Beauty in the Breaking

Book Title: Beauty in the Breaking

Author: Michelle Harper

Publication Information: New York, Riverhead Books, 2020, 304 pp., $18.19, hardcover

Although Beauty in the Breaking is presented as a memoir, it is much more than that. Through the detailed storytelling of patient scenarios, Michelle Harper, MD, an emergency medicine physician, raises challenging issues in both medicine and society. Her reflections are poignant and always thought-provoking. For the physician reader, the patients, their problems, and her dilemmas are realistic and authentic. Her story of rising above her own brokenness is intermingled with those of her patients’ as she moves toward self-healing.

The first part of the book focuses on her own story of being broken. She describes her childhood home as dominated by her abusive, controlling, physician father. When her brother’s arm is broken by their father, Michelle drives him to the hospital. Sitting in the emergency room waiting on her brother, she marvels at the dichotomy of the chaos and the quiet; the people coming and going, sometimes with their lives changed forever. Here is a place that calls to the author’s wounded spirit. The emergency room was for others, like her and her brother, a place where people “converged in these hallowed halls for a chance to reveal our wounds, to offer up our hurt and our pain to be eased” (p. 18). As an emergency room physician she could make her offering to the world for those asking for help, and heal herself.

She tells the story of her marriage that dissolved as she was graduating residency. The book then follows her through her first employment as an attending and subsequent jobs as she struggles to rebuild her life with meaning. She decides to pursue a career in hospital administration, something that she does well and comes naturally to her. Unfortunately, she is dealt a hard blow when she hits a glass ceiling for women, even more impenetrable for a black woman. Although some issues are unique to the author, many physicians will embrace the uncertainties of a young physician developing their own understanding of themselves and their professional identity in the challenging life of a doctor.

Harper goes on to describe her disillusionment with a society whose ills permeate the lives of her patients. Each chapter describes a patient encounter in detail from the medical evaluation to the social issues that physicians see every day as we try to care for our patients. In each story she highlights the underlying social context of the setting—the family, the culture, the bias. Each is revealed on a deep personal, humanistic level. She tells the truth of the world of people in need, ensnarled by their environment by birth, not choice. Compassionately, she cares for all people alike, whether they are suspected murderers, drug dealers, or the man who decides not to be treated for his cancer. Harper connects with the humanity within each patient. She writes, “All bodies ache with wisdom that wants to be appreciated” (p. 276).

And through it all she learns to understand and heal. This book is about the art of medicine, found in the midst of the emergency room at 4:00 am. As physicians, we have windows into sacred truths about people. It is easy to lose heart or be broken from the emotions of caring. But as she writes, “true caring, indeed, true living, comes from being able to hold peace and love for oneself, and from sharing that unwavering, unconditional love, knowing that all life depends on this” (p. 279). Dr Harper invites her readers to become Japanese Kintsugi, broken pottery repaired by sealing the pieces back together with gold, but this time even stronger and more lovely. Out of brokenness, comes beauty.