Equal Partners: A Physician's Call for a New Spirit of Medicine

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Summary: Medicine from the inside, and it's not pretty
Review: Despite its bland title this is a harrowing expose of the relationship between doctors, hospitals and patients. It's also a moving personal story about catastrophe, agonizing recovery and adjustment.

A week after graduating with honors from Harvard Medical School, Heymann suffered a severe seizure and was rushed to the emergency room. Awakening with no memory of the event, she found her arms and legs strapped to a hard slab. Unable to move, surrounded by strangers, she was terrified and kept calling for her husband, wondering what "they" had done to him. No one answered her cries.

And this was only the beginning. As Heymann describes the nightmare of awaiting diagnosis, clinging to the stoicism she learned as a medical student - good patients are quiet patients - she begins to understand that hospitals are constructed around the convenience of the professionals. She reflects on the small things that might ease a patient's anxiety - knowledge mostly. Explanations about what is happening and what they can expect of themselves on release.

Heymann had bled into her brain and surgery was recommended. The operation was botched, through medical oversight, but Heymann's anger about this is less than her anger at the lies, evasions and brush-offs which follow. After numerous conflicting reports, her doctor tells her the hemangioma had all been removed. But one of the books most chilling passages comes later. The pathologist's study concluded that her hemangioma had not been removed. Her doctor never informed her of this report (she does not say how she learned of it).

Discharged after surgery, Heymann is so weak that watching television is too taxing and caring for her toddler son is impossible. No one was prepared for the sort of care she would need. And Heymann herself refuses to compromise her ambitions. She believes strongly that meaning in life comes from helping others. She and her husband (also a doctor) had always intended to work in a clinic in a third world country. They also want a second child.

So she embarks on her grueling internship as soon as possible, terrified of the seizures which may wreck her career. Numerous heart-tugging case histories are interspersed with her own halting progress. Explaining procedures and home care to her patients, she shows how the frightened "difficult" patients are calmed and easier to treat when given a modicum of understanding.

This well-written, moving and deeply scary memoir should be widely read but probably won't be. In a letter Heymann wrote to the New England Journal of Medicine protesting prejudice against people with seizures she described herself as "a physician who has both treated patients with seizures and lived with seizures." The Journal removed only four words. "They would not print that I had lived with seizures, only that I had treated others."