On Call: A Doctor's Days and Nights in Residency

ok, i admit it - i went to med school with Dr. Transue so I am biased - I like her personally. But while that may bias my opinion of the book, it also lets me assess the book from a first hand perspective. Her writing really "captures the moment". It is so accurate that I kept waiting for the part where she mentioned my name or had me walking through the door. Never happened, but regardless - the stories she told were very realistic, and the emotions she conveyed were the same types of feelings that most of us experienced as we went through our medical training. great job emily - waiting for the sequel! signed - one of your gross anatomy partners

Being a Registered Nurse myself and also being married to a physician, I'm very aware of all the hospital stories that occur during training. In fact, I dated many medical students when I was young and working at a teaching hospital. I also now live in Seattle. So this book was a "given" that I would read it. I thoroughly enjoyed every story she told. She struggled with being "human" rather than tough and non-feeling as many doctors appeared to be. And that was an endearing part of her story. Doctors are human and have feelings. And Dr. Transue learned in her training that being tough isn't necessary and that it's ok to become involved in patient care and really "care". I worked L & D most of my clinical career in San Diego. A real tough OB doctor worked with me for years----he could be very matter of fact and hard core with his patients. One day I realized that a patient of mine in the triage room was carrying a stillborn. He was the doc on call. I was concerned that he would be too tough and not soft enough for this patient. But when he pulled the curtains and cried as he told her the baby had died, I realized that he is a caring man and had compassion for his patients---just tried too hard not to show it. I gained a new respect for him and doctors. This is an excellent book about the training for doctors. I highly recommend it for all those newly graduated from medical school. It just might help them with that "human factor".

Emily Transue's book touched a nerve for me. Also an internal medicine resident, I feel that she has written a book that honestly portrays the experiences that residents go through daily. Many of us don't have the time or emotional energy to digest all the profoundly moving experiences that come our way everyday on the hospital wards, and it is easy to feel alone in our experiences. The culture of medicine demands a strong front before colleagues and patients alike, and the innate need to make sense of what's occuring inside of you gets neglected. This book sat on my dresser for months before I decided to pick it up. I didn't think that I needed to read about what I saw daily; in fact, I was avoiding it. To its credit, I couldn't put the book down. True, it was everything that I was used to, but seeing it from someone else's eyes was refreshing. I also recommend Danielle Ofri's Singular Intimacies for those interested in knowing what a young doctor's life is really about.

I've always been fascinated by careers and career choices, so I read about occupations from veterinary medicine to military service. Women write many of these books because, for a long time, the novelty of being female in those occupations would get the book published. We've seen many books by women doctors, including Perri Klass, Frances Conley and Elizabeth Morgan. So what's remarkable in this book is the complete absence of any references to gender and gender issues. One older woman says she'd rather have a woman doctor and the author says sure, she would too. Big deal. Transue writes about "the neurology resident" and then uses "he" or "she" with no comment. Both male and female attendings -- senior physicians -- can be heroic or deficient. Almost as surprising, Transue portrays herself as polite and caring. I must admit I've stayed far from doctors and hospitals throughout my life, but the few I've met were nothing like Transue. She actually apologizes for bothering people. In fact, I suspect she set a world record for a doctor saying, "I'm sorry." Most doctors I've met were arrogant, even rude, but Transue doesn't report a single instance of arrogance. An attending is "distant" and another unsure of herself. But when a patient's relative demands to speak to an attending, and orders Transue to make the call, she complies. On Call deserves five stars because it's well written, almost a page-turner. Transue manages to make a collection of essays hold our interest, even when we rarely learn the ending. For instance, we learn that a man has been estranged from his family, but never why. Most chapters are based on actual patient encounters. Transue helps us understand what's going on but doesn't get bogged down in the (literally) gory details. She describes her own fatigue without whining or pity. She doesn't seem to wonder if things could be changed. And, in what appears to be a teaching hospital, there's little concern with changes in medicine and managed care. In one scene a patient must decide if he'll pay for a no-smoking patch or wait six weeks to begin a no-smoking campaign. Isn't there an irony here worth noting? This non-judgmental style is both the strength and the weakness of On Call. Transue examines her own experience with, well, clinical detachment. She marvels that she could break down crying one day and be a model resident the next. She doesn't share details of her life, so we don't know what gave her the strength to keep her perspective. She went sailing with friends; she baked a blackberry pie; she lifted weights with another resident who became a gym buddy. She alludes to a loyal and loving family and she had a superb education. But we don't know where she lived during residency or what sustained her during the tough times. Perhaps the combination of these factors helped her become such a successful resident. As a career consultant who has studied life transitions, I was fascinated by her final chapter: a real

I read the book in one sitting -- it was that easy to become absorbed in the stories. Dr. Transue writes extremely well, both in describing the medical details (some gory, some extremely technical, but without being condescending or gross for the sake of grossness), and in capturing the emotions she felt and those she perceived in her patients. I hate tear-jerkers -- those maudlin stories where you know the writer is just going for effect. I cried reading parts of this book, but it is in no way a tear-jerker. I felt like I was a silent observer of the real dramas of medicine, guided by a narrator I could trust: one who saw clearly and honestly, and whose reactions and thoughts make me feel more hopeful about the promises of modern medicine. Dr. Transue's patients are lucky to have her care.