The Letter Writer
This is actually an epistolary work of non-fiction which takes the form of letters—obviously—written by an older doctor—specifically, a surgeon—to a young man just setting out upon the world. That world is defined quite early on: “Medicine is a continuum of which you are now a part.” That continuum is one which connects the down and dirty business of practicing medicine with the ethical considerations which makes one doctor better than another.
The Recipient
The recipient of the doctor’s letters and advice remains—like the doctor—unnamed. This choice is clearly made to create a more universal application of the content within. The doctor does not distinguish the mark of a good physician by prejudicial traits. Rather than address the recipient even by what would have been a quite natural gender bias, he relies upon the second person perspective by directly addressing the reader as “you.”
Doctors and Patients
That said, it must be added, however, that most of the anecdotal representations of a physician’s life are conducted exclusively by males. Actual female characters are, for the most part, limited to that of the patient. These anecdotal descriptions serve to allow for the narrator to insert dialogue which facilitates a deeper understanding of the way that doctors and patients must interact. In the introductory section, the author notes that each of these anecdotes “is rooted in an event that I have experienced or witnessed.”
Imelda Valdez
Imelda is the only patient in the entire book who gets an entire chapter named after her. She is a young Indian teenager the doctor poetically describes as a “figurine, orange-brown, terra-cotta” who presses “to her mouth a filthy, pink, balled-up rag” which notifies him immediately even without asking that what lay beneath the rag “was what she had come to show us.” This is an excellent example of the manner in which the doctor connects the anatomical lessons of medicine away from the treatment and toward a better understanding of how doctors come to learn things about their patients which can, in turn, facilitate the ethical behavior when treating them.
