Ms. Silverstein was a healthy 24-year-old law student when she suddenly developed heart failure from a virus and required an emergency heart transplant. “Sick Girl” is the harrowing account of her 17-year journey through our health care system, told in unflinching detail.

Despite being a transplant surgeon, I flinched a lot while reading her story. Ms. Silverstein is often at odds, angry even, with her doctors. And her behavior mystifies some of her doctors in the same way patients have sometimes mystified me.

As I read through “Sick Girl,” I found myself flipping between Ms. Silverstein’s and her doctors’ points-of-view. I thought back to my own reactions to patient choices, then combed through Ms. Silverstein’s prose in an attempt to understand her  and my patients’  motivations.

I also began to think more and more about one patient in particular, a young woman I’ll call Donna.

I met Donna early on in my transplant training when it was a habit of mine to wander through the wards at night. She was always wide awake, so I began to stop by her room to chat. There, in the middle of the night, we would talk about our favorite books and movies, clothes and relationships, until my beeper went off and pulled me away.

But I never asked Donna about her decision, a decision that both horrified and intrigued me.

Given a liver transplant a decade earlier, Donna had been one of the great patient success stories. On her regular follow-up visits, she had delighted the clinic staff with her wicked sense of humor, sartorial style and seemingly “normal,” un-transplant-like life.