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On Call: A Doctor's Days and Nights in Residency

On Call: A Doctor's Days and Nights in Residency
By Emily R. Transue M.D.

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On Call begins with a newly-minted doctor checking in for her first day of residency--wearing the long white coat of an MD and being called "Doctor" for the first time. Having studied at Yale and Dartmouth, Dr. Emily Transue arrives in Seattle to start her internship in Internal Medicine just after graduating from medical school. This series of loosely interconnected scenes from the author's medical training concludes her residency three years later.

During her first week as a student on the medical wards, Dr. Transue watched someone come into the emergency room in cardiac arrest and die. Nothing like this had ever happened to her before-it was a long way from books and labs. So she began to record her experiences as she gained confidence putting her book knowledge to work.

The stories focus on the patients Dr. Transue encountered in the hospital, ER and clinic; some are funny and others tragic. They range in scope from brief interactions in the clinic to prolonged relationships during hospitalization. There is a man newly diagnosed with lung cancer who is lyrical about his life on a sunny island far away, and a woman, just released from a breathing machine after nearly dying, who sits up and demands a cup of coffee.

Though the book has a great deal of medical content, the focus is more on the stories of the patients' lives and illnesses and the relationships that developed between the patients and the author, and the way both parties grew in the course of these experiences.

Along the way, the book describes the life of a resident physician and reflects on the way the medical system treats both its patients and doctors. On Call provides a window into the experience of patients at critical junctures in life and into the author's own experience as a new member of the medical profession.
Emily R. Transue, M.D. is a native of Toledo, Ohio. She attended Yale University, where she received her B.S. in 1992 with distinction in Biology. As an undergraduate, she co-organized the D.E.M.O.S. program for science teaching in elementary schools, which received several state and national teaching awards and was featured on Good Morning, America. Transue received her M.D. from Dartmouth Medical School in 1996, and was also the 1996 recipient of the Pharmacia and Upjohn Achievement Award for distinction in Internal Medicine. She did her residency training in Internal Medicine at the University of Washington in Seattle, and was then awarded a Chief Residency position, which she completed in July of 2000. Transue now works as a general internist at a multispecialty clinic in downtown Seattle.
During her first week as an intern on the medical wards in a Seattle hospital, Dr. Emily Transue watches someone come into the emergency room in cardiac arrest and die. Nothing like this had ever happened to her before, and it was a long way from books and labs. So she decided to record her experiences as she gains confidence in putting her studies to work. The result is On Call, a series of vivid, candid, and engaging interconnected scenes from the author's three-year residency.

The stories—some funny and others tragic—depict the many patients Dr. Transue encountered. They range in scope from brief interactions in the clinic to prolonged relationships during hospitalization. There is a man newly diagnosed with lung cancer who is lyrical about his life on a sunny island far away, and a woman, just released from a breathing machine after nearly dying, who sits up and demands a cup of coffee.

Along the way, On Call describes the life of a resident physician and reflects on the manner in which the medical system treats both its patients and doctors. The book provides a window into the experiences of patients at critical junctures in life, and into the author's own experience as a new member of the medical profession.
"With humor, humility, and gentle wit, Transue leads us into the bizarre, bone-rattling world of medical training. Through her eyes, and her honest, engaging prose, we have a rare opportunity to experience the growth of a true healer. While readers may be lucky to have Transue as their guide, her patients are even luckier."—Danielle Ofri, M.D., Ph.D., editor in chief, Bellvue Literary Review and author of Singular Intimacies: Becoming a Doctor at Bellvue

"Everyone who sees a doctor needs to read this book. Dr. Transue, through her stories, gives a realistic understanding of the pressures, perseverance, and strength required for students of medicine to succeed as practitioners."—Lewis G. Maharam, M.D., FACSM, Medical Director, ING New York City Marathon
 
