CURRENT BOOKS: Fact-Driven Autobiography

Anne Cummings, MD

Becoming Dr. Q: My Journey from Migrant Farm Worker to Brain Surgeon, by Alfredo Quinones-Hinojosa, MD, 328 pages, University of California Press.

Don't tell me the moon is shining; show me the glint of light on broken glass.

--Anton Chekhov

I wanted to like this book. Dr. Quinones-Hinojosa has a compelling back story, but his book is a good example of autobiography’s pitfalls. Many great writers have lamented the pain taken in telling a first-person narrative, particularly the autobiography. Becoming Dr. Q illustrates the dangers of becoming too literal and fact-driven and missing the greater insight of becoming a person and a physician.

One goal of reading literature is to gain a view into another life in order to become more fully human ourselves. In Moby-Dick, American literature’s most famous first-person narrative, Melville employs stylized language, symbolism and metaphor to explore numerous complex themes, beginning with “Call me Ishmael.” Through the journey of the main characters, the concepts of class and social status, good and evil, and the existence of God are all examined, as the main characters speculate upon their personal beliefs and their places in the universe. In contrast, Becoming Dr. Q uses little symbolism or metaphor to explore the very same themes. In the telling of Dr. Q’s journey from migrant farm worker to brain surgeon, the reader is unfortunately asked to travel unaccompanied by beautiful verse, or even to struggle with difficult concepts. The journey, particularly for a physician reader, is dreary and dull, mostly chronicling events of Dr. Q’s life in a straightforward and predictable manner.

“Desperate situations--like the one in which I found myself on the eve of my nineteenth birthday--require desperate choices,” writes Dr. Q. “Having made my decision, I couldn’t allow any regrets or second thoughts to deter me. Don’t look back, I told myself. I had to go forward to find my destiny, crossing the border fence to see where the path on the other side would take me. I had to act boldly, decisively, and immediately. And I had to climb to the top and jump.”

As I read the chronicle of a poor, smart young man being guided by luck and some dedicated mentors through the arduous tasks necessary to become a neurosurgeon, I thought of President Obama’s autobiography, Dreams from my Father: A Story of Race and Inheritance. That book uses complex ideas and metaphor to give insight to Obama’s exploration of self; it is not just a set of directions. By comparison, Becoming Dr. Q reads more like a Google map than a novel. There is little suspense because the reader knows where the facts are leading.

Dr. Q had hardship, and his path was not straight, but I wanted to hear more from him about the greater life lessons learned. I would have been interested in hearing more about the stories his lay midwife grandmother told, but perhaps he was too young and didn’t recall the exact stories.

Halfway through the book, I was surprised to encounter a metaphor, but only the surface emotions are explored and left hanging, like the vine in the metaphor: “Just as I was later grateful to my cousin for the kick that got me out of the fields, one day I’d look back and feel the same about the TA’s remark, which was more thoughtless and ignorant than mean-spirited. The ugly truth that those words revealed at the time, however, was that I had no defense mechanism, to fend off their impact. Because of who uttered them, they planted seeds of shame in me that took root in my being, soon to become weeds and even twisted, thorny vines, constricting me like a vise and making me want to hide my background. I should have said or done something, and I’m not proud that the blow was landed because of my weakness--my embarrassment about who I was and where I came from.”

Compare that to the eloquence of Barack Obama: “The emotions between the races could never be pure; even love was tarnished by the desire to find in the other some element that was missing in ourselves. Whether we sought out our demons or salvation, the other race would always remain just that: menacing, alien, and apart.”

The characters of Dr. Q’s patients and his wife are one-dimensional and cursory, with predictable personalities and characteristics. Describing his future wife, he writes, “Fortunately, there was someone very close to me who reminded me to ignore those voices: Anna. After months of courtship via the U.S. postal system, we were officially dating at last, although we had a long-distance relationship. After we had gotten to know one another intimately in heartfelt letters, I had finally invited her on a first date--a movie and then a moonlight tour of the Berkeley campus. On our evening stroll, I took her hand in mine for the first time and felt it was the most natural thing in the world to do. I couldn’t yet tell her that back in Mexico as a youth I had once received a message in a dream that a woman with green eyes was destined to be my soul mate. Not that I was embarrassed by that story. But speaking those words would have disturbed the magic. Without saying so, I suspect we both knew we would be together from then on.” Nothing about what was heartfelt or intimate about their letters or their relationship is ever revealed.

The truly honest and revealing aspects of Dr. Q’s story come from his revelations of how naive he was every step along the path to medical school and residency, and how he was guided by the influential mentors to whom he was introduced. The most inane conversations are documented, but whether he learned life lessons or gained insight into his future life as a physician is not explored.

In summary, Dr. Q is a fine neurosurgeon who overcame adversity to get where he is today. His story may be interesting, and I hope it inspires others to share his dreams, but the telling of it makes for a less than compelling read.

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Dr. Cummings, a Greenbrae internist, serves on the MMS Editorial Board.

Email: annemcummingsmd@mindspring.com