A DOCTOR'S PATH

A doctor shares the good, the bad and the ugly from his experience in medicine.

Pellegrino, an orthopedic surgeon, begins his book with a brief family history. The author is the hardworking son of poor parents and was moved to study medicine when his mother succumbed to cancer at a young age. The book’s subtitle, with its folksy feel, and the range of Pellegrino’s practice, including volunteer work in Africa and with the poor and uninsured in the United States, create an expectation that the book will have a humanitarian bent. However, the bulk of the book is concerned with Pellegrino’s for-profit practice in American hospitals and clinics, specifically with the more egregious violations of the Hippocratic Oath the doctor witnessed during his years of practice. Pellegrino is now retired, but if he brought to his practice the same skills he brings to the problems he raises in each chapter, he must have been quite adept at his job. The author has an eagle-eye for detail and structure, especially when he dissects the case of an incompetent, dishonest doctor taking advantage of military hospital’s huge bureaucracy to obscure his deceits. Pellegrino’s unwavering dedication to what he believes is right keeps him going through the administrative layers of apathy and denial until he finally makes his case and the offending doctor is removed. But while Pellegrino appears to be the kind of doctor you would want as a surgeon, there is also an unsettling amount of resentment and ill will coloring his narrative. While the doctor seems to be motivated by decency and righteousness, his accounts of clashes with ego-driven, power-mad, money-hungry physicians come bearing big chips on their shoulders. Unfortunately, he can come off persnickety and priggish at these points, and the stiffness of his prose only exacerbates this. There are many good stories here; they just need some warmth and humor to make them truly come alive.

Exactitude is great for surgeons, not so great for storytelling.