Books by Robert Marion

Released: Feb. 1, 1994

Intriguing speculations about the possible effects on world events of the genetic abnormalities of certain well-known figures. Geneticist Marion (Learning to Play God, 1991, etc.) poses such questions as: Did George III of England suffer from porphyria, and if so, how did this affect his handling of unrest in the American colonies? Was George Washington rendered sterile by XYY syndrome, and would the US have become a monarchy if he had had a son? Similarly, questions are raised about the effects on history of abnormal genes in Napoleon Bonaparte, Abraham Lincoln, the Romanov family, and John F. Kennedy. Some of Marion's musings are on firmer ground than others: That the heir to the Russian throne had hemophilia is historical fact; it has not been established, however, that Napoleon had 17-ketosteroid reductase deficiency, a condition that compromises masculinity. Marion rejects the theory that Lincoln had Marfan syndrome, but posits the notion that he suffered from mitral valve prolapse syndrome, which gave him an awkward, gangly appearance, and that the ridicule he suffered because of his looks sensitized him to discrimination and thus shaped his views on slavery. The author asserts that Kennedy's triumph over Addison's disease spurred him on to seek high office and may have given him a sense of invincibility that led him to expose himself to an assassin's bullets. Focus occasionally wavers; the Romanov chapter wanders off into a discussion of the Anastasia story, and the Kennedy section gets sidetracked into an account of how JFK's parents dealt with the problem of their retarded daughter. Entertaining mix of fact and fancy, along with solid information about genetic disorders. Read full book review >
Released: Oct. 1, 1991

Marion, pediatrician and author (The Boy Who Felt No Pain, 1990; The Intern Blues, 1989; the novel Born Too Soon, 1985) tells tales out of school—and out of internship and residency- -dramatizing his thesis that the education of doctors is virtually guaranteed to produce competent but insensitive physicians. According to Marion, most students entering medical school are idealistic and eager to help others. As third-year students, however, they serve as clinical clerks to overworked, burned-out, and callous interns. And once they become interns themselves they too become sleep-deprived and psychologically damaged, often blaming patients for their situation. As residents, young doctors have even more power and responsibility, and the uncaring attitude they developed as interns can have even greater impact on patient care. That this attitude may well remain once their training is finished is clear from Marion's portraits of various older physicians who figure in his stories. Occasionally a story seems designed more to hold a flattering light up to the author than to shed light on the problems inherent in our present system for training doctors, but all are engrossing. Marion knows how to spin a tale, including enough medical detail to lend veracity to his account yet not overwhelm the lay reader. In an epilogue, he makes his own brief recommendations for revamping the education of doctors; after exposure to the medical mind-set presented in his stories, a question remains as to whether his recommendations go far enough. Absorbing stories that reveal the need for major reforms in how doctors are trained. Read full book review >
Released: March 23, 1989

A day-to-day account of the internship year of three young pediatricians, interspersed with commentary by a supervising physician—and it all conveys some strong messages that may not be what the author intended. Marion is a pediatric geneticist at the Albert Einstein College of Medicine in the Bronx. In his role as an attending physician, he met with three interns—two men and a woman—at their orientation; over the ensuing year, they taped journals of the events that changed the three neophytes from trembling medical students to—we hope—competent practicing physicians. Their intent here is to acquaint readers with what exactly happens during an internship—and they certainly do that. But they themselves don't emerge as altogether sympathetic characters in the process. One intern's view early-on here is that "Most people in the nonmedical public . . .They have these myths that we're all like Dr. Kildare or Marcus Welby"—but few readers will agree that this is still a widely held view. In fact, these accounts, while intriguing (especially for medical buffs) and often horrifying, serve rather to reinforce today's emerging physician stereotypes: all three seem terribly young and immature, and on their way—solidly reinforced by this training system—to being thoroughly self-centered and insensitive. The doctors' accounts certainly do provide an accurate portrayal of the devastating process of today's urban internship: contending with astounding numbers of astoundingly ill patients (including the AIDS explosion), on terrifyingly little sleep, with utterly insufficient numbers of hospital staff (especially nurses)—all under sometimes sketchy supervision. Marion hopefully points out that the monolithic medical training establishment is attempting to address these problems, and suggests that his work may help the effort. Read simply as medical theatre, and as solid first-person reporting, this is fine. But readers wishing to hear from someone with more maturity and insight—and compassion—to put the experience into some kind of perspective will do better with a dose of Melvin Konner, or with Robert Klitzman's A Year-Long Night (1988). Read full book review >