THE SOUL OF CARE

The Moral Education of a Husband and a Doctor

By Arthur Kleinman

262 pp. Viking. $27.

Kleinman, a medical anthropologist and psychiatrist, has crammed two books into one in “The Soul of Care.” You can skip the first one, devoted mostly to his early life and medical training; it’s a bit of a dull ramble. But his writing, clipped and starchy in the opening chapters, comes urgently alive after his wife, Joan, is told in her late 50s that she has early-onset Alzheimer’s. During her decade-long struggle with the disease, Kleinman tends to her while grappling with the moral, social and practical implications of caregiving.

Anyone who has been a caregiver will relate to the unending grind of Joan’s decline, to Kleinman’s exhaustion and to his efforts to keep going. And he’s one of the lucky ones: He has the financial means to hire home health aides and then, when that is no longer possible, he places Joan in a nursing home that’s “well-appointed, in a beautiful wooded setting in hundreds of acres of rolling hills and meadowland. … Her new and last place of residence was a single room with a pleasing view that felt more like a hotel room than a hospital room.”

As he cares for his wife, Kleinman, always devoted to his career, discovers that he must search for meaning and validation in other parts of his life. He learns humility: “Stuff, bad stuff, is going to happen, and often you have no control at all over it.” (His mother says that Joan’s disease has “made him human!”) Along the way, Kleinman becomes increasingly aware of how caregiving has become divorced from medicine; when he tries to tell doctors about the difficulties at home, they ignore him. The profession, he worries, has become so fixated on costs that it has almost forgotten about the patients themselves. In a heartfelt, if slightly portentous, call to action in the final chapter, he writes: “Caring is what is morally and emotionally most at stake in human experience. It is what makes life worth living.”

HOW TO TREAT PEOPLE

A Nurse’s Notes

By Molly Case

277 pp. Norton. $25.95.

If Kleinman’s book leaves you despairing about the quality of care in medicine, Case’s will restore your faith.