Michele Harper is a female, African American emergency room physician in a profession that is overwhelmingly male and white. Brought up in Washington, DC, in an abusive family, she went to Harvard, where she met her husband. They stayed together through medical school until two months before she was scheduled to join the staff of a hospital in central Philadelphia, when he told her he couldn’t move with her. Her marriage at an end, Harper began her new life in a new city, in a new job, as a newly single woman.
In the ensuing years, as Harper learned to become an effective ER physician, bringing insight and empathy to every patient encounter, she came to understand that each of us is broken—physically, emotionally, psychically. How we recognize those breaks, how we try to mend them, and where we go from there are all crucial parts of the healing process.
At the highest ranks (doctor, professor) medicine is still a very white field, so I was excited to pick up this memoir by an African-American ER doctor, especially because there was a bunch of buzz around its publication.
The title is apt, as one could say that Harper has “broken” several times in her life. While her family situation looked great from the outside – a doctor’s family in a big house – it hid how horrifyingly abusive her father was, mostly to her mother. She managed to go to medical school herself, fell in love and got married, only to have her husband leave her right before moving to a different city. We follow her as she works at different hospitals and focuses on different parts of the job – administrative, patient care – as she comes to terms with it all.
I can’t go any farther in this review without mentioning that this was a buddy read with the wonderful Louise at the blog A Strong Belief in Wicker. She’s an emergency department doctor in Australia so we had a wonderful time dissecting the text on a medical level along with discussing Harper’s life experiences.
The most solid pro for The Beauty in Breaking is the writing. Some turns of phrase are beautiful, and she’s eloquent when talking about how racism in the medical system has affected her personally, as well as her patients. On that more surface, literary level I have little to complain about.
When it comes to medicine I have questions, though. There are some basic errors (for example, the Glasgow Coma Scale is scored 3-15, not 1-15) so I’m guessing the text wasn’t proofread for medical accuracy. Some of the patient scenarios didn’t make sense – why wasn’t a nurse called in to help with a particular procedure? Why is she ordering a head CT for a run of the mill headache?
While most of the patient stories are interesting and informative, several feel unrealistic. One conversation felt a roleplay scenario that’s part of my training as a medical interpreter – everything clearly said in logical order, with no meandering or backtracking or extraneous information. I’m guessing it was a composite patient, but even composite patients should talk like real people, right?
Harper finds peace via yoga, meditation, and Buddhism, which I’m glad for. I do yoga, too. But I don’t need to read detailed descriptions of her yoga class, and I was surprised that she talked to patients about their “spirit” as much as she did. I’m all for wellness and health in a general sense, but this tipped over into “woo-woo” too much for my liking.
All in all The Beauty in Breaking does a great job discussing certain issues beautifully, but if you’re in medicine yourself details will certainly needle you.
Thanks to Riverhead Books and Edelweiss for providing a review copy.
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Drawing upon the author’s two decades teaching medical ethics, as well as his work as a practicing psychiatrist, this profound and addictive little book offers up challenging ethical dilemmas and asks readers, What would you do?
Dame Sue Black is an internationally renowned forensic anthropologist and human anatomist. She has lived her life eye to eye with the Grim Reaper, and she writes vividly about it in this book, which is part primer on the basics of identifying human remains, part frank memoir of a woman whose first paying job as a schoolgirl was to apprentice in a butcher shop, and part no-nonsense but deeply humane introduction to the reality of death in our lives.
At the University of Wisconsin, Dr. Joshua Mezrich creates life from loss, transplanting organs from one body to another. He examines more than one hundred years of remarkable medical breakthroughs, connecting this fascinating history with the inspiring and heartbreaking stories of his transplant patients. Combining gentle sensitivity with scientific clarity, Mezrich reflects on his calling as a doctor and introduces the modern pioneers who made transplantation a reality—maverick surgeons whose feats of imagination, bold vision, and daring risk taking generated techniques and practices that save millions of lives around the world.
The United States government is given a warning by the pre-eminent biophysicists in the country: current sterilization procedures applied to returning space probes may be inadequate to guarantee uncontaminated re-entry to the atmosphere. Two years later, seventeen satellites are sent into the outer fringes of space to collect organisms and dust for study. One of them falls to earth, landing in a desolate area of Arizona. Twelve miles from the landing site, in the town of Piedmont, a shocking discovery is made: the streets are littered with the dead bodies of the town’s inhabitants, as if they dropped dead in their tracks.
While the writing isn’t amazing it fits the mold aimed for, namely narrative nonfiction of a past event many people may have forgotten or never known about. In that sense it reminded me of 
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Christie Watson spent twenty years as a nurse, and in this intimate, poignant, and remarkably powerful book, she opens the doors of the hospital and shares its secrets. She takes us by her side down hospital corridors to visit the wards and meet her most unforgettable patients.
Though young women with serious illness tend to be seen as outliers, young female patients are in fact the primary demographic for many illnesses. They are also one of the most ignored groups in our medical system–a system where young women, especially women of color and trans women, are invisible.
Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande’s gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable.
Always Doing 