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In Two Voices
For a decade, Linda Clarke and Dr. Michael Cusimano had offices across from one another at St. Michael's Hospital in Toronto. She worked in Clinical Ethics and he was a staff neurosurgeon. They knew one another to say hello, to nod as they passed one another on the stairs, to wish each other a Merry Christmas. Michael's patients sat in the chairs along that shared hallway, waiting for their appointment with him. For ten years, Linda heard their talk outside her door, smiled at them as she passed by, tried to give them their privacy. She was always impressed by the things people endured.
Ten years into her work, Linda got sick; she left her job and, weeks later, she sat in one of those hallway chairs, waiting for her appointment with Dr. Cusimano. In the blink of an eye, she was a neurosurgery patient and he was her surgeon.
Linda and Michael wrote In Two Voices together: it is the intimate account of Linda's surgery with Michael as her surgeon. The story builds a piece at a time as Linda and Michael tell each other their experience and then respond to one another's writing. As the relationship shifts from one of patient and surgeon to one of Linda and Michael as colleagues and friends, they encounter surprises as their trust and mutual understanding develop. Here is an unprecedented view into the experiences of illness, care, and compassion, an intimate picture of the experiences, challenges, skills, and commitment of a surgeon. The worlds of both surgeon and patient are framed by a most critical and delicate surgical procedure.
Ten years into her work, Linda got sick; she left her job and, weeks later, she sat in one of those hallway chairs, waiting for her appointment with Dr. Cusimano. In the blink of an eye, she was a neurosurgery patient and he was her surgeon.
Linda and Michael wrote In Two Voices together: it is the intimate account of Linda's surgery with Michael as her surgeon. The story builds a piece at a time as Linda and Michael tell each other their experience and then respond to one another's writing. As the relationship shifts from one of patient and surgeon to one of Linda and Michael as colleagues and friends, they encounter surprises as their trust and mutual understanding develop. Here is an unprecedented view into the experiences of illness, care, and compassion, an intimate picture of the experiences, challenges, skills, and commitment of a surgeon. The worlds of both surgeon and patient are framed by a most critical and delicate surgical procedure.
180 pages, Paperback
Published May 16, 2019
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Displaying 1 - 4 of 4 reviews
August 8, 2019
I think it’s safe to say we’re all happy that anesthetic has been invented, but it does mean that some of the most pivotal and dramatic moments in our lives are lost to memory.
“Our stories are our skin,” writes Linda E. Clarke the architect of this groundbreaking volume, and one of its co-authors. An operation —whether fully asleep or just sedated — creates a gap in that skin, for better or for worse. In Two Voices repairs that gap, weaving together the narratives of both doctor and patient, who recount the before, during and after of a decisive brain surgery. It also includes a chapter by Linda’s husband and main support, James, thus giving rightful place to an often-silenced voice: that of the care-giver.
Dr. Michael Cusimano, the surgeon, writes of the strange isolation of the doctor/patient relationship. They inhabit the same world but have radically different experiences. Though he’s surrounded by a team of “brothers and sisters” working with him, he and the patient, he writes, are still alone in their worlds. He occupies an important role in many people's lives, yet his actions — not to mention his thoughts and feelings — go unseen and unremembered. The best-case scenario is that they move on to live healthy lives in which he never reappears.
Undergoing surgery means entrusting one’s very life to another. Yet the gap between entrusting and trusting is immense. At stake here is not only Clarke’s life but her memories, the capacity to make memory. This is the very faculty that will later allow her to write the story, and we are acutely aware that with a hair's-breadth slip of the knife, this book might not have come to be. Memory can be said to constitute the self, but the prospect of memory-loss is especially poignant in the case of Clarke, a storyteller by profession.
This is a book that breaks silences and challenges taboos, not just in creating a dialogue between patient and doctor, but in exploring the whole context of the medical incident, the memories reaching back to childhood which bring these two characters together for those few key hours in their lives. The operation is long, in operation-time, but it occupies a small part of the book.
