Bury the dead and Mend the living – réparer les vivants (The Heart/Mend the living by Maylis de Kérangal, book review)

My grandmother mentionned this book to me, a while ago. She said “it’s a book about a heart transplant, it is well written, you should read it”. I know one should always listen to one’s grandmother, and that I in particular should have paid attention because when my grandmother finds a book well written she usually means business (she’s hard to please, in the best of ways of course), but in that case I heard the part “it’s about a heart transplant ergo it is for you” and was – at the time – tired of reading books about medicine. Well, I picked it up despite it and, of course, my grandmother was right. This truly has, as a main subject, the heart of Simon, a young man who dies suddenly, and what becomes of it in the rushed hours after death, when it is decided that it could be transplanted. And from this death – the surreality of it, for the parents, who have to grasp what a cerebral death is, the enormity of grief, the impossibility of death for the living, the young, the healthy, to the symbolic meaning of the heart as much more than a pump, and the difficulty of the decision of donating, for the family, it covers a mountain in a few pages. Everything is true, is well said, in sentences flowing in a fast heart beat, nothing is superfluous, nothing is romanticized but, in this short window in the life and death of a few people, everything is there. And as it ends, leaving you breathless and unsure of the future of this heart beating anew in another person’s thorax, and wanting to carry on with the parents of this young man, the nurses and doctors you meet briefly but who are all so real, so raw, you realize your own heart has been beating frantically with it, all along. 

I could go on and talk specifics but I think the simple truth is there: listen to my grandmother, folks, as for once a french book I’m raving about has been translated (the title is alternatively (I guess there must be a US and UK title) The Heart:a novel or Mend the living, which is much closer to the original title and echoes a quote from Platonov that one of the characters has kept with him: Burry the dead, mend the living. A noble pursuit.

The Fraud Police (and other ramblings about self-doubt)

(I realize that is not the most enticing title there is. I don’t have a better one just now, and, as this is about honesty, I can’t really make up a title with no connection to the article:)

Every now and then, as a doctor but I suspect in any other profession, I have moments of “what am I doing here, who the heck gave me permission to do this, why am I in charge?”. I think about it from time to time, but, as I was listening to Amanda Palmer’s The Art of Asking (read it!) yesterday while drawing fern motives on my crutches (random occupation number…. I’ve stopped counting), she happened to mention the exact feeling. She calls it “the fraud police”, the fear that someone might come and call you on your bullshit: how are you qualified to be in this role, to do that or say this? Who gave you the authority?

I constantly go through this. And not necessarily with the -minority – of patients who are angry, for various reasons, about the health system you happen to be working with, or angry about something completely unrelated, or just belligerent, but as a result challenge every decision you make, contradict the advices, etc… Those are fine, and useful: you are reminded you must absolutely stick to evidence, and, usually, you try to go and find why they have lost trust in you or what you represent. They are a sort of welcome detergent, if you like.

The more troubling ones  – maybe not at first glance – are those who come to you in search of absolute certainties. Whatever the question, they don’t want a balanced answer, they don’t want an “I don’t know”, they will trust whatever you say but you have to have an answer.

And, so many times, over and over. you don’t really have it. Whether the question doesn’t have too much consequence, like, “what is the cause of this cough?” (that is, once you’ve eliminated the possible serious causes, often you just know it’s nothing serious, which is not really the greatest possible answer), or “but when am I going to die?” – and again, most of the times, there is no certainty.

Book review: Of microbes and men: Peste et Choléra (Plague and Cholera) By Patrick Deville

This is a book my father gave me as a graduation gift for finishing my medical studies. If I knew him less, and he me, I might have taken offence in being given a book called “plague and cholera”, as a light-readable treat after 6 years of medical studies, but as it is I was right to suspect it would be a great read.

This is a novelization of a biography, or I suppose you could call it so, of Alexandre Yersin, a Swiss microbiologist, but also an explorer, a doctor, a part time cartographer and sometimes cultivator, a humanist of the turn of the 20th century, who is famous for discovering, and giving his name, to the bacteria that causes the plague, Yersinius Pestis.

How do you tell the individual stories?

It’s been a while since I’ve written. Mostly because I’ve been too tired to function, once the days at work are over, those last two months. I’ve been working as a junior doctor in a walk-in clinic of pschychiatry, dedicated partly to the migrants and asylum seeker population, and otherwise to the “general ” population (whatever that means).
And there would be so much to tell, but it’s also what has kept me silent, in a way: how do you choose which story to tell? how do you pick one more than the other, how do you prevent a single story to become a generality, especially in a subject so prone to generalizations – or rather, two subjects prone to generalizations and stigma: mental health patients and migrants. So migrants with mental health issues, careful where you’re going…

Have some news, have a kit kat. On the smallness of big moments

Sunrise over Thorong peak

Yesterday, I climbed upto a 5416 meter high (every meter counts) pass in Nepal, starting before dawn, to arrive early at the top before the wind was too strong. So we walked, in the dark first, a small caravan of flash lights in the emptiness, looking at the stars slowly disappearing as the sky became clearer, and suddenly the sun  reached the peaks and the world was full of colors. It was one of those moments where nature is so splendid you whish you were an ancient bard, able to compose an ode to it, this beauty, this moment, you feel like it shouldn’t go unnoticed.

Afterwards, we reached the top, I almost lost a few fingers waiting for my companions to arrive, in the icy windswept pass, and we started going down in a growing sandstorm, back to a valley with a village, a good coffee, and a slow WiFi. There, mechanically checking my emails after 5 days of unconnected bliss, I discovered that I had finally received the confirmation that I had passed my final exams. I am now, officially, a doctor. I didn’t really know what to do with this news, to be honest. I went down to the “general store” of the village, and bought the closest thing to a celebration gift for myself I could find : a kit kat (and some toilet paper, less glamorous, that’s another story).