by Jane M. Orient ‧ RELEASE DATE: May 22, 1994
A formulaic, if impassioned, Rx by the executive director of the Association of American Physicians and Surgeons, whose answer to runaway medical costs and uneven care is to put patients, not health care managers, back in the driver's seat. Jane M. Orient is an LMD, a local medical doctor, who practices internal medicine in Tucson, Ariz. Her irreverence towards the establishment is implicit in her definition of an LMD, ``a term of derision used by significant persons such as full professors to refer to doctors in the world outside the academy. The term connotes a bumbler or hick who somehow got an M.D. degree.'' Orient takes money only from patients, not from third- party payers. Because she's chosen to be independent from managed care networks, she is increasingly a ``superfluous woman,'' i.e. her medical opinion doesn't count. Orient compares the state of American medicine to that of an overmedicated patient, one suffering toxic effects from drugs prescribed to regulate conditions that were best left alone. Her answer is decentralization. ``Medicine,'' she argues, ``is based on the doctor-patient relationship founded on the Hippocratic Oath—not on an administrative flowchart. Remember, you can fire your doctor if you like. You can't fire your bureaucrat.'' Orient reviews the pros and cons of the British, Canadian, and German health care systems, as well as the AMA's practice guidelines, and concludes that a free market is the best alternative and the one that does the least harm. In a final chapter called ``Getting It Right,'' she issues her own plan: (1) restore insurance, as opposed to a system of managed care, (2) decrease government regulation, and (3) encourage charity to the poor. A conservative argument against increasing government regulation and bureaucratization of American medicine in the tradition of such free-market thinkers as Milton Friedman.
Pub Date: May 22, 1994
ISBN: 0-517-59011-5
Page Count: 288
Publisher: Crown
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: March 15, 1994
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by Ta-Nehisi Coates ‧ RELEASE DATE: July 8, 2015
This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”
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The powerful story of a father’s past and a son’s future.
Atlantic senior writer Coates (The Beautiful Struggle: A Father, Two Sons, and an Unlikely Road to Manhood, 2008) offers this eloquent memoir as a letter to his teenage son, bearing witness to his own experiences and conveying passionate hopes for his son’s life. “I am wounded,” he writes. “I am marked by old codes, which shielded me in one world and then chained me in the next.” Coates grew up in the tough neighborhood of West Baltimore, beaten into obedience by his father. “I was a capable boy, intelligent and well-liked,” he remembers, “but powerfully afraid.” His life changed dramatically at Howard University, where his father taught and from which several siblings graduated. Howard, he writes, “had always been one of the most critical gathering posts for black people.” He calls it The Mecca, and its faculty and his fellow students expanded his horizons, helping him to understand “that the black world was its own thing, more than a photo-negative of the people who believe they are white.” Coates refers repeatedly to whites’ insistence on their exclusive racial identity; he realizes now “that nothing so essentialist as race” divides people, but rather “the actual injury done by people intent on naming us, intent on believing that what they have named matters more than anything we could ever actually do.” After he married, the author’s world widened again in New York, and later in Paris, where he finally felt extricated from white America’s exploitative, consumerist dreams. He came to understand that “race” does not fully explain “the breach between the world and me,” yet race exerts a crucial force, and young blacks like his son are vulnerable and endangered by “majoritarian bandits.” Coates desperately wants his son to be able to live “apart from fear—even apart from me.”
This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”Pub Date: July 8, 2015
ISBN: 978-0-8129-9354-7
Page Count: 176
Publisher: Spiegel & Grau
Review Posted Online: May 5, 2015
Kirkus Reviews Issue: July 1, 2015
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by Paul Kalanithi ‧ RELEASE DATE: Jan. 19, 2016
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
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A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
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