One Doctor is All We Need

One Doctor: Close Calls, Cold Cases And The Mystery Of Medicine by Brendan Reilly

My rating: 5 of 5 stars


This book reads like part House, part Grey’s Anatomy and part diary, yet much, much more informative. By bringing us into his every day life and meeting his various patients at New York Presbyterian Hospital’s emergency department, Dr. Brendan Reilly explains, by example, why US healthcare, or more precise, ER care, has evolved into the complicated, hard-to-navigate maze that we see today; why most young med school graduates decide to to become specialists instead of primary physicians, which our country desperately needs.

The title, One Doctor, was used. Due to the regulation and involvement of the health insurance industry, most of us do not have a doctor who deeply concerns about us, who knows us well, who rallies for the right care in our behalf. On the other hand, we all have a battery of specialists. We have a cardiologist for our heart, a rheumatogist for our arthritis, an urologist for our prostates...and so on. Specialists make much more money, and where we are referred to once our ailment is out of our primary care’s scope. But, they usually do not know our complete health history since they only focus on a specific part of us. Dr. Reilly claimed that the patient with the one doctor that truly care for him, follows him over time and know him well would win this rat race of so-called American healthcare. It’s the difference between life and death sometimes…or worse, between death and insufferable life.

Sometimes when a patient or family says, “Do everything for me, doctor,” it unnecessarily that they want to try everything possible to live. Sometimes they do not want to hurt the family members who can’t let go, or they’re scared, or they have no idea hanging on could be worse than death. It’s the doctor, a good doctor’s job to find out what these patients really want, since some scenarios can be really worse than death. We all have a different trade-off limit between how much we are willing to suffer to prolong our life, it’s also a responsible doctor’s job to find out. From the various cases we encounter along with Dr. Reilly, we acquire a better understanding of the end of life, terminal illness, palliative care (which is not used enough), the quality of life, letting go, who to assign as surrogate and all other choices we might face in the future which we most likely never prepared ourselves for. We also will learn about the not perfect, but needed advanced directives as well.

As Dr. Reilly stated, “Most of the sad stories happen when this process doesn’t start until it’s too late. That’s how all those folks wind up comatose in nursing home and intensive care units, fogged with drugs and flogged by machines, not a prayer of getting better. It’s a living hell—and the only hyperbole in that phrase is the ‘living’ part.”

Dr. Reilly is a brilliant storyteller and great writer, and also a rare doctor that deeply cares for his patients. I can feel his real concern and love for life and the world. I could also feel the empathy he has for his patients and their families by reading the way he put his thoughts on paper. Several of these stories were deeply moving: Mr. Gunther, who endured a progressive form of cancer earlier in life who now faces another one; Mr. Atkins with a rapidly progressive terminal illness, who does not have time to prepare his family for his death; Ms. Rhodik, who refused to speak, but her family’s decisions are endangering her health. Others were down right disturbing: Fred, who decided that “losing his marbles” was never an option…and many more. We also learn about the cost of a misdiagnosis, as well as the cost of doing too much.

This is a deeply moving book with many though-provoking stories, and lots of useful information from a good and genuinely caring doctor who has over 40 years of experience. Read this book, for your elders, for yourself, for your children…and for the hope of a better health care system in the near future. This book will make you a better patient, advocate, caretaker, healthcare consumer and....human.

Advance reading copy provided by the Publisher via Netgalley

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