Book Title: I Really Didn’t Want to Become a Doctor: Tales and Musings from a Retired Family Doc After Over 50-Plus Years of Practice
Book Author: Howie C. Wolf
Publication Information: Lanham, MD, Hamilton Books, 2017, 77 pp., $24.99, paperback
Reading this book feels like sitting down with a grandparent and hearing story after story—entertaining and enlightening at times, disjointed and repetitive at others. The author, Dr Howie Wolf, recounts in semichronological order his experiences from deciding in college to follow in his father’s footsteps and attend medical school, to serving as a Navy physician, to practicing family medicine, to volunteering in third-world countries.
Dr Wolf identifies himself as a social justice advocate throughout the last 50 years of medicine, but does not adequately acknowledge the ways his perspective is entrenched in white male privilege. He seems to recount many persons of color that he met along the way, at once observing the way “they” really are human just like him and simultaneously espousing a colorblind philosophy, rather than deeply examining the ways that racism impacts health. His self-portrayal as a champion of equality seems insincere in light of the sexist sentiments that are woven subtly into many anecdotes, describing women not in terms of their intelligence and not as equals, but instead by their looks and the extent to which their beauty fit a societal norm of attraction. For example, he reports being surprised when he met a sultry-voiced hospital operator and found “she was probably one of the ugliest women I’d ever seen: bad hair, bad body, and bad teeth” (p. 17). As a young female health professional, it would be difficult to smile and nod at the patriarchal objectification seeping through these stories, had we been sitting together.
Overall, this book would have benefitted from deeper reflection about some of the major themes Dr Wolf was trying to get at. An example of this is found when comparing Dr Wolf’s recollection of learning clinical skills as a medical student at the University of Iowa through interacting with “actors” who were paid to be patients, to an essay, “The Empathy Exams” written by Leslie Jameson1, which is based on her experiences as one of those patient actresses at the same institution. Likewise, Dr Wolf’s chapter, “Activities” could have benefitted from the ample literature2 on how volunteer medical missions may contribute to reinforcing global structural inequalities. He does wonder whether his trips to places like Honduras and Rwanda might hurt more than help, but in the same sentence (p. 52) soothes himself with the words of a fellow volunteer, “we offer these people hope that someone cares about them.”
One chapter, “Examining an Old Adage: Doctors Should Avoid Lawyers” was the highest quality in the book, as here Dr Wolf wrestles with complex dynamics around ethics, malpractice, and the doctor’s role in testifying against egregious acts of other doctors. These reflections were interwoven with specific cases he was involved in. In other chapters, Dr Wolf did relate compelling anecdotes, like being passed from one Navy ship to another over choppy waters to assist in an appendectomy, and fielding questions about sexual health in his son’s elementary school class. These stories seemed disconnected from one another, and might have had more impact with smoother transitions.
In one sentence (p. 14), Dr Wolf relates, almost off-handedly and only as it related to a friend’s story, the experience of being divorced, widowed, and having the tragic experience of losing a child. I found myself wanting to hear more. Perhaps this is where the story is; where readers could learn from how Dr Wolf’s loss and vulnerability and suffering related to that of his many patients. This is the story that readers need, not a relatively sterile recount of somewhat amusing, somewhat arbitrary career stories, but rather a venture into the liminal space between providers and patients—dichotomized as healers and sufferers—and an allowance for epiphany in examining the way in which our own humanity and suffering allows us to provide whole-hearted, genuine, empathetic care.
Telling our stories, writing them down, and reflecting on the larger systems at play has such potential for the writer and the reader, especially after a long career. I was hopeful that this book would provide some comfort to the many family medicine physicians who are questioning their decision to be a doctor, wrestling with compassion fatigue, and needing some encouragement to use their skills, passion, brilliance, and fortitude toward fighting against health care disparities by advancing the future of primary care. This is not the book I was hoping it would be.
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