Incidental Findings: Lessons from My Patients in the Art of Medicine

by Danielle Ofri MD

Overview

In Singular Intimacies, which the New England Journal of Medicine said captured the "essence of becoming and being a doctor," Danielle Ofri led us into the hectic, constantly challenging world of big-city medicine. In Incidental Findings, she's finished her training and is learning through practice to become a more rounded healer. The book opens with a dramatic tale of the tables being turned on Dr. Ofri: She's had to shed the precious white coat and credentials she worked so hard to earn and enter her own hospital as a patient. She experiences the real'slight prick and pressure' of a long needle as well as the very real sense of invasion and panic that routinely visits her patients.

These fifteen intertwined tales include "Living Will," where Dr. Ofri treats a man who has lost the will to live, and she too comes dangerously close to concluding that he has nothing to live for; "Common Ground," in which a patient's difficult decision to have an abortion highlights the vulnerabilities of doctor and patient alike; "Acne," where she is confronted by a patient whose physical and emotional abuse she can't possibly heal, so she must settle on treating the one thing she can, the least of her patient's problems; and finally a stunning concluding chapter, "Tools of the Trade," where Dr. Ofri's touch is the last in a woman's long life.

Product Details

ISBN-13:	9780807097281
Publisher:	Beacon Press
Publication date:	04/01/2005
Sold by:	Penguin Random House Publisher Services
Format:	eBook
Pages:	192
File size:	350 KB

About the Author

Danielle Ofri, MD, PhD, is an associate professor of medicine at the New York University School of Medicine and has cared for patients at New York’s Bellevue Hospital for more than two decades. Writing in the Guardian, Andrew Solomon singled out Ofri as the only woman among an extraordinary new generation of doctor writers, saying, “Ofri has produced four impressive books and numerous articles, all striking for their reversion to empathy, their willingness to sense not only the physical life of a patient, but also the emotional.” Ofri’s books and articles have become academic staples in medical schools, universities and residency programs. She is the editor in chief of the Bellevue Literary Review and writes regularly for the New York Times. Ofri in New York City.

Table of Contents

	Prologue: Incidental Findings	1
1	Living Will	11
2	Common Ground	25
3	Acne	38
4	A Day in the Clinic	41
5	The Journey	60
6	Torment	68
7	Vision	75
8	Terminal Thoughts	94
9	In Her Own Key	108
10	Sat	132
11	Tendrils	141
12	Missing the Final Act	152
13	Emigration	157
14	Tools of the Trade	170
	Acknowledgments	177

Editorial Reviews

Ofri, an attending physician at New York City's Bellevue Hospital and founder of the Bellevue Literary Review, again displays the same sensitivity and carefully crafted writing that distinguished her first medical memoir (Singular Intimacies). The emphasis in these 14 engrossing pieces is on her determination to learn from those she has treated. Ofri begins by recounting a time when the shoe was on the other foot, when she, as a first-time expectant mother, was the patient. After a sonogram, Ofri and her husband were rather casually told that their baby's umbilical cord was missing one artery. Her disorientation and anxiety that day deepened her ability to empathize with those who are ill. In "A Day in the Clinic," she describes how a language barrier left her unable to effectively comfort an Asian man with a brain tumor. In the especially moving "Terminal Thoughts," Ofri intuits that a woman's signature on a Do Not Resuscitate order and her refusal of dialysis were rooted in depression. Ofri reworks her pain medications and extracts a promise that the patient will stay on dialysis. The patient will not be cured, but Ofri's goal is not to provide happy endings; rather, she aims to wed compassion to medical training and knowledge, to recall her ongoing struggles to understand the sick and to make their lives more bearable. (Apr.) Copyright 2005 Reed Business Information.

Publishers Weekly

A second collection of perceptive essays about Ofri's continuing growth as physician, fulfilling the promise of Singular Intimacies (2003). Now an attending physician at Bellevue, the author found that her journey to becoming a healer was filled with lessons learned from patients. After completing her residency in internal medicine at Bellevue, Ofri traveled in Mexico, studied Spanish, and worked in small-town hospitals. Her patients included an old man on Florida's Gulf Coast with no will to live, a young woman in New England needing a hard-to-get abortion, and an impassive Navajo woman in New Mexico whose untreated acne troubled her more than the violence in her life; their cases reminded the author of the limits of her medical skills. On her return to Bellevue, her time was divided between the medical clinic, where she often followed patients for months or even years, and four-week-long stints on the medical wards, where her time with patients was intense but often cut off before their full stories could be known. Among the characters she chooses to profile here are a crotchety old man whose disposition improved when she bought him painting supplies and reading glasses, a disconnected adolescent whose outlook on life changed when she coached him for his SAT, a disturbed woman who faked symptoms to get medical care, and a depressed patient who refused needed treatment. In writing their stories, she is writing her own, Ofri asserts: "In a jungle, they say, you often can't tell which root system connects to which leaves." One of the most valuable lessons a doctor can learn, the author believes, is what it feels like to be a patient. Her prologue reveals just how disconcerting thatexperience is when she finds herself shaken and sore after amniocentesis and a sonogram; a later chapter describes the humiliation and helplessness she felt both during and after giving birth. A pleasure to read, thanks to the author's ability to see her patients as individuals and to form a genuine connection with them. Author tour

Kirkus Reviews

Ofri's thoughtful and honest second book-the title is inspired by her realization, during her own amniocentesis, that conditions that seem minor to doctors are monumental when they happen to you-is equal parts The Man Who Mistook His Wife for a Hat and Kitchen Confidential.—Nicholas Confessore, New York Times Book Review

"Dr. Ofri, a physician, distills wisdom from the maelstrom of New York City's Bellevue Hospital in this emotional memoir. In a series of poignant vignettes, the internist grapples with the hearts of the sick, literally and metaphorically. Her patients range from the terminally ill to manipulative hypochondriacs, from veiled Bangladeshi women to convicted felons. A must-read for students of psychology and medicine in need of a lesson in compassion."—Psychology Today

"Danielle Ofri is a finely gifted writer, a born storyteller as well as a born physician."—Oliver Sacks

"Ofri has so much to say about the remarkable intimacies between doctor and patient and how doctors come to understand their powers and limitations."—Perri Klass

"[Ofri's] writing tumbles forth with color and emotion . . . An important addition to the literary canon of medicine."—Boston Globe

"Ofri supported a postgraduate semisabbatical by taking temporary assignments, filling in where needed at a variety of hospitals and clinics as she traveled the country. The experience, originally planned as a quasi vacation to recover from the rigors of medical residency, resulted in much more than she bargained for. Indeed, Ofri learned more-the incidental findings of the title-about the softer emotional underbelly of medicine than she had picked up clinically . . . Good writing + good doctor = good reading."—Booklist

"Incidental Findings is a beautiful book. Ofri has enough faith in her patients, her profession, and herself to tell it all."—Robert S. Schwartz, M.D., New England Journal of Medicine

"The writing is engaging, and I highly recommend Incidental Findings to anyone who wants to read a short, well-written, and thought-provoking book."—Jason Chao, Journal of the American Medical Association

"A pleasure to read, thanks to the author's ability to see her patients as individuals and to form a genuine connection with them."—Kirkus Reviews

From the Publisher