First Do No Harm by Lisa Belkin documents the tough decisions that doctors have to make in order to treat their patients. Often their decisions have no real answers and sometimes there is no good choice. It is the basic struggle of how to help patients and still maintain some hope even in the face of incredible odds. It also brings up the question of how much human life is really worth yet still addresses the aspect of placing the massive costs of health care on loved ones and the decisions they have to make about treatment.
The book is set in Hermann Hospital, located in Houston, Texas. The doctors and patients are real stories as seen through the eyes of doctors and loved ones. The big decisions between life, death, and treatment are discussed by the ethics committee. The first case introduced is about Patrick, a teenage boy who has lived fifteen years with a disease that prevents him from digesting nutrients. In what could only be called a case of a matter of time, the doctors and parents are forced to decide when it was time to let go. This is just one of the many cases that the ethics committee discusses.
Presented in more story form than a medical fact book, Lisa Belkin takes the position of an objective observer. She documents the disease the patient faces, the struggle for doctors to make a decision, and the overwhelming fear that loved ones faced as they make they decisions. The emotional struggles of the doctors and loved ones are presented in their raw form. The ethic committees meetings are filled with the intensity of making those tough decisions and then carrying them out.
It is tough to walk away from this book without shedding a few tears for those lost and those who are still struggling to find a way to deal with the things life dealt them. There are very few happy endings. But as noted in the epilogue, most of the loved ones have learned to move on with their lives and have found ways to deal with the pain of the past.
Even though this book has been around for awhile, it is still worth reading. It is one of the few non-fiction books that provides the true stories of individuals without being overly dry or boring. While it is factual, it integrates the facts seamlessly into the life stories and keeps things interesting.