A powerful report of the experiences of a physician living and practicing medicine in the inner city. Hilfiker, whose previous book (Healing the Wounds, 1985) described his practice in rural Minnesota, moved to Washington, DC, in 1983 to join a small ecumenical religious community dedicated to working with the urban poor. With his wife and three young children, he moved into an apartment in Christ House, the first two floors of which were a medical recovery shelter for homeless men. Besides caring for patients there, he practiced at a nearby community clinic. As Hilfiker notes, this book is less about medicine than about class, race, and culture—about the ``awful power of poverty to break the human spirit.'' Often his patients, whose identities have been altered here, are beaten down by life, addicted to drugs or alcohol, mentally disturbed or incompetent, and living on the street or in shelters for the homeless. The chasm between the middle-class, white Hilfiker and his poor, black patients is ultimately unbridgeable, and he confesses freely to his feelings of helplessness, anger, frustration, and guilt as he comes to understand that he cannot redress all of society's wrongs—the problems of education, housing, and jobs are simply too enormous. He even comes to fear that he cannot practice good medicine, for his patients' circumstances make it impossible for him to prescribe the best treatments. In 1993, feeling not at all saintly, he retreated to Finland for a year of recuperation with his wife's family. Hilfiker's future remains a question mark, but clearly he does not intend to abandon the poor, and one hopes that he will not abandon writing, either. A deeply disturbing picture of the degradation of ghetto life and a painfully honest account of one man's attempt to do something about it. (Author tour)
Pub Date: Aug. 1, 1994
ISBN: 0-8090-3921-4
Page Count: 288
Publisher: Hill and Wang/Farrar, Straus and Giroux
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: May 15, 1994
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
PERSPECTIVES
Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.
“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues.
It’s no secret, write Banerjee and Duflo (co-authors: Poor Economics: A Radical Rethinking of the Way To Fight Global Poverty, 2011), that “we seem to have fallen on hard times.” Immigration, trade, inequality, and taxation problems present themselves daily, and they seem to be intractable. Economics can be put to use in figuring out these big-issue questions. Data can be adduced, for example, to answer the question of whether immigration tends to suppress wages. The answer: “There is no evidence low-skilled migration to rich countries drives wage and employment down for the natives.” In fact, it opens up opportunities for those natives by freeing them to look for better work. The problem becomes thornier when it comes to the matter of free trade; as the authors observe, “left-behind people live in left-behind places,” which explains why regional poverty descended on Appalachia when so many manufacturing jobs left for China in the age of globalism, leaving behind not just left-behind people but also people ripe for exploitation by nationalist politicians. The authors add, interestingly, that the same thing occurred in parts of Germany, Spain, and Norway that fell victim to the “China shock.” In what they call a “slightly technical aside,” they build a case for addressing trade issues not with trade wars but with consumption taxes: “It makes no sense to ask agricultural workers to lose their jobs just so steelworkers can keep theirs, which is what tariffs accomplish.” Policymakers might want to consider such counsel, especially when it is coupled with the observation that free trade benefits workers in poor countries but punishes workers in rich ones.
Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.Pub Date: Nov. 12, 2019
ISBN: 978-1-61039-950-0
Page Count: 432
Publisher: PublicAffairs
Review Posted Online: Aug. 28, 2019
Kirkus Reviews Issue: Sept. 15, 2019
SEEN & HEARD
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