Product Description

“Life is short, and the Art so long; the occasion fleeting; experience fallacious; and judgment difficult. The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and the externals, cooperate.”
–attributed to Hippocrates, c. 400 B.C.E.

The award-winning author of How We Die and The Art of Aging, venerated physician Sherwin B. Nuland has now written his most thoughtful and engaging book. The Uncertain Art is a superb collection of essays about the vital mix of expertise, intuition, sound judgment, and pure chance that plays a part in a doctor’s practice and life.

Drawing from history, the recent past, and his own life, Nuland weaves a tapestry of compelling stories in which doctors have had to make decisions in the face of uncertainty. Topics include the primitive (and sometimes illegal) procedures doctors once practiced with good intentions, such as grave robbing and prescribing cocaine as an anesthetic (which resulted in a physician becoming America’s first cocaine addict); the curious “cures” for irregularity touted by people from the ancient Egyptians to the cereal titan John Harvey Kellogg and bodybuilder Charles Atlas; and healers grappling with today’s complex moral and ethical quandaries, from cloning to gene therapy to the adoption of Eastern practices like acupuncture.

Nuland also recounts his most dramatic experiences in a forty-year medical career: the time he was called out of the audience of a Broadway play to help a man having a heart attack (when no other doctor there would respond), and how he formed a profound friendship with an unforgettable–and doomed–heart patient. Behind these inspiring accounts always lie the mysteries of the human body and human nature, the manner in which the ill can will themselves back to health and the odd and essential interactions between a body’s own healing mechanisms and a doctor’s prescriptions.

Riveting and wise, amusing and heartrending, The Uncertain Art is Sherwin Nuland’s best work, gems from a man who has spent his professional life acting in the face of ambiguity and sharing what he has learned.

Product Details

• Amazon Sales Rank: #134029 in Books
• Published on: 2008-05-20
• Released on: 2008-05-20
• Original language: English
• Number of items: 1
• Binding: Hardcover
• 224 pages

From Publishers Weekly
In these essays reprinted, for the most part, from the American Scholar, Yale clinical surgery professor Nuland ponders various aspects of the practice of medicine and patient care. Opening the collection by urging his colleagues toward introspection and self-awareness, Nuland stresses that doctors make life-and-death decisions based on their own emotions, strengths, insecurities and very human needs. In another essay concerning human cloning and manipulating DNA to achieve human immortality, the author suggests we put the brakes on radical technologies whose uncertain consequences we have only begun to contemplate. On a trip to China, Nuland is intrigued by a thyroid operation performed under acupuncture where the patient was wide awake and smiling and suffered no anesthetic aftereffects after a two-and-a-half-hour excavation of her neck. Elsewhere, in an essay on grief written shortly after 9/11, Nuland calls Islamic fundamentalism a sickness of the soul, and in the book's final entry, he himself grieves over a cardiac patient who died while waiting for a new heart. Although solid and perceptive, these essays are also occasionally flowery and verbose, and do not offer the rich insights of the author's bestselling How We Die. (May)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

From Booklist
These essays, which Nuland wrote from 1998 through 2004 for the American Scholar, make up a less-unified book than his gripping and powerful How We Die (1994) and The Mysteries Within (2000), each chapter of which proceeds from a particular incident in his surgical career. But then, these pieces’ range of topics is greater, their expositional mainsprings less intimate. Two chapters impressively ponder the first sentence of the first aphorism of Hippocrates, which begins, “Life is short, and the Art i.e., medicine is long.” Others engrossingly discuss the placebo effect, acupuncture during surgery, “Grave Robbing,” electroconvulsive therapy, three classic medical texts, and Thomas Eakins’ two great paintings of surgical teaching. Personal experience powers amusing as well as informative pieces on weight training by the elderly (this could be an outtake from The Art of Aging, 2007), writing, and actually responding to the call for “a doctor in the house.” Oddly, the most personal chapter, first published herein, is the least successful; about a heart-transplant candidate Nuland befriended, it is, atypically for Nuland, insufficiently emotionally distanced. --Ray Olson

About the Author
A clinical professor of surgery at Yale University, Sherwin B. Nuland is the author of numerous books, including The Art of Aging: A Doctor’s Prescription for Well-Being; How We Die: Reflections on Life’s Final Chapter, which won the National Book Award; Lost in America: A Journey with My Father; Maimonides; and Leonardo da Vinci. He lives in Connecticut.

