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Final Exam: A Surgeon's Reflections on Mortality Audio CD – Audiobook, 1 Jan 2007

5.0 out of 5 stars 2 customer reviews

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--This text refers to the Hardcover edition.

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Product details

  • Audio CD
  • Publisher: Phoenix Books (Jan. 2007)
  • Language: English
  • ISBN-10: 1597771384
  • ISBN-13: 978-1597771382
  • Product Dimensions: 14.8 x 2.6 x 13.1 cm
  • Average Customer Review: 5.0 out of 5 stars  See all reviews (2 customer reviews)
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Review

"Do doctors neglect death and the dying, choosing instead... on flogging the last bit of life back into patients?..." -- 'British Medical Journal'

"For me , Pauline Chen's beautifully-written Final Exam: a surgeon's reflections on mortality was fascinating." -- Virginia Ironside, 'The Independent'

"At her best when she writes of individual cases: one turns the page to find out what happened next." -- Dr Theodore Dalrymple, 'Sunday Telegraph' --This text refers to the Hardcover edition.

About the Author

Pauline Chen attended Harvard University and completed her surgical training at Yale University. --This text refers to the Hardcover edition.

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Top Customer Reviews

Format: Hardcover
I bought this more than 2 years ago and it's been on my shelf since. It's a very good introduction to the surgery aspect of medicine if you're thinking about going into it and covers all the morality aspects that books like 'Trust me I'm a junior doctor' etc seem to gloss over. It's also very interesting just as something to read, and very heartfelt. Strongly recommend it.
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Format: Hardcover Verified Purchase
This author is very genuine and she describes each of her stories and reflections in painstaking detail. Her narrative is such that you almost forget she is a doctor by displacing her medical career from the human emotion everyone else shares. You really connect with the patients in the times when it goes awfully wrong. I used to think most deaths arise from such difficult, untreatable injuries/illnesses. But death happens to all of us and can appear in the most subtle and unsurprising processes.
It doesn't matter if you're interested in medicine, or interested in mortality. This is a non-fiction literature that is simply refreshing and enlightening, and should be read by all.
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Most Helpful Customer Reviews on Amazon.com (beta) (May include reviews from Early Reviewer Rewards Program)

Amazon.com: 4.3 out of 5 stars 100 reviews
3 of 3 people found the following review helpful
5.0 out of 5 stars A patient seeking to peek into the mind of a surgeon 15 Sept. 2009
By Sarasota Suncoast Reviewer - Published on Amazon.com
Format: Paperback Verified Purchase
I am one of those people who is always the patient ... and I am one of those complicated patients where things don't typically go as planned. I am probably not one of a surgeon's easiest patients as I tend to test their mettle. That being said, I have had surgeries where surgeons have removed various organs from my neck (thyroid) down to my abdomen (gallbladder and hyster.) All of them have been complicated by one thing or another.

I have asked myself more than once: "How do surgeon's do it?" How do they get to that almost God-like place where they hold life in the balance for a period of time and we, the patient, put our utmost trust in them? It's quite amazing if you think about it.

The one aspect that is not often addressed or talked about is that of death. How does a doctor distance themselves enough emotionally so that they can continue to do their job? How do they get through the first time that they are actually responsible for a patient's death? These are tough questions that require a special journey for doctors. Dr. Chen's book outlines this journey from med student to a fully-fledged practicing physician specialist. She shares the shift that has taken place in medical studies that teach young doctors how to deal with death in a healthy way that includes palliative care. The journey is fascinating and touching.

As a patient, I always wonder. This book helped to pull the curtain back just a little bit more. Thank you Dr. Chen!
34 of 35 people found the following review helpful
4.0 out of 5 stars Caring For the Ill and Personalizing Their Dying 4 Mar. 2007
By prisrob - Published on Amazon.com
Format: Hardcover Verified Purchase
"I think it's like Dr. Courtney M. Townsend, a legend in surgery and a personal hero, recently told me. "We have two jobs as doctors: to heal and to ease suffering. And if we can't do the former, my God we better be doing the latter." Pauline Chen

A few years ago I was part of a poetry group of medical providers. We shared poetry written by or for medical providers that described our work. Most of these poems as it turned it were about the dying, the dead or end-of-life. Our professions had a need to share our profound feelings. Since that time Palliative Care has become a recognized service in many hospitals and communities. Our patients need us and we need each other to share our grief.

Pauline Chen discovered once she was house staff that pronouncing a patient's death was part of her job, the first 'code blue', the first agonizing long death on an intensive care unit, and the day to day life and death of her patients were taking a toll. She was taught it seems to hide her feelings, but then they would not go away and what was she to do? She had an eye-opening experience with a physician who stayed with his patient while he was dying and she realized 'this is what my job is all about." As a transplant physician, Pauline Chen realized that her life and death immersion in very ill patients brought her closer to death than life. As she stated, "zeal to cure is no excuse for failing to communicate prognoses honestly or for sidestepping ongoing dialogue with patients and families as medical events deteriorate." She gives us many examples of her patient experiences and how other physicians reacted to their patient's deaths. As she so eloquently says, " That honor of worrying-of caring, of easing suffering, of being present- may be our most important task, not only as friends but as physicians, too."

