die, we never grow old either. This hubris is perhaps part of human nature.

What Frankenstein teaches us is that we must take responsibility for our creations, and remember that every gleam of hope also betrays a darker path; ultimately, it is not the ‘monster’ that leads to his masters’ demise, but the lack of empathy and responsibility that is displayed. By continually digging deeper and deeper, searching for a way to transform the cells that create us and the organs that give us life, we must not forget the power that lies in our hands, the ever-human desires of greed and selfishness that can take over our quest.

“I might in process of time, renew life where death had apparently devoted the body to corruption”
– Dr Victor Frankenstein, Frankenstein (2)

Many may question how relevant such warnings are in the present day. Perhaps these messages do not apply to our times. Very few of us would turn our backs upon science, casting our technologies aside and turning to the fire to heat our food and the rock to give us shelter. The issues that Frankenstein brought up, of using nature to bring about life, can be found within any hospital across the world. The use of the defibrillator – a device that uses electricity to shock the heart back into rhythm – could be described as the answer that Frankenstein worked so hard to find – to bring people back from the dead, to introduce life so to speak. Would one call this abominable?

Perhaps we are being unfair to Frankenstein – looking at ourselves as medical students and doctors, how many of us would not do the same as him; sitting hours within a cramped room, reading textbook after textbook, trying discover the intricacies of the human body: how does it breathe, how does it sleep, how does it eat, how does it live? Isn’t this what we do every day – delve deep into the human body so that we can learn how to shock it back to its original state?

We can choose to see both ourselves and Dr Victor Frankenstein as lights that shine onto pathways of future knowledge, discovering new cures and assembling fresh treatments along the way. But we must remember that we cannot rely on science alone to answer all of our problems. Ultimately, science cannot work in a lab by itself. It must work within the context of our greater society, and it must be made morally accountable for its actions. By continuing one’s endeavors out of pure selfishness and greed, one may tread down a path from which there is no return. In the end, it is the monster created from Frankenstein’s obsessions that kills him, and this can serve as a warning to us all.


  1. Brown, A.S. 2010. How early experiments with electricity inspired Mary Shelley’s reanimated monster [Online]. Available at: [Accessed: 8th January 2016]
  2. Shelley, M. 2010. Frankenstein. William Collins.
  3. Pires, V.M. 2013. Shelley’s Monster: A Lesson on Scientific Hubris [Online]. Available at: [Accessed: 8th January 2016]

Featured image:
Frankenstein by Khánh Hmoong

General Literature

A farewell to Oliver Sacks

In my life, I haven’t had many heroes. Yes, I have been fascinated with some athletes, scientists, artists, and people around me, but I cannot say that I have had many true role models. In terms of science and medicine, one soul in particular stands out – Oliver Sacks.

In my introductory histology & embryology course, a professor mentioned a funny story during a rather uneventful lecture concerning ocular histology. The story told of an interesting “optical illusion”, and the lecture suddenly became much more engaging. He briefly mentioned that the clinical tale presented was described by Sacks in “The Man Who Mistook His Wife for a Hat”[1]. I often leave many off-side notes, and in this instance I scribbled: do check this guy out. While revising my histology notes for the exam, I spotted this side-note in my “trademark” hieroglyphic handwriting and decided to follow up on it. With that, a new influence in my life began.

Most articles will state that Sacks was a British neurologist, physician, scientist, and prolific author. Although he was born in London, he spent most of his life in New York City. Sacks was a meticulous examiner and analyst of neurological disorders, and he devoted his life to patients who suffered from these debilitating conditions. Many of his works became classics and best-sellers in the arena of popular medicine.

Sacks’ book Awakenings” was used as a scenario for a major Hollywood motion picture [2] . In this true story, Sacks used a new experimental drug, L-DOPA, to treat patients in a state of total paralysis due to “encephalitis lethargica”. The treatment looked promising, as patients seemed to be resurrected and displayed dramatic improvements over their original condition. Unfortunately, the patients eventually regressed, once again falling into despair; once again drifting through the abyss of mere existence, which is what they had been enduring for years before the L-DOPA treatment briefly brought them out of it (the infamous “on-off” pharmacological feature of L-DOPA/Levodopa [3]). This was only one of many adventures that Oliver Sacks embarked upon and described in his novels. He was an intelligent, witty, compassionate, and truly unique writer and clinician who knew how to transpose the emotions, atmosphere, and feelings he encountered during his medical career.

