The author, Samuel Shem, opens these reflections by saying that he was a writer before he was a doctor. His early answers to questions about healing came from stories he read. "Life as it should be in addition to life as it is" became the "motor" of his writing. He loved stories that he heard from patients and the "few humane doctors" he met and decided he would be able to understand people better by writing about experiences with them.

Shem's experience as an intern spawned The House of God (see this database) and he sees writing about his training as an example of the use of resistance when he saw "something unjust, cruel, militaristic or simply not right." He recommends the following to resist the inhumanities in medicine: (1) Learn our trade in the world, (2) Beware of isolation, (3) Speak up, (4) Resist self-centeredness. He says that the healing essence of narrative is in "we," meaning the patient and the physician.


This essay has been helpful to me personally and I use it regularly in medical humanities courses. It fits very well with the theme of the physician as a protagonist in literature. Also it demonstrates the importance of narrative medicine. The advice to all of us is sage and timely. The author's name is well known to most students so they are willing to listen.


This essay was part of the feature, "Medical Writing/ Physician-Writers' Reflections on Their Work" in the Annals of Internal Medicine.

Primary Source

Annals of Internal Medicine (137, No 11: 934-937, 2002)


American College of Physicians

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