by Zoe Pollock

Iris Monica Vargas reviews the new book Final Exam by surgeon Pauline Chen:

Chen says, “we learn not only to avoid but also to define death as the result of errors, imperfect technique, and poor judgment. Death is no longer a natural event but a ritual gone awry.” For Chen, it is a physician’s rituals that allow him or her to evade death, literally and figuratively. “Concentrating on the ritual becomes [the] professional method of coping, an action that allows him or her to spend as little time as possible with the dying patients, concentrating instead on the treatment algorithm.”

But this obsession with doing, the susceptibility to “the intoxicating power of treatment,” isn’t only a physician’s error. As Chen asserts in  Reappraisal, the third and final part of the book, family members and patients are equally at fault. “We battle away until the last precious hours of life, believing that cure is the only goal.” During life’s final, tortured moments, says Chen, we often inflict misguided treatments not just on others but on ourselves. Ironically, the promise of the nineteenth centurythat the body was not just an irrational repository of disease but a potentially reparable biological machine has become the curse of the twenty-first.

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