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Tag: surgeon

Under The Knife by Arnold Van de Laar

In Under the Knife, surgeon Arnold Van de Laar uses his own experience and expertise to tell the witty history of the past, present, and future of surgery.
From the story of the desperate man from seventeenth-century Amsterdam who grimly cut a stone out of his own bladder to Bob Marley’s deadly toe, Under the Knife offers all kinds of fascinating and unforgettable insights into medicine and history via the operating theatre.
What happens during an operation? How does the human body respond to being attacked by a knife, a bacterium, a cancer cell or a bullet? And, as medical advances continuously push the boundaries of what medicine can cure, what are the limits of surgery?
From the dark centuries of bloodletting and of amputations without anaesthetic to today’s sterile, high-tech operating theatres, Under the Knife is both a rich cultural history and a modern anatomy class for us all.

Thanks to NetGalley for this ARC!

I have read many medical history books before but none of them were as gruesomely interesting as this one. The juxtaposition of the gory surgeries and the dry writing makes for an excellent read. So many different surgeries are discussed in this book, it seems, that there should be something for everyone. If you are a fan of spurting blood, swollen intestines, gangrene, and reading about a man performing surgery on himself without anesthesia, then this book is definitely for you. If you are the squeamish type, stop reading immediately and find something else.

Each one of the 28 chapters discusses a different type of surgery, complete with history and famous examples. Some of the people van de Laar writes about are JFK, Bob Marley, Lenin, and Napoleon. I can honestly say that I learned multiple new facts in each chapter. This, plus the straight-up medical language (that may be incomprehensible to most people) made this book a winner for me. I have a medical background so this was an easy read, but I can see most people trying to figure out some of the jargon and getting discouraged. The author does provide many explanations and word sources (such as Latin or Italian) as well as a glossary at the end, but there is also a good deal of medical verbiage. The chapter also brings us into the present time, and how this surgery is performed using clean instruments and updated techniques.

As I mentioned before, the gore factor is extremely high. I don’t recall ever experiencing this level of detail, even in books containing Hannibal Lecter. A simple sentence telling us that the Sun King only bathed once or twice in his lifetime, and generously opened a window so a visitor could have fresh air speaks volumes. Can’t you just smell the stench from here?!?

There are also chapters on eunuchs, ancient Rome, and bloodletting. The detail in which van de Laar describes each procedure is magnificent. Facts just keep unrolling on the page, with minimal asides for the human detail found in so many other books written by doctors (such as Sandeep Jauhar or Atul Gawande). The book is nearly devoid of emotion; there are only procedures and facts.

I absolutely loved this book. I also may never be able to get some of the gory images out of my mind – but that’s ok.

Want your own copy? You can pick it up

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Unfortunate Event by Marc David Veldt

unfortunate

A man’s life can easily be shattered by a single unfortunate event.
After a patient dies following a routine operation, hospital administration needs a scapegoat. They find their victim in Dr. Jack Andrews, a brilliant anesthesiologist. Andrews’s actions had no bearing on the patient’s death, but he finds himself thrown to the legal wolves by his so-called colleagues as they scramble to protect themselves.

Facing a relentless, amoral prosecutor and allied with a malpractice insurance company acting in its own best interests, Andrews loses everything-his money and his standing in the medical community. His money-obsessed wife divorces him, taking with her their two children.

Jack’s opponents think they’ve won. They think they’re the most ruthless players in the game of life. But Jack’s about to introduce them to the game’s next level. He’s got nothing left to lose, and a mind trained to make life-or-death decisions. People start to die-people who wronged Jack Andrews.
A tense thriller, ” Unfortunate Event” explores the dark side of operating room culture, the cutthroat world of malpractice law, and the mind of one man as his world crumbles around him.

Word Slinger Publicity gave me a copy of this book in exchange for an unbiased review.

