On the Ragged Edge of Medicine offers a glimpse into a medical practice for the homeless and urban poor. Told through fifteen patient vignettes, and drawn from the author’s decades of experience in Portland, Oregon, this revealing memoir illuminates the impact of poverty on the delivery of health services and the ways in which people adapt and survive (or don’t survive) in conditions of abuse and deprivation. Kullberg’s stories show the direct and sometimes devastating effects of poverty on public health, poignantly demonstrating that medicine is as much a social enterprise as a scientific one.

Patricia Kullberg, MD, MPH, served more than two decades as Medical Director at Multnomah County Health Department and primary care doctor for persons living with physical, mental and addiction disorders. She has written award-winning articles about health and medicine, and in 2015 published her first novel, Girl in the River, about the intimate life of a working girl in mid-twentieth century Portland. Kullberg and her husband live in her home town, Portland, Oregon, where she facilitates writing workshops for incarcerated women through Write Around Portland and volunteers as radio engineer at Portland’s community radio station, KBOO.