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'Working my bloody tail off'


Doctors – the highest forms of human beings
Sherwin Nuland Surgeon
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I got this whole image of physicians as being wonderworkers. Because, you know, here's my mother, she's got a… it was really a chronic disease. She kept going in and out of the hospital. It was misdiagnosed for several years. They thought it was some sort of gynaecological thing, and of course it turned out to be cancer of the lower intestine. And when a doctor… whether it was my cousin Willy or anybody else, came to the door of our little apartment… the light changed, everything changed. No matter how worried we were about my mother's condition, the mere fact that this man, who knew each of us, who knew what to say to each of us, who essentially communicated to us, as long as I'm here, nothing's bad going to happen. So that became my image of a physician, and it was also perfectly clear that doctors didn't give a hoot about money, because nobody ever charged us anything. And we went to free clinics. You know, my mother, when she was hospitalized, it was what they called the ward service. My father, meantime, had a worsening neurological disease, and none of us knew what it was. Willy had made the diagnosis years before, and, jumping ahead, one day in medical school, I looked up from my physiology textbook and realised that what my father had was syphilis. He had tertiary syphilis, the third, late stage of syphilis, and it had affected his entire spinal cord with a condition called tabes dorsalis. What happens with tabes is, among other characteristics, you have no messages from your muscles and from your extremities telling you where they are. We don't realise how important that faculty called proprioception is. That, you know, you can touch your finger to your nose because you know where your finger is, you know where your nose is.

My father, you know, that's what he would do. So, he walked with a very erratic gait. His bladder didn't function like yours and mine do. He was sometimes incontinent, so I grew up with sickness. There were a lot of doctors around. There was a lot of hospitalization and nothing ever cost anything. But one thing that I recognized: when we went to those free clinics, the doctors in those free clinics were not nearly as nice as my cousin Willy and the friends that he brought to care for us. They… we were immigrants, my father had a thick accent, my mother had a thick accent. We were, sort of, emotionally pushed around a lot, treated badly by clinic secretaries, and so when I started thinking about medical school, pretty much as a high school senior and a college freshman, I promised myself I was going to be like cousin Willy and his friends, that money wasn't going to count for me, and this was a sacred trust.

I didn't frame it in those words until decades later, but, you know, there was something really special about these men. And they were all men at that time. This was not just a gift that they gave to others, but some kind of gift that they had been given from somewhere. And they were, to me, the epitome… of civilisation, of humanity. They were the highest form of human being, doctors were. And here I was, a kid who just decided that I was going to go to medical school because it was something I had to tick on an application. And from then on in, bingo.

Sherwin Nuland (1930-2014) was an American surgeon and author who taught bioethics, the history of medicine, and medicine at the Yale University School of Medicine. He wrote the book How We Die which made The New York Times bestseller list and won the National Book Award. He also wrote about his own painful coming of age as a son of immigrants in Lost in America: A Journey with My Father. He used to write for The New Yorker, The New York Times, Time, and the New York Review of Books.

Listeners: Christopher Sykes

Christopher Sykes is a London-based television producer and director who has made a number of documentary films for BBC TV, Channel 4 and PBS.

Tags: physicians, cancer, hospital, medical school

Duration: 4 minutes, 22 seconds

Date story recorded: January 2011

Date story went live: 13 September 2011