Surviving the Fall

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The Personal Journey of an AIDS Doctor

Peter A. Selwyn

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This poignant and eloquent book is a memoir of the first decade of the AIDS epidemic in the Bronx, a physician’s firsthand account of the emergence of an epidemic and the lives that it touched. it is also an exploration of how the physician was himself transformed by his experience with these patients.

Dr. Peter Selwyn, now a well-known researcher and clinician in the area of HIV and drug abuse, came to Montefiore Medical Center in the Bronx as a medical intern in June 1981. He remained there for ten years, caring for patients with AIDS. During that same span he got married and became a father. Absorbed in the pain and losses of his patients and their families, Dr. Selwyn finally acknowledged the grief he had carried for decades following the sudden death (and apparent suicide) of his father when the author was an infant. He realized that, like AIDS, suicide stigmatizes both those who die and those who survive. Surrounded by dying young parents, he understood what it meant to have a father and to be one. For him, it was a process of healing in the midst of the epidemic. His story can help us see AIDS (and any life-threatening illness) as an opportunity to go through our own fear, pain, and darkness and to come out on the other side. Recognizing the darkness and passing through it, observes Dr. Selwyn, is a prerequisite for anyone seeking to be an effective caregiver, whether professional or personal. It is a process that can teach us how to accompany patients or loved ones through illness and to witness and relieve their suffering as they approach death.

This is an uplifting story of loss, discovery, and coming to terms with the past, a story with an important message for anyone dealing with the challenges of living, dying, and being human.

Peter A. Selwyn, M.D., is professor and chairman of the Department of Family Medicine at Montefiore Medical Center and Albert Einstein College of Medicine in the Bronx, New York. He has been a caregiver for patients with AIDS and their families for more than fifteen years.

"A wonderful book full of lessons for us all."—Bernie S. Siegel, M.D., author of Love, Medicine, and Miracles

"Profoundly moving. Peter Selwyn shares his unique insights as a professional in the midst of the AIDS epidemic. The story of his personal and professional motivation is compelling and informative."—James W. Curran, M.D., M.P.H., Dean and Professor of Epidemiology, Rollins School of Public Health, Emory University

"Profoundly moving. Peter Selwyn shares his unique insights from the midst of the AIDS epidemic. The story of personal and professional motivation is compelling and informative."—James W. Curran, M.D., M.P.H., dean and professor of epidemiology, Rollins School of Public Health, Emory University, and former director for HIV/AIDS, Centers for Disease Control

"The literature of AIDS has found a rich new voice. Dr. Selwyn's experience—illuminated by the struggles of people with AIDS—leads beyond medicine to the essence of life itself. His work, his life, and ultimately his joy and confidence transmit the precious gift of hope."—Jonathan Mann, professor, Harvard School of Public Health, and former director of the Global Programme on AIDS of the World Health Organization

"The literature of AIDS has found a rich new voice."—Jonathan Mann, professor, Harvard School of Public Health and former director of the Global Programme on AIDS of the World Health Organization

"More than another chronicle of an AIDS doctor, Selwyn's work allows us to share his own very personal voyage. Not so much a book about AIDS as an example of what AIDS allows us to see in ourselves."—Paul Volberding, M.D., Director: AIDS Program, San Francisco General Hospital

"Not so much a book about AIDS as an example of what AIDS allows us to see in ourselves."—Paul Volberding, M.D., director, AIDS Program, San Francisco General Hospital


"Surviving the Fall illuminates the human bonds tragedy makes visible. It is, in the most fundamental sense, a book about compassion, particularly for the stigmatized—AIDS victims, drug abusers, a suicide, his son. It is about the life force—not in a pretentious, hyperbolic way, but in the gritty striving sense that adapts and adapts and adapts—always seeking health, love and purpose. It is about flawed and hurt people, among whom we are all numbered, though few of us are as aware and articulate about it as Dr. Selwyn. It is about healing."—Sue Chance, M.D., author of Stronger than Death: When Suicide Touches Your Life

