The Beauty in Breaking is the memoir of an African American physician who, in her own words, has “been broken many times” (p. xiii).  

Despite maintaining a veneer of affluence, the author, her mother and siblings live in constant fear of being battered by her father. Following one particularly vicious attack, she accompanies her injured brother to the local emergency room. That day she serendipitously discovers her calling: “As my brother and I left the ER, I marveled at the place, one of bright lights and dark hallways, a place so quiet and yet so throbbing with life. I marveled at how a little girl could be carried in cut and crying and then skip out laughing” (p. 18).  

Much later, the author (Michele Harper) undergoes a shattering breakup and divorce. She endures disappointments at work, some of which, regrettably, can only be explained by the color of her skin.    

As she picks herself up time and time again, Harper discovers her inner resilience: “The previously broken object is considered more beautiful for its imperfections” (p. xiii). She learns from the experience of her own suffering to develop compassion in her clinical work. The bulk of the Beauty in Breaking is devoted to case studies of the author’s clinical encounters with patients in the emergency room.


Many of Harper’s observations will resonate with other clinicians. We have all had to treat someone whose views or behaviors are unpleasant, even reprehensible. In “Erik: Violent Behavior Alert” the author grapples with her feelings upon being presented with a patient who has assaulted another female physician in a previous visit. At first, she acts out by delaying the inevitable: “Yes, this patient would wait. He would wait while I pushed my chair back, stood up, walked to the break room, poured myself a cup of coffee, went to the restroom, and finished some notes” (p. 79). When she discovers the patient is in bad shape, she has an entirely different perspective. This is a wonderful teaching moment.      

Most valuably, we learn in The Beauty in Breaking about what it is like to be an African American doctor.  In “Dominic: Body of Evidence,” Harper recounts the story of how she refused to examine a patient against his will. A resident questions her authority in a manner that communicates “one of the ubiquitous microaggressions faced by people of color” (p. 104). The resident then proceeds to go over Harper’s head in a demeaning manner she might not have dared with a white physician. Harper is reminded of a meeting with her department chairman: “You didn’t get the position… You’re qualified. I just can’t ever seem to get a black person or woman promoted here. That’s why they always leave! I’m so sorry, Michele” (p. 109). The prejudices inherent in the medical profession have rarely been illustrated with as much candor as they are here.   

This is a sensitive book which approaches such painful topics as domestic violence and racism, and which gets to the heart of what it means to be a healer.


Riverhead Books

Place Published

New York



Page Count