No Apparent Distress: A Doctor’s Coming-of-Age on the Front Lines of American Medicine Audiobook

A brutally frank memoir about doctors and patients in a health care system that puts the poor at risk

In medical charts, the term “N.A.D.” (No Apparent Distress) is used for patients who appear stable. The phrase also aptly describes America’s medical system when it comes to treating the underprivileged. Medical students learn on the bodies of the poor—and the poor suffer from their mistakes.

Rachel Pearson confronted these harsh realities when she started medical school in Galveston, Texas. Pearson, herself from a working-class background, remains haunted by the suicide of a close friend, experiences firsthand the heartbreak of her own errors in a patient’s care, and witnesses the ruinous effects of a hurricane on a Texas town’s medical system.

In No Apparent Distress, she chronicles her experiences and the raging disparities in a system that favors the rich and the white. This is at once an indictment of American health care and a deeply moving tale of one doctor’s coming-of-age.

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“Pearson’s vivid writing sometimes lulls you into the trance of a good story—character, voice, plot, conflict—but there’s always the sucker punch at the end to remind you of the gruesome endpoint of the American health-care system: If you don’t have money, you can be sent out to die…[Pearson’s] courage, honesty, and doggedness are evident on every page.”

— New York Times