by Iris Monica Vargas
BOOK REVIEW – from SeedMagazine
We stand under the bright, warm lights of the surgery room with young surgeon Pauline W. Chen. As the lights illuminate the hairs on the back of her neck, we watch her as she pokes a hole through the patient’s belly, into his diaphragm. Our fingers fuse with hers, as she clears away the cobweb-like tissues between the heart and the spine. Soon our entire arm has penetrated the body of another person. Between the transgression of the act and the reassurance of that warm space, we feel, as she does, the hardness of the vertebral bones on the back of the forearm. Against the tender skin on the underside of our wrist, we, too, are surprised by the strong, twisting contractions of the heart.
In Final Exam, Pauline Chen — a transplant surgeon who graduated from Harvard and Northwestern University’s Feinberg School of Medicine, and then completed her surgical training at Yale University, the National Cancer Institute, and UCLA — takes us on a journey many of us would unlikely experience on our own. We confront death, our fear of it, and the busyness with which we fill our daily routines such that we temporarily forget own mortality. Alongside Chen, we grapple with what it means when a loved one is terminally ill, how to assist them in their dying, and how to die best.
Why are we so bad at taking care of the dying? Convinced that she was going to spend her days, like the heroic doctors of her imagination, in “triumphant face-offs with death,” Chen applied for medical school only to discover that even the best schools would not prepare her to ace the “final exam”: knowing how to take care of the dying. To do that, she would have to learn to place herself in her patients’ shoes.
Collected as a series of evocative essays, Final Exam depicts Chen’s years of experience as a physician-in-training and practicing surgeon. The book is divided into three parts. In the first, Principles, Chen walks us through the halls of medical school showing us what she deems the essential paradox in medicine: that “a profession premised in caring for the ill also depersonalizes the dying.”
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