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June 2018

When Physicians Turn Into Patients—Becoming Kafka’s Cockroach

Author Affiliations
  • 1Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 2Institute for Health Policy, Management, and Evaluation, and Department of Medicine, University of Toronto, Ontario, Canada
  • 3Department of Medicine, Mount Sinai Hospital and University Health Network, Toronto, Ontario, Canada
JAMA Intern Med. 2018;178(6):753-754. doi:10.1001/jamainternmed.2018.1467

Many readers approach Franz Kafka’s literature with trepidation and unease. In contrast with the books of his Victorian-era predecessors, Kafka’s novels are not filled with pithy moral messages or instructions about how to live a good life. Instead, they are dark and confusing analyses of a world that lacks order, where people suffer unusual fates and navigate punishing odds. The beleaguered heroes of his novels gain no wisdom or salvation as they surmount difficulty on difficulty; their “prize,” if they are lucky, is to avoid endless punishment or a cruel death. Protagonists often make this frightening journey alone—pushed into exile and abandoned by friends and family when they are needed the most.

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    2 Comments for this article
    Humility, Equanimity in human experiences
    H. Robert Silverstein, MD, FACC | Preventive Medicine Center
    Allan et al: I am curious re your educational backgrounds. You have a college honors English analytical understanding of Kafka's "The Metamorphosis," one of my favorites, as is especially "The Trial" for its revelation that life may be completely unpredictable, incomprehensible, and unfair. You have a true sympathy for the ill: much of the very role of a physician. Yet I wonder if you could not have focused more on the necessary humility and bravery required of us all. While I realize you have the right to what you wrote, I think you could have given equal time to the idea that the world turns, and we may need the essential maturity to realize that we are not in control, and must have the courage to persevere through whatever with a degree of healthy equanimity. Things are what they are: nurturing such is another of the essential roles of physicians.

    Kafka in Medicine
    Larry Husten, PHD in English | CardioBrief.Org
    This is a wonderful essay, but it should be emphasized that The Metamorphosis (or anything else by Kafka) can not be used to as a tool to imbue physicians with sympathy and perspective they may have previously lacked. The bleak rigor of Kafka offers little of utilitarian value, but of course there will always be those who will attempt to extract a comforting lesson from him. In the end Kafka will have the last laugh. If you think the Metamorphosis is dark try "In the Penal Colony." And if you think Kafka offers hope that we can improve our understanding of the world try "Investigations of a Dog."