No Apparent Distress: A Doctor's Coming of Age on the Front Lines of American Medicine

In medical charts, the term “N.A.D.” (No Apparent Distress) is used for patients who appear stable. The phrase also aptly describes America’s medical system when it comes to treating the underprivileged. Medical students learn on the bodies of the poor—and the poor suffer from their mistakes.


Rachel Pearson confronted these harsh realities when she started medical school in Galveston, Texas. Pearson, herself from a working-class background, remains haunted by the suicide of a close friend, experiences firsthand the heartbreak of her own errors in a patient’s care, and witnesses the ruinous effects of a hurricane on a Texas town’s medical system. In a free clinic where the motto is “All Are Welcome Here,” she learns how to practice medicine with love and tenacity amidst the raging injustices of a system that favors the rich and the white. No Apparent Distress is at once an indictment of American health care and a deeply moving tale of one doctor’s coming-of-age.

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