Wednesday, November 20, 2013
The Devil Wears Scrubs
We are in a boom time for news and information about all things medical. The same democratization of information that allows us to look up information on our own (hello, Drs. Google and Wikipedia) has also brought myriad new voices to the public’s discourse through multiple outlets: blogging, social media, podcasting, etc.
Medical bloggers and influencers, people with a proclivity for making complicated concepts clear, have many opportunities to straddle the worlds of old and new media as they hone their voices and build their brands. New media exposure can lead to more traditional tracks like book publishing.
Medical books have always been a popular genre. With the rise of self-publishing, this is no doubt even more true today. Medical books most often take the form of self-help (“what you need to know about this diet or disease”), odysseys (“my cancer story”), predictions (“The Creative Destruction of Medicine”) polemics (“why the U.S/Canada/U.K./Obamacare is so good/bad/other) and, of course, memoir (“how I survived internship/residency”).
Memoirs usually are good for their shock value, some laughs, and some broader life lessons learned by the subject/author. I’ve read many “I survived internship” stories, and they invariably contain a scene involving a rectal exam, stool and shame. (Guilty as charged.)
The most famous tell-all memoir of internship is Samuel Shem’s (aka Stephen Bergman) fictionalized version of his first year at Boston’s Beth Israel hospital, or what he called “The House of God.” Bergman blew the lid off of the inhuman culture that exists in medical training, where we expect trainees to become indoctrinated in the ways of the system and turn students’ idealism on its head.
The most recent internship memoir I’ve come across is “The Devil Wears Scrubs,” by Freida McFadden. It’s a self-published, slightly fictionalized account of the first month of McFadden’s internship. She had a rocky start.
My belief is that people think medical memoir has staying power as a genre because of the vicarious thrills of what it takes to become a doctor. In reality, I think the fascination is much more of along the lines of, “Holy crap! I can’t believe someone’s life could be so awful.”
Dr. McFadden (also a nom de plume, like the aforementioned Dr. Shem) writes well and is a good humorist, both in eviscerating the evil resident who lords over her (“Alyssa”) and in being self-deprecating as she realizes to her horror that she is unable to muster feeling for patients that die (though not always), as it’s one less work item on her to-do list.
Dr. McFadden is alternatively known as Dr. Fizzy, Fizzy McFizz, and Doctor Cartoon. As a cartoonist, she has lampooned the medical profession and its system of training for years in her brutally honest cartoons. They were collected in a previous book, “A Cartoon Guide to Becoming a Doctor.”
I’d recommend “The Devil Wears Scrubs” to anyone in or considering going to medical school. It’d make a good gift for any family member thinking along those lines. If you’re a lay reader and enjoy the medical memoir genre, you’ll find the book accessible. McFadden does a good job of showing how one can maintain her humanity in a system designed to squeeze it out of us.
I asked Dr. McFadden if she thought “Alyssa” would see her book. “Unlikely,” she wrote back to me. “Although if I had her address, I’d anonymously send her a copy!”
This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.
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Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.
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Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.
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