No-punches-pulled scrutiny of the flawed system that produces our nation's doctors. As the husband of an overstressed, overworked, and overtired resident in pediatrics, Duncan (Hernando de Sota, 1995, etc.) saw firsthand the impact our present residency system had on one doctor. Here he looks at the bigger picture: how it affects not just doctors but patients and society in general. For four years he followed hospital residents on call, keeping records of their actions, attitudes, hours, supervision, and patient outcomes; he also interviewed dozens of doctors, medical educators, patients, and nurses. The result is an anecdote-filled account of what's wrong with the system and how it came to be the way it is. Where statistics are available, he cites them, but one of the flaws of the present system is its failure to collect hard data on its own level of safety or effectiveness. Where reforms have been made— as in New York State, where the famous Libby Zion case led to legislation restricting the number of hours residents can work— he describes them, but these are few and far between. Duncan is persuasive in his argument that a system that once worked fairly well when medical knowledge was limited now drops inexperienced and minimally supervised young physicians into complex, difficult situations, that it overworks and underpays them, and that it too often fails to protect patients from the hazards of treatment by sleep-deprived and undersupervised residents. Concluding with a warning that the very survival of our nation's teaching hospitals is being threatened as managed care reshapes the medical marketplace, Duncan offers no solutions to that problem but has some practical suggestions for revamping residency programs. An up-close and sobering picture of medical education's imperfections. (Author tour)

Pub Date: June 1, 1996

ISBN: 0-684-19709-X

Page Count: 304

Publisher: Scribner

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: April 15, 1996

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Stricter than, say, Bergen Evans or W3 ("disinterested" means impartial — period), Strunk is in the last analysis...



Privately published by Strunk of Cornell in 1918 and revised by his student E. B. White in 1959, that "little book" is back again with more White updatings.

Stricter than, say, Bergen Evans or W3 ("disinterested" means impartial — period), Strunk is in the last analysis (whoops — "A bankrupt expression") a unique guide (which means "without like or equal").

Pub Date: May 15, 1972

ISBN: 0205632645

Page Count: 105

Publisher: Macmillan

Review Posted Online: Oct. 28, 2011

Kirkus Reviews Issue: May 1, 1972

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Analyzing his craft, a careful craftsman urges with Thoreauvian conviction that writers should simplify, simplify, simplify.


New York Times columnist and editorial board member delivers a slim book for aspiring writers, offering saws and sense, wisdom and waggery, biases and biting sarcasm.

Klinkenborg (Timothy; or, Notes of an Abject Reptile, 2006), who’s taught for decades, endeavors to keep things simple in his prose, and he urges other writers to do the same. (Note: He despises abuses of the word as, as he continually reminds readers.) In the early sections, the author ignores traditional paragraphing so that the text resembles a long free-verse poem. He urges readers to use short, clear sentences and to make sure each one is healthy before moving on; notes that it’s acceptable to start sentences with and and but; sees benefits in diagramming sentences; stresses that all writing is revision; periodically blasts the formulaic writing that many (most?) students learn in school; argues that knowing where you’re headed before you begin might be good for a vacation, but not for a piece of writing; and believes that writers must trust readers more, and trust themselves. Most of Klinkenborg’s advice is neither radical nor especially profound (“Turn to the poets. / Learn from them”), and the text suffers from a corrosive fallacy: that if his strategies work for him they will work for all. The final fifth of the text includes some passages from writers he admires (McPhee, Oates, Cheever) and some of his students’ awkward sentences, which he treats analytically but sometimes with a surprising sarcasm that veers near meanness. He includes examples of students’ dangling modifiers, malapropisms, errors of pronoun agreement, wordiness and other mistakes.

Analyzing his craft, a careful craftsman urges with Thoreauvian conviction that writers should simplify, simplify, simplify.

Pub Date: Aug. 7, 2012

ISBN: 978-0-307-26634-7

Page Count: 224

Publisher: Knopf

Review Posted Online: May 14, 2012

Kirkus Reviews Issue: June 15, 2012

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