November-December Book Club - No Apparent Distress

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Froggy88
Regular Member


Date Joined Mar 2017
Total Posts : 45
   Posted 11/4/2017 8:46 AM (GMT -7)   
Welcome, readers. For November and December, the book for reading and discussion will be Rachel Pearson's "No Apparent Distress: A Doctor's Coming-of-Age on the Front Lines of American Medicine," which was released earlier this year. Most of the book involves the author's experiences as a medical student, caring for mainly indigent patients in the Galveston area.

As far as the applicability for here, several of the cases involve cancer, with misdiagnoses, as well as undertreatment and nontreatment that I found shocking. There will be certainly a lot to discuss in terms of the different experience levels of medical personnel and how that impacts treatment, the callousness that our medical system (and society) engages in in refusing treatment to the uninsured, and how people (doctors and patients) react in the face of such a system.

As usual, the first month (November) is for reading/listening, and the following month (December) is for discussion.

Please respond if you're joining in this time around.
11/16 DRE+ PSA 3.66
Dx 03/17 (Age 56), 1/14 positive, G6 (5%), T2a
05/17 PSA 1.38
Currently on AS

81GyGuy
Veteran Member


Date Joined Oct 2012
Total Posts : 2072
   Posted 11/4/2017 12:30 PM (GMT -7)   
Yes, I'll participate.
Age: 71
Chronic prostatitis (age 60 on)
BPH w/ urinary obstruction, 6/2011
TURP, 7/2011
Ongoing high PSA, 7/2011-12/2011
Biopsy, 12/2011: positive 3/12 (90%, 70%, 5%)
Gleason 6(3+3), T1c
No mets, PCa likely still organ contained
IMRT w/ HT (Lupron), 4/2012-6/2012
PSAs (since post-IMRT): 0.1 or lower

Froggy88
Regular Member


Date Joined Mar 2017
Total Posts : 45
   Posted 11/11/2017 9:14 AM (GMT -7)   
Just a reminder that this book is on the agenda for discussion next month. Hopefully we can get a few more to join in.

As encouragement, I'll blurb from a review:
"Dr. Pearson relates a number of ... instances of hesitation, error, awkwardness, and confusion as she progresses through medical school. As I noted earlier, these are all standard student responses, as are the array of hostile, difficult, engaging, and grateful patients. What makes No Apparent Distress stand out is the author’s ability to bring her feelings and these characters to life. She also has a distinctive voice, an attractive mixture of naiveté, passion, sharpness, and common sense that hooks the reader and makes him keep turning pages."

This ties in with something worth keeping in mind for reading, the various relationships between doctors and patients. There is some tendency on both sides of the relationship to devolve (or default) to an interaction on a surface level, with the doctor as a mere provider of medical services and the patient merely a consumer of such services -- what Martin Buber termed an I-It mode of existence. What keeps doctors and patients from more often engaging on a personal level? To what extent is it desirable to overcome these barriers?

Anyway, those questions (and more) are on the agenda for next month. Please chime in if you'll be participating.
11/16 DRE+ PSA 3.66
Dx 03/17 (Age 56), 1/14 positive, G6 (5%), T2a
05/17 PSA 1.38; 09/17 PSA 1.47
Currently on AS
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