DEPARTURE FROM THE DARKNESS AND THE COLD

A doctor weighs the rigors, discontents, and joys of practicing medicine in this collection of essays and poetry.

In these pieces, Hergott, a cardiologist and emeritus professor of medicine at the University of Colorado, delves into the physically and emotionally grueling realities of a medical career as well as the humane idealism at its core. Several essays decry the subjection of doctors to the dictates of markets and corporate health care providers’ demands; the result, he contends, is burned-out physicians with little time to care for their patients’ emotional needs or to maintain family lives of their own. Hergott re-creates the ordeal and trauma of medical training—his nerves were so bad on one day of his residency, he writes, that he had to leave the hospital—and the hard-won confidence in his abilities that grew over time. He also tells stories of appropriate medical treatment choices that resulted in patients’ deaths—every doctor has some—and discusses the painful process of learning and moving on from them. Other, contrasting stories tell of health care professionals forging connections with patients despite obstacles. Hergott recalls a ward full of nonresponsive hydrocephalic infants, many abandoned by their parents, who received tender care from the ward nurses; World War II veterans who opened up to him about things they’d never discussed with anyone; and a doctor in an elevator who lifted the spirits of a fragile patient just by making small talk with her. In several essays, he recounts the death of his adult son, Zachary, in a 2009 plane crash and the rudderless grief that he weathered in its wake—and the colleagues, patients, and strangers who helped him through it with simple gestures of caring.

Hergott writes in a limpid style that’s vivid and often haunting: “They were young men, their bodies pale, translucent, and incomplete,” he writes of convalescents at a military hospital. “Each had part of an arm or a leg missing or had some other wound inconsistent with the perfection of the rest of the body.” His prose moves between clinical precision (“I felt the clamp placed in my hand and as I began to move it toward the cords a thought flashed in my mind…I could completely occlude his airway—which would be catastrophic,” he frets while treating a choking toddler) and more lyrical observations that skillfully evoke mood and feeling (the toddler’s mother had “her son enfolded in her arms, her head bent with her face close to his, she speaking softly to him in a way no one else could”). Even more than his prose, Hergott’s poetry offers dense imagery that conveys psychological wounds beneath physical ones, as in a piece about a brain surgery patient: “When the staples come out, / and the bone beneath has healed, / and your flowing hair— / artfully parted during— / covers the scar after, / there will be nothing seen / of what proceeded.” The overall result is a rich and absorbing portrait of a doctor’s life.

A luminous meditation on a healer’s experience that’s anguished and exuberant, by turns.