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No Apparent Distress: A Doctor's Coming-of-Age on the Front Lines of American Medicine
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No Apparent Distress: A Doctor's Coming-of-Age on the Front Lines of American Medicine

4.02  ·  Rating details ·  672 ratings  ·  124 reviews
In medical charts, the term “N.A.D.” (No Apparent Distress) is used for patients who appear stable. The phrase also aptly describes America’s medical system when it comes to treating the underprivileged. Medical students learn on the bodies of the poor—and the poor suffer from their mistakes.

Rachel Pearson confronted these harsh realities when she started medical school in
Hardcover, 260 pages
Published May 9th 2017 by W. W. Norton Company
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Apr 10, 2018 rated it really liked it
No Apparent Distress: A Doctor's Coming of Age on the Front Lines of American Medicine by Rachel Pearson, MD is a 2017 W.W. Norton Company publication.

This book is an eye-opening shocker told from the personal experience of Rachel Pearson a young woman who enters the medical profession and trains in various public hospitals and small town clinics, learning the hard way that despite her compassion and will to care for patients, the poor and uninsured face more challenges in getting the care they
When Rachel Pearson was a medical student at the University of Texas Medical Branch in Galveston, she was given the opportunity to work at the St. Vincent community clinic. Medical students who volunteered there were able to acquire “hands on” experience while working with poor, uninsured patients who were primarily minorities, as well as with prisoners in the nearby correctional facility.

In this revealing memoir, Dr. Pearson sheds light on the injustices imbedded in the American health care sy
I’d recommend this clear-eyed insider’s glimpse into American health care to readers of Lab Girl and surgeon Henry Marsh. Like Hope Jahren’s memoir, it’s a detailed and earnest story of finding a scientific vocation; like Marsh’s books, it has something of a confessional tone. Rachel Pearson is keenly aware of her failings as a trainee doctor and expresses regret about the patients she didn’t save due to her greenness. She opens and closes with the story of Mr. Rose; she missed a tumor the siz ...more
Jul 16, 2017 rated it it was amazing
as someone who's spent four years working with mentally ill homeless people, i relate strongly to the feeling that, to paraphrase the author, your life becomes unspeakable. the vast majority of the world can't handle these stories, but you need to let them out somewhere. where do they go? rachel pearson turned hers into art. mostly pitch-perfect little keyhole-glimpses into a world that is impossible to explain, to define, to really convey the true meaning. it's difficult to put down, mesmerizin ...more
Canadian Reader
Pearson has written about her fairly recent medical training in south Texas in a sort of hybrid memoir/social justice issues piece. She includes a few representative details about her childhood. The daughter of hardworking, poor, and, for some time uninsured parents, she—and her brother—were much loved and very clever. Originally planning to pursue a career as a writer, she realized through discussion with her dad that she preferred practical work, whose impact could be seen and felt. Medicine j ...more
Jan 21, 2017 rated it it was amazing  ·  review of another edition
If you are deeply concerned about the plight of the poor in America—and, in particular, the roadblocks they face in getting even the smallest health care need met—then this is going to be an extremely difficult book for you to read.

