OPEN HEART

What begins as a memoir of one man’s encounter with modern medicine expands into contemplation of the state of health care today.

Neugeboren (Transforming Madness, 1999, etc.) was told in 1999 that his coronary arteries were nearly 100 percent blocked and that he must immediately undergo bypass surgery. Fortunately, four of his close friends—Rich, a cardiologist; Phil, a neurologist; Jerry, an AIDS doctor; and Arthur, a psychologist—shepherded him through this crisis, making sure he got the best of care. Reflecting on the experience afterward, he concluded that while his surgical procedure depended on high technology, what made the difference between life and death was decidedly low-tech. His successful outcome, he asserts, was due in large part to the fact that he received the attention of doctors who knew him and listened to him. His opinion was confirmed about a year later when consulting two reputable New York urologists. The first never connected with him as a human being; the second paid attention to his concerns and answered his questions. For Neugeboren, who left the second doctor’s office feeling reassured and relieved even though this physician’s assessment of his condition was more serious, the crucial difference was that the first doctor practiced the impersonal science of medicine, while the second combined science with the art of medicine. That art, he warns, is often missing for many of us in our encounters with modern medicine. The author includes numerous excerpts from his own journals and long quotes from conversations with his four closely involved friends, who discuss not only the author’s particular case but the state of medicine today, how they came to choose their professions, and what they think about their work. In his examination of the healing arts, Neugeboren also draws on the books of numerous other thoughtful writers on medical matters, including Lewis Thomas, Sherwin Nuland, Gerald Grob, and Daniel Callahan.

A skillful blending of personal experience and public concerns.