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Last Updated on August 6, 2019, by eNotes Editorial. Word Count: 607

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No Apparent Distress is a 2017 memoir written by Dr. Rachel Pearson. It tells the story of the author’s medical education and training in a free, student-run hospital where all people are welcomed, especially those without medical insurance. It is a testimony to the struggles of those who cannot afford a decent medical treatment and must go in a clinic where the medical staff is literally practicing and learning medicine on their health and body. It depicts the story of the poor and underprivileged patients who often suffer because of the unfair and unjust health care system.

The memoir has gained a fair amount of positive reviews, especially about the narrative. Pearson's honesty and the authenticity of the scenery and the setting has been praised by many readers and professional critiques alike. It offers another perspective into the medical world, this time from a doctor’s point of view.

The title of the book is an interesting element. "No Apparent Distress" or NAD is a term used by doctors to describe patients who are in no immediate life danger and present no symptoms that threaten their health. Ironically, it is also symbolic of the current medical system in Texas and America in general, where many uninsured, poor and homeless people are in fact, very much into apparent distress.

The main action happens in St. Vincent’s House, a free, student-run clinic in Galveston, Texas, with the motto “All Are Welcome Here,” where Dr. Pearson and her colleagues volunteered to practice medicine. There, she experiences loss, grief, depression, friendship, heartbreak and compassion and witnesses the consequences of an unjust system in which not all are treated equally. She explains how limited their resources are and how just down the street is a clinic about “luxury medicine” for Botox injections and hair removal treatments, which further accentuates the irony of the phrase No Apparent Distress and of the book itself.

The book covers many contemporary themes such as racism, politics, the unfair treatment of the poor and homeless, a flawed health care system, and medical ethic and error. Pearson writes of Mr. Rose—an African American man living in poverty who sought out help in St. Vincent. During the examination process, Pearson makes a mistake and misses a tumor in his stomach which delays his diagnosis and endangers his life. She feels regret and guilt and explains how one simple error or lapse in judgment can cost someone their life. At the same time, however, she expresses her anger toward a country that couldn’t provide for Mr. Rose and doesn’t care for those who are just like him. The massage she is trying to convey is obvious.

Essentially, No Apparent Distress is a book about medicine, equality and morality. Through various personal opinions, experiences and factual information, Pearson explains to us how the people, especially the poor, the homeless and the uninsured, suffer when the community doesn’t care about their health and gives them limited access to medical help. She believes that all doctors should treat their patients fairly, no matter their race or socioeconomic position. All of the health care systems that don’t allow equal medical help to everyone are simply products of a society that follows political agendas that can only harm the people.

The author also explains how she originally wanted to be a writer, but decided to pursue medicine instead. Believing that no one should limit themselves to just one area of expertise, she promises to continue to write about her experiences as a doctor in order to shine light to the societal problems that are more often than not ignored.