The one thing that drew me to this book was that the author is an anesthesiologist, and I was looking forward to accurate and copious medical detail.
I wasn’t disappointed! I was also pleasantly surprised by the quality of the writing and how thrilling the plot was. Jack Andrews is a very sympathetic character that undergoes a sweeping personality change as a result of his verbally abusive and emotionally absent wife, job stress, and accidental death of a patient that was not his fault.
The story line is set up well as we see a patient suddenly go downhill after a routine surgery. The medicine was good, but an unknown combination of events caused the patient to spiral downwards and eventually die. The details showing doctors scrambling to lay blame and divert attention away from themselves is chilling and unfortunate if truly accurate.
Andrews is a magnet for almost every cliché surrounding the medical profession: he’s married to a money grubbing woman who teaches their children to view their father as a giant wallet, his coworkers are a coterie of doctors that eschew their personal life to chase the almighty dollar, and his malpractice lawyer is a drunken has-been who only cares about getting the case settled quickly so he can go back to his bottle.
Author Marc David Veldt makes this situation sound plausible. Some of his most cringeworthy bits of dialogue are from the mouth of Kate, the doctor’s wife. In one chapter, she is lambasting her husband for having to miss work during his malpractice trial. She asks:
“How long will the trial take?”
“About 3 or 4 weeks.”
“You can’t be expected to miss that much work. We have no income if you aren’t working. You’ll just have to make the lawyers attend the trial. There’s no reason you have to be there all the time.”
“Gee, honey, I think it’s expected that I show up for my own trial.”
“It isn’t fair. Why should the children and I have to suffer because some guy had a poor result?”
“Dying is a very poor result.”
“You just aren’t tough enough, are you? I can’t believe I’m supposed to raise children with someone who isn’t strong and has all these problems.”

Every time Kate spoke it was pretty much along the same lines, and I hoped to read later on that he had injected her with some potassium chloride or something.

Eventually Dr Andrews gives in to let the machine chew him up and spit him out. He loses everything he cares about, and the only thing left for him is to seek justice….his own way. The brilliant, organized mind of an anesthesiologist turns to nefarious deeds, and this is where the story takes a darker turn. He plots the murder of everyone who has wronged him in a cool, calculated plot that did stretch credulity a bit, but for the most part it was easy to digest.  Even as he plots the demise of his enemies, he still remains a sympathetic character. I stayed up long past my bedtime to see what would happen to the good doctor!

Andrews’ character is well defined, whereas some of the others were not. There was an equal amount of dialogue and description to keep things constantly moving forward in a compelling way, and there was suspense as well towards the end of the book when the police started putting the pieces together.

UNFORTUNATE EVENT is a hidden gem of a book and easily readable, no medical background needed. The events put forth in the book really made me think about the world of malpractice law and how vulnerable doctors may be in this litigious society. The author writes in such a way as to exploit the desire for money, and this causes the reader to realize the pressure on doctors and how this affects each decision they make.

I’d love to see more of Veldt’s work and I hope he continues to write. Want your own copy? You can pick it up [easyazon_link identifier=”1502913402″ locale=”US” nw=”y” tag=”gimmethatbook-20″]here[/easyazon_link].

 

 

 

Doctored by Sandeep Jauhar

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This was another book I picked up at the library for myself, and I was excited to see the author of [easyazon_link asin=”0374531595″ locale=”US” new_window=”default” nofollow=”default” tag=”gimmethatbook-20″ add_to_cart=”yes” cloaking=”default” localization=”yes” popups=”default”]Intern: A Doctor’s Initiation[/easyazon_link] had written another book. This one is of a bit darker tone, as he talks about his struggle to keep focused and happy saving lives and battling insurance companies. The main focus of this book is money and cronyism: how much it costs for medical care, how much the doctors are getting paid, ways to circumvent insurance companies’ unwillingness to pay, and quid pro quo buddy systems where referrals are the goal.

Once again, as in other books written by doctors, this was pretty depressing. On page 11 Jauhar talks about how doctors are disillusioned:

In 2001, 58% of about 2000 physicians questioned said their enthusiasm for medicine had gone down in the previous five years, and 87% said their overall morale had declined during that time. More recent surveys  have shown that 30 to 40% of practicing physicians would not choose to enter the medical profession if they were deciding on a career again, and an even higher percentage would not encourage their children to pursue a medical career.

There are many reasons for this disillusionment besides managed care. An unintended consequence of progress is that physicians increasingly say they have inadequate time to spend with patients. Medical advances have transformed once terminal diseases – cancer, AIDS, congestive heart failure – into complex chronic conditions that must be managed long term.

So.  We have people living longer, restrictions placed on doctors by HMOs, pressure to make ends meet at home,  and doctors being forced to produce referrals in order to maintain the old boy network. That could definitely make anyone disillusioned. What’s scary about this situation is that people’s lives are at stake here. All anyone wants is to be able to trust their physician, that he will do no harm.

