Saving Grace: What Patients Teach Doctors about Life, Death, and the Balance in Between

As I prepared to write this review, I looked back on 16 books assessed in Anesthesiology in 2022 and was struck by the diversity of material: textbooks, “current issues” books, history books, and three memoirs: two written by surgeons and one by a cystic fibrosis patient. It is rare for an anesthesiologist to tell the story of our daily lives, so it is delightful to find that one of the latest books to land in the review pile is Saving Grace: What Patients Teach Their Doctors about Life, Death, and the Balance in Between, a memoir by David D. Alfery, M.D.

Memoirs are tricky things: if too celebratory, they read like a narcissist’s diary, if too introspective, like dark confessions from an analyst’s couch. Dr. Alfery, however, presents us with an anthology of a different sort; a collection of stories from his career that contribute in one way or another to the education of a physician’s soul. He names the stories for the lessons they offer—titles like “Respect,” “Dignity,” “Gratitude,” and “Grief.” If you’re looking for a self-aggrandizing memoir of a doctor who changed the world or a collection of harrowing experiences in the operating room describing that “10% terror” we all know too well, look elsewhere—although there certainly are harrowing stories here that are both moving and well told. But, Dear Reader, beware. This book is not for the faint of spirit. I am certain than any anesthesiologist with career longevity will recognize more than a few of Dr. Alfery’s cases as their own, even if they go by different names.

I personally was struck by astonishing parallels between the author’s career and my own. We are about the same age. Both of us left a different path in medicine to find anesthesiology. We each made a last-minute decision to apply to a top-notch program and were accepted into our specialty because someone else made a last-minute decision to drop out. Both of us found a life-long love in this wonderful career of ours and a niche in cardiac anesthesiology. Finally, both of us have had strikingly similar moments of revelation and joy and grief: from Alfery’s tale of a severely burned patient named Grace to a little girl called Lidia who awoke weeping in the recovery room because she was “normal,” I found I could still name each and every corresponding patient from my own career, see their faces, and recall their stories as clearly as if they happened to me last week.

Dr. Alfery is a man of faith, and several vignettes in the book both gently and humbly give us glimpses of how his faith has informed his professional experience and growth. Readers who, as I do, live in one of the country’s growing “none” zones—regions where the population is more likely to check the box “none” than any other on surveys that ask their religious affiliation—would do well to pay heed. For whether you are a person of faith or not, most of our patients actually are. An open-minded respect not only tears down one more barrier to their belief in us but, as Dr. Alfery shows us, opens the door to the experience of the amazing privilege of taking care of them.

There is something here for everyone. For anesthesia residents, these are illuminations of the lessons that teach us how to be “real” doctors—the kind that see the person beyond the disease and understand the true privilege of being invited into a patient’s life. For nonphysicians, they are stories that explore the challenges and joys of medical practice and reveal some of the magic of the anesthesiologists’ unique profession. For anesthesiologists advanced in their careers, it is a reminder of where they have come from and how much they have learned. It is a reaffirmation that as a community, we anesthesiologists share common stories, if we have bothered to listen to our patients and taken them into our own hearts along the way. An affirmation that just as often—maybe more often—in these brief encounters, our souls are tutored in the spirit behind medicine by the only people who can teach us those sacred skills: our patients.

This book is not long—149 pages—and is told in elegant and vivid language that does not require a medical education to understand, yet in sufficient technical detail that any practicing anesthesiologists will have no trouble finding themselves in them. A highly recommended read for teachers, students, patients, and physicians alike.