No Apparent Distress: A Doctor’s Coming of Age on the Front Lines of American Medicine

Mr. Rose tells her about his life and about his non-specific abdominal pain. He had many symptoms, but none of them were a clear indication of a specific, treatable problem. With a doctor standing by, Pearson conducts a thorough exam. Mr. Rose is shocked to learn that he is 20 pounds lighter than he thought. He lost 20 pounds in a month and had last weighed himself at the liquor store, leading the doctor to suspect alcoholism rather than cancer, particularly since Mr. Rose had a swollen belly.

Mr. Rose had reported that his urine stank. After testing it, all of his values were abnormal. Pearson forgot to mention this to the attending physician when debriefing him. She makes a point of being at every appointment with Mr. Rose. He is sicker each time, and in more pain, but “there wasn’t much [they] could do without the studies [they] needed to diagnose him” (97). That semester, Pearson takes a course about the heart and is able to recognize an abnormality called an S3 in Mr. Rose’s heartbeat. In November she receives an email with the subject line “Your Patient.” It is from a woman named Chandler who is training in the ER at John Sealy.