THE MEASURE OF OUR DAYS - New Beginnings at Lifeís End, by Jerome Groopman, MD, Penguin Putnam Inc, New York, © 1997, ISBN: 0-670-87570-8, 238 pp, $24.

Review by Del Meyer, MD

Our profession has recently focused on pain management and end-of-life care since a law enacted in July 2001, that become effective on January 1, 2002, requires us to take continuing medical education on this topic. What our legislature has reduced to legalese, needs to be seen in a medical perspective. I believe this book does that.

Jerome Groopman, Professor of Immunology at Harvard and Chief of Experiment Medicine at Beth Israel Deaconess, explores lifeís lessons as he describes eight patients with life-threatening illnesses gazing into the face of death. He is able to transform medical case studies into spiritual journeys to help us understand why some are ennobled by it, others defeated.

During his second year as a medical student at Columbia, he experienced a major confrontation with death. He rushed home from his dormitory to find his father in the final throes of cardiogenic shock. He watched him die. Groopman feels that his father died before his time and before he, his family and friends could prepare for his passing. The family physician offered no medical expertise or emotional comfort. This experience committed Groopman to caring for his patients and their loved ones with compassion and scientific excellence.

Groopman feels that being in research and actively engaged in scientific discovery allows him to see the world of disease through a very different lens from that at the patientís bedside. When worn down by the anguish and frustration of fighting a losing battle against a disease for which there is no cure, he takes refuge in his laboratory. He recalls that his fifth-grade friend, Eric Gold, was stricken with acute lymphoblastic leukemia. One day, Eric disappeared and the class wondered what mysterious poison had caused their playmateís death. As an oncologist, he points out that today Eric would be cured.

Groopman recalls how talking about death was nearly taboo in our society. "Now," he says, "issues of illness and mortality are being debated even in our courts and legislatures. When I listen to such discussions, I realize how distant law and precept are from the turmoil and struggle that occur at each patientís bedside."

After discussing the eight patient stories, Groopman gives a final epilogue. While writing this book, his mother developed breast cancer. The death of his father gave him the impetus and strength to do his lifeís work; looking to the future, he continues to seek lessons from his patients on how he and his mother should live. This is not something that can be learned in a classroom, forced upon us by lawmakers. Or, as Dr Mark Skousen, President of the Foundation for Economic Education says, "The triumph of persuasion over force is the sign of a civilized society." When we arrive in such a society, our lawmakers will have little to do.