Monday’s Musing 7/25/22-Literary medicine

It’s not a secret that I love to read. I am an equal opportunity book devourer; westerns are a little hard to get down but I’m game. One of my very favorite genres is medical. Fiction, non-fiction, it’s all the same to me. I’ve been reading it since I first read House of God by Samuel Shem in high school. But isn’t that a busman’s holiday? No, not really. These books have situations and patients in them that I will never experience but if I learn about an avenue to treatment I can utilize it in the future. The following is a section of my favorite medical reads, fiction and non-fiction.

House of God by Samuel Shem. This book was published in 1978. I consider this book required reading for all who want to go into healthcare. It is also where many of the phrases that are still used today come from. And when I use phrases from the book, I get a blank stare in response. To name a few is O-sign, that is a patient asleep on their back, with their mouth open. Q-sign, that is a patient asleep on their back their mouth open with their tongue hanging out. Buff the chart is to make the chart pretty so that a different department will accept the patient. Neuro or Orthopedic height refers to how high the bed or operating room table is. This means that a fall from that height will be a neuro consult because of a head injury, or an orthopedic consult because of a fracture. GOMER, which I know is still used today refers to get out of my emergency room, or a patient who may be malingering. LOL and LOLNAD does not mean laugh out loud, it means little old lady, and LOLNAD means little old lady in no additional distress. The original text speak is medicine because we love our shortcuts. Entire conversations can be had in letters. And my favorite phrase from the book is that there isn’t a body cavity that can’t be reached by a 14-gauge needle and a good strong arm. This is a sexist book, written in a sexist time, but I can read past that. In fact, I am due for my annual rereading, and I will definitely be packing it for the plane ride.

Walk on Water by Michael Ruhlman. This book was published in 2003 and opened my eyes to pediatric cardiology, which was a service line I had/have no experience in. There can be devastating birth defects that were a death sentence for the infant in years past. This is a powerful book. There is a scene where the primary surgeon, the resident, and medical student, and the scrub nurse are all hunched over a teeny tiny baby when suddenly there are graham cracker crumbs in the field. That the medical student, as I recall, had been eating in the lounge prior to the case with his mask dangling from his ears and under his chin. This scene made me change my own nursing process and I now remove my mask anytime I am eating.

Intensive Care: The Story of a Nurse by Echo Heron. Upon reviewing publication dates I was surprised that this was published in 1987 as it feels quite modern. The issues that nursing staff deal with have not changed; sick, sick patients, doctors who don’t really know what they are ordering, lack of higher up support. This book could be written today. Echo Heron is a nurse in San Francisco in the early 1980s, attendant with the AIDS crisis. She writes with compassion about nursing and the patients.

This is Going to Hurt by Adam Kay. This was published in 2017 and I read it in 2018. This is about a doctor in England under their system and deals with the punishing pace that doctors must train under. I reread it before the BBC miniseries came out and it was just as stunning this past year as the first time I read it.

Complications by Atul Gawande. This was published in 2002 and is about an MD and life on the wards. He is a surgeon specializing in endocrine and general surgery. In this book he explores the limits of medicine and what a doctor can do and cannot do. This was recommended to me several times since and each time I have to say that I read it when it came out and his subsequent books as well. The Checklist Manifesto, published in 2009, is a companion book I would argue, and speaks to using a checklist, much like an airplane pilot, to drive decision making and ensuring that all important steps are taken. The World Health Organization published the pre-operative checklist in 2008, which is funny because I distinctly remember using a prototype in California as early as 2005. Both are solid reads and worth a reread.

The Immortal life of Henrietta Lacks by Rebecca Skloot. This was published in 2010 and was very splashy at the time. Henrietta Lacks had cervical cancer and the cells that were biopsied went on to drive medical innovation and much of the processes that medicine uses today. She died in 1951 and her cells live on, multiplying and being used for medical research. This is the book that made me think that research might be a good fit for me.

Nurse by Peggy Anderson. Although this was published in 1990 the stories are from the 1970s. And they tell of a different time and place, where nurses were required to give up their chairs to doctors. I got my copy before the graduated high school at the used bookstore (shout out to Paperbacks Unlimited in Santa Rosa, CA). My mom graduated in the 1970s and this book made me feel closer to her college days. And how different life is now on the wards with the quick discharge of patients, both to make room for more patients, and to decrease the cost of hospitalization. Definitely will be reread in the near future because I still have my copy.

Notes on Nursing by Florence Nightingale. The OG nursing book was published in 1859 and concerned care of the soldier during the Crimean War. Things that we do today can be traced back to this book. Cleanliness, fresh air, antiseptic practices, this book has it all. In 1847 Ignaz Semmelweiss was discovering that going from cadaver work straight to delivering a baby was probably not the best practice. I can believe that Florence Nightingale was aware of Semmelweiss and hand hygiene’s impact on survival rates or it may have been convergent evolution of ideas. It remains one of the bestselling nursing books to this day.

Seven books that still inform and impact my nursing career. Are all of these worth a reread? Absolutely. I think I will get started.

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