"Exercising personal autonomy around one's death is no simple matter today -- especially in settings of ever-more sophisticated and fragmented medical care. As Pauline W. Chen points out in "Final Exam: A Surgeon's Reflections on Mortality," the medical profession bears a good measure of responsibility for this dilemma. But "Final Exam" is neither an angry rant nor a bloodless treatise about medicine's failings. By sharing stories of her own maturation into a healer as well as a technically skilled doctor, Chen in this fresh and honest memoir engages and educates on many levels. At the same time, the author's principal goal -- to hold herself and fellow physicians accountable for providing better end-of-life care -- is ever in view." Claire Dunavan

My role in my profession is to help my patients with their living through their dying. This would not be possible without my team mates and colleagues. My best friend, with whom I share each patient death, found this book and told me about it. Thank you. Pauline Chen has written a book that should be read by all medical providers. It is indeed a good thing to be compassionate and to be there, physically and emotionally with our patients. Highly Recommended. prisrob 3-04-07
44 of 44 people found the following review helpful
5.0 out of 5 stars How Many Physicians Would Pass The Exam? 17 Feb. 2007
By Foster Corbin - Published on Amazon.com
Format: Hardcover Verified Purchase
Pauline Chen is a surgeon who does liver transplants. She is also a fine writer as FINAL EXAM - A SURGEON'S REFLECTIONS ON MORTALITY proves so well. She writes with both passion and humility about the contradiction she sees in the field of medicine: that doctors, who witness death so often that it should almost become routine essentially are no better at dealing with the end of life than their patients are. (She actually uses the word "dysfunctional" to describe many physicians' attitudes toward death.) She believes there are many reasons for this phenomenon. Doctors are trained to be healers; that is why most of them went to medical school. To lose a patient to death somehow is an admission of failure. Many physicians will continue aggressive but useless therapy for a dying patient to pacify the patient's family. Sometimes they fear litigation or they may continue treatment-- we can only hope occasionally-- for financial gain. But whatever the reasons, they are not good enough. The patient loses, but the physician loses as well the chance to do-- what Chen would call-- "something more than cure" and "nurture our [physicians'] best humanistic tendencies."

Dr. Chen discusses candidly her first experience with death, when she was a sophomore in college, of her maternal grandfaather. Then in medical school she spent 12 weeks with a cadaver: "My very first patient had beeen dead for over a year before I laid hands on her." She writes about her first patient to die and her inability to contact a dying friend. She confronts her fears about her own mortality when she is about to harvest organs (a procedure she had done eighty-two times previously) from an automobile accident victim and discovers that the donor is a brain-dead thirty-five-year old Asian American woman: "For a moment I saw a reflection of my own life and I felt as if I were pulling apart my own flesh."

This beautifully written book reminded me of another fine book by another physician, Abraham Verghese's MY OWN COUNTRY, an account of his treating the first patients-- most of whom would certainly die horrible deaths-- with HIV/AIDS at the local VA hospital in Johnson City, Tennessee in the 1980's. Both these books should be required reading for medical students.

When I finished Dr. Chen's "reflections," I thought of (1) how fortunate her patients are to have a surgeon so sensitive and so human and (2) wondered how many physicians would take time out from their busy schedules to read her wise words.
5.0 out of 5 stars Beautifully written, humbly offered 10 Oct. 2014
By V. Mickey - Published on Amazon.com
Format: Kindle Edition Verified Purchase
Starting with her earliest medical training in anatomy with dissection of cadavers, Pauline Chen takes us on a journey into the sacred territory of the human body, and challenges the medical profession's failure to train physicians in the care of the dying. This book should be required for anyone training for the medical profession. As we follow her personal journey to becoming a surgeon specializing in liver transplants, she respectfully acknowledges the "so much that is right" about medical training, but reveals the dilemma of medicine's lack of preparation for the inevitability of death. Her authentic personal narrative offers the challenge to change how the dying should be treated in the professional medical world, in a way that invites soul-searching rather than offering any formulaic responses.

I am not a medical professional, so I was particularly grateful for her "inside the human body" perspectives that amplified my awareness of the wonder and sacredness of the body's deliberate design to succumb to death in a passage as meaningful as birth.

Beautifully written, humbly offered, moving beyond words. Thank you, Dr. Chen.
5.0 out of 5 stars Highly Recommended 10 Oct. 2014
By Alaska - Published on Amazon.com
Format: Kindle Edition Verified Purchase
I highly recommend this book! Dr. Chen's authentic writing, part memior and part thesis, explains the training medical students undergo. She discusses how this training, the culture of medicine and other factors have failed to prepare doctors to communicate with patients and family members about death and dying.

Dr. Chen's book reminded me of the doctor who told a friend to 'put your affairs in order' when she woke up after surgery. That surgeon's total failure to convey news that an expected benign tumor was advanced stage cancer emotionally gutted his groggy patient. Final Exam sheds light on how this highly recommended surgeon could so spectacularly fail to communicate with compassion.

This book is well written and an easy read for the layman. As I finished this book, I recalled the debates about what 'the doctor said' whenever my family had dealt with a terminal diagnosis. I had chalked it up to a mix of stress and different communication styles yet Dr. Chen reminds us that the doctor's ability to communicate is essential.
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