In medical education, we explore different avenues – from basic to clinical sciences, bench to applied medicine, bedside to operating room, small rural ambulances to comprehensive medical centers. We try to reach a correct diagnosis. We try to adjust and find a sweet spot in our therapeutic modalities. We do our best to cut out what is sick and preserve what is still functional. Likewise, we are all attracted to different things. My “thing” is the nervous system and it has been for quite some time. If I was ever in doubt about such a choice, people like Sacks were there to remind me of my passion. Sacks’ stories of neurology and intricate brain puzzles consumed my attention on a daily basis. A few of his books, in particular, made a profound impression on me.

In “Musicophilia”, Sacks writes about the relationship of music and neurological disorders [4]. I was impressed when I learned how different clinical neurologic entities like stroke, cerebral hemorrhage, or head trauma can modify the processing of the sound and even alter someone’s musical inclinations. Likewise, in his book “Hallucinations” he talks extensively about how hallucinations can be generated as a consequence of trauma, drugs, or other physiological alterations [5]. Reading through Sacks’ books, I am continuously re-fascinated by his scholarly capacities alongside his humble and gentle nature. If the equation of human ego equals 1/knowledge, then Sacks had a miniscule, irrelevant amount of ego within himself. I rarely encounter such a trait these days, especially on the wards in daily clinical routines.

The last day of the August was humid and I had just returned home from a beautifully refreshing swim. I was soon struck with the news that Sacks had passed away. I was overwhelmed by the feeling of sadness. The world lost an outstanding individual, a soul that will be dearly missed by many. A few months earlier, in his New York Times column, Sacks wrote that he was diagnosed with metastases originating from his ocular melanoma. In this farewell piece, Sacks sensed his end was near and reflected on his life, which was well lived by any standard [6]. He announced that his final work, an autobiographical sketch of his life entitled “On the Move: A Life”, would soon become available [7]. His life was one of compassion and dedication; he was a source of warmth and kindness for those who were in need. He genuinely understood human suffering and worked to alleviate it to the best of his ability. Although I lived in New York City during my college days, I did not have the privilege of meeting Sacks. Regardless, I can find some consolation in the fact that he only departed physically – his writings, works, and grand opus will continue to inspire generations of minds to come. Goodbye, dear Dr. Oliver Sacks and thank you!


  1. Sacks O. The Man Who Mistook His Wife For A Hat: And Other Clinical Tales: Odyssey Editions; 2010.
  2. Sacks O. Awakenings: Knopf Doubleday Publishing Group; 2013.
  3. Lloyd K, Davidson L, Hornykiewicz O. The neurochemistry of Parkinson’s disease: effect of L-dopa therapy. Journal of Pharmacology and Experimental Therapeutics. 1975;195(3):453-64.
  4. Sacks O. Musicophilia: Knopf Doubleday Publishing Group; 2008.
  5. Sacks O. Hallucinations: Pan Macmillan; 2012.
  6. Sacks O. My Own Life New York, NY: The New York Times; 2015 [cited 2015 02/19/2015]. Available from:
  7. Sacks O. On the Move: A Life: Knopf Doubleday Publishing Group; 2015.
Featured image:
oliver_sacks by Mars Hill Church Seattle

The Spouter-Inn: let’s see what’s inside

Photo courtesy of Tony Sun
Photo courtesy of Tony Sun

The third chapter of Moby Dick, “The Spouter-Inn,” is all about how to interpret new things. Ishmael, who settled on staying in the hotel called “The Spouter-Inn:–Peter Coffin,” tells readers about what he sees upon entering the hotel. Let us compare Ishmael to a medical student, first entering a new floor, say the neurology floor of a hospital. Ishmael and student are both faced with the task of making meaning from whatever presents itself. On that floor, the student wonders: who are the people sitting in the center of the floor? What is the meaning of the NPO signs next to some room entranceways? On entering Spouter-Inn, Ishmael wonders: what is this painting I see? What are the “monstrous clubs and spears” doing on the wall? I draw this comparison between Spouter-Inn and the neurology floor because I remember thinking about Ishmael’s first visit to that inn when I entered the neurology floor, where my physical diagnosis practice took place. I wasn’t sure what to expect, and there is not much to do for preparation. Like Ishmael, I just walked in and did my best to make sense of what I saw. If there was any “preparation” on my part, it was reading Moby Dick and knowing about the analogous situation of walking into a foreign Spouter-Inn.

