Newly minted medical interns know where they stand. It’s undoubtedly the bottom rung of their career ladder, but the position gives new physicians valuable proximity to experienced doctors in practical situations they couldn’t experience in the classroom. When everything goes well, an internship is experiential learning at its best. Sometimes, though, the system fails both the student and the very people it aims to help: the patients. In this articulate memoir, John G. Deaton recounts his early medical training and the tragic case that led him to question both his role as a doctor and the ethics of the medical profession.
Only a few weeks into his internship, Deaton found himself overwhelmed by his assignment at Memorial Hospital in Corpus Christi, Texas. Instead of joining a community of learned colleagues, he found himself essentially alone in a sea of desperately ill patients. Among them was seventeen-year-old Maria Chavarria, nine months pregnant and suffering from disabling stomach pains. Solving Maria’s case would become an obsession for Deaton, who came to blame himself, his supervising doctor, and the entire medical system for her mistreatment.
Deaton confronts every question raised by Maria’s medical saga. Was he too timid in pursuing his early diagnosis of intestinal obstruction? Did the supervising doctor intentionally delay Maria’s much-needed surgery? Did their treatments make her condition worse? And, above all, why would nobody admit that anything had gone wrong?
Maria’s story isn’t the only one Deaton tells, and his accounts of emergency room blunders and near misses take the reader right into the hospital, as he looks to the nurses for guidance during a complicated birth or improvises treatment for a choking child. He also takes the reader back in time to his own rural childhood, in highly detailed scenes from one-room schoolhouses to roadside creeks. The biographical vignettes are engaging, but they divert attention from the medical story.
Deaton is an experienced author, with scores of scientific papers and several previous books to his name. He uses sophisticated language to tell his story, but balances it with a down-to-earth, self-effacing sense of humor. He can be eloquent: “You think your own experience is exclusive, but it isn’t.” And he can be blunt: “I had a big mouth, a chip, an attitude.” The combination makes him the credible narrator of a story that at times approaches the unbelievable.
With his memoir, Deaton hopes that exposing the behind-the-scenes workings of medical schools and hospitals will lead to desperately needed improvements.