"A young physician's on-the-spot notes from her three-year residency in internal medicine, shaped into a collection of pithy, revealing little stories. The stories, which range in length from a couple of pages to a dozen, begin with the first morning of Transue's internship and end on the last evening of her residency. The transformation from frazzled, uncertain intern to assured, competent physician is a long process, one the author reveals as exhausting, challenging, full of surprises, and often scary. Nearly half the stories take place during Transue's first year: it's as an intern that her experiences with patients are most intense, and it is the year in which she learns the most. Her rotation takes her through intensive care, cardiology, oncology, and the emergency room; death is no stranger in these places, and the narrative shows her growing acceptance of this fact of life. Throughout, the stories focus on patients and their conditions: the homeless man in ER who's covered in bugs; the battered young liver patient who insists that her boyfriend would never hurt her despite black eyes, bruises, and a broken leg; the teenager wanting her first birth-control prescription; the 70-year-old woman learning that her late husband had given her a sexually transmitted disease; the old doctor dying of prostate cancer. Transue intersperses scenes from her private life—nightclubbing, dancing, sailing, working out at the gym—that offer a sharp contrast to her experiences inside hospital walls and give the reader as well as the author respite from disease and dying. In her second year, she becomes a resident, with responsibility for interns and students as well as for patients, a role that continues in her third year. By then, the excitement has faded, but her confidence has blossomed, and she is well launched in her medical career. The perfect gift for anyone contemplating medical school."—Kirkus Reviews
 
"During her three years as a resident in internal medicine at the University of Washington in Seattle, Transue wrote about her patients as a way to guard against burnout and share her experiences with friends and family. This moving collection of her stories conveys vividly, sometimes painfully, the atmosphere of overwork, exhaustion and insecurity in which a resident works: the long shifts and sleepless nights, the moments when she cannot contain her tears, the times when she is haunted by fears that she has made the wrong decision. But she never loses sympathy for her patients—the heart attack victim who regrets not remembering his near-death experience, the old woman who has a pet name for her walker, the psychotic who imagines he is in constant pain and just wants her to hold his hand, even the grumpy man with emphysema who smokes two packs a day and complains about the treatment he has to receive as a result, and the habitual drunks lined up every night on stretchers in a back hallway. It's reassuring to read that a doctor isn't afraid to express compassion for her patien

Product Details

  • Amazon Sales Rank: #44313 in Books
  • Published on: 2005-08-01
  • Released on: 2005-07-14
  • Original language: English
  • Number of items: 1
  • Binding: Paperback
  • 256 pages

Features

Editorial Reviews

From Publishers Weekly
During her three years as a resident in internal medicine at the University of Washington in Seattle, Transue wrote about her patients as a way to guard against burnout and share her experiences with friends and family. This moving collection of her stories conveys vividly, sometimes painfully, the atmosphere of overwork, exhaustion and insecurity in which a resident works; the long shifts and sleepless nights, the moments when she cannot contain her tears, the times when she is haunted by fears that she has made the wrong decision. But she never loses sympathy for her patients—the heart attack victim who regrets not remembering his near-death experience, the old woman who has a pet name for her walker, the psychotic who imagines he is in constant pain and just wants her to hold his hand, even the grumpy man with emphysema who smokes two packs a day and complains about the treatment he has to receive as a result, and the habitual drunks lined up every night on stretchers in a back hallway. It's reassuring to read that a doctor isn't afraid to express compassion for her patients and that she is eager to listen and learn as they talk about their hopes and fears. There are many touching moments here, especially when she's reminded by a patient who is dying that it's important to look out the window and enjoy the view on a sunny day. Her descriptions of medical procedures can be graphic, but she presents an intriguing picture of a side of medicine many people never see.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

From Booklist
How does one progress from humble med student to self-assured physician? It isn't easy, and while Hollywood may be able to spin humor from the idea of medical residency, the reality is drastically different. As internist Transue learned on her very first day, despite a doctor's best efforts, people die. Being expected to simply hold the hand of someone saying a final good-bye to a son or mother can be traumatic for a recent graduate hell-bent on saving lives. Likewise, keeping a straight face while viewing a hilarious tattoo can present its own challenge. Transue found a way to put her residency experiences into perspective while protecting her sanity: she kept a journal. She jotted down thoughts, impressions, and entire conversations to help make sense of a stressful, often chaotic job. The result is something to share: an often heartbreaking, sometimes humorous account of a student wending her way through a labyrinth of medical hurdles to become a caring, compassionate healer. Donna Chavez
Copyright © American Library Association. All rights reserved

Review

“With humor, humility, and a gentle wit, Transue leads us into the bizarre, bone-rattling world of medical training. Through her eyes, and her honest, engaging prose, we have a rare opportunity to experience the growth of a true healer. While readers may be lucky to have Transue as their guide, her patients are even luckier.”
- Danielle Ofri M.D., Ph.D, author of Singular Intimacies: Becoming a Doctor at Bellevue and This Side of Doctoring