For Ishmael, a painting hanging on the wall caught his attention, though he couldn’t make sense of what the painting was about. However descriptive he was about what he saw in the painting, he couldn’t give readers a definite sense of what the painting was. While you might see a painting at the Metropolitan Museum of Art and text your friend what you saw (Washington crossing the Delaware, or the like), Ishamel tells readers this:

A boggy, soggy, squitchy picture truly, enough to drive a nervous man distracted. Yet was there a sort of indefinite, half-attained, unimaginable sublimity about it that fairly froze you to it, till you involuntarily took an oath with yourself to find out what that marvellous painting meant. Ever and anon a bright, but, alas! deceptive idea would dart you through.–It’s the Black Sea in a midnight gale.–It’s the unnatural combat of the four primal elements.–It’s a blasted heath.–It’s a Hyperborean winter scene.–It’s the breaking-up of the ice-bound stream of Time…But stop; does it not bear a faint resemblance to a gigantic fish? even the great Leviathan himself?

Remembering Ishmael’s struggle to make sense out of that painting, I felt a comfort of familiarity, the best feeling I think that someone can feel when thrust in a new situation. It’s OK that Ishmael couldn’t make sense of the painting he saw on the wall, just as it’s OK that I didn’t know what to make sense of the labels telling me: NPO, or D5 0.45 NS. It’s no big deal to look those acronyms up on my smartphone, or just simply ask someone, the latter of what was done in Ishmael’s time: “based upon the aggregated opinions of many aged persons with whom I conversed upon the subject. The picture represents a Cape-Horner in a great hurricane.” This comfort of familiarity I mentioned earlier arises not necessarily from previously seeing the acronyms “NPO” and “D5 0.45 NS,” though seeing them before certainly does add to familiarity–no, this comfort comes from knowing that it’s not uncommon for someone, someone even as smart as Ishmael, to see something and be entirely uncertain what it is and to have several guesses as to its meaning.

Featured Image:
Silver Bank Outtakes by Christopher Michel


The carpet-bag: what to bring with me?

In the first chapter of Moby Dick, “Loomings,” Ishmael gives his reasoning for going on a sailing journey. He is anxious, irritable, and needs to find an escape from his current life, symbolized by the land, so he plans on going to sea as a sailor. In my previous post, I likened his narrative in the first chapter, redolent of the famous Shakespearean monologues, to an exchange between a patient and a physician. I noted that understanding Ishmael’s narrative is analogous to understanding a patient’s story. In chapter two, “The Carpet-Bag,” Ishmael prepares for his sailing journey and leaves Manhattan island, but he faces a problem:

Quitting the good city of old Manhatto, I duly arrived in New Bedford. It was a Saturday night in December. Much was I disappointed upon learning that the little packet for   Nantucket had already sailed, and that no way of reaching that place would offer, till the following Monday (Ch. II)

Ishmael realizes he must look for a hotel to spend the cold December weekend. He surveys the area and finds several hotels: The Sword-Fish, The Crossed Harpoons, and The Trap. Finally, he stumbles upon one that seems reasonable, at least by its name:

Moving on, I at last came to a dim sort of light not far from the docks, and heard a forlorn creaking in the air; and looking up, saw a swinging sign over the door with a white painting upon it, faintly representing tall straight jet of misty spray, and these words underneath- “The Spouter Inn:- Peter Coffin.”Coffin?- Spouter?- Rather ominous in that particular connexion, thought I. But it is a common name in Nantucket, they say, and I  suppose this Peter here is an emigrant from there (Ch. II).

Here, Ishmael’s response to something seemingly as simple as the name of a hotel illustrates an important point—that the perception of language shapes how one feels about what one’s exposed to in life. This is a vital issue in science and medicine, one that deserves more attention in medical education. A few weeks ago, Dr. Mary Simmerling of Cornell University gave a lecture to first year medical students about the ethical, social, and economic issues surrounding kidney transplantation, and in her lecture, she talked about “how much language matters.”

As someone trained in philosophy, I’m very attuned to how the choices we make about words have a huge impact… And I think it’s so true when talking to patients. When I was in graduate school, we called what we now call ‘deceased donors,’ ’cadaveric donors’. So, who wants an organ from a cadaver, and who wants an organ from a deceased donor? Right? So, every word counts. And, it’s really important that we are careful in how we talk about things and describe them because it makes a big difference in how people think about things and how receptive they are, and how willing they are to do things. For example, ‘harvesting’ versus ‘recovering’ an organ—all these things that you might not think really make a difference… The way we talk about things has a huge impact on how the public thinks about them, how we think about things, and most importantly, about how the patients that you care for are going to understand and think about what you’re saying to them.

