Words to Live By From A Doctor, Mother, Author

It would be easy to resent Perri Klass. Just look at her biography on the Web site of the National Library of Medicine: "While earning her MD [at Harvard, where else?] Klass bore her first child, knit baby sweaters, contributed articles to Mademoiselle and the New York Times as well as to scientific and medical journals. She also wrote her first book . . . ."

But her 10th and latest book, "Treatment Kind and Fair: Letters to a Young Doctor" (Basic Books, $24.95), demonstrates that she is no preening prodigy. Written as letters to Orlando, the baby born during medical school who is about to enter it himself, the volume reveals Klass to be thoughtful, humane, shrewd and altogether unpretentious. Her reflections on the transformative nature of medical training manage to be absorbing and instructive, even for those familiar with the genre.

A professor of journalism and pediatrics at New York University and medical director of a national literacy program, Klass tackles some of the most timely and controversial dilemmas that will confront newly minted physicians: how to handle the inevitable mistakes, when to keep a patient's secret, and where to draw the line between one's personal needs and those of a patient.

Her amusing description of herself as "a terrible patient in every sense" -- she acknowledges she doesn't eat a prudent diet or exercise, and insisted on leaving the hospital four hours after giving birth -- illustrates the ways doctors separate themselves from patients by denying that harm or disease could befall them.

"The ways I fall short of the goals I professionally and glibly recommend to others give me a certain realism," she observes, "and a certain understanding of the challenges of real life."

In a chapter titled "Bugs, Drugs and Data," Klass describes her unvarnished feelings about one of the biggest changes she has witnessed in pediatrics: the stunningly successful impact of childhood vaccines and the Internet-fueled backlash they have spawned, which is predicated on the debunked theory that some cause autism.

During her career, Klass writes, she has witnessed the devastation wrought by diseases that are now preventable -- and which still cut a wide and deadly swath through the developing world.

"I suppose I shouldn't be angry, but I am part of that medical generation that still saw children devastated and dying from H flu [ Haemophilus influenzae] and strep pneumo [ Streptococcus pneumoniae] and I am not good with parents who refuse their children this protection," she writes.

"There are no comparable horror stories out there about the diseases themselves, about the previously healthy, delightful child left retarded or deaf or dead after measles or meningitis," she notes.

Her reflections on the ways that a career in medicine affects doctors' families, including her own, may resonate with readers who hold stressful, demanding jobs in other fields.

"Keep an eye out for what medicine does to you," she advises. "Look at the ones you love with the same attention and care and compassion that you expend on complex patients and differential diagnoses. And don't forget to say thank you." ¿

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