As I write this review,the date is currently January 23, 2017. Three days ago, Donald Trump was inaugurated as the 45th President of the United States of America. The House of Representatives and the Senate is in Republican control and it’s just a matter of time befor
Sep 24, 2017 rated it liked it
Shelves: audible
This is a pretty good book but it had some problems that made it very tedious at times. Her editor should have told her that if a character in your book appears for a short finite time you do not need to give their entire life history and your reader most definitely does not want to read that. Going with your brother on a commercial fishing trip is interesting; a detailed description of how the boat and commercial fishing works is not, at least not in a medical memoir. This is more a memoir than ...more
Jamie Holloway
Mar 06, 2017 rated it it was amazing
I liked reading about a doctor and her journey through school and life and with her patients. I know I sometimes forget that doctors are humans with emotions. This is a good book for viewing doctors as humans who feel and do care about their patients.
Apr 28, 2018 rated it liked it
Shelves: health-medicine
This book shows in no uncertain terms the inequities of our current health system. I knew there were major problems, but never had read about people who are diagnosed with, for example, cancer and who can't get any medical help for it. They are literally turned away from all the hospitals and assistance programs in a pretty wide area. I thought there was more of a safety net than there actually is. At least, there's hardly any safety net in Texas, and those who are poor and nonwhite fall through ...more
Theresa Smith
May 22, 2017 rated it did not like it
It boggles the mind that someone who wants to save lives begins her book with stories of abortions. She chose stories that may, to her, have shown compassion for a woman but, in reality, displayed a total lack of empathy and concern for the woman and especially for the babies. How can you go through so much expense and study and work to save others and yet so casually destroy human life and present it as a good? Women deserve better than this.
Oct 03, 2018 rated it really liked it  ·  review of another edition
A lot of familiar lessons that I am glad to keep thinking about.
Eric Wurm
May 08, 2017 rated it really liked it
Shelves: first-reads
It can be difficult for a patient to understand just how much a physician must experience in order to be called "Doctor". Dr. Pearson takes us on her quest through the trials and tribulations on her way to taking the hippocratic oath. Hippocrates surely had less philosophy to master than the modern day practitioner.

Whether its dying patients or turning away the cancer-diagnosed for lack of funding, Pearson elucidates the struggle to achieve care for the sick even in the age of the Affordable Ca
Jun 02, 2017 rated it really liked it
Thought-provoking. New and relevant perspectives about healthcare in the United States.
Jul 18, 2017 rated it really liked it  ·  review of another edition
Is health care a "human right"? If so, what does that mean in practice?

In my profession in the social work field in a hospital, I see many of the injustices that Pearson writes about on a day-to-day basis. Luckily, the state I live in has expanded Medicaid to help many more people, so it's not quite as desperate as she describes. However, I appreciated her insight into the other ways that medicine treats the poor badly - through experimentation and practice, to name a few - as well as how her pr
Oct 29, 2017 rated it really liked it
Shelves: reviews-given
pretty good writer... engrossing read. the whole premise was about the disillusionment of the free-medical care system and bureaucracies and such but she then closes with how without those experiences it wouldn't have made her the would-be doctor and human she is today... it was like she had to write a paper or this novel was a dissertation of some sorts where she had to put some positive acknowledgements of the system so she doesn't get ostracized by the medical community. Which totally put a d ...more
Mar 13, 2017 rated it liked it  ·  review of another edition
Rachel Pearson's memoir of going through medical training in Galveston, Texas.
Reading the back cover was unnerving where she says that medical students learn
on the bodies of the poor, and the poor suffer from their mistakes. **gulp**
Some of her training took place in a clinic for the uninsured. They didn't have access
to the same tests, procedures, surgeries, that people received when they had insurance.
So unfair. But it all comes down to money. The health system favors the rich and the
white pati
May 08, 2017 rated it it was amazing
I won an advance reader's copy in a Goodreads Giveaway.

Every one of the 217 would-be killers in the House of Representatives who voted for the AHCA last week should be forced to read this book, and/or spend a day in their local safety net hospital assisting people to apply for Charity Care.

Real stories from a real doctor who worked in rural Texas during medical school.

