Letters to a Young Doctor By Richard Selzer (review)

Ghadially's book is more than an atlas and a reference book. In spite ofits size, it is a concise and easily understandable textbook. It establishes a specific terminology which strengthens die reputation of ultrastructural pathology as an exact science. Until recently, biochemistry enjoyed excessive prestige, while morphological investigations had to constantlyjustify dieir existence. Many important concepts in cell biology (e.g. autophagy, muscle contraction) are based on correlation of structure and biochemistry. AU the thousands of forms illustrated in Ghadially's book are undoubtedly associated widi yet unknown chemical composition and processes. The research biochemist should be challenged by this variety of structure and routinely include ultrastructural studies widi each biochemical study he performs. Zdenek Hruban Department ofPathology University ofChicago Letters to a YoungDoctor. By Richard Selzer. New York: Simon & Schuster, 1982. Pp. 205. $13.95. Literature and medicine have always enjoyed a symbiotic relationship. Literature has often employed illness as a major theme and doctors as main characters. Suffering and healing are popular literary subjects. Likewise, many medical professionals have significantly contributed to world literature. The tradition of the physician-writer includes Rabelais, Anton Chekhov, Oliver WendeU Holmes, Arthur Conan Doyle, A. J. Cronin, William Carlos Williams, and Somerset Maugham. This plethora of dual professionalists may at first glance appear unusual, but upon closer inspection it becomes apparent diat many of the qualities necessary for the good physician are also necessary attributes of the good writer—such as refined powers of observation, dedication, intellectual curiosity, sensitivity, and compassion. A medical career is a window to human nature. As such, a medical practice offers an infinite opportunity to develop characters, plot, and theme. In recent years an entire corps of talented physician-writers have emerged, including Michael Crichton, Walker Percy, Robin Cook, and Richard Selzer. Of diese writers, Selzer is the most effective in fusing literature and medicine as a means of understanding die human condition. In his latest book, Letters to a YoungDoctor, Selzer, a practicing surgeon, continues his exploration ofeveryday life. This book is the fourth collection of short stories and essays Selzer has published. His previous books include Rituals of Surgery, Mortal Lessons, and Confessions ofa Knife. His new book is similar to the others in style and content. All contain generally short pieces of fiction or essays, often in die form of autobiographical reflections or case histories. Selzer utilizes die medical world and the human body as metaphors for life. In all ofhis books, Selzer envisions disease in a unique manner. He writes, "To read diis book is to understand that disease raises die sufferer, granting him from out of his fever and his fret an intimate vision of life, a more direct route to his soul. Now he has die body of a poet." ThroughoutLetters to a YoungDoctor, disease seems to sanctify its host; but Uiis Perspectives in Biology and Medicine, 26, 3 · Spring 1983 \ 507 collection deals with much more thanjust disease. The selections include a variety of topics covering virtually everything from conception ("The Virgin and the Petri Dish") to death ("Remains"). A significant portion ofthe book is devoted to Selzer's letters to a young doctor who is just beginning his surgical training. These letters serve as the inspiration or raison d'être of this book. The advice and personal reflections in these letters are sincere, profound, and startling. In short, these letters are a very candid impression of the present state of medicine and a hope for the future. Selzer's stories are simultaneously warm, shocking, humorous, and severe. His characters are always delightfully real—perhaps because most are probably based on his patients, colleagues, or conglomerations of these people. The reader invariably cares deeply for these characters even when they assume undesirable qualities or attitudes. In one story, "Brute," Selzer comments on guilt and anger by telling the story of treating a huge violent man in the emergency room. Although this brute would make a terrible son-in-law and awful neighbor, the reader nonetheless grows to respect and even sympathize with the fellow after only a few pages. In "Toenails," Selzer exhibits his comic skills in a charming and touching story ofan old man he meets in a...