In No Apparent Distress, Rachel Pearson writes a riveting account of her time in medical school. She’s especially focused on her work at a student-run charity medical clinic in Galveston, TX. Given everything happening these days along the Texas border, it’s even more meaningful.

Pearson also delves into some of her earlier experiences, since they affected her choice to become a physician. For example, the chapter with graphic details about working in an abortion clinic. That’s my trigger warning for you. Her family is also strongly working class, rather than being heavily privileged.

In the toss up between becoming a writer or a doctor, Pearson chose both. She attended the University of Texas Medical Branch in Galveston so she could concurrently enroll in their Ph.D. program for Medical Humanities. Because, you know, just going to med school alone isn’t quite enough. As readers, we certainly benefit from her skill as a writer, which she most likely honed in the Ph.D. program.

Prior to enrolling in med school, Pearson completed what’s called a post-baccalaureate year. That’s all the required pre-med classes compressed into a short time period. Her bestie that year was a man named Frank, and Pearson tells his poignant story with humor and tenderness.

But Pearson tells the bulk of her story within the walls of St. Vincent’s House. It’s a student-run clinic, caring for the poor and indigent with dignity. Clearly, though, the students make mistakes pretty regularly. Thankfully, older students and supervising doctors can usually improve the situation. 

Pearson survives, although not all of the clinic’s patients do. But such is the reality of life, especially in a community like Galveston, which divides so clearly between haves and have nots.

My conclusions

Pearson is exquisitely vulnerable throughout this book. She never shies away from telling the painful truths of her experience, even when it makes her look incompetent. And as the book progresses, she gains so much knowledge and, yes, competence, that she ultimately seems almost too hard on herself. But I applaud her ability to tell her unvarnished truths.

I particularly appreciated Pearson’s insights into the state of medical care and the medical field today. Her commentary is unflinching, and sometimes it’s difficult to fathom how we as a society can be this incredibly uncaring. Each patient story made me sadder than the last.

For example, she talks about the medical school interview process. Telling people she intended to go into primary care, they reacted as if it was “a waste.” She wouldn’t make much money, and nor be respected the same way. (Reminded me of Elderhood by Louise Aronson.) But as Pearson writes about her family and upbringing, her reasons become clear. And I couldn’t help but admire her choice.

I also learned a lot about Texas history and culture from this book. In Galveston, Pearson says you must understand hurricanes. Having lived in hurricane country for eight years, her telling moved me. The connections between Mother Nature and the island’s segregation and racial bias makes all the difference for the patients of St. Vincent’s

Obviously, this book fits perfectly into my love of a good medical memoir. Pearson balances personal stories, cultural commentary, and medical information. Delicate though it is, she pulls it off with surgical precision. Pretty good for a primary care doc.


Many thanks to my nonfiction postal book club buddies for another great set of selections. Can’t wait for our 2020 round! In addition to this one, our 2019 books were: The World Without Us, The Pun Also Rises, and Down Girl.