"Surviving the Fall is an important work for those wanting to better understand the unique individual afflicted with AIDS and drug addiction, as well as a doctor's discovery of the parallels between his own wounds and those he is treating."—Timothy E. Quill, M.D., Professor of Medicine and Psychiatry, University of Rochester, and Primary Care Internist


 

"This book is a testament to resilience and the protective role of altruism. It is also a reminder to all of us how our professional lives are shaped by our personal experiences, even damaging ones, and how our practice can be enriched and made healthier by the recognition of the personal dimension of our professional lives."—Michael Farrell, Addiction


"The parallel emotional search for his father Selwyn renders credibly and so movingly that at the end, after the transfer of his father’s ashes to a brighter and more open location, we join him in an unburdening sigh."—Booklist

"This is a fascinating insight into the day-to-day life of an AIDS doctor, during the early days of the epidemic. It documents the first wave of the AIDS epidemic in the Bronx, revealing the pain and losses of the doctor's patients. . . . A highly recommended book to anyone who has been touched by this dreaded disease called AIDS. All libraries should have multiple copies."—AIDS Book Review


"An extraordinarily well-written and engrossing story of a family physician who has become a specialist in AIDS management for a variety of personal reasons. . . . [Selwyn's] humility about himself, his work, his family and the evolution of his personal growth is refreshing and makes the book very difficult to put down. . . . Powerful reading."—Richard Sadovsky, American Family Physician

"This moving account by a noted researcher and clinician who has cared for HIV patients since the earliest days of the epidemic helps to ‘restore some humanity to the statistics’ and in the process explores many of the ways of being a physician and many types of healing."—American Journal of Public Health

"This moving account by a noted researcher and clinician who has cared for HIV patients since the earliest days of the epidemic helps to 'restore some humanity to the statistics' and in the process explores many ways of being a physician and many types of healing."—American Journal of Public Health

"Selwyn takes his readers on an engaging and touchingly personal odyssey. Simultaneously, the reader is taken inside the family lives of the doctor and his patients as all strive to make sense of lives torn asunder by premature death. . . . Poignant accounts of how these patients—their lives and deaths—changed the doctor's life fill this book."—David Nord, Death Studies

"This book remains a welcome one in this, the darkest time of the plague, when most of us would choose to forget rather than continue to fight. I believe this book will be one of great use not only to AIDS care providers and to AIDS activists, who will take solace in its many truths; but also to medical students, house staff, and physicians in general, whose own half-truths may be unsettled by it."—Rafael Campo, Doubletake

"Surviving the Fall, adamantly refuses to let AIDS fade away. By bravely following it out into the most marginalized of communities—and through a parallel, more personal narrative, to the margins of his own self-awareness—he creates a compelling story of healing in our time . . . Dr. Selwyn exhibits a reverence for our shared humanity that lesser doctors often do not. This book will be one of great use not only to AIDS care providers and to AIDS activists, but also to medical students, house staff, and physicians in general. It also has a more general appeal, in that it so faithfully explores an issue of fundamental significance to all people—the nature of elusive empathy—both by celebrating its triumphs and demonstrating its shortcomings." —Rafael Campo, Doubletake

"This is a book well worth buying, reading, and leading as we all take the journey to care for patient and to learn to live with ourselves."—Jo Ann Rosenfeld, Family Medicine

"This book is not only for hospice and end-of-life care givers. Every medical school faculty and nursing school faculty should assign it to their students; it is relevant to the medical historian. Psychiatrists will find its worth in showing the influence by which personal, family, and social values shape the medical practitioner."—Florence S. Wald, Hospice Journal

"Selwyn poignantly and accurately describes the lives of his patients with AIDS and the clinical life of an AIDS doctor; this alone makes this book well worth reading. Much more important, however, and the best reason to read this book is Selwyn's ability to take the lessons he learned from his patients and from AIDS and apply them to himself."—Kevin Carmichael, Journal of the American Board of Family Practice


