Departing lessons (book excerpt: Final Exam)

Massachusetts transplant surgeon Pauline W. Chen, MD, writes about how she learned to become more compassionate toward dying patients and shows physicians ways to enhance end-of-life care.

By Pauline W. Chen, MD, AMNews contributor. April 9, 2007.

Book Excerpt
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This excerpt explores Dr. Chen's early interest in medicine and her introduction to death in medical school.

The dissection of the human body had fascinated me since I was 7 years old. I had some idea back then that I might want to become a doctor. At the time my Agong [maternal grandfather] had just been diagnosed with a brain tumor, and my mother took my younger sister and me back to Taiwan for the summer to be with him. The diagnosis, the operation, and the neurologic deficits resulting from the removal of a part of my grandfather's brain would eventually color the rest of my grandparents' lives together. Nonetheless, at the time I was enthralled by the way his neurosurgeon comforted my grandmother and family. He was a big, bald Taiwanese man, with a round face, hands like bear paws, and a demeanor that was at once humble and confident. When he came out to the waiting room to an audience of anxious family members, his words -- "I got it all out" -- fell on us like a great light from the heavens. That experience convinced me that medicine was the work of gods.

An aunt who was in medical school at the time heard about my interest and offered to take me to her anatomy lab. I was fascinated by the idea that there might be secrets about life and death lurking there. At that age I already had come to believe that dissection was the greatest event that separated physicians from the rest of us. To be able to stomach such an experience, I thought, would prove my mettle, and to sneak a peek into the inner workings of a body -- a dead body, no less -- would put me in a league beyond any other second-grader I knew. My parents, however, quickly vetoed the idea, fearing that such a close-up and possibly gruesome experience might scar me permanently.