I’ll take Dr. Simmerling’s point one step further with a personal example. I recently participated in a small group discussion about taking a complete patient history, and the question came up of whether or not to ask about religious identification as part of the social history. I noted that asking about this issue is relevant but can be difficult to bring up in conversation. But there are ways to ease into this conversation. For example, asking patients what support groups they turn to in times of trouble is a better way to start this topic than asking directly about what religion they identify with. How can physicians be more conscientious about how they present information and ask questions? There are two ways, and the first is simply keeping this issue in mind while speaking to patients, students, or colleagues. The second way is to read more, and particularly imaginative literature and poetry, because such works are written in ways that require readers to be attuned to how language is used. Moby Dick gives readers a poem and play clothed in what appears to be a novel, but it really is an enormous prose-poem, and the dialogue between characters very much resembles interactions in Shakespeare’s plays. Reading Moby Dick is great practice for physicians and very much deserves to be alongside Bates’ Guide in a student’s carpet-bag.

Featured Image:
Moby Dick by Mal Jones


Ishmael’s narrative: an emotional response

“Call me Ishmael” is the first line in Moby Dick and probably the most famous opening line in all of American Renaissance era literature. Taken in a different context: “Call me Ishmael,” or perhaps: “My name is Ishmael,” could also be a first exchange between a doctor and patient. Coincidentally, our Ishmael in Moby Dick tells readers something that resembles what a patient might say to a doctor following initial greetings:

moby dick
Photo courtesy of Tony Sun

[So doc,] Some years ago—never mind how long precisely—having little or no money in my purse, and nothing particular to interest me on shore, I thought I would sail about a little and see the watery part of the world. It is a way I have of driving off the spleen, and regulating the circulation…whenever my hypos get   such an upper hand of me, that it requires a strong moral principle to prevent me from deliberately stepping into the street, and methodically knocking people’s hats off—then, I account it high time to get to sea as soon as I can.

So, translation? That is to say, can a physician translate Ishmael’s opening account into a chief complaint and past medical history? Here is my attempt: Ishmael is a middle-aged male (his age is not given) who complains about feelings of boredom and tiredness. He also describes a history of behavioral symptoms that suggest underlying feelings of anger. Ishmael mentions he looks for ways of “driving off the spleen”—the most fitting definition of “spleen” given by the Oxford English Dictionary is: “irritable or peevish temper.” Imagine now, if a patient used that exact phrase, “driving off the spleen,” to describe his anger and how he tries to rid it. As a student, I encountered patients during my preceptorships that mentioned similar behavioral symptoms including becoming “more irritable” and “losing their temper.” I found it challenging but helpful to imagine such feelings and consider them in the context of the patient’s chief complaint and past medical history. This allowed me to move with the patient’s sorry and avoid awkward moments and responses. As an exaggerated example, responding with a huge smile to a patient saying they’re “irritable” is not an ideal reaction and creates a difficult situation. Many times, these problems may not even be apparent until later reflection. To give students more chances to reflect, some medical schools such as Weill Cornell Medical College offer students recorded sessions of them interviewing mock patients. As a student, taking complete patient histories is not an easy task, and we can use all the practice we can get.

To wrap the above discussion into the ongoing theme of my posts—how reading imaginative literature is useful to doctors and scientists—I would suggest that my classmates, and also upper years and residents, make time to read poems and imaginative fiction that elicit a wide range of emotions. To this end, I can give the example that reading Othello and King Lear elicits very different emotional responses than reading, say, A Midsummer Night’s Dream and As You Like It. Yes, readers should read deeply into the variety of emotions in these plays, but they must remember to feel those emotions within the characters of Othello and Lear, or in our case, Ishmael and Ahab. This reading followed by feeling is a practice that physicians can use while taking a patient history: read and hear the patients’ situation, and then feel with the patient. Importantly, students and doctors can practice this even outside the clinic, while reading a poem, play, or novel.

Coming back to Melville’s novel, Ishmael announces his decision to go on a whaling journey at the end of Chapter 1: “By reason of these things, then, the whaling voyage was welcome; the great flood-gates of the wonder-world swung open.” Ishmael’s decision to “get to sea” then brings readers into Ahab’s infamously mad pursuit of the white whale.

