What Medical School Doesn’t Teach About Death

To say that the practice of palliative care comes to vivid life in Sunita Puri’s pages may seem like a bad choice of words. But her memoir about tending to seriously, often incurably, sick people pulls off that feat. The driven daughter of Indian immigrants (her father is an engineer, her mother an anesthesiologist), she was in for a shock during her residency. She had been trained to equate success with patients’ survival. Now she realized that she had been taught nothing about addressing patients’ “debility, mortality, suffering.”

Puri focuses on the struggle to accept limits in our mortal lives and in our medical culture—and in her own career. Allergic to sanctimony, she deals in visceral, and lyrical, details. “His body remained,” she writes about the death of a patient whose treatment she had agonized over, “but he had quietly and comfortably moved out, leaving behind his tattoo, his bruises, his clot, his cancer.”

In a high-tech world, her specialty is not cures, but questions—about pain, about fraught prospects, about what “miracle” might really mean. Her tool is language, verbal and physical. Wielding carefully measured words, can she guide but not presume to dictate? Heeding the body’s signals, not just beeping monitors, can she distinguish between a fixable malady and impending death? Puri the doctor knows that masterful control isn’t the point. For Puri the writer, her prose proves that it is.