Macmillan Childrens Publishing Group
In Shock

In Shock

My Journey from Death to Recovery and the Redemptive Power of Hope

Rana Awdish

St. Martin's Press

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A riveting first-hand account of a physician who's suddenly a dying patient and her revelation of the horribly misguided standard of care in the medical world

Dr. Rana Awdish never imagined that an emergency trip to the hospital would result in hemorrhaging nearly all of her blood volume and losing her unborn first child. But after her first visit, Dr. Awdish spent months fighting for her life, enduring consecutive major surgeries and experiencing multiple overlapping organ failures. At each step of the recovery process, Awdish was faced with something even more unexpected: repeated cavalier behavior from her fellow physicians—indifference following human loss, disregard for anguish and suffering, and an exacting emotional distance.

Hauntingly perceptive and beautifully written, In Shock allows the reader to transform alongside Awidsh and watch what she discovers in our carefully-cultivated, yet often misguided, standard of care. Awdish comes to understand the fatal flaws in her profession and in her own past actions as a physician while achieving, through unflinching presence, a crystalline vision of a new and better possibility for us all.

As Dr. Awdish finds herself up against the same self-protective partitions she was trained to construct as a medical student and physician, she artfully illuminates the dysfunction of disconnection. Shatteringly personal, and yet wholly universal, she offers a brave road map for anyone navigating illness while presenting physicians with a new paradigm and rationale for embracing the emotional bond between doctor and patient.

EXCERPT

Introduction

A Chance to Die


Medicine can be a magical lens through which to view the human body. Focus its light on an unsorted pile of symptoms and it will converge them neatly into a diagnosis. A swollen, red “strawberry”...

Reviews

Praise for In Shock

"In a gut-wrenching memoir approaching Job-level suffering, Awdish recounts her ordeal as a doctor-turned-patient and the many changes in her perspective and practice of medicine...Awdish’s emotional tenor is electric (and understandable): angry, anxious, self-pitying, vulnerable, even terrified. But she’s also heroic, smart, and determined.” —Booklist (starred review)

"In Shock should be required reading in every medical, nursing and health professional school. Dr. Awdish cuts to the core of what is ailing the healthcare system: a loss of humanity. Her honest and poignant appraisal of how modern medicine systematizes illness and suffering is a wake up call to rethink medical pedagogy and the concept of how we truly heal. Ultimately, she gives us hope that through better understanding of each other and ourselves, we can reinvigorate the human connection at the heart of healthcare." —Andrew J. Shin, JD, MPH, Senior Director, Policy, The Schwartz Center for Compassionate Healthcare

"A compassionate and critical look at medicine and illness from both a doctor’s and a patient’s perspective...Awdish has written a unique and insightful memoir." —Publishers Weekly

"A sobering, well-rendered reality check on the desperate need for advanced training on compassion-centric modes of patient care." —Kirkus Reviews

"Dr. Rana Awdish brings the much-needed voice of the patient to life in a courageous retelling of her catastrophic illness and stunning revelations of the major disconnect between the communication caregivers deliver and what patients need. Rana’s story is not only compelling; it’s a call to action. This book will, hopefully, spur the change needed to develop a culture of empathy among providers beginning in our training programs and carrying through to practices, hospitals and health systems." Wright Lassiter III, President & CEO, Henry Ford Health System

"Dr. Rana Awdish suffered through catastrophic illness and loss as a young physician. Her perspective on her experiences as a patient transformed her understanding of how medicine is practiced today. In Shock reminds us of the essential aspect of the individual narrative and the vital importance of communication; not just between patients and their doctors but between doctors and themselves. Dr. Awdish's compassion for both her patients and those providing care for patients comes from profound insight into the vulnerability that illness imposes and the suffering that asks for acknowledgement and understanding." —Susan Clark Ball, M.D., M.P.H, M.S., Associate Professor of Medicine at Weill Cornell Medical College and Assistant Director of the Bernbaum Unit, Center for Special Studies, New York Presbyterian Hospital

