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The Beauty in Breaking

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Notes From Black Reads

A Barnes & Noble Best Book of 2020, The Beauty in Breaking is a riveting and heartbreaking memoir from a Black emergency room physician in an overwhelmingly male and white profession who examines how healing others teaches her how to heal herself. In its captivating narrative, intimate tone, and transformative message, The Beauty in Breaking is a book that cries out to be shared. As Elisabeth Egan said in The New York Times, “The reader should not open this book without a pen in hand. There are so many powerful beats you’ll want to underline.”


A New York Times Notable Book

“Riveting, heartbreaking, sometimes difficult, always inspiring.” —The New York Times Book Review

“An incredibly moving memoir about what it means to be a doctor.” Ellen Pompeo

As seen/heard on Fresh Air, The Daily Show with Trevor Noah, NBC Nightly News, MSNBC, Weekend Edition, and more

An emergency room physician explores how a life of service to others taught her how to heal herself.

Michele Harper is a female, African American emergency room physician in a profession that is overwhelmingly male and white. Brought up in Washington, D.C., in a complicated family, she went to Harvard, where she met her husband. They stayed together through medical school until two months before she was scheduled to join the staff of a hospital in central Philadelphia, when he told her he couldn’t move with her. Her marriage at an end, Harper began her new life in a new city, in a new job, as a newly single woman.

In the ensuing years, as Harper learned to become an effective ER physician, bringing insight and empathy to every patient encounter, she came to understand that each of us is broken—physically, emotionally, psychically. How we recognize those breaks, how we try to mend them, and where we go from there are all crucial parts of the healing process.

The Beauty in Breaking is the poignant true story of Harper’s journey toward self-healing. Each of the patients Harper writes about taught her something important about recuperation and recovery. How to let go of fear even when the future is murky: How to tell the truth when it’s simpler to overlook it. How to understand that compassion isn’t the same as justice. As she shines a light on the systemic disenfranchisement of the patients she treats as they struggle to maintain their health and dignity, Harper comes to understand the importance of allowing ourselves to make peace with the past as we draw support from the present. In this hopeful, moving, and beautiful book, she passes along the precious, necessary lessons that she has learned as a daughter, a woman, and a physician.

ISBN-13: 9780525537397

Media Type: Paperback

Publisher: Penguin Publishing Group

Publication Date: 06-29-2021

Pages: 304

Product Dimensions: 5.10(w) x 7.90(h) x 1.00(d)

Michele Harper has worked as an emergency room physician for more than a decade at various institutions, including as chief resident at Lincoln Hospital in the South Bronx and in the emergency department at the Veterans Affairs Medical Center in Philadelphia. She is a graduate of Harvard University and the Renaissance School of Medicine at Stony Brook University. The Beauty in Breaking is her first book.

Read an Excerpt

Dr. Harper:

The View from Here

It wasn't at all how I had pictured graduation from my emergency medicine residency at Mercy Hospital in the South Bronx would be, but it certainly was a blistering end. I sat near the aisle, next to my mother, who was next to my stepfather. I had told my brother and sister not to bother with the trip. I figured my sister would be busy with her obligations as an army lieutenant. I assumed that my brother would be preoccupied with his family or with landscaping his new home. That's what I told myself. The truth was closer to my not wanting them to see me like this. I didn't want witnesses there to confirm that this had really happened, that this celebration I had looked forward to for the last four years of medical school, and then during the four years of residency, felt more like a funeral. There was a noticeable absence by my side, where I had always imagined my husband would have stood.

Husband. The word cut like a slur.

Ex-husband was more accurate. The last time I spent time with Dan was in May, in our twelve-hundred-square-foot, two-bedroom prewar co-op in the South Bronx. Our marriage was unmistakably over, but we had continued cohabitating because my move to Pennsylvania was still more than one month away, just after graduation. (Neither Dan nor I had the money for another place at that time with the sale of our co-op still pending.)

We had previously settled on Philadelphia. Our families were in the Northeast, and we were Northeasterners at heart. New York City was too expensive, anything north of New York was too cold, and anything south of DC was no longer the North. Most of New Jersey was far too suburban, and the parts that offered big-city comforts were just as expensive as New York City. This had left only Philadelphia, which had easy access to New York, DC, New Jersey, and Maryland, and had a reasonable cost of living compared to its competition. Neither one of us had ever lived there, but it seemed to make the most sense on paper. I didn't know anyone in Philadelphia, but Dan's parents had just moved to one of its bedroom communities, and he had a couple of friends who lived nearby.