Jauhar tells his story, warts and all: he is frustrated at not being able to practice his own medicine, without having to network. His marriage is straining due to lack of money. He seems to be suffering from depression that is untreated. Personally, I would not want to be in the hands of a doctor that was being pressured on so many fronts. But Jauhar perserveres, tries to practice good medicine, and attempts to play the game. He marvels at the circumstance of a man, admitted to the hospital because of shortness of breath. During his 30 day, $200,000 stay, he was seen by SEVENTEEN doctors and underwent TWELVE procedures. He was discharged with only “minimal improvement in his shortness of breath” and “follow ups…with SEVEN specialists“.

As the book proceeds further, Jauhar discusses taking away the financial incentive to over test patients, and make suggestions on how to fix our beleagured healthcare system. His arguments are sound, and probably could only happen in a perfect world. I urge you to read this book, only if it will help arm you against unscrupulous surgeons and the overreach of the billing department.

The only problem I have with the book is that I wasn’t sure if Jauhar wanted to make it a story about him, or a general story about our healthcare. He will start off a chapter with a patient’s story, then end up talking about how it affected him and how frustrated he was,  then insert a dialogue he had with his young son. Then the next chapter will start off with personal thoughts and stories about how he was mentally checked out of his marriage, and suddenly mention a patient. There was also a  long part about him trying to moonlight, but not billing enough, not seeing enough patients, and not playing the game–but instead of trying to fix things, he seems to go into a vapor lock (that could be the depression) and let things just swirl around him and get worse.  He seemed to be very wishy washy here, and let his brother and father galvanize him into action by calling in favors and getting him money making opportunities. Nothing he did made him happy, and that whole middle section of the book was very depressing and drawn out. Eventually things get better at home for the author…..but our healthcare system stays broken.

This was a very illuminating read, and a good follow up to INTERN– we see how Jauhar grows as a doctor and becomes more self aware.  DOCTORED is a great book for anyone who thinks all doctors are millionaires. Want your own copy? You can pick it up [easyazon_link asin=”0374141398″ locale=”US” new_window=”default” nofollow=”default” tag=”gimmethatbook-20″ add_to_cart=”yes” cloaking=”default” localization=”yes” popups=”yes”]here.[/easyazon_link]

Final Exam: A Surgeon’s Reflections on Mortality by Pauline W. Chen

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Final Exam was a book I picked up myself from the library. It was on my own personal reading list, which I haven’t been really able to get to these days. This is not a new book; it was published in 2007, but the ideas that Dr Chen speaks of should be relevant and in use today.

The mission of all doctors is to maintain life–by performing surgery, by prescribing medication, by encouraging life changes such as dieting or quitting smoking. But–everyone eventually dies, no matter how brilliant the surgeon was, or how much weight a patient lost. Many doctors gloss over this fact and prefer to focus on living and making a better quality of life.

Who will champion a better quality of death? No, Dr Chen is not  going to talk about euthanasia, or discuss funeral services. She is going to bring to the forefront a subject that has been assiduously avoided in human medicine for a long time: death is very much a part of life, and it should not be spoken of in hushed tones or pushed to the back of one’s mind. To truly care for your patients, you must realize that death is truly part of life.

No one wants to consider their own mortality, especially someone who is going to the hospital for an operation.  Dr Chen postulates that all doctors can give better care by embracing their own personal feelings and fears about death, and listening to what their patients are telling them, either with words or what their body is saying.

There is a great deal of explicit description in Final Exam:  of medical procedures and people struggling to die, those with sickness or those who have developed complications after surgery. Dr Chen starts out with her own personal experience with a cadaver in medical school and brings us all the way to her visceral reaction when a good friend of hers dies.

This book’s message is a powerful one, and not for the faint of heart. I thoroughly applaud Dr Chen for suggesting that doctors make themselves more emotionally available and vulnerable. Too often a patient’s death is couched in a sense of failure, of medicine gone wrong. A delicate balance needs to be attained, and I hope Dr Chen has started a dialogue by writing this book.

I loved this. You can pick up your own copy [easyazon_link asin=”030727537X” locale=”US” new_window=”default” nofollow=”default” tag=”gimmethatbook-20″ add_to_cart=”default” cloaking=”default” localization=”default” popups=”yes”]here[/easyazon_link]!

Also, if you haven’t already, download the Kindle reading app here.

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