The people have long-standing relationships to illness, which they bring into the surgery with them. In Two Voices fleshes out these stories, not only taking them into consideration but foregrounding them.
The introduction by doctor-writer Brian Goldman quite rightly remarks upon the significance of this book in medicine and medical education, but there are no easy answers presented. If a clear lesson emerges, it is about the importance of patience when it comes to healing. It is an organic process, not a straight line, and it has no distinct end. The tests that the medical system uses to determine "cure" are in absolute contrast to the time it takes the patient to truly recover, and — even if symptoms abate completely — there is the integration of the event to take into consideration. It must take its place in the patient's story. This, the book demonstrates, is a lifelong process.
The concept and structure the slim volume alone make it a worthwhile read, not only for medical students but for anyone interested in boundary-pushing literature. Its risk-taking extends to the point of interrogating its own validity at times, as various characters question Clarke’s need for details about her own surgery. There’s no easy answer presented, but — as Clarke points out — storytelling itself changes things. “The story has shifted our landscape, and has shifted us as well. Such is the way of story.”
In Two Voices is, above all, a great story, in two distinct and eloquent voices, at once affecting, thought-provoking and page-turningly exciting.
“Our stories are our skin,” writes Linda E. Clarke the architect of this groundbreaking volume, and one of its co-authors. An operation —whether fully asleep or just sedated — creates a gap in that skin, for better or for worse. In Two Voices repairs that gap, weaving together the narratives of both doctor and patient, who recount the before, during and after of a decisive brain surgery. It also includes a chapter by Linda’s husband and main support, James, thus giving rightful place to an often-silenced voice: that of the care-giver.
Dr. Michael Cusimano, the surgeon, writes of the strange isolation of the doctor/patient relationship. They inhabit the same world but have radically different experiences. Though he’s surrounded by a team of “brothers and sisters” working with him, he and the patient, he writes, are still alone in their worlds. He occupies an important role in many people's lives, yet his actions — not to mention his thoughts and feelings — go unseen and unremembered. The best-case scenario is that they move on to live healthy lives in which he never reappears.
Undergoing surgery means entrusting one’s very life to another. Yet the gap between entrusting and trusting is immense. At stake here is not only Clarke’s life but her memories, the capacity to make memory. This is the very faculty that will later allow her to write the story, and we are acutely aware that with a hair's-breadth slip of the knife, this book might not have come to be. Memory can be said to constitute the self, but the prospect of memory-loss is especially poignant in the case of Clarke, a storyteller by profession.
This is a book that breaks silences and challenges taboos, not just in creating a dialogue between patient and doctor, but in exploring the whole context of the medical incident, the memories reaching back to childhood which bring these two characters together for those few key hours in their lives. The operation is long, in operation-time, but it occupies a small part of the book.
The people have long-standing relationships to illness, which they bring into the surgery with them. In Two Voices fleshes out these stories, not only taking them into consideration but foregrounding them.
The introduction by doctor-writer Brian Goldman quite rightly remarks upon the significance of this book in medicine and medical education, but there are no easy answers presented. If a clear lesson emerges, it is about the importance of patience when it comes to healing. It is an organic process, not a straight line, and it has no distinct end. The tests that the medical system uses to determine "cure" are in absolute contrast to the time it takes the patient to truly recover, and — even if symptoms abate completely — there is the integration of the event to take into consideration. It must take its place in the patient's story. This, the book demonstrates, is a lifelong process.
The concept and structure the slim volume alone make it a worthwhile read, not only for medical students but for anyone interested in boundary-pushing literature. Its risk-taking extends to the point of interrogating its own validity at times, as various characters question Clarke’s need for details about her own surgery. There’s no easy answer presented, but — as Clarke points out — storytelling itself changes things. “The story has shifted our landscape, and has shifted us as well. Such is the way of story.”
