A brilliant young transplant surgeon brings moral intensity and narrative drama to the most powerful and vexing questions of medicine and the human...
read full description
reviews
Jan 17, 2009
Laurel
rated it: 
I was drawn to this book for obvious reasons (death and dying) and was excited to read a book about the medical field that wasn't all fiction-y and soap opera-y. I heard about this in the New York Times, and someone had cited it as one of the best books of 2007. After reading it, I find that title somewhat surprising, unless it was judged on the unique subject matter and not the writing itself.
Pauline Chen is a doctor, not a writer (she described a nurse's eyebrows as " More...
8 comments
like
(3 people liked it)
Aug 02, 2011
I love memoirs about medical school and doctors going through their years of training. This one, however, doesn't rank very high on my list.
First of all, Dr. Chen is not a very good storyteller. And while she doesn't present herself in a very flattering light through most of the book, she also doesn't show herself as a very sympathetic character.
She makes enlightened statements about how end-of-life care should be handled differently than it usually is by medical professionals here in the 21st More...
First of all, Dr. Chen is not a very good storyteller. And while she doesn't present herself in a very flattering light through most of the book, she also doesn't show herself as a very sympathetic character.
She makes enlightened statements about how end-of-life care should be handled differently than it usually is by medical professionals here in the 21st More...
Jan 04, 2009
Pris
rated it: 
Caring For the Ill and Personalizing Their Dying, 4 Mar 2007
"I think it's like Dr. Courtney M. Townsend, a legend in surgery and a personal hero, recently told me. "We have two jobs as doctors: to heal and to ease suffering. And if we can't do the former, my God we better be doing the latter." Pauline Chen
A few years ago I was part of a poetry group of medical providers. We shared poetry written by or for medical providers that More...
Jan 05, 2012
I liked it. I think it's a good topic and decent book for future and probably also current doctors and nurses.
This part about a benefit of residents working insane hours interested me:
pg 86 - 87
At 4:30, after the operation was essentially done, the attending surgeon left my close friend Susan, also a surgical fellow, and me to finish closing up the patient's skin. Together she and I had been up for over forty-eight hours. To hurry us along and prevent us from falling ove More...
This part about a benefit of residents working insane hours interested me:
pg 86 - 87
At 4:30, after the operation was essentially done, the attending surgeon left my close friend Susan, also a surgical fellow, and me to finish closing up the patient's skin. Together she and I had been up for over forty-eight hours. To hurry us along and prevent us from falling ove More...
Jan 13, 2011
MCOH
rated it:
Pauline Chen does a great job of letting us into her world - we see what it's like to become a surgeon and deal every day with death and dying, guilt and anxiety, grief-stricken family members, a grueling work schedule, and the constant pressure to defeat death, to save each and every patient forever - an obviously impossible task.
While I appreciated Chen's perspective, for me, the issues are framed so differently. When I think about death, I think about working now towards creating a More...
While I appreciated Chen's perspective, for me, the issues are framed so differently. When I think about death, I think about working now towards creating a More...
May 12, 2010
Kim
rated it:
The author, a surgeon, writes about death from a doctor's point of view, which is to say, a point of view completely uncomfortable with death. She recognizes this, and has spent the past few decades of her practice moving toward a place where she can truly be with people at the end of their life, rather than seeing death as a failure of her attempts to cure them. She touches on the policy and educational changes in the medical community to better address end of life and palliative care issues,
More...
Dec 18, 2009
Charles
rated it:
Hospital shows – ER, Grey’s Anatomy, House and so on – have inured us to the sight of the moist workings underneath the skin, and inspired us with the drama of dedicated (and usually good-looking) young doctors saving lives. As for death, Luka and McDreamy and Gregory House take it in their stride – on TV it’s just the occasional unfortunate byproduct of so much heroism.
Pauline Chen, a real-life surgeon, has another way of looking at it. Death is one thing medical school doesn’t do a More...
Pauline Chen, a real-life surgeon, has another way of looking at it. Death is one thing medical school doesn’t do a More...
Oct 24, 2010
Chuck
rated it: 
It seems to be well-known, at least anecdotally, that medical specialists often lack emotional rapport with their patients. This can be especially troubling if the diagnosis is dire, and the patient wants to talk about end-of-life issues. What's the source of this difficulty? Do particular medical specialties tend to attract emotionally constipated individuals, or is there something endemic to physician education that exacerbates the problem? In Final Exam Dr. Pauline Chen reflects on this q
More...
Sep 26, 2011
Lindsay
rated it:
"For doctors, care at the end of life is, as this book's title implies, our final exam."
Dr. Pauline Chen composed a series of nine reflections from her experiences in medical school, internship, and residency. Through these stories and reflections, Dr. Chen comments and criticizes how she as a doctor was taught to deal with death of a patient, how to interact with the patient's family, but most importantly, what to do when you know your patient is going to die in a day/week/mont More...
