Volck’s memoir describes his medical practice and learning in a variety of settings (Cleveland, Baltimore, Cincinnati), but, more importantly, in non-metropolitan places, such as Tuba City on the Navajo Reservation in Arizona and rural clinics in Honduras. He suggests that his knowledge of medicine has largely come as he has practiced it and not from his formal education. Further, he believes that best medical practice is not primarily high-tech, urban, or industrial. Each of the 15 chapters has a title—a topic, a person, or a theme—but also one or more locations specified. For example, we have “Chapter One, A Wedding, Navajo Nation, Northern Arizona,” suggesting the importance of culture and locale. Further, the chapters include personal associations from several realms beyond the topic and place as Volck seeks to understand medicine, healthcare, and how we live in the world.           

Of the first seven chapters, five are set in Navajo land, where Volck is an outsider by his cultural heritage and his profession, a doctor with a pediatrics specialty. From time to time he reflects on his training, the English verb “to attend,” and specific patients, such as two-year-old Alice in Tuba City and eight-year-old Brian in Cleveland. Both children died while in his care. Working on the front-line of medicine, he considers the weaknesses of our modern attitudes toward death and our wishes for control. He also wrestles with personal lifestyle issues of balancing medicine, family, and an urge to write.
Other chapters describe restlessness in his profession, the growth of his family (including the adoption of a Guatemalan baby girl), hiking in the Grand Canyon, camping in the rain, and a retreat with Benedictine monks. Chapter 11 “Embodying the Word” discusses literature and medicine, lectio divina (a Benedictine reading practice), and the need to listen carefully to patients’ stories.
The final chapter returns to Cincinnati, Honduras, and Tuba City. Volck has found more projects in the Navajo Nation, including a youth service project from his church. With permission, he conducts interviews and plans a book on the Navajo, “drawing on cultural history, anthropology, history, medicine, and politics” (p. 201).


This is a thoughtful and engaging book. It provides insight into the limits of typical modern Western medicine in contrast to medicine delivered in rural and/or impoverished areas, including inner cities. The prose is rich and evocative with close observation and effective description. The book interweaves many areas: narratives of medical events, social criticism (for example, racism and consumerism), parental distress, the nature of gifts, and his pervasive intent to change and improve medicine. He believes that physicians should slow down, listen carefully to their patients, work on understanding their cultures, and locate medical settings where they are not forced to work by rote procedure, Evidence-Based Medicine, or high-tech, time-pressured medicine. The word “attending” of the title rings through the book; he urges the values of being present and observing with care. There are many sensitively described pediatric patients. We meet and remember Henry, Sean, Cristia, Khalil, Robert, Jenrry, Jasmine, and CP. These are touching and illuminating stories, not strictly medical “cases.” Throughout Volck shows his love for his patients, their families and cultures, as well as for surrounding nature and the power of words and stories. 


The book’s major themes —of love, of culture, of reverence—are also suggested in two pieces of art. The painting on the cover shows the head of a young woman in profile; she is swaddled by colorful bedclothes. In the final pages we learn that this is 20-year-old Temma, daughter of Tim and Sherrie Lowly and that Tim is the artist. Volck came to know this family through the art. He is not the doctor to Temma, although he has treated other similar children. While Temma would be medically styled as “profoundly disabled,” Volck sees her as “broken and beautiful, damaged and dignified” (pp. 184, 185). The second image is the black-and-white frontispiece (p. vii). It shows Temma lying on her back and carried by six women described as “a community lightly bearing her” (p. 185). Volck comments, “My profession…habitually defines conditions and states by what a person lacks rather than what she is” (p. 184).  


Cascade Books

Place Published

Eugene, Oregon



Page Count