|Genre||Case Study (255 pp.)|
|Keywords||Acculturation, Art of Medicine, Catastrophe, Childbirth, Communication, Depression, Doctor-Patient Relationship, Empathy, Grief, Impaired Physician, Infertility, Marital Discord, Medical Education, Medical Mistakes, Narrative as Method, Physician Experience, Power Relations, Professionalism, Psychotherapy, Suffering, Suicide, Women in Medicine|
Subtitled "The Story of a Gifted Young Obstetrician's Mistake and the Psychologist Who Helped Her," this is an absorbing account of a young female physician's torment following the difficult delivery of a baby who was soon thereafter diagnosed with cerebral palsy. "Doctor Amelia" seeks counseling after she has taken an indefinite leave of absence from her practice and faculty position. The book intertwines reconstructed counseling sessions in the voice of the doctor-patient, with the therapeutic strategy and personal reflections of her therapist, author Dan Shapiro.
The obstetrician enters therapy because she has lost confidence in her professional abilities. Once deeply engaged in her chosen profession, she has lost her enthusiasm for it and feels "numb." Her marriage is under strain. When asked if she is suicidal, she hesitates and then denies she is. Shapiro thinks there may be trouble ahead, and so does the reader. Gradually, Doctor Amelia reveals the incident that triggered her changed emotional state. She had delayed performing a cesarean section on a patient who was in extended labor and whose baby was showing deceleration of its heartbeat rate. A few weeks later, the baby's pediatrician informed Doctor Amelia that the baby had cerebral palsy and now the baby's parents are filing a lawsuit.
This is a work of creative nonfiction, based on a true story that has been somewhat modified to protect patient confidentiality. Amelia's monologues, rendered in italics, were reconstructed from the author's session notes. Amelia's narrative is gripping and her exploration, with Shapiro's help, of the psychodynamic that resulted in such profound depression (she does attempt suicide) is revealing. Although it turns out that the delivery process may not have caused the child's cerebral palsy, there seems to be no question that mistakes of judgment were made.
The book raises important issues--how physicians are trained to suppress emotions, how mistakes have a profound impact on the physicians who make them (that is--virtually all physicians) yet frank discussion of this impact is rare. Also important and not often articulated (as Amelia does) is the "feeling like a fraud" syndrome that many young professionals, especially women, experience.
A parallel narrative concerns the experience that therapist Dan Shapiro and his wife have with fertility experts. Shapiro, before being treated for Hodgkin's disease (see Mom's Marijuana, annotated in this database), had banked his sperm; he and his wife are attempting to conceive their second child during the course of Doctor Amelia's therapy. In telling his story along with Amelia's, Shapiro conveys his own (sometimes negative) reactions to what he is hearing during his sessions with her. Physicians and psychotherapists, Shapiro argues, are human beings with human responses to challenging circumstances. He makes the case that such humanity must be acknowledged and incorporated into personal and professional life, in order to serve best those one is trying to help.
|Publisher||Random House: Harmony|
|Place Published||New York|
|Annotated by||Aull, Felice|
|Date of Entry||01/19/04|