{"id":3344,"date":"2022-04-19T10:00:44","date_gmt":"2022-04-19T09:00:44","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-humanities\/?p=3344"},"modified":"2022-04-08T09:16:26","modified_gmt":"2022-04-08T08:16:26","slug":"grief-connects-us-a-neurosurgeons-lessons-on-love-loss-and-compassion","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-humanities\/2022\/04\/19\/grief-connects-us-a-neurosurgeons-lessons-on-love-loss-and-compassion\/","title":{"rendered":"Grief Connects Us: A Neurosurgeon\u2019s Lessons on Love, Loss, and Compassion"},"content":{"rendered":"<p><strong>Book Review by Jeffrey M. Brown<\/strong><\/p>\n<p><strong>Stern, Joseph D. <em>Grief Connects Us: A Neurosurgeon\u2019s Lessons on Love, Loss, and Compassion. <\/em>Central Recovery Press, 2021.<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>Joseph Stern\u2019s recent book, <em>Grief Connects Us<\/em>, opens with a study in contrasts. \u201cMy younger sister was an actress,\u201d Stern writes.<\/p>\n<blockquote><p>She was creative, trusting, warm, an engaged wife and mother, full of life\u2026. Victoria loved an audience and could keep them spellbound.<\/p>\n<p>I am a neurosurgeon, more comfortable with a single patient in the quiet of an examining room where I can apply logic and science to solve the problems and mysteries of the human body and disease. (1)<\/p><\/blockquote>\n<p>Over the course of the ensuing pages, Stern unfolds the story of his relationship with Victoria as it approached a devastating end: Victoria\u2019s leukemia diagnosis in 2014 at the age of 51, the rapid progress of her illness, the vertiginous experience of her treatment, and the sudden shock of her death less than one year later. Along the way, he offers a series of poignant vignettes about Victoria\u2019s life that seem to erupt from his own measured account. A brief precis on the delicacy of managing graft-versus-host reactions is followed immediately by a story of how the child Victoria earned the nickname of \u201cthe Imp\u201d at home. A broad summary of the probability of locating a genetic match in relatively narrow Jewish bone marrow donor registries is punctuated by an outraged assertion from Victoria\u2019s journal: \u201cI am mad at Hitler all over again\u201d (73). Through a <em>trompe l\u2019oeil<\/em> effect of contoured shadowing, the snapshots Stern includes of Victoria and her family seem to float off the pages. It is often as though Victoria cannot be bound within Stern\u2019s book: the impressions he offers of her luminous personality strain against his own careful prose, held in place by only the most tenuous of forces.<\/p>\n<p>The net effect of these touches is, of course, an ironic counterpoint to the title\u2019s central theme. <em>Grief Connects Us<\/em> is an entry into the popular genre of hybrid medical memoir: works that synthesize personal accounts of extraordinary medical challenges with efforts to draw conclusions that speak to generalizable forms of treatment or cultural understanding. Over the past decade or so, this particular literary structure has been leveraged to an impressive array of effects in books like Siddhartha Mukherjee\u2019s <em>The Emperor of All Maladies <\/em>or Atul Gawande\u2019s <em>Being Mortal<\/em>. For these most prominent examples\u2014both monumental bestsellers, both directly cited in Stern\u2019s book\u2014personal writing provides not an end in itself but rather a frame to engage a non-specialist audience and a springboard for the work\u2019s wider historical or cultural ambitions.<\/p>\n<p>At first glance, Stern\u2019s book seems to adopt the same agenda-based approach, which is implied within the book\u2019s full title. <em>Grief Connects Us: A Neurosurgeon\u2019s Lessons on Love, Loss, and Compassion <\/em>is divided roughly in two. In the first half, Stern offers an account of Victoria\u2019s illness, documenting with painful honesty the sequence of discoveries and choices, tests and treatments, and opportunities to reassess personal relationships and life\u2019s meaning that defined their family\u2019s journey, often in defiance of medical certainty. In the second half, Stern zooms out, presenting those \u201clessons\u201d by indicating how his experience led to new epiphanies. He accomplishes this first by surveying other patients and physicians, providing a wider assessment of communication failures and the forms of vulnerability that each had experienced. Finally, he details the advantages of prioritizing the emotional experience of medical treatment, and he patiently outlines how those advantages are felt both by those who give and those who receive care, including impressive accounts of the way that institutions and spaces might be modified to achieve these goals: from the creation of \u201chealing gardens\u201d to the adoption of better policies for the management of sound, light, and diurnal rhythms of activity in the ICU.