The Soul of Medicine

By SHERWIN NULAND

If you find yourself having more dealings with your insurance company than your doctor, you may grow wistful reading Sherwin Nuland’s latest. In The Soul of Medicine, the How We Die author, a practicing surgeon for more than 30 years, collects stories from colleagues describing their most memorable patients. He alters identifying details and presents them in the style of The Canterbury Tales (“The Gastroenterologist’s Tale,” “The Nephrologist’s Tale”), following many with his own commentary. Most of the episodes occurred decades ago, giving the book a distinctly nostalgic tone. Nuland recognizes this, writing of today’s practitioners, “Though some appear to ignore or be unaware of it, all physicians have a pastoral role in the care of each patient entrusted to them. They should be guides, wise counselors, and medical advocates.” Still, the book makes for fascinating reading: from the dramatic (the surgical resident who discovers a patient’s chest is filled with fecal matter, the result of a perforated colon) to the mundane (the dermatologist who painstakingly determines that a patient’s shampoo is the cause of an unsightly rash), each chapter illuminates the intricacies of diagnosis and treatment. And Nuland’s writing, as ever, is thoughtful and elegant, as in his description of the work of geriatricians, who “treat their patient like a fine old engraving, a line of which may have significance that would be overlooked were it not observed so carefully.” Newbies in the field would do well to read this book, full of the moments of grace that such scrupulous observation can yield.