What I learned about being a doctor from a Gen Z chef’s memoir | Expert Opinion

I never imagined that a Gen-Z gourmet chef could offer some of the most vivid, insightful, and humbling wisdom about medicine I have ever read. Yet that is exactly what I found in Fatima Ali’s beautiful, heart-wrenching autobiography, Savor: A Chef’s Hunger for More.

Fatima was an accomplished chef who died at age 29 in January 2019 after a brutal struggle with Ewing’s sarcoma, a rare, aggressive form of bone cancer most often seen in young children. Born and raised in Pakistan, then schooled at the famed Culinary Institute of America, she quickly became recognized for her creative adaptations of the foods and flavors from her childhood.

Her career accelerated after she won on an episode of the show Chopped and had a subsequent appearance on Top Chef. But her illness thwarted her dream of owning a restaurant, and Savor, co-written with food and travel writer Tarajia Morrell, was instead her impassioned parting gift and legacy.

The first part of the book tells the story of Fatima’s childhood in Pakistan and a growing romance with food, which began with trips to the outdoor market and cooking traditional fare with her grandmother. Fatima then invites the reader deep into her personal life’s journey with intimate descriptions of family struggles, personal trauma as she comes of age, and her culinary education in the United States.

The learning gifts for physicians come in the final third of the book, when Fatima is diagnosed with cancer and begins treatment. She painfully depicts our health-care system’s inefficiencies, as she goes from doctor to doctor seeking a clear diagnosis. As a primary care physician, I was particularly distressed to read that Fatima’s doctor told her he was “too busy” to see her and to “come back next week.” She describes pleading for appointments and a much-needed biopsy.

We meet her oncologist who, while thorough and empathic, counsels her about fertility and egg harvesting and what is “really important to you,” when really these issues are moot because she must start chemotherapy immediately. “Why ask me what I’d save in a fire and then tell me all they can do is their best?” she writes.

When Fatima’s illness reaches a terminal stage, her care shifts to pain management. The palliative care team interrupts a session with her writing partner in her hospital room. She is on doses of pain medication too large to safely send her home with, so the senior physician tries to convince her that another MRI (she’s had dozens) of the spine in her neck area may reveal another possible pain relief intervention, like radiation therapy.

Finally, Fatima says simply, “I don’t think, at the end of the day, it’s worth it.”

Fatima writes that her refusal deflated and unnerved the care team, who were so driven to accomplish their mission of easing her pain and getting her home that they seemed to forget to listen to their patient.

In telling her story, Fatima shines a strobe light on some blind spots that all physicians are vulnerable to. Reading her book reminded me that, in my zeal to diagnose and relieve suffering, I must always consider first my patients’ needs and wishes. What I think is medically best may not be the right course of treatment if it doesn’t align with what they want.

As aptly stated long ago by Francis Peabody, the much-admired Harvard educator and physician, “The secret of the care of the patient is in caring for the patient.”

I thoroughly enjoyed learning about Fatima’s life, talent, passion for food, and the unique mark she left on the culinary world. I also found an unexpected mentor.

Jeffrey Millstein is an internist and regional medical director for Penn Primary Care.