In Two Voices is, above all, a great story, in two distinct and eloquent voices, at once affecting, thought-provoking and page-turningly exciting.
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August 25, 2019There are some relationships that are deep and profound. What can be more profound than individual placing trust in a surgeon, whose task has no margin of error. Because of the obscure nature of her condition, Ms. Clarke was wary of the medical profession. Some had labelled her as a malingerer; would this one label her as such, as well. The surgeon had to gain her trust. One of her most important lines is the book is “what I know about suffering and medicine: that a compassionate response can ease the deepest suffering because it eases the isolation and the fear that the exile of pain carries. What I know: this is one of the most profound roles of medicine.”
In medical ethicist and storyteller, Linda Clarke’s and neurosurgeon, Michael Cusimano’s book, “In Two Voices: A Patient and a Neurosurgeon Tell their story,” they collaborate to expose retrospectively, their personal experience through their journey as healer and patient. Both neurosurgeon and patient recollect their memories of their journeys from childhood to this diagnosis to surgical intervention and to recovery. And we’re not talking about a routine tonsillectomy here. We’re talking about the removal of a benign tumor deep in Clarke’s brain. In this dialogue between surgeon and patient, as they recollect the path they took together, profound lessons about the nature of the doctor-patient relationship are highlighted. What I appreciated about Clarke’s story was her raw honesty and her understanding of the difference between pain and suffering – an important distinction for all healers to know. What I appreciated about Cusimano’s story was the fact that he prays before every surgery – for him and his patient, not to mention the kindness he appears to bring to his work. Clarke appeared to feel his care for her; something research tells us, promotes healing. It reflects a humility for which surgeons are not known (an unfortunate stereotype). As a psychotherapist, I deeply appreciated the insights and the profound reflection on one of the most sacred of relationships, that of the healer and the patient.
In medical ethicist and storyteller, Linda Clarke’s and neurosurgeon, Michael Cusimano’s book, “In Two Voices: A Patient and a Neurosurgeon Tell their story,” they collaborate to expose retrospectively, their personal experience through their journey as healer and patient. Both neurosurgeon and patient recollect their memories of their journeys from childhood to this diagnosis to surgical intervention and to recovery. And we’re not talking about a routine tonsillectomy here. We’re talking about the removal of a benign tumor deep in Clarke’s brain. In this dialogue between surgeon and patient, as they recollect the path they took together, profound lessons about the nature of the doctor-patient relationship are highlighted. What I appreciated about Clarke’s story was her raw honesty and her understanding of the difference between pain and suffering – an important distinction for all healers to know. What I appreciated about Cusimano’s story was the fact that he prays before every surgery – for him and his patient, not to mention the kindness he appears to bring to his work. Clarke appeared to feel his care for her; something research tells us, promotes healing. It reflects a humility for which surgeons are not known (an unfortunate stereotype). As a psychotherapist, I deeply appreciated the insights and the profound reflection on one of the most sacred of relationships, that of the healer and the patient.
March 17, 2022
Going from giving care to needing to receive care, Linda Clarke found the transition from health care worker to patient a difficult one. She didn't get sick, until she did, and even then she was loathe to admit it. She felt humiliated and ashamed over a condition she did not cause and could not fix. She felt that way because of her family experiences with illness, and because of how some doctors treated her as if she were only seeking attention. Instead, Clarke was seeking someone to diagnose her brain tumor, and finally someone did.
Dr. Michael Cusimano was Linda's surgeon, and 10 years after her surgery he reunites with her in order to write this book. Here Linda and her surgeon tell both sides of the story; what it is like to be a patient facing a life-threatening illness and equally dangerous procedure, and what it is like to be that patient's surgeon. The two walk us through her illness, her diagnosis, her surgery, and the aftermath/recovery. The story is told in their alternating voices, with them picking up where the other left off, and responding to each other's narrative.
