41 pages • 1-hour read
No Apparent Distress: A Doctor’s Coming of Age on the Front Lines of American Medicine
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Symbols & Motifs
“ALL ARE WELCOME HERE”
The sign that hangs in the St. Vincent’s waiting room says that everyone is welcome. This includes Malachai with his odd demeanor and criminal background, the uninsured, people of every ethnicity, the homeless, and anyone else, including Pearson and the rest of the staff. “It was my House” (218) she thinks when she sees it one day during her fourth year of school. In Pearson’s view, this should be the view of every hospital and physician, and she is continually frustrated that financial realities can make people feel unwelcome because they are unable to receive treatment, or at least, some of the treatments they most need.
The Keys to the House
In Chapter 25, Pearson gives the keys to St. Vincent’s to Jacqueline, who is immediately overwhelmed by how much she has to remember. The keys opened every door in the clinic. They are a symbol of how varied the responsibilities of the volunteers, residents, and doctors at the House are. They have access to rooms holding patients with cancer, diabetes, schizophrenia, depression, strep throat, the common cold, and every other ailment that can afflict a human body and mind. The key ring is massive, and Jacqueline cannot see how she can possibly handle it. Pearson passes the responsibility to Jacqueline and assures her that the keys will do their job, as long as Jacqueline works hard to do hers.
Cancer
Cancer is constantly present in the book in its literal sense. Pearson gives stories of patients with brain cancer, throat cancer, abdominal and pancreatic cancer, and more. Cancer is a mass of malignant cells that attack the body and destroy its strength and vitality. It reduces people to weakened, pain-stricken versions of themselves. As a metaphor, cancer is usually discussed in militant terms, both in No Apparent Distress and in the writings of authors such as Susan Sontag. The creeping depression Frank and Pearson experienced, just like the ways in which medical bureaucracy creeps into the lives of Dr. McCammon, patients like Mr. Klein, and Jacob, also has characteristics of the ways in which cancer spreads.
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