From physician Muñoz, a chronicle of becoming a doctor at the extremely demanding Johns Hopkins cardiology program.
After an introduction, the opening section of this memoir of a year of fellowship rotations at Johns Hopkins hospital—a fellowship is a three-to-four–year, post-residency position overseeing residents while being overseen by an attending specialist—is ill-advised. The author drones on about his pedigree—Princeton, Johns Hopkins, Harvard, Johns Hopkins again—the odds of becoming a Hopkins Fellow (1 in 10,000), and the Navy SEAL–like training involved (the book’s title speaks volumes), and it exudes smug superiority. But forgive these mercifully few pages to get a quite satisfying immersion into what medical specialization requires. Muñoz thankfully shifts from embarrassingly tedious to humanely sympathetic as he chronicles how he had to acquire a measure of expertise in what can be described as stations of the cardiology cross: consultation, nuclear medicine, heart failure and transplantation, intensive care, electrophysiology, echocardiography, and more. The author is honest enough to admit which tasks bored him, which opened him up to the big picture—how a heart transplant is not just about blood type, but “habits, foibles, fears”—which attending doctors he admired and why (“Dr. Franklin’s ability to listen and connect with his patients also means that they are often extremely well informed”), or why not to jump to fast conclusions. Muñoz has nothing new to say about some old questions—“Why are we allowed to make these calls over people’s fates? Who are we to decide? It’s fair. It’s not fair. Someone has to do it. No one should do it”—and he pays no more than lip service to the critical quality of empathy. He shines, however, in explaining a wide variety of conditions, and there is polish to the patient vignettes, giving them deeply human appeal.
Muñoz offers little turning of new ground in what has become a fertile genre, but the book is enjoyably idiosyncratic and elucidative.