A review by brothena
In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope by Rana Awdish
emotional
informative
reflective
medium-paced
2.0
This book came out (and I remember hearing about it) during my last year of residency. I distinctly recall speaking to one of my inpatient attendings about it and resolved to read it, even though I typically avoid reading medical-adjacent books since I read to disconnect from that part of my brain. So here I am, 5 years later picking it up as I try to chip away at backlist titles. Consumed on audio which is NOT read by the author (as evidenced by mispronunciation of medical jargon, frequent spelling out N.I.C.U, etc).
I think I may have enjoyed this book more had I read it while in training, or while I was actively in an inpatient setting. I'm an outpatient primary care physician, and as such, have to take into account patient values, logistics of attaining medication/ treatment, and engage in shared-decision-making on a 25-times-a-day basis. As such, the big morals of the importance of keeping these things in mind felt unnecessarily preachy and redundant to me as this is the crux of my field, but is decidedly much more difficult in higher acuity situations such as inpatient / emergency practice.
I also felt very scoff-y at the segment where Awdish is caustic towards the attitude of an attending who told her during her training of the importance of depersonalizing patients in order to not become too emotionally involved to focus on appropriate medical decision making. In high-acuity care scenarios, this IS applicable, but you would be hard-pressed to find a physician who would advocate this mindset all the time. A degree of emotional separation needs to be in place in order to be able to move on to the next patient after seeing devastating outcomes. It felt so overly simplistic an attitude to just say "hey, you should really care about and for your patients, let yourself get emotionally involved" as it so clearly can cloud judgement in extremes. There is a time and a place, and I've never felt unprofessional or been made to feel that way when I have cried with patients, but girl-- during a resuscitation (which is the example used) is just NOT THE TIME.
I was similarly HUH about the section regarding physician suicide, and again wondered how long ago Awdish was in training, as this is widely known to be a big issue in the field and can't imagine any residency program responding as callously as hers purportedly did.
I did appreciate her candor in discussing how isolating being a physician can feel in terms of decompressing after the gravity of discussions being held on a daily basis, and often feel lucky that my partner is also in the field and do not have to wrestle with not having that outlet (her partner is not in medicine).
Also, in reading these reviews I am VERY EYEROLLY at the reviews that essentially preach WELL OF COURSE, ALL PHYSICIANS ARE HEARTLESS ASSHOLES AND NURSES ARE THE TRUE EMPATHS. Everyone in this field has encountered both of these, but the inverse can also be true. Nurses have more face-to-face time with the patients, which can and often creates an invaluable bond and information source, but to extrapolate that most physicians simply don't "care enough" to "take the time" is so wildly offensive, simplistic, and inaccurate.
Also, in reading these reviews, do not agree with the sentiment that Awdish is some sort of sociopath in how she dealt with the loss of her first child. When you are in the field and have the ability to intellectualize grief over something so emotionally gutting, I think this can be a natural response.
Overall, I think this can be a humbling read for physicians that can serve as a reminder as to how powerless it can feel to be a patient, and how much weight phrasing and verbiage can have, but definitely think it's written in the extremes. Not sure if I would recommend widely, or even if I"m glad I read it, but think it may have just felt redundant to me based on my specialty.
I think I may have enjoyed this book more had I read it while in training, or while I was actively in an inpatient setting. I'm an outpatient primary care physician, and as such, have to take into account patient values, logistics of attaining medication/ treatment, and engage in shared-decision-making on a 25-times-a-day basis. As such, the big morals of the importance of keeping these things in mind felt unnecessarily preachy and redundant to me as this is the crux of my field, but is decidedly much more difficult in higher acuity situations such as inpatient / emergency practice.
I also felt very scoff-y at the segment where Awdish is caustic towards the attitude of an attending who told her during her training of the importance of depersonalizing patients in order to not become too emotionally involved to focus on appropriate medical decision making. In high-acuity care scenarios, this IS applicable, but you would be hard-pressed to find a physician who would advocate this mindset all the time. A degree of emotional separation needs to be in place in order to be able to move on to the next patient after seeing devastating outcomes. It felt so overly simplistic an attitude to just say "hey, you should really care about and for your patients, let yourself get emotionally involved" as it so clearly can cloud judgement in extremes. There is a time and a place, and I've never felt unprofessional or been made to feel that way when I have cried with patients, but girl-- during a resuscitation (which is the example used) is just NOT THE TIME.
I was similarly HUH about the section regarding physician suicide, and again wondered how long ago Awdish was in training, as this is widely known to be a big issue in the field and can't imagine any residency program responding as callously as hers purportedly did.
I did appreciate her candor in discussing how isolating being a physician can feel in terms of decompressing after the gravity of discussions being held on a daily basis, and often feel lucky that my partner is also in the field and do not have to wrestle with not having that outlet (her partner is not in medicine).
Also, in reading these reviews I am VERY EYEROLLY at the reviews that essentially preach WELL OF COURSE, ALL PHYSICIANS ARE HEARTLESS ASSHOLES AND NURSES ARE THE TRUE EMPATHS. Everyone in this field has encountered both of these, but the inverse can also be true. Nurses have more face-to-face time with the patients, which can and often creates an invaluable bond and information source, but to extrapolate that most physicians simply don't "care enough" to "take the time" is so wildly offensive, simplistic, and inaccurate.
Also, in reading these reviews, do not agree with the sentiment that Awdish is some sort of sociopath in how she dealt with the loss of her first child. When you are in the field and have the ability to intellectualize grief over something so emotionally gutting, I think this can be a natural response.
Overall, I think this can be a humbling read for physicians that can serve as a reminder as to how powerless it can feel to be a patient, and how much weight phrasing and verbiage can have, but definitely think it's written in the extremes. Not sure if I would recommend widely, or even if I"m glad I read it, but think it may have just felt redundant to me based on my specialty.