My future posts will follow Ishmael’s narrative and bring to light elements that relate to medicine and science.


Featuring image:
Sea and sky by Theophilos Papadopoulos

General Literature

Moby Dick and Medicine

Last weekend, my classmates and I went on a ski trip to a most excellent resort in Vermont. This trip was partly a literature retreat for me, as I chose to reread a large portion of Herman Melville’s Moby Dick on the drive there and back. Upon arriving at the resort, I was inspired to write this post for two reasons. Firstly, the main room had a scenery that I felt to be most conducive to writing (see photo). Secondly, I had been thinking during the drive up to Vermont about how rereading Moby Dick, or any other piece of imaginative literature, is related to rereading texts in medicine, including our current lung unit’s clinical cases (as some of my classmates had been doing in the van), or even re-“reading” a real-life scenario during a pulmonary ward rotation. I realized that there are many similarities, some of which I will share in this post. Again, my central question is: what is the usefulness of reading imaginative literature for the progress of science and medicine?

Photo courtesy of Tony Sun
Photo courtesy of Tony Sun

First, I’d like to introduce, or for some readers, re-introduce Melville’s Moby Dick, a supreme example of American Romanticism. The Romantics were involved in a movement that affected Western art, music, and literature, primarily in the 19th century. In America, the chief Romantic writers were R.W. Emerson, N. Hawthorne, H. Melville, W. Whitman, and H.D. Thoreau. These writers wrote about the art of rereading texts, created characters that had to re-experience situations, and presented the meaning of redoing what has already been done or experienced. The last is of crucial importance and is what unifies the first two themes: rereading and re-experiencing. For any belated reader or writer, there is naturally an anxiety of comparison with precursor writers and readers. Belated individuals may ask themselves: how can I read in an original way, or, how can I write original ideas? For Melville, his question might have been: how can I create and write an original character that embodies vengeance, when Shakespeare had already done so with Iago, or John Milton with his Satan. But Melville overcame this anxiety. He created Ahab, a fusion and reworking of the characteristics found in Iago and Milton’s Satan.

You may ask: how does Ahab and Melville relate to science and medicine, and how is Romanticism related to the art of medicine? I see two main links, one being that reading the Romantics enables one to be more knowledgeable about the issue of originality, and two being that observing how the Romantics handle the art of redoing enables one to redo something and still retain originality. These two links are not mutually exclusive, and the second naturally follows the first—learning what originality is enables one to redo things in original ways. Take this for example: a pulmonary intern (keeping the lung theme) sees a case of fibrotic lung disease that had been presented recently at grand rounds. Now, repeat this situation maybe ten times, that is to say, the intern sees ten more patients with fibrotic lung disease and goes to ten more grand rounds on fibrotic lung disease. Could such repetitiveness lead to boredom for the intern? I can’t answer this from experience, as I’m only a first year student, but I’ve heard the answer to be: “Yes.” A bit of originality could help the intern out here, so here I invoke the experience of reading and rereading Melville: when I reread Moby Dick, or reread any other book, I remind myself to be more aware of where I reread, how long I reread, and how I feel when I’m rereading. And then I compare these to my previous experiences of reading Moby Dick, that is to say, where I first read it, or, where I previously read it. I would argue that the intern can try something similar with clinical cases and grand rounds: where did I last see this case of fibrotic lung disease? And how did I feel when I last saw this case? These questions can make each case of fibrotic lung disease original and interesting.

To finish this post, I’d like reflect on my previous post. In my first post titled “Imaginative Literature and Medicine,” I laid out my objectives and motivations for writing in this blog, and I identified three focal points that I can discern in the medical humanities: 1. a literary focus, in which writers identify characters in literature that are scientists and doctors and write about these characters; 2. a medical focus, in which doctors and scientists reflect on personal anecdotes and write about them creatively in the form of poems or short stories; and 3. a practical focus, in which writers identify links between literature and medicine and argue for the usefulness of reading imaginative literature in practicing medicine and science. My interest is in the third category, and admittedly, I think this is the most underdeveloped of the three categories. This second post on Melville, Moby Dick, and medicine (a convenient alliteration, I might add) is meant to not only continue where I left off in the first post, but also to start a trend for future posts, in which I will be drawing more links between medicine, science, and the American Romantic writers: R.W. Emerson, N. Hawthorne, H. Melville, W. Whitman, and H.D. Thoreau.

Featured image:
Ahab reloaded by José María Pérez Nuñez