Recommended for anyone who cares about healthcare in the US.
Jul 31, 2017 rated it it was amazing
A very timely telling of the terrors of today's medical opportunities to the less privileged. Through her schooling and clinic volunteering, Pearson experiences the heartbreak of having to let people suffer due to not having the right insurance to get them the needed care. Doing all she (and her comrades) can to help those in need, it leaves an abyss of what can actually be done. I was surprised that she admitted to a number of medical errors she made in her training, but applauded her frankness ...more
Nov 13, 2018 rated it it was amazing  ·  review of another edition
This book was EXCELLENT. Rachel is the kind of doctor I would want treating my parents. I appreciated her candor as she highlighted the rigors of med school and the things she wished she’d done differently. I’m not a physician but I have patients who have stuck with me since my pharmacy training. Patients who made an impact on me and influence my practice to this day. This book is a memoir of Rachel’s medical school experience but it’s also an example of the way our medical system fails people o ...more
This book has many layers of meaning that explored the lesser known areas in the high profile subject matter, that is medicine, which most people claim to know a great deal about. “No Apparent Distress” is such a substantive title. It’s true that the best way to go about empathising with others is to experience what others have experienced, but the fact of life is we can’t live out ten thousand different lives just so we can empathise with the many people we encounter. But we can hear out their ...more
Laura Jean
Jun 01, 2018 rated it it was amazing
This is a fascinating look at the evolution of a doctor. It's also a pretty insightful insider's look at health care for the indigent and working poor in Texas. Finally, I found the author's philosophies about working in medicine and helpful for me as a librarian. I often also deal with ill and/or indigent patrons, and I want to provide the best service I can, while still not burning out. So I tried to consider some of her ideas for myself.
Nov 09, 2018 rated it it was amazing  ·  review of another edition
Shelves: audio-books
his is a great story of one womans quest to give care to her patients. its also a good outline of how many people pur system fails due to its need for money over people. hopefully one day we can get care for everyone regardless of socio-economic status.

I enjoy journalistic medical account and this was a great combo by an actual doctor. sometimes doctors writing can be very dry or clinical but this infused emotion and was able to get some great info out.

I highly recommend this book.
Jenni Ritchie
Oct 18, 2018 rated it it was amazing  ·  review of another edition
I wish everyone could gain the insights on the US healthcare mess that the author relates in this account of her medical training experiences. While the stories themselves are quite interesting, I could picture them well since they are mostly set in the Galveston area and the impact of recent hurricanes is discussed.

There is even less of a safety net for the uninsured than I imagined. It will make you think about medical ethics and humane treatment.

Admirable storytelling and honesty about her o
Aug 15, 2017 rated it it was amazing
This book was beautifully written and kept me turning the pages way past my bedtime. The author was vulnerable without being overly confessional. The book was in a lot of ways just as political as it was personal, without ever hitting you over the head with its message. That said, I wish everyone who feels healthcare is a privilege, not a basic human right, would read this book.
May 13, 2017 rated it really liked it
Shelves: new
Dr Pearson honestly describes her journey, successes, and failures through medical school challenges and the healthcare system itself. She touches on the struggle individuals face determining their roles, balancing personal issues with rigorous studies as a student and later balancing their humanity with the cold realities of medical possibilities and financial restrictions. It is a timely look at the inequalities of our healthcare system (I can imagine an author's note in the paperback release ...more
Patricia Baker
Jun 14, 2017 rated it really liked it  ·  review of another edition
received advance reading copy to read and review.

loved this book. having worked in the medical field for a number of years, I have used the phrase used for the title of this book. in charting I would sum up the condition of a patient sometimes in these words. liked her story of having to work hard to get into the medical field. having worked in the abortion clinic and other places would broaden a student's outlook while working as a doctor. do not know if I completely agree that the poor people
Jan 27, 2017 rated it really liked it
Shelves: favorite-2017
Well written, compelling nonfiction about a doctor choosing to go to medical school in Galveston, Texas a year after Galveston was devastated by flooding in 2008. Pearson focuses mostly on her time volunteering as a student at a free clinic: St. Vincent's. While the university's hospital used to focus on care for people who could not afford it, they stopped providing this in large part in the years leading up to and after the flood, so many of the people who go to St. Vincent's cannot follow up ...more
Mar 09, 2018 rated it really liked it
Truly inspiring book for someone pursuing the medical field. Through Pearson's personal stories from her time in medical school and time spent volunteering at a student-run free clinic in Galveston, TX, she reveals the brokenness of the American health system, the trials of working with the uninsured, and the compassion and sacrifices it takes to be a good doctor.
Millie Mo
Jul 24, 2018 rated it it was amazing  ·  review of another edition
For anyone working in a healthcare position, NAD does a fantastic job in detailing the life of a medical professional and a journey that includes human error and lessons while working with others. The writing is honest and really makes you reflect and think on your own work with patients.
Forrest Link
Jan 31, 2017 rated it really liked it
A compelling and honest account of learning to be a physician under very difficult circumstances. Pearson is an excellent writer with a keen ear for dialog.
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