Contrasts in Care

Chapter 4 Contrasts in Care

I wanted to communicate: Yelling louder does not help me understand you any better! Don’t be afraid of me. Come closer to me. Bring me your gentle spirit. Speak more slowly. Enunciate more clearly. Again! Please try again! S-l-o-w down. Be kind to me. Be a safe place for me. See that I am a wounded animal, not a stupid animal. I am vulnerable and confused. Whatever my age, whatever my credentials, reach for me. Respect me. I am in here. Come find me. Jill Bolte Taylor, My Stroke of Insight (2016: 75) ∵

In the bestselling memoir Heartsounds: The Story of a Love and Loss (1980), American journalist and editor Martha Weinman Lear (1930–) describes the traumatic hospitalization of her husband, Dr. Harold Lear, a urological surgeon and sex therapist who after suffering a massive heart attack in 1973 was sub- jected to years of “ruinous open-heart surgery, medical error, arrogance, and indifference” (1980: xi).1 The couple was stunned to find that increasingly, this “once powerful surgeon found himself at the mercy of the profession in which he had always taken such pride” (xi). After being hospitalized, Dr. Lear quickly recognized the pervasiveness of “bad medicine”: “These people [physicians] do not listen to the patient, they do not think in terms of what is best for the patient. They are too enveloped in their own authority” (45). As would be true of stroke survivor and medical researcher Jill Bolte Taylor (1959–) nearly twenty- five years later, Dr. Lear struggled against attempts to deny his personhood, rebuking for instance the medical students who had awakened him from a sound sleep so that they could listen to his heart. He asserts, “I’m not just an interesting heart sound…. I’m a tired person” (457).2 And after being brushed

1 Heartsounds was adapted into a film of the same title in 1984 starring Mary Tyler Moore (1936–2017) and James Garner (1928–2014). 2 Taylor, a Harvard-trained brain scientist, suffered a massive stroke on December 10, 1996. My Stroke of Insight describes her personal journey of recovery and how her “stroke of insight has given me the priceless gift of knowing that deep inner peace is just a thought/feeling away”

Contrasts in Care 231 off repeatedly by the nursing staff, he scrawls in his notebook, “I am not a dog in a kennel” (480). Martha Lear notes early in the memoir: “The social atroci- ties committed by the staff! It was as though, by the simple act of signing in, patients forfeited the right to be treated with respect” (48). Dr. Lear died in 1978, five agonizing years later, at the age of fifty-seven. In the afterword to Heartsounds, Martha Lear makes her peace with how her husband was treated, believing that “much of the anger I felt was simply, primi- tively, because they could not do the impossible: they could not make him well” (509). In 1980, Lear told Judy Klemesrud of the New York Times Book Re- view that “pointing the finger of blame was never one of my motives in writing” the memoir and that she was pleased with the positive response the book had received from dozens of physicians, declaring the medical reaction “splendid” (Klemesrud 1980). But health professionals often related to the book precisely because of its indictments of medical practice. Those who responded in such a way include Dr. William A. Nolan (1928–1986), author of The Making of a Sur- geon (1970), who in the Washington Post Book World observed “I wish I could say that Martha Lear has painted a distorted portrait of healthcare in the Unit- ed States, but I can’t” (Poetry Foundation, n.d.). In fact, whatever intentions Lear might have had, many reviewers of Heartsounds read the book as a con- demnation of medicine. As Maggie Scarf (1980) noted in the New York Times Book Review, the doctors, as a group, “come off badly”; Heartsounds exposes not only the “inadequacies in the health-care system” but also “occasional acts of callousness that leave one breathless, speechless with rage.” This was despite the fact that the patient-autonomy movements of the previous decade had long revealed medical paternalism as outmoded and “brought the conviction that patients were equal partners with physicians in making medical decisions about themselves” (Spiro 1993a: 3). More recently, physician and journalist Abi- gail Zuger has written that Heartsounds was animated by “cold fury,” Lear hav- ing “skewered the medical system of the 1970s for ineptitude large and small” (2014a). The memoir, according to Zuger, is quite simply “an indictment of a system in dire need of reform” (ibid.). More than three decades after the events of Heartsounds, Lear found herself in the same hospital, in the same cardiac unit, being treated for complications from a heart attack by the same attending physician who had looked after her husband. She describes this experience in Echoes of Heartsounds: A Memoir (2014), what she terms a “companion piece” to Heartsounds. Moments after her

(2016: 169). As is true of the narratives examined in this chapter, her memoir contrasts health professionals, including physicians, who treat her with respect, and those, including nurses, who are oblivious to her needs (77, 83).