Customer Reviews

not up to Nuland's standard
This book is a collection of recycled pieces written for the magazine of the Phi Beta Kappa society. Nothing is inherently wrong with a compilation, although the pieces didn't flow all that smoothly together. More important is the subject matter addressed; many of the chapters just didn't capture my interest the way his previous books have. And the writing seems a bit pretentious; never use a short word when a longer one can found. Its almost like the articles were written to impress those who are thought to fancy themselves to be of a certain refined intellectual and critical level (eg PBK members), as if to say "sure, I'm a doctor and not a college professor but I have a big vocabulary too!"

A book that highlight's a venerated surgeon's writing skills
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"All of this is prologue [the preceding pages of the book's introduction] to introducing the substance of my book and explaining the title I having chosen for it. By now it is doubtless clear that [the book's title] "The Uncertain Art" refers to medicine and that I have been attempting in the foregoing paragraphs [of this book] to stake out a territory whose boundaries are sufficiently vague that I feel free to roam wherever inclination leads me. Roam, that is, so long as I stay within sight of the assignment I have given myself, which is to write as a doctor, about issues associated with doctoring."

The above is found near the end of the introduction to this book authored by Sherwin Nuland, a clinical professor of surgery at Yale University and the author of numerous books.

Each of the chapters (except for the last one) in this book is a "slight modification" of the "sequence of [stand-alone] essays" the author wrote between 1998 and 2004 for the publication "The American Scholar." Thus, the new writing in this book actually consists of a brief "Author's Note" (found at the beginning), the Introduction, and the last essay or chapter.

It seems to me what Nuland has attempted to do was to take a series of stand-alone essays that he had written previously and tried to connect them so they would have a common theme. The theme being how a doctor has to make decisions and judgements in the face of uncertainty.

However, I had a difficult time extracting this theme from his essays or chapters (except for the two chapters that dealt with Hippocrates). Don't get me wrong. All the essays are well-written and show considerable thought in composition but taken as a whole, they don't seem to have any cohesive theme.

If you reread the quotation that begins this review, you'll see that Nuland tells us in the last sentence that he wrote about "issues associated with doctoring." However, there are several essays (such as the joy of writing and reflections on 9/11) that seem out of place.

The subtitle of this book is "Thoughts on a Life in Medicine." However, there is much research (especially historical research) that actually makes up the bulk of this book, not just the author's thoughts.

There are no references in this book. Most of the essays are well-researched and show considerable attention to detail (such as essays on the hidden meaning of medical words, grave robbing, the medical school & the university, and electroconvulsive therapy). Where did the author get all this information?

Finally, scholarly publications such as "The American Scholar" demand references. It's my guess that the original essays had references but for some reason it was decided not to include them with this book. Why?

In conclusion, the essays that make up this book are well-written but don't clearly accentuate either the book's title or subtitle.

(first published 2008; author's note; introduction; 21 essays or chapters; main narrative 185 pages; acknowledgements; index)

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More, please
I enjoyed this book, as I do all of Nuland's offerings, but it wasn't riveting - it was more like meandering through a park. Most of these pieces were previously published in periodicals, and like many compilations, the necessary brevity normally demanded by magazine editors left me, in several cases, wishing for more fleshing out of the various subjects introduced. I especially missed that which Nuland has done so well in his previous books - brought the subject matter literally to life based on specific stories of his patients. This was done only in the final chapter, and not coincidentally, this chapter was by far the most interesting, compassionate, and illustrative of his central thesis. Nevertheless, considering the nonsense that passes for literature today, well worth having and reading more than once.