Book Reviews

No Apparent Distress by Rachel Pearson, MD


If you are deeply concerned about the plight of the poor in America—and, in particular, the roadblocks they face in getting even the smallest health care need met—then this is going to be an extremely difficult book for you to read.

As I write this review,the date is currently January 23, 2017. Three days ago, Donald Trump was inaugurated as the 45th President of the United States of America. The House of Representatives and the Senate is in Republican control and it’s just a matter of time before a new Supreme Court Justice is appointed—who will most certainly be a Conservative—which means all three branches of the Federal government will be under Republican control. By the time this review is published in late April, it is very likely that under this Republican majority, the Affordable Care Act will have been repealed, which will be particularly devastating to the most vulnerable in our society who gained coverage through the medicaid expansion (if they were fortunate enough to live in a state that expanded medicaid).

Which makes this a most timely read, indeed.

No Apparent Distress recounts the author’s days as a medical student in Galveston, Texas, detailing some of her experiences working in St. Vincent’s Student-Run Free Clinic. Staffed by volunteer students and physicians from University of Texas Medical Branch, St. Vincent’s offered health services for the uninsured poor. Financial limitations restricted the care patients received, sometimes with deadly results.

Pearson doesn’t shy away from admitting her own mistakes and shortcomings as a medical student; she shares those stories with regret and the 20/20 hindsight that wisdom brings. Nor does she hide her frustration about the disparity of care available to the insured vs. the uninsured, given examples of the inequalities she noticed while working/learning at the office of another doctor whose patients were insured and had considerable financial means, as well.

The Haves… and the Have-Nots.

If ever there was a book that inspired compassion for those less fortunate, it’s this one. If you’re seeking understanding about what it’s like to be poor and uninsured in America, I urge you to read this book. It’s definitely an eye-opener.

I received an advance review copy of this book courtesy of Netgalley and W. W. Norton & Company.

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Author: Rachel Pearson, MD
Title: No Apparent Distress: A Doctor’s Coming-of-Age on the Front Lines of American Medicine
Genre: Nonfiction, Memoir
Publication Date: May 9th, 2017 by W. W. Norton & Company
Rating: 5 stars

About the Book

In medical charts, the term “N.A.D.” (No Apparent Distress) is used for patients who appear stable. The phrase also aptly describes America’s medical system when it comes to treating the underprivileged. Medical students learn on the bodies of the poor—and the poor suffer from their mistakes.

Rachel Pearson confronted these harsh realities when she started medical school in Galveston, Texas. Pearson, herself from a working-class background, remains haunted by the suicide of a close friend, experiences firsthand the heartbreak of her own errors in a patient’s care, and witnesses the ruinous effects of a hurricane on a Texas town’s medical system. In a free clinic where the motto is “All Are Welcome Here,” she learns how to practice medicine with love and tenacity amidst the raging injustices of a system that favors the rich and the white. No Apparent Distress is at once an indictment of American health care and a deeply moving tale of one doctor’s coming-of-age.

About the Author

RACHEL PEARSON, MD PhD, is a resident physician who also holds a PhD from the Institute for the Medical Humanities. Her writing has appeared in Scientific American, the Guardian, and the Texas Observer. She is a fifth-generation Texan, currently training as a pediatrician at Seattle Children’s Hospital.

Author photo and bio via publisher’s website.