Linda has a strong voice, and a great knack for storytelling. Dr. Cusimano has a big heart, and a pristine bedside manner. Together they are trying to de-mystify the surgical process from both sides, and show a side of patient care that isn't always there, but always should be. Dr. Cusimano allows emotion into his tale, explaining the technical details of the procedure but also sharing how he felt in those moments, what the true risks were as they arose, and how touch-and-go Linda's procedure really was. Linda went through all the range of emotions that a patient can feel - fear, courage, denial, rage, and ultimately understanding for what she'd lived through and how it changed her. I think this is a fantastic way to reach out to others who have felt diminished by illness and medical treatment and to encourage them to release their fear and shame through the telling of their own stories. I hope that it is also an olive branch to the medical community, encouraging empathy in patient care despite a system set up to strip out the "caring" portion of the roles.
Dr. Michael Cusimano was Linda's surgeon, and 10 years after her surgery he reunites with her in order to write this book. Here Linda and her surgeon tell both sides of the story; what it is like to be a patient facing a life-threatening illness and equally dangerous procedure, and what it is like to be that patient's surgeon. The two walk us through her illness, her diagnosis, her surgery, and the aftermath/recovery. The story is told in their alternating voices, with them picking up where the other left off, and responding to each other's narrative.
Linda has a strong voice, and a great knack for storytelling. Dr. Cusimano has a big heart, and a pristine bedside manner. Together they are trying to de-mystify the surgical process from both sides, and show a side of patient care that isn't always there, but always should be. Dr. Cusimano allows emotion into his tale, explaining the technical details of the procedure but also sharing how he felt in those moments, what the true risks were as they arose, and how touch-and-go Linda's procedure really was. Linda went through all the range of emotions that a patient can feel - fear, courage, denial, rage, and ultimately understanding for what she'd lived through and how it changed her. I think this is a fantastic way to reach out to others who have felt diminished by illness and medical treatment and to encourage them to release their fear and shame through the telling of their own stories. I hope that it is also an olive branch to the medical community, encouraging empathy in patient care despite a system set up to strip out the "caring" portion of the roles.
June 11, 2019
This unique book tells the story of Clarke’s brain surgery from her point of view and the surgeon’s point of view. Clarke tells of the long journey to diagnosis as well as a lengthy stay in ICU. She describes encounters both helpful and not helpful with health care professionals. Cusimano describes prepping for the surgery, the surgical procedure and the options that were considered along the way. He also describes some of his feelings before, during and after the surgery. As Clarke and Cusimano collaborate on writing this book years after the surgery the reader also gains an insight into the power both of what is said and what has been left unsaid .
As I read the book I continually remembered a brief encounter early in the narrative
as the two initially discuss and agree to write this story together: “Remember, I’m no writer, Mike said. I smiled. And I’m no surgeon, I answered laughing.”
This story truly is a personal life and death event for Clarke. The day of surgery had a profound impact on her life and the lives of all of her family and friends. For Cusimano this was one surgery in the midst of countless other surgeries and events in his challenging job as a neurosurgeon. Both authors are experienced health care educators who took personal risks on this collaboration and offer this book as a resource to students and to health care professionals. I believe this book can be a resource to any one of us who has ever been a patient or a caregiver (including health care professionals), our families and our friends.
As I read the book I continually remembered a brief encounter early in the narrative
as the two initially discuss and agree to write this story together: “Remember, I’m no writer, Mike said. I smiled. And I’m no surgeon, I answered laughing.”
This story truly is a personal life and death event for Clarke. The day of surgery had a profound impact on her life and the lives of all of her family and friends. For Cusimano this was one surgery in the midst of countless other surgeries and events in his challenging job as a neurosurgeon. Both authors are experienced health care educators who took personal risks on this collaboration and offer this book as a resource to students and to health care professionals. I believe this book can be a resource to any one of us who has ever been a patient or a caregiver (including health care professionals), our families and our friends.
Displaying 1 - 4 of 4 reviews