"Selwyn poignantly and accurately describes the lives of his patients with AIDS and the clinical life of an AIDS doctor; this alone makes this book well worth reading. Much more important, however, and the best reason to read this book is Selwyn's ability to take the lessons he learned from his patients and from AIDS and apply them to himself."—Kevin Carmichael, Journal of the American Board of Family Practice

"Surviving the Fall should be required reading for nursing and medical students seeking to enter HIV care."—Roslyn J. Leiser, RN, Journal of the Association of Nurses in Aids Care

"Surviving the Fall should be required reading for nursing and medical students seeking to enter HIV care. . . . Throughout the book . . . [Selwyn] describes the lives and struggles of his patients with respect, compassion and dignity."—Rosalyn J. Leiser, RN, Journal of the Association of Nurses in AIDS Care

"Poignant revelations from the heart of a physician."—Kirkus Reviews

"A moving personal account of a doctor’s discoveries about himself as he struggled to care for his dying AIDS patients. . . .Poignant revelations from the heart of a physician."—Kirkus Reviews


"Selwyn’s profiles of AIDS patients are lovingly and beautifully written, and he paints an involving and realistic picture of the devastating impact of AIDS."—Libra


"A wonderful book full of lessons for us all."—Bernie S. Siegel, M.D., author of Love, Medicine and Miracles


"Physicians have made substantial contributions to the autobiographical literature, but not many have passed the test of soul-baring, Augustinian self-analysis required by confessional literature. William Carlos Williams is among the few. More recently, Rafael Campo and Jack Coulehan—like Williams, both are physician-poets—have made their marks on the literature of private thoughts. Now Peter Selwyn brings us Surviving the Fall, a wrenching account of his search for self-discovery. Selwyn’s story of how he confronted his past is much more than autobiography. It is an examination of a personal crisis brought on by the stress of working with patients afflicted by both drug addiction and AIDS. Surviving the Fall tells an ennobling story of how one physician sorted out his professional obligation and his life."—Robert S. Schwartz, New England Journal of Medicine

"Dr. Selwyn has taken his story in this little book and transformed it into a tale of humanism, self-examination, and raw emotion, which, at least for this reader, reached truly epic proportions—an outstanding accomplishment that should be read by all."—Beryl Lovitz, Oncology Times

"Selwyn successfully intertwines his own story with portraits of his most memorable patients, resisting the temptation to turn them into martyrs."—Publishers Weekly

"Selwyn successfully intertwines his own story with portraits of his most memorable patients, resisting the temptation to turn them into martyrs. . . As befits a memoir, this book’s best moments are the intensely personal ones. . . Selwyn credits his journey through the AIDS epidemic with making him a better doctor, but the healing went both ways as he found a new understanding that would allow him to treat the untended wounds left by his father’s death."—Publisher’s Weekly

"Selwyn's well-written, powerful book will inspire younger physicians, encourage older ones, and will move and enlighten everyone who is, or has cared for someone who is, seriously or terminally ill."—Herbert Hendin, M.D., Suicide and Life-Threatening Behavior

"Dr. Selwyn's vantage point, from what must have seemed like the epicenter of the AIDS epidemic, has allowed him to write poignantly about this illness and its effects on patients and their families. But equally fascinating to the reader is the inner journey Dr. Selwyn makes, exploring his won past and how it has conditioned him, made him into the extraordinary witness that he is."—Abraham Verghese, M.D., Professor of Medicine, Texas Tech University

"Dr. Selwyn writes poignantly about the AIDS epidemic and also explores his own past, showing how each illuminates the other and makes him into the extraordinary witness he is."—Abraham Verghese, M.D., author of My Own Country: A Doctor's Story


Recognized by the New England American Medical Writers Association Chapter with a Will Solimene Award of Excellence in Medical Communication
ISBN: 9780300082760
Publication Date: April 10, 2000
176 pages, 5 1/2 x 8 1/4