<\/p>\n<p>Throughout this section, Stern\u2019s integration of others\u2019 voices produces kaleidoscopic effects, in spite of his general thematic focus on \u201cemotional agility,\u201d compassion, and palliation. One fellow doctor meditates on religious values; a page later, another reflects on the regional distribution of medical expertise and what it means to sever a patient from a local community in pursuit of \u201cbetter\u201d care. The number of issues and perspectives they address can be dizzying, and Stern adopts a light touch in editing and collating their comments. These acts of ventriloquism are not, therefore, the incidental effect of a neurosurgeon\u2019s preference for grounded research. Rather, they are the very substance of his work: an effort to establish \u201cconnection\u201d on a direct and intimate level, where even the appropriation of others\u2019 voices is not simple or obvious but rather a matter of the sincere personal effort and deep ambivalence that is threaded throughout the entire work.<\/p>\n<p>Indeed, while Stern presents himself always as gently supportive of Victoria\u2019s choices, another image of him appears briefly in an interpellated section of her personal journal: \u201cJody [a family nickname for Stern] said I need the radiation, no discussion. He had also said way back in the beginning that if I didn\u2019t do what they told me and tried some Eastern approach, as is so much more my orientation, he would come to Santa Monica and drag me there himself\u201d (73). The disconnection between Stern\u2019s own reserved prose and the frantic image Victoria draws of him is never directly addressed; instead, such gaps proliferate across the book, as Stern recognizes that even the most essential connections may transform as time moves forward and contexts shift. In tantalizing and heartbreaking passages, we are reminded that the book that we are reading is not the one originally intended. Confident in her survival, Victoria had hoped to publish her journal herself as a record of victory; Stern\u2019s original draft was scrapped, rewritten, and supplemented after the sudden death of Victoria\u2019s husband in 2017; even the published book appends a short epilogue written after the emergence of COVID-19, which bristles at the limits of compassionate \u201cconnection\u201d right in its final sentences: \u201cWhat good is a yard sign celebrating \u2018COVID warriors\u2019 if you are unwilling to wear a mask to protect others (including healthcare workers) more vulnerable than yourself?\u201d (257).<\/p>\n<p>It is in these moments that the true import of Stern\u2019s title reveals itself. The \u201clessons\u201d that Stern\u2019s book presents are not programmatic or prescriptive. Instead, Stern teaches through example, allowing us to emulate the lessons he himself has struggled to learn in assembling this work. Beginning with the gulf that separates Stern\u2019s own sensibility from that of his sister, <em>Grief Connects Us<\/em> recognizes that the bridges spanning such divides are always ad hoc, delicate, and unique: threads suspended above an abyss, maintained by good will, generosity, a respect for enduring difference, and an awareness of their inherent instability. Tracing Stern\u2019s \u201cconnections\u201d is a highwire act that requires and engenders its own form of \u201cemotional agility.\u201d As a beautiful memorial to Victoria\u2019s virtuosity, reading Stern\u2019s book is <em>moving<\/em>: its call to action is sustained our own effort to navigate the distances it creates.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Book Review by Jeffrey M. Brown Stern, Joseph D. Grief Connects Us: A Neurosurgeon\u2019s Lessons on Love, Loss, and Compassion. Central Recovery Press, 2021. &nbsp; Joseph Stern\u2019s recent book, Grief Connects Us, opens with a study in contrasts. \u201cMy younger sister was an actress,\u201d Stern writes. She was creative, trusting, warm, an engaged wife and [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-humanities\/2022\/04\/19\/grief-connects-us-a-neurosurgeons-lessons-on-love-loss-and-compassion\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":345,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2965],"tags":[15166],"class_list":["post-3344","post","type-post","status-publish","format-standard","hentry","category-book-reviews","tag-book-review"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Grief Connects Us: A Neurosurgeon\u2019s Lessons on Love, Loss, and Compassion - Medical Humanities<\/title>\n<meta name=\"description\" content=\"Jeffrey M Brown reviews Joseph D Stern&#039;s Grief Connects Us: A Neurosurgeon\u2019s Lessons on Love, Loss, and Compassion.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-humanities\/?p=3344\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Grief Connects Us: A Neurosurgeon\u2019s Lessons on Love, Loss, and Compassion - 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