We had deferred every other decision until after my residency-when one member of a couple is in residency, the couple is in residency-but now all that would change. In our new city, I had imagined we would walk over cobblestone streets hand in hand. Ginkgo leaves would waft gently onto the sidewalks as we passed. We'd try all the new restaurants because we'd finally be able to afford them. I couldn't wait to advertise all our starter IKEA furniture on Craigslist and purchase the type of furniture an adult woman actually wanted to pack up and take with her when she relocated. Our home's style would be a mix of elegant and eco-industrial. We'd burn candles all the time, vanilla and spiced amber to start. We'd finally have placemats, napkins, and sleek new flatware. We'd wander the city museums on Wednesdays and host dinner parties on Fridays. We'd enjoy our discretionary income and then, after a couple of years, we could discuss having kids.

So our split could have been a scene from a terrible indie film, the one where the perfect, young, progressive New York City couple-the white independent filmmaker husband and the black physician wife who had met at Harvard's freshman ice-cream social-endure a shocking, painful breakup. The couple has already overcome so much when, only months before she graduates from her residency, with a planned move to Philadelphia to be near his friends and family, he lowers the boom.

"You're doing well in your career, and I'm not," he told me that night. "If I'm with you, I'll focus on your success. I have to find myself. The only way I can do that is if I'm not with you. You'll be fine in Philadelphia. I can't go."

It felt like a cliche, a plot point that everybody else but the main characters themselves sees coming.

I knew what would happen next in the movie. It would start raining outside-first a drizzle and then a torrential downpour, as Whitney Houston crooned "I Will Always Love You." As the music grew louder, I would rest my head on his shoulder. Then, as the song reached its crescendo, my heart would break.

In real life, forty-eight hours after his declaration, I found an attorney and filed for divorce.

We had talked until three o'clock in the morning, our words alternating between clench-fisted blame and gut-wrenching pleas. We had paced miles in that bedroom, until our bodies broke from fatigue. Finally, we had collapsed into bed. I tossed and turned the rest of the night away, unable to dispel the slideshow of snapshots that was our story-well, my version of our story. I knew that time would fade each image to a hazy deja vu.

I begged the universe to make me remember our cheesy romantic dancing in the rain on a temperate April afternoon nine years before; our special Queens hummus recipe we had concocted from a handful of Food Network recipes and whatever happened to be our flavor preference of the week; our road trips to the Jersey Shore; his touch, which was smooth and soft in the way of a person whose work is more cognitive than physical; the brown pools of his eyes that told me that beneath his athletic build, he was fragile; and every second of the thirteen years we had shared. I begged the universe to make our breakup feel fair or right, and to let me survive.

I had attempted to soothe myself by crawling up close and snuggling into him. I lay there in the nook made by his arms, timing my breath to the heavy breath of his sleep, the rhythmic calm of his presence. (Dan had always had this gift: He could sleep anytime, anywhere.) His sculpted body felt supple as the muscle softened in slumber, providing the perfect cushion for bite-size me. I'm still amazed at how the body yields when it relaxes. I don't know if it was because, in true Iron Chef fashion, he frequently whipped up fresh Italian dishes with whatever ingredients were on hand, or because of his long days running around the New York City streets for his film shoots, but that night, Dan smelled like a mixture of warm bread and grass. I inhaled deeply, as if it were the most precious breath I would ever take. I felt as if I were levitating there, as if in a hot-air balloon going up, up, up. I wanted so badly to come down, to snuggle closer, but there was a rampart of air, of breath, between us.

I looked over the edge of the balloon's wicker basket and waved good-bye to this place. I thought of our earlier plan, before we knew we were breaking up, to rent out the co-op as an investment property when we moved to Philadelphia, until the real estate market swelled to secure us a hefty sale price. It was our surefire way to get rich, we had mused.

As the balloon kept rising, I panned the landscape to catch a glimpse of my in-laws and silently bade them good-bye, too. It had taken them nearly a decade to become comfortable with their baby boy dating a black woman, with their having a black daughter-in-law. In the end, it was worth it: Our bond had weathered strong. The thought of my relocating to their area without their son made the pang of my move that much more acute.

I said my farewells, too, to the two beautiful, olive-skinned, kinky-haired children Dan and I might have had. I could still feel the curls that framed their cherubic cheeks, which had my dimples. Their Italian American and African American heritages would have blessed them with lean, muscular bodies and round, ample butts. She would have been Nella Vita, and he would have been August. I could hear their giggles and their bye-byes dissolving into shrieks and cries. I tried to hold on to their images, but the balloon was drifting too high, and I was receding from them and my in-laws and the apartment and everything else I had known for the past thirteen years.

Now the balloon was up too far for me to jump down. The air felt thin at this altitude, and the only bubble of oxygen was right there on my ex-husband's chest and neck. My eyes traced his every contour-the mandible, the clavicle, the iliac crest-because I knew it would be the last time. I knew that at some point, he would wake up, and I would have to move. Trembling, I fumbled for my phone to snap one last picture of him asleep in bed. It was a terrible photo: The image was blurry and, in the low light, sepia-toned. I couldn't help but laugh, anticipating his response when I showed it to him after he woke-unless, of course, I simply deleted it.