Dr. Pauline Chen composed a series of nine reflections from her experiences in medical school, internship, and residency. Through these stories and reflections, Dr. Chen comments and criticizes how she as a doctor was taught to deal with death of a patient, how to interact with the patient's family, but most importantly, what to do when you know your patient is going to die in a day/week/mont More...
Sep 07, 2011
Zack
rated it:
This book is exactly what the title describes: it's a transplant surgeon's reflections on mortality. Pauline Chen discusses a number of events and patients she's encountered, mostly from med school through her post-residency transplant surgery fellowship, and how each of them in some way has shaped or is emblematic of her own feelings about death. She identifies fear of death and reluctance to discuss it as a significant and pervasive problem in medicine, and doesn't fail to hold herself account
More...
Jun 24, 2011
Ann
rated it:
A surgeon's reflections on death and dying. It's particularly insightful as Chen's work is in transplants--she has spent time harvesting organs from those who are brain dead, as well as doing liver transplants on children and adults. She incorporates a lot of research into her discussion, and this outlines why physicians don't have end of life discussions with their patients (time, training, fear of death, the # of sub specialists involved in patient care who always assume someone else has had
More...
Jun 09, 2011
Mohamed
rated it:
This book takes the reader into the views of transplant surgeon Dr. Pauline Chen on the issue of patient mortality. She was born to Taiwanese immigrants who came to study at Harvard University in Cambridge,Massachusetts. As a child she was attracted to medicine through the means of plastic see through dolls which showed the underlying human anatomy. After finishing high school, Dr. Chen attended Harvard and completed Medical school at Northwestern Medical school in Chicago,Illinois.
More...
Jan 30, 2009
Peter
rated it:
This is a book everyone should read. It's not easy - she deals with the difficult issues of death and with her own and our mortality. Her perspective is that of a physician dealing with dying on a daily basis. But it is also an issue that sooner or later we all deal with related to our loved ones and eventually ourselves. The vivid clinical descriptions made me stop in places to take a few deep breaths before continuing, but they served the purpose of focusing my attention and making reading a d
More...
Oct 07, 2011
Sarah
rated it: 
This is certainly not a feel-good, enjoyable read in the sense of warm fuzzies, but I believe it is something that most people should pick up if they have time. I wanted to include in my review my favorite lines from the book, as Dr. Chen is a very eloquent writer, but I realized quickly I would basically be copying the entire book. She covers some VERY controversial topics such as * how far DO you go with treatment in the face of a horrible prognosis, * why would you stop treatment, * why wou
More...
Feb 16, 2009
Frank Jude
rated it:
The subtitle of this book says it all: "A Surgeon's Reflections on Mortality." Pauline Chen is a transplant surgeon with an apparently uncommon sense of reflective thinking. While reading this book, I was moved by the realization of how much suffering -- both the buried, denied suffering of medical staff, and the often confused, scared suffering of dying patients -- is caused by western medicine's framing of death as defeat!
Chen makes the case that only when doctors face t More...
Chen makes the case that only when doctors face t More...
0 comments
like
(1 person liked it)
Dec 27, 2009
Louis
rated it:
Not long ago, I was at a Pittsburgh Symphony Concert which had pieces that reflected on death and mortality Pittsburgh Symphony: reflections on death. This is another view of the topic, in this case the final exam is for doctor's, who have to face the fact that their patient is facing death and how dealing with this should be part of the doctor's profession. Pauline Chen, a transplant surgeon, makes the case that (1) providing care in death is not part of a regular doctor's training, (2) it r
More...
4 comments
like
(1 person liked it)
Jul 30, 2009
Mike
rated it:
Thought this would be a good book to read as the health care debate unfolds in the US. I highly recommend the book to anyone in the medical professions, but think there are more appropriate treatises on death and mortality for other audiences. Mary Roach's Stiff: The Curious Life of Human Cadavers offers a more lighthearted glimpse into that which awaits us all. For a philosophical and psychological examination of mortality, Ernest Becker's The Denial of Death is indispensable and potentially li
More...
0 comments
like
(1 person liked it)
May 12, 2009
Jackie
rated it:
This book gets four stars mostly because I was so impressed to see a surgeon reflect on death and dying -- a topic so often ignored by physicians. Chen is open and frank about her experiences and even admits to her own failings in certain patient cases. I highly recommend this book to those who are dealing with serious illness in their lives. Most readers will come away from the book better understanding the tough questions patients should ask their doctor about treatment/likely outcomes/qual
More...
Jul 21, 2009
Debi
rated it:
I liked this book- very informative- but not for the feint of heart if you get uncomfortable about medical things, death. The author takes us through her years as a medical student, intern, resident as she trains to become a transplant surgeon. It is a real insider's look at not only the life of the hospital setting, but what went on in her mind as she learned that dealing with death both professionally and personally is a very big part of every doctor's training. She writes well and really l
More...
Jul 11, 2011
Jupie
rated it:
This was one of the books I read for my Bedside Harp courses. It was an interesting look at how a doctor is trained. It showed the intense training and how they have to put the rest of their lives on hold until they finish the many years in school. She also has to come to terms with death and how it is thought of. As a doctor, she is to keep people alive, but she has an understanding that people should die with dignity.
