Abstract
In the first weeks of medical school, before having any real knowledge of diseases, diagnoses, and treatments, freshly minted students are instructed on the importance of listening. We are taught that empathy is the foundation of medicine—that we must engage openly, ask thoughtful questions, and use tactful silence to elicit stories and emotions, all with the goal of understanding our patients and the conditions that afflict them. While this practice is well-intentioned and teaches us useful skills, breaking down the barrier between a physician and a patient is not so straightforward. In many cases, eliminating this barrier may not even be possible.
In Reservations for Nine, Dr. George Beauregard acknowledges this gap between patients and their physicians and offers perspective on the far-reaching implications of a cancer diagnosis. As a practicing physician, cancer survivor, and father of an adult child stricken with metastatic colorectal cancer, the intersection of Dr. Beauregard’s various identities and experiences uniquely positions him to reflect and comment on cancer, its treatments, and how the disease can impact a family.
Dr. Beauregard begins his story by providing the reader with the context of his life. He highlights his childhood, his journey to medicine, and his life as a young physician with four children. In detailing his medical practice, he reflects on sharing difficult news with his patients and then goes on to describe the experience of being diagnosed with his own advanced bladder cancer: “It assaults your preconceived notions and plans. Any likelihood of having a carefree existence gets erased” (63). Despite this uncertainty and a daunting treatment regimen, Dr. Beauregard is eventually cured of his cancer. Devastatingly, this reprieve is short-lived. Only months after receiving a clean bill of health, Dr. Beauregard’s son, Patrick, is diagnosed with stage 4 colorectal cancer at the young age of 29. Just as one family member’s cancer journey came to a happy close, another had begun.
Fundamentally, Reservations for Nine centers Dr. Beauregard’s own perspective as he recounts his son’s cancer journey. In fact, the most compelling moments of the memoir come not from the details of Patrick’s various treatments, but rather the author’s reflections on the experience of losing a child. As a physician and cancer survivor, Dr. Beauregard can at least conceptually understand what Patrick is going through. As a father, however, the unfairness of his son’s prognosis is incomprehensible.
In my reading, the author writes this memoir to try to process his grief, using the act of storytelling as a form of coping. Despite this attempt to process and reflect, Dr. Beauregard establishes more of a timeline than a cohesive story. He includes various milestones in Patrick’s treatment and details other important events such as weddings, pregnancies, and family vacations, but for much of the memoir, the author portrays himself and his family members merely by the actions they take rather than delving into their unique perspectives and feelings. This memoir attempts to be vulnerable in that, inherently, it reveals the intimate details of a family’s multigenerational battles with cancer. For that, I commend Dr. Beauregard. However, many of the details the author shares often lack corresponding reflection and depth, with only occasional moments of true vulnerability. This leaves the reader without a strong connection to the Beauregard family or their story.
At the outset, I had hoped that Dr. Beauregard would use his unique position to offer us insight on the role of a doctor, the role of a parent, or even the role as a public health advocate in the face of such tragedy. Unfortunately, he does not venture to explain how his experience informs these roles or shapes his broader perspective. In his storytelling, Dr. Beauregard neglects to reveal his inner dialogue as a grieving parent, shielding the reader from the fear, grief, anger, and confusion that surely accompanied his loss. Instead, he remains largely anchored to a scientific perspective, occasionally citing various research developments or explaining the basics of cancer pathophysiology.
Interestingly, though, Dr. Beauregard’s measured reflections mirror my own early clinical experiences interviewing parents of seriously ill children. In speaking with these families, parents often oscillate between openness and stoicism. They toe the line between sharing their fears and trying desperately to maintain composure in front of their child: “I have to be strong for him,” they tell me as their eyes well up. In a similar way, the emotional distance evident throughout Dr. Beauregard’s book may reflect a fundamental instinct to separate oneself from something as unfathomably painful as the death of a child.
As a medical student early in my training, I have come to appreciate this tension between vulnerability and self-preservation. It challenges me to think beyond the details of clinical medicine and grounds me in my role as a listener. It prompts me to think about how I can invite my patients to share their stories while creating space for the full spectrum of emotions they might experience. In this sense, the author’s restraint reminds us that in coping with serious illness and grief, self-protection is an understandable response.
In his own words, Dr. Beauregard shares that due to his lived experience, he has a “much deeper understanding of the great distance that separates patients and doctors, and how little physicians really understand what their patients are going through” (9). As a reader and as a medical student, this lesson is incredibly valuable. It highlights that as much as we try to understand our patients, there is a fundamental difference between hearing a person’s story and truly understanding the complex emotions and perspectives that define their experience. Although Reservations for Nine offers a stilted narrative, it also demonstrates an important point: real understanding comes not by simply sharing information, but from connection and genuine vulnerability.