"Everyone who sees a doctor needs to read this book. Dr. Transue, through her stories, gives a realistic understanding of the pressures, perseverance and strength required for students of medicine to succeed as practitioners."
- Dr. Lewis G. Maharam, medical director for the New York City Marathon

Customer Reviews

From one resident to another...5
Emily Transue's book touched a nerve for me. Also an internal medicine resident, I feel that she has written a book that honestly portrays the experiences that residents go through daily. Many of us don't have the time or emotional energy to digest all the profoundly moving experiences that come our way everyday on the hospital wards, and it is easy to feel alone in our experiences. The culture of medicine demands a strong front before colleagues and patients alike, and the innate need to make sense of what's occuring inside of you gets neglected.
This book sat on my dresser for months before I decided to pick it up. I didn't think that I needed to read about what I saw daily; in fact, I was avoiding it. To its credit, I couldn't put the book down. True, it was everything that I was used to, but seeing it from someone else's eyes was refreshing. I also recommend Danielle Ofri's Singular Intimacies for those interested in knowing what a young doctor's life is really about.

Today's Resident: Smart, Female and Very Tired5
I've always been fascinated by careers and career choices, so I read about occupations from veterinary medicine to military service. Women write many of these books because, for a long time, the novelty of being female in those occupations would get the book published.

We've seen many books by women doctors, including Perri Klass, Frances Conley and Elizabeth Morgan. So what's remarkable in this book is the complete absence of any references to gender and gender issues. One older woman says she'd rather have a woman doctor and the author says sure, she would too. Big deal. Transue writes about "the neurology resident" and then uses "he" or "she" with no comment. Both male and female attendings -- senior physicians -- can be heroic or deficient.

Almost as surprising, Transue portrays herself as polite and caring. I must admit I've stayed far from doctors and hospitals throughout my life, but the few I've met were nothing like Transue. She actually apologizes for bothering people. In fact, I suspect she set a world record for a doctor saying, "I'm sorry."

Most doctors I've met were arrogant, even rude, but Transue doesn't report a single instance of arrogance. An attending is "distant" and another unsure of herself. But when a patient's relative demands to speak to an attending, and orders Transue to make the call, she complies.

On Call deserves five stars because it's well written, almost a page-turner. Transue manages to make a collection of essays hold our interest, even when we rarely learn the ending. For instance, we learn that a man has been estranged from his family, but never why.

Most chapters are based on actual patient encounters. Transue helps us understand what's going on but doesn't get bogged down in the (literally) gory details. She describes her own fatigue without whining or pity. She doesn't seem to wonder if things could be changed.

And, in what appears to be a teaching hospital, there's little concern with changes in medicine and managed care. In one scene a patient must decide if he'll pay for a no-smoking patch or wait six weeks to begin a no-smoking campaign. Isn't there an irony here worth noting?

This non-judgmental style is both the strength and the weakness of On Call. Transue examines her own experience with, well, clinical detachment. She marvels that she could break down crying one day and be a model resident the next. She doesn't share details of her life, so we don't know what gave her the strength to keep her perspective. She went sailing with friends; she baked a blackberry pie; she lifted weights with another resident who became a gym buddy. She alludes to a loyal and loving family and she had a superb education.

But we don't know where she lived during residency or what sustained her during the tough times. Perhaps the combination of these factors helped her become such a successful resident.

As a career consultant who has studied life transitions, I was fascinated by her final chapter: a realization that the major changes in our lives often are not marked by ceremony. Going from residency to medicine was more important than graduating from medical, but marked only by a brunch and a certificate.

Transue concludes she's grateful for those years but wouldn't ever want t do it again. Paying dues is always hard but usually worth the effort. Transue was lucky to pay hers when she was very young and to end with something that was worth the price.

to think i knew emily way back when ...5
ok, i admit it - i went to med school with Dr. Transue so I am biased - I like her personally. But while that may bias my opinion of the book, it also lets me assess the book from a first hand perspective. Her writing really "captures the moment". It is so accurate that I kept waiting for the part where she mentioned my name or had me walking through the door. Never happened, but regardless - the stories she told were very realistic, and the emotions she conveyed were the same types of feelings that most of us experienced as we went through our medical training. great job emily - waiting for the sequel!
signed - one of your gross anatomy partners