Between Expectations: Lessons from a Pediatric Residency

Between Expectations: Lessons from a Pediatric Residency

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by Meghan Weir
     
 

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When Dr. Meghan Weir first dons her scrubs and steps onto the floor of Children’s Hospital Boston as a newly minted resident, her head is packed with medical-school-textbook learning. She knows the ins and outs of the human body, has memorized the correct way to perform hundreds of complicated procedures, and can recite the symptoms of any number of diseases by…  See more details below

Overview

When Dr. Meghan Weir first dons her scrubs and steps onto the floor of Children’s Hospital Boston as a newly minted resident, her head is packed with medical-school-textbook learning. She knows the ins and outs of the human body, has memorized the correct way to perform hundreds of complicated procedures, and can recite the symptoms of any number of diseases by rote. But none of that has truly prepared her for what she is about to experience.

From the premature infants Dr. Weir is expected to care for on her very first day of residency to the frustrating teenagers who visit the ER at three in the morning for head colds, each day brings with it new challenges and new lessons. Dr. Weir learns that messiness, fear, and uncertainty live beneath the professional exterior of the doctor’s white coat. Yet, in addition to the hardships, the practice of medicine comes with enormous rewards of joy, camaraderie, and the triumph of healing.

The three years of residency—when young doctors who have just graduated from medical school take on their own patients for the first time—are grueling in any specialty. But there is a unique challenge to dealing with patients too young to describe where it hurts, and it is not just having to handle their parents. In Between Expectations: Lessons from a Pediatric Residency, Dr. Weir takes readers into the nurseries, ICUs, and inpatient rooms of one of the country’s busiest hospitals for children, revealing a world many of us never get to see. With candor and humility, she explores the many humbling lessons that all residents must learn: that restraint is sometimes the right treatment option, no matter how much you want to act; that some patients, even young teenagers, aren’t interested in listening to the good advice that will make their lives easier; that parents ultimately know their own children far better than their doctors ever will.

Dr. Weir’s thoughtful prose reveals how exhaustion and doubt define the residency experience just as much as confidence and action do. Yet the most important lesson that she learns through the months and years of residency is that having a good day on the floor does not always mean that a patient goes home miraculously healed—more often than not, success is about a steady, gradual discovery of strength. By observing the children, the parents, and other hospital staff who painstakingly provide care each day, Dr. Weir finds herself finally developing into the physician (and the parent) she hopes to become. These stories—sometimes funny, sometimes haunting—expose the humanity that is so often obscured by the doctor’s white coat.

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Editorial Reviews

Publishers Weekly
It's a given that doctors-in-training will suffer through sleep deprivation and stress, but pediatrician Weir brings something more heartfelt—and joyful—to this achingly personal chronicle of her residency at Children's Hospital Boston and Boston Medical Center. Weir's grim introduction to Connor, a fragile preemie, forces her to wonder whether "the ends will justif even the most agonizing means." There is her anger at baby Myranda's drug-addicted mother, her panic over blue-baby Briony, her struggles to tell 19-year-old Harry's father that his son has a brain tumor, and her realization that when you don't know what to do, you should know whom to call. The most memorable parts of Weir's grueling training are the complicated kids and families, the hope she inspires in them—and the hope they give her in turn. Yet, she shows, doctors working with very sick children must know when they're offering families too much hope, or not enough, and that there's a cost to everything they do. Here's a white coat insider's account with better writing and more soul than most medical dramas. (Mar.)
From the Publisher
"An eviscerating chronicle of life as a pediatric resident...Weir’s sharp honesty begets the doctor’s best friend: trust." —Kirkus Reviews

“A searing, compassionate, well-written and inspiring account by a young woman doctor out on the leading edge of caring for children. A marvelous book.” —Samuel Shem, M.D., author of The Spirit of the Place and The House of God

Between Expectations is a beautifully written and profoundly personal account of learning the often strange and often sad realities that make up a doctor's life. Dr. Weir's humanity is impressive as she describes the vivid stories of her journey, and the patients who helped shape her as a doctor. — Perri Klass, MD, author of Treatment Kind and Fair: Letters to a Young Doctor

"In this intensely personal work, Meghan Weir has skillfully captured both the struggles and triumphs of residency training. She has pulled back the curtain to reveal a demanding world most readers will not have seen. Her honesty describing her own transformation from medical student to physician and in addressing issues often left unexplored is refreshing and moving. " —Lauren A. Smith, MD, MPH Associate Professor at the Boston University School of Medicine

