Exam Room Confidential: The Wellborne Files

Siegel, a doctor, uses fiction (inspired by an actual case he encountered as an internist) to air fetid linen in the medical profession.

Dr. Charlie White tries to do his best for a severely ill woman, but he fears her own brother seeks her death, assisted by a dysfunctional hospital culture. The setting is a Florida hospital, where White’s last-angry-man first-person narration tends to paint him as one of the few decent, compassionate individuals left practicing the healing arts. A somewhat scrambled flashback structure opens with the emergency admission of longtime patient Agnes Wellborne, felled by a stroke, among other serious medical issues. Short, bracing chapters recall memories of White’s work with the Wellborne family, chiefly the chronically ill Agnes, her sister, Marion, and their brother, Harris, a coldblooded lawyer who will inherit the estate if he survives his siblings. As Marion languishes in the background, suffering a mysterious environmental poisoning, Agnes, good-hearted wife and mother but a lifelong smoker with commensurate ailments, is hospitalized again and again, at one point facing a misdiagnosis of colon cancer; only Dr. White’s intercession prevents grueling, unnecessary therapy. In the present crisis, Harris seems eager for Agnes to receive all possible treatment, but White suspects the lawyer banks on the health care establishment’s own pathology—inexperienced EMTs, a vainglorious ICU physician, conceited and do-nothing surgeons—to ensure Agnes dies in a prolonged, hideous life-support ordeal. The situation brings White to an extreme crisis of conscience. Though the tale occasionally and jaggedly runs into mystery/crime-thriller territory—with characters who sometimes have only enough attributes to illustrate a painful point Siegel is trying to make—the novel has the voice of a medical insider who has firsthand knowledge and an urgent need to share his highly critical clinical chart. Several pages of footnotes and a glossary of terms will help readers see through the jargon.

A somewhat bitter pill but a vital prescription for readers who want to know what really goes on in the critical-care ward.