Book Review: Postmortem by Maria Phalime

A South African child, born in Soweto, grows through her hardships and losses, excels at school, and decides that to pursue a medical career. She endures great challenges to reach her goal, but after four years as a qualified doctor, she hangs up her stethoscope and leaves the medical profession for good.

What causes our brightest, most passionate minds to leave behind a dream they would have died for? Postmortem: The Doctors Who Walked Away is, at its core, an autopsy not only of Maria Phalime’s career, but of the many South African doctors who have left.

But first and foremost, it is a memoir. Phalime does not presume to speak for others like her. She shares her story: her childhood, her pain, her medical career. And then she tries to tease apart the fibers of her undoing.

As a memoir, Postmortem reads well. I am a fan of memoirs, but find that they are sometimes too drawn out and too detailed, becoming more of a glorified journal. Not the case here, and at 208 pages I read this nearly in a single sitting.

Phalime starts off introspective, blaming none but herself. She seeks simply to understand what went wrong. In doing so she interviews other “doctors who walked away” as well as some who managed NOT to walk away.

She touches on the fact that med school admissions may be missing the mark entirely, and that the inherent tendency to admit overachieving Type A-personalities (I am one of those, too) may be its very downfall. She also discusses the potential that 18-year-olds opting to study medicine may not have an accurate idea of what they are REALLY getting themselves into.

Ultimately, Phalime does face the reality that as much as personal factors influenced her leaving, so too did external factors. She then addresses the failings of the South African system in such an open-minded way that I wish all politicians, policy makers and healthcare professionals would read it.

If I was worried that it would be a bitter narrative, I need not have been. At no point does Phalime blame those who stay behind. In fact, she offers very good points of view that can improve the situation of our South African doctors.

Parts of this book made me weep. Parts made me interminably sad. And parts gave me hope. I think it takes a gifted author to put those together.

postmortem quote

This is a topic fraught with emotions, so I will keep my discussion for another day. But I must say that in my journey my viewpoints have changed much. As a layperson I frowned upon doctors who left, deeming them selfish. As a junior student, I wondered how anyone could ever wish to leave our great profession. Now, as a near-graduate, I have more empathy and understanding for the doctors who leave, as I have seen myself and my colleagues struggling with the same issues.

Perhaps in a sense, this memoir does not feel “finished” – but perhaps it should not be. The conversation needs to be carried forward, beyond the pages of the book.

Postmortem is a seminal work for this decade, and it would do our country well if our role-players heeded its message.

I received a copy of this book from the Author and her publishers (Tafelberg) in exchange for an honest review. Her website can be found here. An excerpt of her memoir can be read here.

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30 thoughts on “Book Review: Postmortem by Maria Phalime”

  1. Sounds like a very interesting read – I wonder if I can find it in the UK. South Africa must also be a…fascinating? thought provoking? place to do medicine, given all the diversities and inequalities you have in your history and present. I spent three months there about five years ago (before medicine) and came away with more questions than answers!

    1. I don’t know if the physical copies will ship to the UK, but apparently there is an ebook version in the making, so that would be an option. Yeah, ZA is pretty thought provoking and fascinating (and some other adjectives too). The history and inequalities influence the practise so much more than anyone could have predicted. Never a dull moment though. What did you do in SA? In my opinion, people who think they got all the answers while traveling are probably just fooling themselves. Sometimes, questions ARE the answers. I’ve lived here all my life and I still don’t have all the answers I seek. 🙂

      1. I was there as part of a youth volunteering programme with an organisation called VSO – maybe you know of it. We spent most of the time in a village in Venda, right up near the Zimbabwe border. I’d love to see the hospitals though – that’d be something interesting I think. Good luck deciding where to work by the way!

    1. It definitely exceeded my expectations! I doubt Canada has the same issues though, although it would be very interesting to compare reasons doctors leave where you are.

  2. This is one amazing review! I think we all have days other than those ‘days’ when we look at type B’s and wonder wow! Must be fun wearing their shoes. Partying day and night. Meh!

  3. barefootmedstudent, you are missing the thrust of this powerful, plainitve missive from your future – the bravery of this book in articulating the realtiy of being a doctor in south africa is a call to everyone , it may start a change in the culture of medicine that has been tolerated for too long – let’s hope it does.

    1. I agree that it may start a change in medicine. I’m just not sure what you mean by me missing it, as I specifically refer to that in the review, and say that I hope it will bring change.

  4. Sounds like a great book to get my hands on!! I am currently doing my MBA research on risk management competences (skills, attitudes and behaviour) that SA hospital doctors should have, hence me landing on this webpage. The clinical skills are not enough……..and our training has not caught up with the dynamic changes in our environment.

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