Book Review: The Calling

The Calling, a collection of personal stories on the unique relationships between patients and their physicians, was written by Blair Grubb, MD, and recently published by the University of Toledo Press. In this interview, we talk with Dr. Grubb, Director of Electrophysiology Services at the University of Toledo Medical Center, about his published work.

What was your motivation in publishing this collection of stories?

In truth it was more of a gift to my wife, and I wanted to get it out while she was still able to see it. But I had also always wanted to put the stories together, which had been in different sources over time, and then the University of Toledo Press approached me wanting to know if it would be possible to publish a collection. In working with them, I sent over everything I ever wrote, and the editorial board pared it down to a group of stories they felt would be most applicable to the average reader. The book has been fairly successful — it is currently one of the more successful books by the University of Toledo Press, and I’m happy to help recontribute to the university’s expansion. But the main motivation was to have in one place a series of stories. I admit I had also always wanted to publish a non-technical medical book — I’ve published tech books and patient education books and a number of scientific papers over the years — but I truly wanted to do something like this, as I aspire to be a writer in addition to the other things I do.

What audience is the book intended for?

The book really is intended for anybody. The university did purchase this book to give out to each of the incoming medical students this year; there is an event called the white coat ceremony, in which they give the incoming medical students a white coat and they take an early oath of ethics and service — and the university gave each of the medical students a copy of the book as a way to instill in them the idea of the special relationship they have with patients. However, the audience of this book is both patients and physicians. Many of the stories were written for a physician audience; I believe that part of the reason many physicians tend to experience emotional and social problems is because of their lack of contact with the very people they treat — they’re sort of estranged from their own patients. Physicians are human beings, and the people they care for are human beings, and there is probably no other place in American society where that kind of special relationship exists between the physician and the patient, or as I like to say, between the healer and the patient. There are a lot of physicians out there, but there are very few healers. The stories in this book are there to remind physicians about the wondrous and deep experiences that can be had by simply trying to share in the lives of your patients and by listening to them. I think I mentioned in one of our previous conversations that the average amount of time a physician spends with a patient is only 7 minutes. That would be great if we could cure every illness, but patients have chronic needs, are afraid, angry, frustrated, and feel their needs are not being met, and doctors tend to rush through to the next patient. Despite the fact that doctors technically do more than we have ever done in the past, patients are less satisfied than ever before in the past, and I think in part it’s because of a lack of connection.

Some of the stories are about my own personal experiences as a patient, some are personal stories about losses such as when my father passed away, and some are other people’s experiences — for example, I wrote several pieces about my wife. However, for the most part the stories dwell on interactions I’ve had with patients, and I think those interactions can be looked upon as either mundane or as something unique that happened between you and another person. In the one story, “Daybreak in Angkor Wat,” I describe trying to care for a difficult patient who was a Vietnam veteran and an alcoholic and heavy smoker, but he had his own story to tell; he had his own rich past that was very interesting, and in the story I related that. So he went from being perceived as this sort of ‘drunk vet’ to being a person who had something to teach and something to say. I think that physicians all have these types of surprising interactions, and you can either choose to ignore them or choose to experience them. In some ways it is kind of like life itself — you can choose to rush through your day and ignore everything, or be fully participating in the world around you.

Frequently appearing themes in the book are death, faith, and seeming “coincidences.” How will this book help medical professionals cope with such topics?

Every physician is going to have to deal with making mistakes, learning how to balance their own personal life with the demands put on them by being a physician, and figuring out how to remain a person in spite of the ever-increasing demands of documentation and other demands in the healthcare system. Hopefully these stories will help people find their own ways of coping. Michel de Montaigne, known for popularizing the essay as an art form, simply wrote of things that happened to him — there wasn’t any particularly notable message in his writing except to relate what happened to him. In reading these now, almost 500 years later, you feel like he’s talking about yesterday, that nothing’s changed — I feel that way, I had that happen — and it gives you a different perspective on life. So I think part of my goal is to help physicians and people in general pay more attention to their own world, their own interactions, and be more fully alive, because everything can disappear in a moment. Some physicians look at patients like they’re a sort of subspecies — they treat them in a very pejorative way — but patients are people just like us, and someday every physician will be a patient. If anything, I’ve learned a sense of awe and wonder at the world itself that we tend to forget.

Do you think that writing has made you a better doctor?

Yes, I think it has. It has made me focus my thoughts better; writing makes you think more closely about things and pay more attention to things. The editor at the University of Toledo Press, Joel Lipman, who is a very well-known poet and one of Ohio’s poet laureates, told me once that as a writer you find yourself really paying attention to conversations and oftentimes eavesdropping on conversations to hear how people speak and describe things. You start paying attention to the little things that other people don’t.

What inspires you to write? Who, if anyone, has influenced your writing?

One of the authors that I have been heavily influenced by is Chaim Potok, who wrote a series of books, one of which was called The Chosen. As far as a style, writer Danielle Ofri and Sherwin Nuland, who is another medical writer, have influenced me to a great extent.

Do you feel the book will reach out to people of all faiths?

I would hope so. I am Jewish, so I approach things from that perspective. I’m not asking anyone to accept or reject the themes in the book, it’s just who I am. My hope is that it will reach out to people of all faiths, because I think the stories in the book carry universal themes.

Which is the oldest story in the book?

The oldest is “It Should Once Again See Light,” written in 1996.

Are there any previously unpublished stories included in this book as well?

No. I sent them, but the publisher chose not to use them. I sent everything I’ve written and they decided what they wanted to use.

Have you kept in touch with the patients mentioned in this book?

Yes. Oftentimes I change people’s names, but in the first story, “The Calling,” the patient’s real name is Paul, and he is still my patient.

Where will the book be available for purchase?

The book is available on Amazon, and it is also on the University of Toledo Press website.

What’s next for you? What projects do you have coming up?

I’m actually giving a reading at a poetry event, and I’m trying to publish a collection of poetry. I’ve had about a dozen poems published in various venues, most recently in Pharos, which is a medical humanities journal for members of Alpha Omega Alpha.