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The physician cannot heal himself. Helplessly he witnesses the indiscriminate dispensing of sleeping pills in order to give the house staff an easier night, the neglect of infections, the imperious commands made by the vertical to the horizontal. His exhausted wish is for "a rule that every doctor must spend one week a year in a hospital bed. That would change things in a hurry."
Recuperation is slow and recovery elusive. Further heart problems bring Lear back to the hospital, this time for bypass surgery. After the operation, he suffers the most dreadful euphemism in the doctors' lexicon: "Complications." Rudeness and evasion become the order of the day, and a fatal demoralization sets in. "The patient," Martha Lear notes, "had been blamed for his illness, had been handed back his questions, unopened, and had been left feeling rejected, abandoned ... This is classic in long chronic disease; this is what the failures of the body do unerringly to the soul."
Any account of a good man's death is bound to be moving. But Heartsounds is far more than case history. Martha Weinman Lear is a born writer, and the resonances in her prose go back to Greek tragedy with its catalogue of grief and noble despair. By the cathartic ending, when there are no more tears to shed and no more afflictions to remember, Martha Lear is finally able to forgive. She realizes that the professionals could not per form a miracle: "The doctor does not exist who could treat such a gravely ill patient for such a long time without making mistakes . . . given their mortal limitations, they were more than good."
Still, forgiving is not forgetting, and her profoundly affecting chronicle is seeded with ideas and warnings. The antimedical book was born out of a moral demand: as long as patients feel the lack of care, as long as doctors act with an omniscience that is only an act, volumes like Cousins' and Lear's will continue to resound with cries from the heart. And the stethoscope will not be the best way to hear them. —Peter Stoler