Death of the Good Doctor: Lessons from the Heart of the AIDS Epidemic
by Kate Scannell, MD
Review by Keegan A. Checkett

Poetry in life is a common metaphor, although few realize its truth. William Carlos Williams posthumously achieved international fame in medical and literary circles for his ability to catch, as snatches of verse, the truly important moments in people's lives that lose their essence in the emergency or banality of the time. Shakespeare, Frost, George Eliot, Fitzgerald, and many other prestigious authors famed for their ability to portray truth in life occasionally wrote a character, passage, or poem that addressed some aspect of medicine. None of them truly captured this medical aspect or devoted themselves to it until Williams.

Now Kate Scannell, MD, has published a collection of short semibiographic sketches depicting the trials and tribulations of life and of practicing medicine. Each chapter begins with a quote, set off so that it is not so much a theme but an invocation to the author of the quote, a Muse who successfully managed to capture life's poetry in his or her own writings. After all, few fields other than medicine are more abundant in poetry. A tremendous percentage of life's true moments occur in a medical setting; a physician bears witness to all these moments and to his or her own. As Williams said in The Autobiography of William Carlos Williams: "... as a writer I have never felt that medicine interfered with me but rather that it was my very food and drink, the very thing which made it possible for me to write ... Oh, I knew it wasn't for the most part giving me anything very profound, but it was giving me terms, basic terms with which I could spell out matters as profound as I cared to think of."^{(1: p 357)}

Scannell invokes Williams' spirit in her short story collection, Death of the Good Doctor: Lessons from the Heart of the AIDS Epidemic. Although she has not yet reached the level on which poetry dwells, Dr. Scannell found through her work on the AIDS ward the key to unlocking and revealing the hidden character within her patients. She does not relate these lessons. Rather, she recreates the situations through which she gained understanding.

As Scannell explains in the prologue, the good doctor in her was the highly trained, efficient product of intensive medical training in school, residency, and research. She could nail afflictions and single-handedly defeat problems with her arsenal of skills and drugs. Her fundamental flaw, however, was her inability to see the heart of a situation, the real problems that her terminal patients were facing in the dark ages of AIDS, the mid-1980s. As she relates the story in the prologue: early in her career on the AIDS ward, she misinterpreted a patient's request for help as a request to sustain his life. Learning the next day that he simply had wanted to die pain-free, without life support, the 'good doctor' in her died and was replaced by the tough, eccentric, sharp-sighted caregiver who spent the next five years easing patients' physical and emotional pain. Nearly a decade later and after exponential advancement in the AIDS field, Scannell addresses these patients and their characters while recovering from her battle with ovarian cancer. Compiling these stories, Scannell finds her own.

Death of the Good Doctor is a carefully packaged collection of character sketches, featuring Scannell, her patients, and their families as the leading characters. Scannell's ability to re-create these patients and their struggles lends the book its vibrancy and credibility. The text reads easily and quickly because she captures the moment, intimately detailing the traits that define a person. She may devote extraordinary effort to describing a patient's worry over proper death etiquette without a word about his background. The etiquette concern is the crux of this particular patient's proper treatment, not his dementia.

Fortunately, Scannell's story is not that of a female Patch Adams-meets-AIDS unit. Nor can she compare to William Carlos Williams. What she does do is recall the better attributes of both by creating a book that although not the work of a literary genius, is accessible to readers of all levels, with or without medical or literary experience. Scannell refrains from drawing all of the conclusions in her stories or making any sweeping statements. By presenting the heart of a story and outlining her insights, she leaves it open for the reader to interpret the driving force behind each patient and behind herself. The resulting text is laden with rich character description, Scannell's sharp wit, and heart-tugging anecdotes in a context that intellectually stimulates the reader.

Rewritten, Death of the Good Doctor has enormous potential as a screenplay, because the material is familiar to every human being and easily accessible to every reader. The amount of intelligent thought devoted to the text depends solely upon the reader. Taken at face value, Scannell's work is a dynamic, engaging, and unique creation that, at the least, will affect the reader on a subliminal level. On dedicated reading, the insight and self-knowledge gained undoubtedly will nourish the discernment, creativity, and shrewdness required for skillful patient interaction.

$14.95 Paperback - 200 pages (September 1999) Cleis Press; ISBN: 1573440914

1. Williams WC. The autobiography of William Carlos Williams. New York: Random House; 1951.

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