Related to This Book

No Apparent Distress

A Doctor's Coming-of-Age on the Front Lines of American Medicine

Rachel Pearson (Author, University of Texas)

Overview | Formats

A brutally frank memoir about doctors and patients in a health care system that puts the poor at risk.

In medical charts, the term “N.A.D.” (No Apparent Distress) is used for patients who appear stable. The phrase also aptly describes America’s medical system when it comes to treating the underprivileged. Medical students learn on the bodies of the poor—and the poor suffer from their mistakes.

Rachel Pearson confronted these harsh realities when she started medical school in Galveston, Texas. Pearson, herself from a working-class background, remains haunted by the suicide of a close friend, experiences firsthand the heartbreak of her own errors in a patient’s care, and witnesses the ruinous effects of a hurricane on a Texas town’s medical system. In a free clinic where the motto is “All Are Welcome Here,” she learns how to practice medicine with love and tenacity amidst the raging injustices of a system that favors the rich and the white. No Apparent Distress is at once an indictment of American health care and a deeply moving tale of one doctor’s coming-of-age.

Book Details

  • Hardcover
  • May 2017
  • ISBN 978-0-393-24924-8
  • 6.5 × 9.6 in / 272 pages
  • Sales Territory: Worldwide

Other Formats

  1. Book CoverNo Apparent Distress: A Doctor's Coming of Age on the Front Lines of American Medicine


Endorsements & Reviews

“Engrossing....Pearson’s vivid writing sometimes lulls you into the trance of a good story—character, voice, plot, conflict—but there’s always the sucker punch at the end to remind you of the gruesome endpoint of the American healthcare system....Her literary skill is apparent in her book. Her courage, honesty and doggedness are evident on every page.” — Danielle Ofri, New York Times Book Review

“ of the better doctor-in-training books.” — Booklist

“Educative and thoughtful....Pearson's inspired collective of illuminating clinical episodes immediately sparks to life....Eloquently and briskly written.” — Kirkus

No Apparent Distress is filled with the moving stories of a medical student’s journey providing health care at the margins of American life. Rachel Pearson shines a spotlight on the brutal inequalities present within our healthcare system.” — Damon Tweedy, MD, author of Black Man in a White Coat

“Rachel Pearson comes from a hard place. In her memoir, No Apparent Distress, she tells the story of a Texas hospital that has been flattened by a hurricane and is being rebuilt—literally rebuilt—around her and her colleagues while they pursue their medical training. Working at a clinic for the poor and uninsured teaches Pearson the empathy she will need to cultivate if she expects to act as an effective advocate for her patients. It also teaches her about the inequities and injustices of the American health care system, and the labor of love required of anyone who decides to pursue the practice of medicine in this country.” — Judy Melinek, MD, and T. J. Mitchell, coauthors of the New York Times best-selling memoir Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner