The title of this bracing memoir — I Can't Save You — by former ear, nose and throat surgeon Anthony Chin-Quee seems to suggests an inability or unwillingness to save lives.
But upon further reading, its seeming surrender actually affirms the Hippocratic Oath when you consider that Chin-Quee, a Black man who struggles with racial barriers throughout, can't save others without first saving himself — and that, as the tale tells, the author has to let go of his personal demons to prosper in his medical calling.
Unlike Damon Tweedy's Black Man in a White Coat, a 2015 memoir that dispassionately recounts a Black physician's complex responses to racial and class bias through the linear trajectory of his medical training, I Can't Save You, with its deliberately messy assemblage of shifting narrative perspectives, poetry, anecdotes, and hallucinatory performance, represents the structural equivalent of a mixtape or shadow box where the author's phobias, formative memories, and Ralph Ellison's The Invisible Man intersect.
On one level, in capturing the dissonance between medicine's all-consuming demands and its practitioners' fallibility, I Can't Save You can be read as an indictment of the American Dream as represented by the social prestige of a medical degree that attracts high-achieving candidates of color without providing them the institutional support to fight discrimination, nurture their mental health, or lessen their financial hardship. But, still, the medical profession represents an aggravating factor, not the source of Chin-Quee's deep-seated trauma.
His trauma originates with his father, a Chinese-Jamaican immigrant. While Chin-Quee Sr. narrowly escaped poverty and racial violence by becoming a lawyer, he was a gambling addict and pathological liar who deserted his family and became disbarred for multiple ethical lapses. Chin-Quee Sr. would haunt his son's recurring nightmares as a silent, menacing double. At once repelled and enthralled by his errant father, young Tony, while smart and artistically inclined, has trouble articulating his fears and desires. In choosing medicine, he thinks the profession's dichotomy "of altruism and masochism" will enable him to obliterate his self-loathing for a good cause.
But, as Chin-Quee writes, the grueling pace of medical school and post-graduate residency that prioritizes bureaucracy and an assembly-line patient care model, plus a volatile social fabric where interns resort to binge drinking after hours as a coping mechanism, leads the author to spiral into a destructive cycle of depression and alcohol dependency. Chin-Quee wonders whether his chosen vocation has failed him:
"[With] ninety-ninth percentile MCAT and Step and Board scores as entrance keys to the profession, we too often neglect to screen for traits that truly matter: the self-awareness and strength of character necessary to weather the devastating emotional trials that are sure to come; the humility and grace required to be an effective, collaborative, and avid lifelong learner."
Thus I Can't Save You, in contributing to the interdisciplinary field of medical humanities by employing literary and artistic expression to shed light on the symbiotic relationship between medicine and a host of intangible conditions that affects a doctor's training and approach to patient care, can also be read as a passionate testimony in support of The Declaration of Geneva — the modern version of the Hippocratic Oath, first adopted in 1948 and last revised in 2017 — also called a Physician's Pledge (the Pledge).
In acknowledging the adverse effects of increasing workload, lack of sleep, and other occupational stress on a doctor's ability to provide quality care, the Pledge has incorporated the concept of physician wellness into its most recent version, "I will attend my own health, well-being, and abilities in order to provide care of the highest standard." Eventually, Chin-Quee successfully manages his depression, and is able to stand up for himself and to look out for others.
While acknowledging the deterministic forces that can make or break an aspiring physician, Chin-Quee also affirms individual agency. The author embraces two early setbacks in his medical career as learning opportunities — a far cry from the time when he sought to self-destruct in the name of professional vanity.
Chin-Quee's astute, no-holds-barred insights offer a window into the world of medical practitioners — and also celebrate the nuanced and diverse humanity of physicians.
Thúy Đinh is a freelance critic and literary translator. Her work can be found at thuydinhwriter.com. She tweets @ThuyTBDinh
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