SOMETHING AWESOME

A doctor reflects on medicine and the human drama underlying it in this heartfelt memoir.

Friedman recaps his 44-year career as a neurosurgeon, including a long tenure as the chairman of the department of neurosurgery at the University of Florida, in loose, episodic chapters full of reminiscences, medical lore, case studies, policy briefs, and philosophical musings. Among the grab bag are his recollections of confusion, anxiety, and sleep deprivation as a resident; detailed descriptions of surgical procedures; a poignant elegy on his mother’s decline and death from a brain tumor; explanations of his groundbreaking research into using electrical monitoring of neural activity to guide neurosurgeons; a sharp critique of American health care, which he calls a “disgrace” for its high cost, poor quality, and lack of universal coverage; a look at his own efforts to improve quality in his neurosurgery department with checklists and meticulous teamwork; a lengthy account of the assassination of Abraham Lincoln, complete with the autopsy report; and a plangent chapter authored by his colleague Jobyna Whiting recounting an incident in which she treated a doomed victim of an auto accident and the shame-ridden man who killed her. Friedman’s narrative is a bit of a ramble, but his workmanlike prose and lucid discussions of complex medical issues make the many digressions a pleasure to follow. Personal relationships are central to his portrait of doctoring: He’s warmly appreciative of supportive teachers and mentors—and critical of the “impatience” and “cruelty” of others—and conveys both the camaraderie of medical practice and the occasional eruptions of poisonous office politics, including bogus allegations of financial misconduct leveled at him by an underperforming surgeon he tried to fire. He’s at his best in describing the emotional turmoil that besets every doctor amid the vagaries of life and death. (“A woman with everything to live for had come to me for help and, instead, had died….And thus began the process that occurs every time I have a bad result: relentless self-doubt and self-loathing. You veer into imposter syndrome where, for a time, you believe that you’re not really a good neurosurgeon, that you are entirely unworthy.”) The result is a frank, revealing view of a doctor’s experience.

An intimate, insightful meditation on the science, art, and business of healing.