Michelle Au, M.D. Seattle, Washington, Grand Central Publishing, 2011. Pages: 336. ISBN-10: 0446538248. ISBN-13: 978-0-446-53824-4. Price: $24.99
Having experienced medical school, residency, fellowship, and motherhood, I cracked open the book This Won't Hurt a Bit (and Other White Lies): My Education in Medicine and Motherhood by Michelle Au for a chance to connect with an author likely to have shared several of my adventures. Incidentally, I read the first page just hours after taking the final oral board certification test for anesthesiology and days after finding out I was expecting my second child. Anesthesiology has been a male-dominated field until recently, and there is little precedent or guidance for combining the trials and tribulations of medical education and motherhood. I had attempted to gain some insight from various parenting magazines, but they offered little help because there are few medical education tracks that allow on-site child care, working from home, and flexible hours. This Won't Hurt a Bit provides a realistic, entertaining, and very personal look at the implications of daring to live through the challenges of medical education.
Michelle Au is a practicing anesthesiologist in Atlanta, Georgia, the wife of a surgeon, and the mother of two. Her book is drawn from years of her reflective writings (in an online journal called the Underwear Drawer ) about her experiences in medical school and residency and how they affected her personal development as a young woman, a promising physician, and a new mother. She obtained her medical degree from Columbia University College of Physicians and Surgeons, after which she spent 2 yr as a pediatric resident at Children's Hospital of New York. She then completed her training in anesthesiology at Columbia-Presbyterian Hospital in New York City. Since her second year in medical school, Michelle Au has maintained an online journal of her experiences and recently (May 2011) began a featured blog for Psychology Today , for which she contributes the “human side of medicine and unmask[s] doctors, one white lie at a time.”
The book proceeds chronologically through the many phases of medical education, beginning with the classic preclinical start of medical school, about which Dr. Au emphasizes the youthful excitement of early training weighed down by the grueling study hours and monotonous laboratory work. Most of the book is devoted to the clinical years of medical school as the author reflects on her first and most memorable patient interactions. Some are exhilarating, some are tragic, and many are heart wrenching and very familiar to those of us who survived with stories of our own. She started a residency in pediatrics but made the transition to anesthesiology after 2 yr of training. This is atypical, but her experiences in pediatrics make the book more appealing to a wider audience. In fact, this book is appropriate for all students, trainees, and young physicians, regardless of their chosen specialty, especially because all physicians care for children throughout their education.
The author's extremely witty sense of humor is well known to readers of her “Scutmonkey Comics,” and her first book retains this element of her writing style. For example, the discussion about adopting a puppy and the section “Four Short Plays about the Preclinical Years of Medical School” made me laugh out loud. Other captivating parts of her story include her relative anxiety about delivering her first child at an academic hospital in July (granted, I thought and experienced the same thing!) and the description of her experience at a New York hospital on September 11, 2001.
There is a strong sense of professional, artistic, and personal growth and development throughout the book. Her intuitions become more holistic, her discussions more thoughtful, and her reflections more well-rounded. This is a very personal account of the author's experience in medical school, residency training, and early parenthood. Individuals will enjoy their own personal recollections and memorable moments, but I believe Dr. Au could have better captured the privilege of becoming a physician and the awe and accomplishment of finishing medical school and residency. Furthermore, the overwhelming tasks of studying for and taking the board certification exams were missing from her story. I will never forget a colleague standing behind me in line for the final oral board certification exam saying, “All of my education and training comes down to the next 75 minutes.” Preparing for the board exams, both written and oral, while working full time as an anesthesiologist, wife, and mother is no ordinary task and personally overshadowed the better part of a year for me. One Saturday morning when my husband took our preschooler to breakfast, she told the waitress, “Mommy is studying for a test, and I drive her crazy sometimes.”
In summary, This Won't Hurt a Bit (and Other White Lies): My Education in Medicine and Motherhood exposes the reality of medical education and the irony within the practice of medicine that physicians are human but our patients want us to be more. We must be all-knowing, extensively experienced, always present or available, and yet as compassionate and able to care for them as we would a member of our family. This should be an impossible mission on its own, let alone when combined with the demands of marriage and a young family. Dr. Au summarizes this point beautifully when she states, “I now have two full-time jobs—residency and parenthood—each of which demand my complete attention, almost all of my waking hours, and both of which society has drilled into me are my first, most important priorities. The stakes are huge. [Halfway] efforts at either would be unacceptable.” It is good to know that I'm not alone.