"In Shock is an ideal text for courses in narrative medicine, and similar classes that are now increasingly taught under a variety of names in medical schools nationwide. It is a welcome addition to a canon that includes such diverse works as Arthur Frank’s The Wounded Storyteller, Danielle Ofri’s Singular Intimacies, and What Patients Say, What Doctors Feel, Samuel Shem’s The House of God. Together, these works lay bare the dilemma of the doctor in the age of the modern estrangement from care (as opposed to cure) and in bearing witness to this crisis, they urge us forward." —Matthew von Unwerth, Program in Narrative Medicine, Columbia University

"Devastating and life-affirming all at the same time. As a fellow physician and mom, I founded myself immersed in In Shock, both by Rana Awdish’s description of her heartbreaking losses as well as her triumphs of making it back to life repeatedly, to ultimately tell this story so beautifully. She reminds us all of the critical importance of maintaining our “human-ness” when we are taking care of the very ill." —Lynn E. Fiellin, M.D., Associate Professor of Medicine and the Yale Child Study Center, Yale University School of Medicine

“This book is remarkable—should be required reading for every medical caregiver. In Shock is so beautifully written, so full of wisdom about illness, emotional connection and ripe with ideas for improving communication with my patients. I was so moved by Dr. Awdish’s courage, resilience and passion to improve medical practice.” —Jeffrey Millstein, MD, Penn Medicine

"A very important book and the perfect antidote to the ever increasing canon of rather self-congratulatory medical literature hitting our shelves. Awdish looks at the way we practice medicine with a combination of love and outrage. She writes beautifully about the secret, shameful feelings many doctors feel they have to hide and she shows us how we might do better. After reading this book, I feel like a different doctor." —Dr. Gabriel Weston, author of Direct Red: A Surgeon's Story

“Perhaps the bravest book that I have ever read in its gripping honesty and powerful lessons. An unrivaled view of healthcare as it really is—its triumphs and missteps—through the riveting, nakedly honest story of a physician who became seriously ill...reads like a page-turning novel.” —Leonard L. Berry, Ph.D., Regents Professor, Mays Business School, Texas A&M University and Senior Fellow, Institute for Healthcare Improvement

"When Rana Awdish's brief description of her medical experiences was published in The New England Journal of Medicine, one leading health care expert (who did not know Rana) tweeted that everyone who takes care of patients should read it. The same is true for In Shock, her book that describes her medical ordeal and the insights that flowed from it. Her story of her clinical problems and what she experienced as she endured them reads like The Odyssey. The moment toward the end when she takes the stage to describe her experiences for her medical colleagues is nothing less than electrifying. And the insights about the nature of healing with which she concludes her book are an inspiration." —Tom Lee, Chief Medical Officer for Press Ganey Associates, Inc.

"In Shock is a brilliantly written account of Awdish's near death experience and what it is like to be on the "other side" of medicine. Through her sometimes shocking, often heartbreaking and always honest storytelling, Awdish poignantly brings to the forefront both our collective and individual shortcomings despite our best intentions. She clearly demonstrates the necessity and urgency for us to move away from "The House of God" culture, where we were trained to detach and depersonalize, to one that needs to be centered around empathy and caring, not just for the sake of our patients, but for our own humanity. The next generation will look back on In Shock as a transformational book and it will be mandatory reading for everyone in healthcare." —Sara Hegab, MD, Senior Staff Physician, Pulmonary and Critical Care Medicine, Henry Ford Hospital

Reviews from Goodreads

About the author

Rana Awdish

DR. RANA AWDISH is the Director of the Pulmonary Hypertension Program at Henry Ford Hospital in Detroit and a Critical Care Physician. She was recently named Medical Director of Care Experience for the ($6 billion, 24,000 employee) Health System. She was awarded the Speak-Up Hero award in 2014 for her work on improving communication, as well as the Critical Care Teaching Award in 2016. In 2017 she was a finalist for the Schwartz Center’s 2017 National Compassionate Caregiver of the Year (NCCY) Award and the Physician of the Year award from the Press Ganey National Client Conference. Dr. Awdish is board-certified in Internal Medicine, Pulmonary and Critical Care Medicine.

Rana Awdish

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Rana Awdish

From the Publisher

St. Martin's Press

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