Soon, a sticky New York City spring morning dawned. Sunrise oozed through the blinds and sketched a pattern on Dan's left cheek. I peeled the sheet back to feel the shallow breeze of the fan as it fought a pathetic battle against the humidity, and I thought about my next step.

I would fall apart.

Part of it would be due to loneliness, and a greater part would be the loss of what had been, up to that point, the only relatively stable relationship I had ever had with a man.

I wasn't angry the marriage was over. I wasn't bitter. I knew that we had run our course. Our breakup had never really been about the moving; it had been about two people at a crossroads. Dan wanted to live abroad to study his craft, knowing full well that I couldn't move after my residency. I needed to start working and to pass my board certification examination. He knew that I was not the type of woman to kamikaze my career for a man. I was also not the type of woman to stand in the way of another person's path. For Dan's part, he would leave because he had to. And I would let him go because there was no question that I had to.

No, the sadness on its way was over something greater than loneliness or "losing a man." The breakup of my marriage was stoking in me the deep sense of abandonment that had lain dormant during my marriage, the loss of the home life I had craved but never had. I knew on some level that this was the real source of my grief.

I didn't know the details yet-how or when-but that New York City spring, I knew it wouldn't be long before I slipped into a well of despondence, one where there was neither color nor light, but where, goddess willing, there was a bottom. I knew, too, that there would be no fighting any of it.

Now, here at my final residency ceremony, I shifted in my seat and glanced at my mother as she proudly anticipated my name being called. I concentrated on the rhythmic tapping of my heel. Just a few minutes more in this auditorium and I could start the business of moving on. I was careful not to kick the stranger beside me, to make the tapping fine and swift so it wouldn't bother anyone but could still distract me. I looked down at my ring finger-I could still see the light tan mark where my wedding band had been, the skin around it darkened by the sun. I quickly rubbed my index finger over the area. I rubbed it to take away the pain, and I kept rubbing, hard, as a single errant tear seared my right cheek. The strategy wasn't working.

Every graduation had sucked in its own way. High school graduation had sucked the least. The ceremony itself was revelrous. My whole family attended-no great feat, given that my family is small. Grandma showed up in one of her lacy church hats, which was nicely complemented by her deep berry lipstick. Grandpa, taciturn and smiling, was there in a smart suit, his camera, as always, by his side. He was the family photographer and the consummate observer. Grandma was the matriarch and the voice for them both. My mother's favorite sister, Eileen, was there, and my parents, my brother, and my sister, cheering with the rest of those gathered at the commencement for the National Cathedral School. The feeling of being surrounded by my fellow classmates, sixty-six other young women, many of whom would undoubtedly alter the course of history in critical ways, gave me unparalleled pride.

So, high school graduation itself wasn't bad. Leaving my family home for college was the bittersweet bit: The place was all I had known as a little girl, and yet nearly everything about it had been wrong. As I packed, listening to Deee-lite on my CD player, I took with me my inner child. The girl I was, who had never been permitted to come out to explore and be fanciful and weightless. Tucked into a small box, I carried her on the long drive to Cambridge, Massachusetts, because outside of the Orchid Street walls she might finally find a playground.

I won't go into detail about my college experience. Much has been written about centers of elitism and privilege like Harvard University. Some of it is true. It is true that at one of the first social events at Harvard I attended, a white male classmate told me that I couldn't possibly be black because I didn't speak like the two black people he knew from his neighborhood-and since he was, clearly, the arbiter of "blackness" he felt he had the right to say that to me. What I didn't know at the time was that this would be a fitting introduction to the four years of micro- (well, really, macro-) aggressions to follow. It is true that when a student sexual violence prevention group I was a part of approached one of the deans with a multipoint plan, her response to our inquiry to centralize resources for rape victims was "Harvard doesn't hold your hand." She meant it. In less than the time it took for her to close her door, the discussion was over. It is true that when I heard of the scandal of wealthy people literally purchasing their children's admissions into these universities, I wasn't surprised-this rampant inequity was well-known to all of us who were there; the only thing bizarre about the story was that the public behaved as if they weren't aware. While these ivory towers have traditionally served to elevate those who already have unearned privilege, they may hinder those who do not, by virtue of immutable attributes such as color, family class, sexual orientation, gender, and physical ability. The increased scrutiny on these institutions to live up to the standards of conduct that they profess to exemplify is warranted.

Table of Contents

Introduction xi

1 Michele: A Wing and a Prayer 1

2 Dr. Harper: The View from Here 21

3 Baby Doe: Born Perfect 45

4 Erik: Violent Behavior Alert 70

5 Dominic: Body of Evidence 93

6 Jeremiah: Cradle and All 113

7 In the Name of Honor 138

8 Joshua: Under Contract 166

9 Paul: Murda, Murda 204

10 Sitting with Olivia 234

11 Jenny and Mary: What Falls Away 257

Epilogue 278

Acknowledgments 281

Works Cited 283