As a busy internist, it has been easy for me to justify forsaking nonmedical reading in order to keep up with the journals, the monographs, the updates, and the "Seminars in __" that pile up on my office desk and eventually spill off of my nightstand at home. But in this era of AIDS, the reading of fiction, poetry, and literary nonfiction has taken on a different quality for me, I might even say an urgent quality: Fiction and poetry allow me to freely cross the boundaries that limit me in the daytime. For all of the sophisticated medical technology that surrounds me, the thing I cannot do during my hospital hours is get into the minds of my patients and see their thoughts; I cannot turn back time; I cannot control the universe but am instead controlled by it; I cannot prevent the inexorable decline of the CD4 count ... . And ultimately, no matter what our particular specialties, none of us can conquer death—not our own nor that of our patients. But in the magical world of fiction and in the related world of our dreams, we conquer all these obstacles; we achieve, from our reading, from the safety of our recliners and our beds, the kind of success we are denied at other times. This kind of "success" is necessary to balance the realities of medical practice.
That certain stories should speak to us—"call" to us as Robert Coles would say—is a wonderful and mysterious phenomenon. Many physicians I know point to a seminal book—anything from Sinclair Lewis's Arrowsmith to William Carlos William's Doctor Stories—that triggered in them a desire to be a physician. Sometimes, as in somerset Maugham's Of Human Bondage, the story is only tangentally related to medicine or doctoring. But somewhere in the web of the tale being told, somewhere in the voyage of the protagonist, a young college student is able to enter fully into this fictional world, suspend judgment, and eventually match her or his destiny with the destiny about which the author has written. I collect these "transformation" or "siren-call" stories with the same relish that I collect stories of wart cures: Both have the same magical quality of a marvelous outcome triggered by a discrete event with the mechanism in between falling into the shadowy world of the soul.
At a recent conferenc, an older and much respected academic internist was heard to say (in the context of how difficult it is to attract young medical students into internal medicine), "What internal medicine needs is another Arrowsmith". But our need for Arrowsmiths does not stop once we enter medicine. We are, I believe, continually redefining ourselves according to events in our physical world: parenthood, tenure, promotion, incorporation ... . And to enter the world of fiction and poetry is to redefine and renew ourselves psychically, as if these works are mirrors that allow us to see ourselves and our doctor roles more clearly.
The following list, then, is personal, brief, and merely representative of the process described above. To suggest a commonality in theme is to succumb to a cognitive, ordered, left brain view of the world, the very thing this list seeks to explode.
John Irving
Published in 1985
Much like The World According to Garp and A Prayer for Owen Meany, this novel has an important central theme—in this case, abortion. Few writers of contemporary fiction are as successful as Irving is in drawing readers into a complex world and then delivering them from it in a manner that is always satisfying and usually transforming.
Michael Ondaatje
Published in 1992
This novel won the Booker Prize. Much is left to the reader's imagination, which is the joy of all reading—creating one's own rich, colorful, fictional dream with just enough help from the author. This book, like Galvin's book below, is more prose-poetry than prose; the music in the language makes each page a treat.
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Love in the Time of Cholera
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Gabriel Garcia Marquea
Published in 1988
The fact that one of the main characters is a physician is incidental to the beauty of this novel. Perhaps the finest love story ever told, written by the master of magical realism.
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A Good Man Is Hard to Find
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Flannery O'Connor
Published in 1948
A physician would do well to observe his or her patients as closely as Flannery O'Connor observes her characters; these precise, finely tuned stories have few landscapes. Her characters seem to be studied as if under the bright light of a dissecting microscope.
Walker Percy
Published in 1987
This physician-writer's work often concerns itself with man's need to find faith and human connection in a world without apparent meaning. The Thanatos Syndrome, with its thriller-like plot, is perhaps the most accessible of Percy's work.
Paul Monette
Published in 1992
The author of the deeply moving Borrowed Time: An AIDS Memoir now writes without self-pity about the trials of growing up. Both books are must reading for anyone who cares for persons with AIDS.
Michael Ondaatje
Published in 1984
These poems are to be read aloud, preferably to someone else. That Ondaatje should make this list twice says much about his appeal for me.
James Galvin
Published in 1992
A slim volume, set in the West. It is an absolute jewel and seems a perfect example of how language and particular scenery—in this case that of Wyoming—refines consciousness.
Robert Boswell
Published in 1992
A wonderful novel about the hole-in-the-heart, down-in-the-trenches kind of love. It has also been described as the depiction of a struggle between moral wisdom and blind faith.
The Collected Stories
Published in 1960
A disturbing, beautiful, terrifying collection by a marvelous writer who died in a concentration camp in 1940. This book includes the Red Cavalry stories, which are an anomaly: The author is a Jew who rode with the Cossack regiment; there existed between Jew and Cossack not just hatred but polar opposition.
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