- Singular Intimacies: Becoming a Doctor at Bellevue
Danielle Ofri's Singular Intimacies: Becoming a Doctor at Bellevue is far more than the story implied by the subtitle. Yes, it is a collection of narrative essays that tell the story of Ofri's journey from medical student to intern to resident to doctor at Bellevue Hospital in New York City. But it is also the searing story of how one doctor learns that when it comes to healing, intimacy (along with narrative) is as important as therapeutic applications of science—perhaps more important when healing becomes impossible, and the patient is facing death.
Ofri's beautifully written collection consists of essays that could stand alone, and many of them have been published elsewhere, including in Best American Essays and this journal. Nevertheless, read together they form an [End Page 140] intricate memoir—an essay cycle, one might call the book—in which each narrative enriches and is enriched by those that follow.
Ofri introduces the term "singular intimacy" in the opening essay, "Drawing Blood." Pondering an emergency procedure she witnesses in the cardiac care unit on her first day at Bellevue, she writes: "Just by being near [the patient] and touching him during that near-death episode, I felt like I'd been privy to a singular intimacy." It is as if being near death has opened Ofri's eyes to life. Afterwards, the patient "couldn't just recede into the multitudes of old men in the hospital, and I couldn't be just another medical student on the team. . . . Not after I'd touched his skin and felt the life racing through it while the needle bore into his heart, prying out the near-fatal fluid." She also begins to associate this patient's manner and situation with her grandfather's, eventually believing that her history and the patient's have "collided and combined."
Ofri's eye for detail and character and brutal honesty about her own anxieties, aspirations, and moments of hubris create a clear-as-ice narrative and sidestep contemporary clichés about intimacy. In this book intimacy is risky and hard won, as in the opening essay about the heart patient whose history collides with hers, and where her efforts at familiarity lead to awkwardness: the patient makes a pass at her and then faults her friendliness when she objects. At other moments, conversely, awkwardness leads to familiarity. In "Stuck," panicked after being accidentally pricked with a contaminated needle, Ofri confronts a patient about her medical history only to find herself being soothed and embraced by the patient.
The collection also intertwines intimacy with loss. Two of the most stunning essays chronicle the deaths of people Ofri had come to love, an old friend and a difficult, abrasive surgeon. Josh is the friend, a close pal since grade school and confidant in adulthood, someone to calm her stress about medical school over dinners out. She has just begun medical school when Josh reveals to her, but few others, that he has inherited his father's dangerous heart condition, IHSS, but she declines to listen with her stethoscope. In "The Burden of Knowledge," Ofri tells the story of the immediate aftermath of Josh's sudden death, especially in light of her increasing skill and participation in "codes," the emergency procedures surrounding cardiac arrest. Ofri had refused to listen to Josh's congenitally thickened heart muscle, but now she cannot keep herself from imagining Josh's death, his "code," in the details provided by her insider knowledge.
As she does in several other essays, in "The Burden of Knowledge" Ofri juxtaposes the messy real-life version of hospital emergencies with what she [End Page 141] calls the sanitized TV versions. "A real-life code," she writes, "is an anarchy of people yelling, IVs messily inserted, iodine splattering, rubber gloves and blood-soaked gauze flying about, reams of EKG paper spilling endlessly onto the floor, the smell of singed flesh after 360-kilojoule shocks. It is brutally physical. If you don't break some ribs then you haven...