The stories recorded on the pages of Patients Are a Virtue have been several years in the making. Some were written down within hours of the actual encounters; others were not recorded until years later. This latter fact testifies to the meaning of an epiphany—an awakening, a revelation steeped with an intensity not easily forgotten.
These tales can be read on several levels. First and foremost, I offer them as encounters typical in daily clinical practice. Sir William Osler, one of the 19th century’s leading proponents of humane medical practice, wrote: “Dealing as we do with poor suffering humanity, we see the man unmasked, exposed to all the frailties and weaknesses; and you have to keep your heart soft and tender, lest you develop too great a contempt for your fellow creatures.” In moving through these tales, I hope that the general reader is able to sense that underlying tenderness as each story unfolds.
As illness narratives, these tales also serve to introduce the student to the art of medical practice. He or she can follow the clinician’s thought processes that lead to accurate assessments of the patient’s condition. A perceptive reader will find that, in some instances, try as the clinician might, he can offer only a listening ear or a gentle touch: many conditions have no cure otherwise. And the student will also witness those occasional failures of diagnosis; along with the clinician, he will learn to profit from these mistakes.
Finally, the stories themselves illustrate the healing process inherent in the clinician-patient relationship. As clinicians, our willingness to suffer with the patient through the act of compassion holds up this inherent hope.
Years ago I read that the best advice for an aspiring author is to write about what you know. I let it up to my readers to decide to what extent these tales measure up.