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Publisher's Summary

A brilliant young transplant surgeon brings moral intensity and narrative drama to the most powerful and vexing questions of medicine and the human condition.

When Pauline Chen began medical school 20 years ago, she dreamed of saving lives. What she did not count on was how much death would be a part of her work. Almost immediately, Chen found herself wrestling with medicine's most profound paradox: that a profession premised on caring for the ill also systematically depersonalizes dying. Final Exam follows Chen over the course of her education, training, and practice as she grapples at strikingly close range with the problem of mortality. She struggles to reconcile the lessons of her training with her innate knowledge of shared humanity, and to separate her ideas about healing from her fierce desire to cure.

From her first dissection of a cadaver in gross anatomy class, to the moment she first puts a scalpel to a living person; from the first time she witnesses someone flat-lining in the emergency room, to the first time she pronounces a patient dead, Chen is struck by her own mortal fears. There was a dying friend she could not call, a young patient's tortured death she could not forget, and even the sense of shared kinship with a corpse she could not cast aside when asked to saw its pelvis in two.

Gradually, as she confronts the ways in which her fears have incapacitated her, she begins to reject what she has been taught about suppressing her feelings for her patients, and she begins to carve out a new role for herself as a physician and as human being. Chen's transfixing and beautiful rumination on how doctors negotiate the ineluctable fact of death becomes, in the end, a brilliant questioning of how we should live.

©2007 Pauline W. Chen; (P)2007 Phoenix Audio

Critic Reviews

"A graceful, precise, and empathetic writer." (Booklist)

What members say

Average Customer Ratings

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  • Overall

Brilliant and Moving

I have just finished listening to this book and can't wait to listen to it again! It is both fascinating and touching to see patient care from a physician's perspective. Chen's attention to detail is exquisite.

9 of 9 people found this review helpful

  • Overall

Not just about end of life

This is not just about end of life issues. This is about what is going on in the minds of doctors as patients and families struggle with end of life issues. It explores training and human issues along the way.

It's not for everyone, but I found this to be helpful, insightful, and clearly expressed.

8 of 8 people found this review helpful

  • Overall

End of Life thoughts

I am a hospice nurse, so this topic of death and dying always interest me. I enjoyed the book, and the authors' reading, but the microphone seemed to click on and off repeatedly....as she'd pause to breathe, or give emphasis...the mic would click. It became very annoying during specific stretches.

Otherwise, I enjoyed her perspectives and self analysis regarding death and guiding patients in decisions for their care.

1 of 1 people found this review helpful

  • Overall

ICU PA

I work in the field, and I loved this book. It may not be for everyone, but its for ANYONE who works in healthcare or has been very ill. Dr. Chen is thoughtful and explains the inablility of many of us in the profession to allow death to be part of life.

1 of 1 people found this review helpful

  • Overall

Are you sure you want to be a surgeon?

I don't think the author knew what to call this book; it sort of dealt with end of life issues but was really a travelogue of experiences she had while becoming a surgeon. I was left wondering why she wrote the book rather than thinking about the subject matter itself. It seemed she was unsure if the twelve plus year focus it took to become a transplant surgeon to the exclusion of most everything else in her life was the right choice for her.
It's hard to say who this book is for; it would probably be a good listen for young adults interested in a medical career who also liked sad stories. Her stories did keep me interested (although I wish the book had more of them) and I found myself staying up late one night to finish the book.

1 of 1 people found this review helpful

  • Overall
  • Performance
  • Story

personal, insighful,revealing

I worked in the medical field as a professional medical coder (billing) for 30 years.
I've always wondered on how the doctors feel about theie patients' death.
I read their reports and get affected. Now I understand how the Providers feel.
Pauline showed that it is indeed a noble profession.
I like that she narrated it too!

  • Overall

Good start, then loses steam

The book starts strong, but falls very flat in the middle. The author's descriptions are so vivid you can see, and smell, the things she's describing. Her medical school experiences come alive. Once she gets to talking about her experiences as a surgeon, she wanders away from the vivid story-telling, and gets into some really boring narration. I quit listening about 2/3 of the way through; the book no longer held my interest or attention. One final thing, the author is a good reader and has a voice that's easy to listen to.