"In this intensely personal work, Meghan Weir has skillfully captured both the struggles and triumphs of residency training. She has pulled back the curtain to reveal a demanding world most readers will not have seen. Her honesty describing her own transformation from medical student to physician and in addressing issues often left unexplored is refreshing and moving. " —Lauren A. Smith, MD, MPH Associate Professor at the Boston University School of Medicine

"It's a given that doctors-in-training will suffer through sleep deprivation and stress, but pediatrician Weir brings something more heartfelt—and joyful—to this achingly personal chronicle of her residency." —Publisher's Weekly

"Bound together by her luminously detailed and emotionally literate prose, Weir’s recollections compellingly portray the challenges and rewards of modern medicine, and the slow and stumbling process through which a physician is formed. " —[tk] reviews

Kirkus Reviews

An eviscerating chronicle of life as a pediatric resident in two dissimilar Boston hospitals.

It is not easy to like Weir at the beginning of the book. She does not deign to edit her responses to what were often dire circumstances, and she writes with greater deliberation than she displayed on the ward. On the page, she lets her emotions flow exactly as they did at any particular moment, informed by her education or anger about extremely difficult scenarios, such as the tiny premature baby with multiple complications whom she would have let go, his present and future so hopeless, but whose parents refused to surrender. Or the parents who "ask questions for the sake of asking them, to feel involved, much as children do when they are three or four." Or the teenagers, "with their propensity for sullenness and outright lies, their inability to state in any simple and straightforward terms what was bothering them and why they needed to see a doctor." Slowly, without making a show of it, Weir demonstrates that she is simply being fair to her understanding of each situation. She never gives any less than her best, but a resident's workload is impossibly punishing and the situations wretched. She not only gathers the medical talent that may cure a life-threatening problem, but she shows the ineffable will to push through the fugue states and existential despair, a misery testified by another resident during a review session: "It would have been helpful if someone had told us ahead of time that all the Onc kids were going to die." Readers will weep at points, but, without guile or fanfare, the author also presents many instances of tenderness.

As the cold certainty of heartbreak surrounds her, Weir's sharp honesty begets the doctor's best friend: trust.

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Product Details

ISBN-13:
9781439189092
Publisher:
Free Press
Publication date:
03/01/2011
Sold by:
SIMON & SCHUSTER
Format:
NOOK Book
Pages:
288
Sales rank:
582,898
File size:
2 MB

Meet the Author

Meghan MacLean Weir, M.D. obtained her undergraduate degree in Molecular Biology at Princeton University with work on viral protein expression and then went on to study medicine at Stony Brook University.  She also was awarded a Master’s in Medical Anthropology from the Institute for Social and Cultural Anthropology at Oxford University for work done there on the impact of poverty, undernutrition, and infections on children in sub-Saharan Africa.  She completed her residency training in pediatrics at Children’s Hospital Boston and Boston Medical Center and during this time held the position of Teaching Fellow in Pediatrics at the Boston University School of Medicine and Clinical Fellow in Pediatrics at the Harvard Medical School.  She has participated in research and training programs in South Africa, Liberia, and Sri Lanka that have been funded in part by the Stony Brook School of Medicine, Children’s Hospital Boston, Massachusetts General Hospital, and the American Academy of Pediatrics.  Her essays have appeared in hospital publications at both her former and current institutions and excerpts of her writing have been used in the Humanism in Medicine curriculum for interns at the Boston Combined Residency Program.  She and her husband continue to live in Boston where she will soon assume a position as Staff Pediatrician at the Children’s Hospital.

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Between Expectations: Lessons from a Pediatric Residency 4 out of 5 based on 0 ratings. 9 reviews.
AnthonyYounMD More than 1 year ago
Meghan Weir's book is a fantastic read. Meghan chronicles her life in a pediatric residency, complete with heartwarming and sometimes heartbreaking tales about the many patients she encounters, including premie babies with heart defects, children in the heme-onc ward, and even her harrowing experiences while spending time in a sparsely-equipped hospital in Liberia. While the patient stories are haunting, what shines through the most for me are the words which she carefully and meticulously chooses to describe the interactions with her patients, parents, and coworkers. If Dr. Weir is half as good at treating patients as she is at writing, then her patients are in great hands. This book is a perfect gift for someone who is considering becoming a doctor, especially a pediatrician. It will also be enjoyed by anyone who has had a sick child. I encourage everyone to buy it, read it, and contemplate some of the larger subjects of childhood life and death that she tackles. I loved this book. I adored her writing. I hope she writes a sequel.
Anonymous More than 1 year ago
Great
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