This is the well-written and gripping story of the author's first year in her new career as a nurse on an oncology hospital floor. Brown came to nursing after leaving the fairly pampered life of an English professor, and I found myself admiring her courage in making such a drastic career change. I've read a lot of medical memoirs written from the perspectives of doctors and patients; this is the first nurse's memoir I've read. I found myself appreciating the nursing perspective a great deal; as Brown makes abundantly clear, the vast majority of hands-on patient care in hospitals is delivered by nurses, not M.D.s, most of whom in Brown's book remain rather shadowy figures that she is always having to track down to obtain permission to do what she already knows is right for her patients.
Because Brown works on an oncology unit, there are not a lot of cheery stories of miraculous recoveries to be found in the pages of this memoir. Many of her patients will and do ultimately relapse; some of them die during the year that this book covers. Brown makes an excellent case for the need to improve how the medical establishment deals with patients and families on end-of-life issues. Probably the most emotionally powerful sections of the book are those involving Brown's feelings of helplessness as it becomes clear that a patient is very near the end of life and the difficulties inherent in talking with the patient and family members about their preferences for aggressive treatment at this stage. If you have not had such conversations regarding DNR orders and health proxies with your loved ones before reading this book, you'll definitely be inspired to do so after.
Equally powerful and illuminating are the sections of the book where Brown describes how she is able to cope with the knowledge that so many of her patients will not get better and in fact will die prematurely: She focuses on the moment and the fact that, while she and medicine may not be able to save a particular patient's life, she CAN work to make this a better day for them right now--and maybe that's enough.
Brown doesn't mince words when it comes to describing some of the less pleasant aspects of nursing (I had no idea that doctors would even contemplate performing a poop transplant [!!], as they considered in one example of intractable diarrhea). While that sort of detail made it clear to me that I would never be cut out to be a nurse myself, simply reading about Brown's matter-of-fact acceptance that taking care of sick people will involve messy stuff like blood and poop--and that it is no big deal at all for her and her colleagues--will probably make any future hospital stays I endure a lot less embarrassing for me.
Brown also does a good job of explaining just what it is that nurses do all day and why they may not be available to answer your every push of the call button within 60 seconds. It's exhausting, physically demanding work, and anybody who anticipates being in a hospital at any point of their lives (which, face it, is just about all of us) should be eternally grateful that there are dedicated professionals like Brown who are willing to endure the stress and burn-out of nursing because they care about people.
One of the sections of the book that resonated the most with me was the epilogue, where Brown talks about the lesson that SHE has learned from her patients: Life is fragile. We are every one of us vulnerable, and every day is a wonderful gift. She relates the anecdote of her husband indulging a mid-life impulse to buy the grand piano he had long dreamed of, a decision that brought him "a joy like nothing else in his life." She ends her book with words that we would all do well to heed: "People say, why wait? But really they should say, don't wait. Listen when you can, tell the people in your life you love them, and buy the piano."
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