The Uncertain Art

March 17, 2008
In these essays reprinted, for the most part, from the American Scholar
, Yale clinical surgery professor Nuland ponders various aspects of the practice of medicine and patient care. Opening the collection by urging his colleagues toward introspection and self-awareness, Nuland stresses that doctors make life-and-death decisions based on their own emotions, strengths, insecurities and very human needs. In another essay concerning human cloning and manipulating DNA to achieve human immortality, the author suggests we put the brakes on radical technologies whose uncertain consequences we have only begun to contemplate. On a trip to China, Nuland is intrigued by a thyroid operation performed under acupuncture where the patient was wide awake and smiling and suffered no anesthetic aftereffects after a two-and-a-half-hour excavation of her neck. Elsewhere, in an essay on grief written shortly after 9/11, Nuland calls Islamic fundamentalism “a sickness of the soul,” and in the book’s final entry, he himself grieves over a cardiac patient who died while waiting for a new heart. Although solid and perceptive, these essays are also occasionally flowery and verbose, and do not offer the rich insights of the author’s bestselling How We Die
.

April 15, 2008
These essays, whichNuland wrotefrom 1998 through 2004 forthe American Scholar, make up a less-unified book than his gripping and powerful How We Die (1994) and The Mysteries Within (2000), each chapter of which proceeds from a particular incident in his surgical career. But then, these pieces range of topics is greater, their expositional mainsprings less intimate. Two chapters impressively ponder the first sentence of the first aphorism of Hippocrates, which begins, Life is short, and the Arti.e., medicine is long. Others engrossingly discuss the placebo effect, acupuncture during surgery, Grave Robbing, electroconvulsive therapy, three classic medical texts, and Thomas Eakins two great paintings of surgical teaching. Personal experience powers amusing as well as informative pieces on weight training by the elderly (this could be an outtake from The Art of Aging, 2007), writing, and actually responding to the call for a doctor in the house. Oddly, the most personal chapter, first published herein, is the least successful; about a heart-transplant candidate Nuland befriended, it is, atypically for Nuland, insufficiently emotionally distanced.(Reprinted with permission of Booklist, copyright 2008, American Library Association.)