Tag: hospital (Page 2 of 2)

Internal Medicine by Terrence Holt

March 17, 2015 / Kyle Wendy Skultety / 0 Comments

A collection of essays about life as a surgical intern.

Terrence Holt, whose In the Valley of the Kings was hailed as a “work of genius” (New York Times) and made Amazon’s Top Ten Short Story Collections of the year, brings a writer’s eye and a doctor’s touch to this powerful account of residency.

Intense, ironic, heartfelt, and heartbreaking, these nine vivid stories put us at the bedside of a patient dying in a house full of cursing parrots, through a nightmarish struggle to convince a man that he has cancer, at a life-and-death effort to keep an oxygen mask on a claustrophobic patient, and in the lounge of a snowbound hospital where doctors swap yarns through the night.

Out of these “dioramas from the Museum of Human Misery”, Holt draws meaning, beauty, wonder, and truth. Personal, poignant, and meticulously precise, these stories evoke Chekhov, Maugham, and William Carlos Williams, admitting readers to the beating heart of medicine. Internal Medicine is an account of what it means to be a doctor, to be mortal, and to be human.

This book was on my “to-read” list, so I picked it up from the library. Attempts to reach the author for a review/giveaway copy were unsuccessful.

It only took a few pages for INTERNAL MEDICINE to become a great read. Told in the voice of a doctor, explaining how he handled difficult cases during his internship, this book is alternately chilling and poignant. The take away message is this: doctors have self doubt and fatigue just like everyone else, despite the brave front they put on.

Each chapter told the story of one patient, and how Holt learned from their situation. One lesson was patience, one was bravery, one was teamwork, and so on. Brilliant details and situations that everyone can identify with are what makes this such a moving and important read.

As I read about the woman whose oxygen saturation was dipping into the 80’s, yet she kept ripping her O2 mask off due to claustrophobia, I ferverently hoped I would never be ill and lingering in the hospital. The intimate details of how the human body betrays us all is what will stay with you, long after the book is finished. Holt’s writing style is easy to follow, and full of honesty.

Each chapter can be read as a stand alone, and I recommend that–for you will need time to digest the life lessons revealed with each patient’s final outcome. Holt does not hide his fear, his disgust, his anger, and his weariness. He exposes himself – and the entire medical profession – with stories that cannot help but touch your soul. What makes this book so wonderful is that the stories take place during his internship, where each moment is a learning experience and a doctor’s intuition is “make or break”. The spin on each chapter would be totally different if it was written under the guise of a man who was completely comfortable with his medical knowledge, with his ability to heal and comfort. Instead, there are questions and internal monologues, which make the doctor not larger than life, but truly human and with foibles.

The book can be graphic at times, so beware. Seasoned readers of the medical genre will enjoy it, as there are some things that I haven’t read about previously. The scenes and maladies are diverse, and there is a chilling story from a mental hospital thrown in for good measure. The only chapter I had a problem with was the last one: a seemingly out of place fable (told on a regular basis by doctors) about an incident that may or may not have taken place in real life–a rambling and unsatisfying tale told (in this case) by an older doctor in an on call room where others are trying to get some rest. I’m not sure why the author chose to end with this story, as it took the life out of the other eight chapters that went before. Other than that, I have nothing but praise for INTERNAL MEDICINE. This should be on the must read shelf for all those about to enter the medical profession.

Want your own copy? You can pick it up [easyazon_link asin=”0871408759″ locale=”US” new_window=”default” nofollow=”default” tag=”gimmethatbook-20″ add_to_cart=”yes” cloaking=”default” localization=”yes” popups=”yes”]here[/easyazon_link].

Doctored by Sandeep Jauhar

December 27, 2014 / Kyle Wendy Skultety / 0 Comments

[easyazon_image add_to_cart=”yes” align=”left” asin=”0374141398″ cloaking=”default” height=”500″ localization=”yes” locale=”US” nofollow=”default” new_window=”default” src=”http://ecx.images-amazon.com/images/I/41KtPYMFbSL.jpg” tag=”gimmethatbook-20″ width=”333″]

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]