Doctors were not taught how to deal with dying patients. They More...
Doctors were not taught how to deal with dying patients. They More...
Feb 05, 2009
In her first full-length book, Pauline W. Chen, a liver-transplant specialist, shares her unique perspective and her wealth of experience, having honed her skills at some of the world's most prestigious medical institutions__including Harvard, Yale, and UCLA. Chen showcased her writing ability as a finalist for a National Magazine Award in 2006 with her essay "Dead Enough? The Paradox of Brain Death," and critics applauded the portraits in Final Exam for their insight and the author's
More...
Oct 06, 2009
Sarah
rated it:
Probably the medical side of me helped me enjoy this so much. There were parts that were a bit overfilled with stats or medical jargon probably only MDs would find interesting and/or care about, but I really enjoyed the stories intertwined in Dr. Chen's medical career, from med school, to intern and resident, to years of being an accomplished surgeon. Along the way her eyes were opened to the fact that terminal patients are not receiving the best care from their Drs. and often the best care on
More...
May 31, 2009
Laura
rated it:
An easy read with some bits of wisdom to take away, but it's going a little too quickly for my liking. I just realized the last 30-40 pages are notes, so two very casual sessions with this book have brought me more than halfway through.
Finished: Interesting, quick read for medical students. There were moments of her medical school training that hit a very similar note with my own experience, and many of her later struggles in residency and fellowship I could see a future version of More...
Finished: Interesting, quick read for medical students. There were moments of her medical school training that hit a very similar note with my own experience, and many of her later struggles in residency and fellowship I could see a future version of More...
Sep 07, 2010
L
rated it:
Great book exploring medicine & mortality.
Things I liked..
- lots of stories, from her time as a medical student & resident to her experiences as a practicing surgeon
- reflections on medical culture and its attitude of immortality (every death is a result of an error, preference for aggressive treatment rather than palliative care).
- Chen's honesty about her struggles and fears with mortality and times when she was not the best doctor she could have been
Overall More...
Things I liked..
- lots of stories, from her time as a medical student & resident to her experiences as a practicing surgeon
- reflections on medical culture and its attitude of immortality (every death is a result of an error, preference for aggressive treatment rather than palliative care).
- Chen's honesty about her struggles and fears with mortality and times when she was not the best doctor she could have been
Overall More...
Jan 07, 2011
Terri
rated it:
I really enjoyed this book. The author is a well-versed writer, and her story is a unique and touching one. The only drawback is that there were situations and patients she described that affected her greatly, detailing their impact on her, drawing you in, but not providing a conclusion. I was left wondering what had happened to the patient or people that she had dealt with at times because she was focusing on demonstrating how deeply it touched her, but left out a key part for me... so what HAP
More...
Oct 02, 2011
Melissa
rated it:
If I had to pick a surgeon, this author may definitely be the one I would chose. I picked up this book to get a better understanding of the doctors I am dealing with during my internship and I have to say I now have a much deeper respect for medical doctors overall than I did before. The first chapter is all about the trials and tribulations of working with and through a cadaver from head to toe in Gross Anatomy and how that experience defines a doctor's life. I realized right after that chapter
More...
Jun 26, 2008
Stacy
rated it:
A Dr. admits how the medical field doesn't take care of dying people very well--very much appreciated that someone comes clean about this :). After witnessing what my grandmother went through being shuffled from hospitals (3) to nursing homes (2) with poor consistency in paperwork and finally getting relief with hospice, I'm glad that this book is out there. Dying is not fun to watch or be around, but it's a fact of life. I was more at peace with my grandmother's death than her suffering through
More...
Jun 08, 2010
Becca
rated it:
Final Exam is a beautiful, moving piece of non-fiction. Both scholarly and intensely personal, Dr. Chen's first book is a concise but thorough description of her own experiences with death and dying throughout her medical training and the effect it has had on her professional and personal relationships with the dying. Her experiences are largely universal -- her descriptions of her first patient whose death she felt responsible for echoed -- and she backs them up with citations from the medial
More...
Apr 06, 2008
Kate
rated it:
While most of us would prefer to die in an instant in our sleep, the reality is that nine out of ten of us will die of a prolonged illness like cancer, diabetes, congestive heart failure, dementia or some other ghastly slow, creeping malady. That being the case, how prepared are our physicians to walk us through those final miles of life? According the Chen, not very. She describes why physicans have such a tough time with death through her own moving experiences and reactions to dying patient
More...
Jan 28, 2008
Nanci
rated it:
Library Journal says: "Numerous articles and books have shown that many physicians do not know how to treat terminally ill patients appropriately and humanely. Some physicians, in fact, use extreme and futile medical interventions to treat dying patients, with little regard to their costs, the pain and suffering they cause, or even the patients' own wishes. Chen, a young Asian American transplant surgeon, further addresses this profound paradox of medicine?a profession premised on caring fo
More...
