In these essays reprinted, for the most part, from the American Scholar
, Yale clinical surgery professor Nuland ponders various aspects of the practice of medicine and patient care. Opening the collection by urging his colleagues toward introspection and self-awareness, Nuland stresses that doctors make life-and-death decisions based on their own emotions, strengths, insecurities and very human needs. In another essay concerning human cloning and manipulating DNA to achieve human immortality, the author suggests we put the brakes on radical technologies whose uncertain consequences we have only begun to contemplate. On a trip to China, Nuland is intrigued by a thyroid operation performed under acupuncture where the patient was wide awake and smiling and suffered no anesthetic aftereffects after a two-and-a-half-hour excavation of her neck. Elsewhere, in an essay on grief written shortly after 9/11, Nuland calls Islamic fundamentalism “a sickness of the soul,” and in the book’s final entry, he himself grieves over a cardiac patient who died while waiting for a new heart. Although solid and perceptive, these essays are also occasionally flowery and verbose, and do not offer the rich insights of the author’s bestselling How We Die
. (May)
