Indian Journal of Medical Ethics

BOOK REVIEW

Bedside manners

Shalini Govil

DOI: https://doi.org/10.20529/IJME.2010.094


Michael A La Combe, Christine Laine (editors). The last half hour of the day. An anthology of stories and essays that have inspired physicians. Philadelphia: American College of Physicians; 2008. 290 pp.

All my reading life, the best part of the day has been that last half hour curled up in bed, reading a book. The last half hour of the day… is dedicated to people like me – “Physicians who aspire to a lifelong habit of a half hour’s reading before turning out the light”. The list of authors is like a roll call of the greatest writers and philosophers that have ever lived – Plato, Neruda, Hemingway, Chekhov – and in itself requires no further persuasion to read. But what makes this book attractive to a physician is that it deals with issues doctors frequently face but rarely ever articulate.

Editors Michael LaCombe and Christine Laine have compiled this anthology from favourite prose sent in by doctors from across the globe. It covers a wide spectrum of time (Hippocrates to Pamuk) and literary styles (Socratic dialogue to science fiction). There are a fair number of stories written by doctors and patients scattered amongst the fiction and non-fiction greats – Marie Curie, for instance.

The book is divided into five sections – Achievements, Discoveries, Calamities, Victories and Pure fancy. In Achievements, there is a lovely description of the perfect way to care for the sick in an extract from Thomas More’s Utopia where every town would have four large hospitals on its outskirts that would be so welcoming and caring that people would prefer to go to a hospital than lie sick at home.

In Discoveries, there is a beautiful, contemporary piece entitled “Laundry” by Susan Mates, who, while folding her baby’s diapers in the laundry, reflects on the wisdom of her decision not to investigate a patient with metastatic cancer for a possible pneumonia. Marie Curie in an essay on Pierre Curie, generously shares with us a rare personal glimpse of the scientist: “Thus without ever forsaking his inexhaustible patience, Pierre Curie used sometimes to say to me: ‘It is nevertheless hard, this life that we have chosen.'”

The section on Calamities is filled with raw, heart-breaking accounts of sudden severe illness. In “People like that are the only people here”, Lorrie Moore describes the discovery of her baby’s malignant kidney tumour in a startling, minimalist style: “A start: the Mother finds a blood clot in the Baby’s diaper. What is the story? Who put this here?” Raymond Carver’s story, “A small, good thing”, explores the abrupt intrusion of death into quiet, ordinary lives: a mother orders a birthday cake for her son’s party, one that never takes place after the boy is fatally knocked down by a car on the way to school. On his birthday.

In Victories, the essay “On not winning the Nobel prize” by Doris Lessing explores the dying love of reading – alive only amongst those who have no easy access to books. She writes of a black friend in Zimbabwe who “…taught himself to read from the labels on jam jars, the labels on preserved fruit cans.” Alexander Solzhenitsyn, in the voice of “The old doctor” (from Cancer ward), shares the meaning of life: “…to preserve unspoiled, undisturbed and undistorted the image of eternity with which each person is born. Like a silver moon in a calm, still pond.”

The final section, Pure Fancy, contains Edgar Allan Poe’s classic Gothic tale, “The masque of red death” where Prince Prospero falls dead after confronting a mysterious stranger at a masquerade ball. The anthology ends with a science fiction story from Ursula Le Guin, the only story that did not engage me but as this section’s introductory quote from Abraham Lincoln declares, “People who like this sort of thing will find this is the sort of thing they like”!

There are a few authors I would have liked to see included, AJ Cronin and Lloyd C. Douglas amongst them, and undoubtedly every reader will have an old favourite that has been omitted. But such is the downside of any anthology.

In India, where doctors are not exposed to the “humanities” once they leave high school, our experience of literature is often confined to the odd, compulsory Oliver Twist or Hamlet. This book offers an opportunity to bridge that gap; it hopes that with a simple start of a half hour every day, a life-time habit of reading will be established. In the words of Osler, “Start at once a bed-side library and spend the last half hour of the day in communion with (the) saints of humanity.”