This memoir by Rachel Pearson details her extraordinary childhood in poverty with a loving family that moulded her personality, her success in education and her start in creative writing, and then her move to medical school and then working as a medical student in rural Texas. She is a talented writer who is profoundly concerned with social issues and the importance of fair and compassionate treatment for people who live in very difficult circumstances. Most of the memoir is about the free clinic she worked at in Galveston. Early in the work, she talks about the effect of Hurricane Ike on the local area in 2008, and the long term devastation it caused. It is a notable memoir because it draws attention to how inequality in the USA means that poor people are at a great disadvantage and suffer significant health risks. Many people died because health care that had been available was withdrawn because of the economic consequences of the hurricane.

Pearson discusses many of her patients. Some of them are not very cooperative or just have such difficult lives that they are not in good positions to help themselves. Many present challenges because they are not able to follow up with the care needed to keep themselves healthy. And there are just regular medical mysteries. Pearson shows her love of Texas culture and her family roots in the state, which drives her dedication to work for the population she treats.

As a memoir, Pearson’s stories have the power of well told anecdotes and these make the book good reading. But they point to important social issues in medicine, and indicate the terrible unfairness of the US health system in its treatment of people in poverty.

© 2019 Christian Perring

Christian Perring teaches in NYC.