Prose

“Why are you so obsessed with him?” my wife asked. “Because he seems so content,” I answered. “He has life figured out.” “Based on his clothes?” she said. “You have no idea what happens to him after he gets on the train.”

That night discussing Jamison’s failed antiarrhythmic therapy and her cardiologist’s inability to pick up on her alcohol abuse wasn’t the first time I’d heard a doctor say, “When you’re a hammer, all you see is a nail.” Doctors often throw this phrase around when we explain missed diagnoses or a surgeon’s refusal to consider non-operative therapies or even a patient’s insistence that her headache is due to a brain tumor. But we’ve also employed this cliché to describe how we don’t turn off our doctoring outside the hospital or clinic. We wonder aloud if our neighbor has a pituitary tumor. We tell our uncle he will die of a heart attack before he retires if he doesn’t lose fifty pounds. We comment on the salt or fat or carbohydrate content of meals. We speculate on why some of our kids’ friends are always covered in snot.

I wonder if Marina Benjamin considered another title for her excellent book, The Middlepause. Specifically, I wonder if she thought about using “Mental Menopause,” a catchy moniker used by one of her friends as they discuss their mutual exploration of middle age and beyond. “It’s more a mental menopause I’ve been struggling with,” this friend shares, “with every significant choice I’ve ever made suddenly up for review – education, career choice, where to live, children; even your key relationship, which is so established, it requires work.”

These honest recollections, confessions of how the mind and the body will grasp at anything to survive the residency years, how Kalanithi found his “munching apples” moments in the trauma bay with some harmless jokes and a soggy ice cream sandwich, are why I consider When Breath Becomes Air essential reading for any doctor-in-training, why I push the book on so many medical students, residents, and fellows.