Nurses understand power dynamics.  We know when we are expected to defer to docs, just as our patients know when they are expected to defer to us.  But often, underneath the carefully constructed chains of command, conflicting emotions coalesce and fester. There is the rage of the patient who feels objectified by a system which equates a human being with his lab values.  Similarly, on another front the medical student is often “pimped” to the point of humiliation.  For innumerable reasons, we accept these things.  Our feet ache and our backs are sore.  We’ve been told that this is just the way things are.  At the end of the day, we need the pay check and the health insurance.   So when someone has the courage to rock the medical establishment’s seemingly impenetrable boat we ought to listen.  When someone like Dr. Rafael Campo allows us inside his questioning, compassionate, and razor sharp mind, as he has invited us to do with The Desire to Heal, we ought to firstly accept the invitation and shortly thereafter thank him.

Dr. Campo is an internist at Beth Israel Deaconess Medical Center in Boston, Massachusetts, and is perhaps best known in the literary world for his poetry.  Yet, his unflinching prose deserves equal attention.  Originally published in 1997, The Desire to Heal continues to be clinically relevant.  This is not just a back-slapping book for doctors.  Nurses will recognize themselves in his reflections on patient care, his relationship with illness, and his evolution as a healer.

For those accustomed to glossy tales of emergency room heroics or weepy sagas about life and death, Campo’s essays may rankle.  And for those steeped in the science-driven world of medicine, Campo’s raw honesty and his stark portrayal of human physicality may shock.  The opening line of his title essay “The Desire to Heal” conjures the most literal vision of physical desire.  We are alerted from his very first sentence that all bets are off - Campo is a man first and a doctor second.  He admits to attractions to patients.  He openly discusses professional jealousy, inadequacy, superiority, judgment, humility, and most of all desire.  This act, coming as it does from a respected and prestigiously trained physician, is still revolutionary a decade after publication.

In The Desire to Heal we watch Campo come to terms with his homosexuality during a San Francisco residency that coincides with the American advent of HIV/AIDS.  Several of his essays explore his sometimes problematic Cuban-American identity.  HMOs take a serious hit in “Imagining Unmanaging Health Care”, while his essay “Fifteen Minutes after Gary Died” is a haunting account of AIDS, fear, competition, and the power of the written word.  

In person, Campo is not what one would expect.  He is soft-spoken and listens with keen, attentive interest.  His demeanor suggests trustworthiness, gentleness, and sincerity.  One wonders if writing provides an opportunity for a rabble-rousing alter-ego to run amok.  Or, perhaps he is simply akin to the rest of us - a complicated bundle of opinions and competing desires, an individual who fights for the rights of his patients even as he gripes about his own status as a minority, a gay man, or a junior member of a medical team. 

Nurses who read this book will breathe a sigh of relief.  With The Desire to Heal Dr. Rafael Campo delivers a swift blow to the forces of power at play in American hospitals.  But his book accomplishes much more than this.  While The Desire to Heal is both lyrical and a call-to-action, at its heart it is a celebration of the most essential of human experiences.                   

 

Reference:

Campo, R. (1997).  The Desire to Heal:  A Doctor’s Education in Empathy, Identity, and Poetry.  New York: W.W. Norton and Company.                  

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