One-Minute Book Reviews

May 18, 2012

What I’m Reading … Susan Gubar’s ‘Memoir of a Debulked Woman: Enduring Ovarian Cancer’

Filed under: Memoirs,Nonfiction,What I'm Reading,Women — 1minutebookreviewswordpresscom @ 1:39 pm
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“What I’m Reading” is a series about books I’m reading that I may or may not review later

What I’m reading: Memoir of a Debulked Woman: Enduring Ovarian Cancer (Norton, 296 pp., $24.95), by Susan Gubar.

What it is: A feminist scholar’s memoir of the medical “calamities” she endured after undergoing the standard medical treatment for advanced ovarian cancer, known as debulking surgery.

Why I’m reading it: Few authors have written in depth about having advanced ovarian cancer, partly because few women survive the disease long enough to do it.

Quote from the book: “the state of contemporary approaches to ovarian cancer is a scandal.”

Probability that I will review the book: 100%

Publication date: April 2012

Read an excerpt from Memoir of a Debulked Woman or learn more about the book.

About the author: Gubar co-write The Madwoman in the Attic: The Woman Writer and the Nineteenth-Century Literary Imagination, a book widely used in college classes.

You can follow Jan (@janiceharayda) on Twitter by clicking on the “Follow” button in the right sidebar.

© 2012 Janice Harayda
www.janiceharayda.com

March 14, 2012

Maybe He Should Have Called It ‘Cutting for Oliver Stone’ – A Review of Abraham Verghese’s ‘Cutting for Stone’

Filed under: Fiction,Novels — 1minutebookreviewswordpresscom @ 11:44 pm
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Twin brothers grow up in Ethiopia as the Eritrean People’s Liberation Front steps up its violence

Cutting for Stone. By Abraham Verghese. Vintage, 667 pp., $15.95, paperback.

By Janice Harayda

Maybe he should have called it Cutting for Oliver Stone. Like the controversial director’s JFK, Abraham Verghese’s first novel abounds with far-fetched characterizations, heavy-handed moralizing, and historical implausibilities or inaccuracies. Also like the movie, it has a dense plot and enough facts to give its story a gloss of truth.

But you wonder if even Stone would have taken the liberties that Verghese does in this tale of mirror-image identical twin brothers — one is right-handed, the other left- — born in Addis Ababa in 1954. Marion and Shiva are orphaned at birth by the death of their mother and the disappearance of their father. As luck would have it, and luck often does have it in this novel, they grow up as the wards of sympathetic doctors who guide them toward medical careers of their own as the Eritrean People’s Liberation Front steps up its activity against Emperor Haile Selassie.

Cutting for Stone shows Selassie riding through the eucalyptus-scented streets of Addis Ababa in a green Rolls-Royce with his chihuahua, Lula, in his lap. At a nearby hospital doctors give a man a swig of Johnnie Walker to relax before a vasectomy. And after Marion begins his internship at a charity hospital in the Bronx, the novel keeps rolling out its gurney of medical lore. As you take your last breaths, you may or may not find it comforting to know that American doctors refer to dying patients as “circling the drain” and like to say that “if you had more than seven tubes in you, you were as good as dead.”

This semi-autobiographical material has provided perhaps too many temptations for Verghese, a professor medicine at Stanford who was born in Ethiopia in 1955. He lards his story with gratuitously detailed accounts of surgical procedures that, in the words a critic for the Economist, reflect “a somewhat whimsical notion of what they entail.” For the convenience of his plot, he has changed the dates and other details of major news events, such as a failed coup against Selassie and the hijacking of an Ethiopian airplane by Eritreans. In an otherwise naturalistic novel, he allows Marion to speak bizarrely from the womb and to believe he can read his twin’s mind, although he has so little control of point of view that it is often hard to know his intentions.

Verghese has won reputation as a literary writer in an industry tries to categorize novelists as either literary or commercial, and on the evidence of this book, he requires reclassification. He is writing a pop fiction. Cutting for Stone resembles the later novels of James Michener in its clichéd, stilted, or redundant images that keep the plot moving 50 miles an hour in a 60-miles-per-hour zone. It brims with phrases such as “babbling brook,” “the populace” for “the people,” and earrings that “hung down” from lobes instead of “hung.”

Why, then, has Cutting for Stone found fans who range from book club members to Martha Stewart and President Obama, who had it with him on a 2011 vacation on Martha’s Vineyard? Several factors may explain what the quality of the writing doesn’t. One is that the hospital settings allow Verghese to deal with timely issues such vaginal fistulas and female genital mutilation in Africa. Another is that you inevitably learn from a 667-page book stuffed with Ethiopian history and culture, much as you do from Michener’s Alaska and Poland. And Verghese writes about two subjects slighted by contemporary novelists: work and religion, in this case Ethiopian Christianity.

Perhaps above all, Cutting for Stone brims with earnest, Oprah-ready ideas. Marion reflects: “All sons should write down every word of what their fathers have to say to them. I tried. Why did it take an illness for me to recognize the value of time with him?” Peter Godwin writes far more elegantly about Africa in When a Crocodile Eats the Sun, a memoir of Robert Mugabe’s Zimbabwe. “In Africa,” he notes, “you do not view death from the auditorium of life, as a spectator, but from the edge of the stage, waiting only for your cue.” In a book more than twice as long as Godwin’s, Verghese leaves you waiting only for such a gracefully expressed idea.

Best line: A servant who gave in to her drunken employer’s advances in Ethiopia asked, when he had finished with her, “Will there be anything else?”

Worst line: No. 1: “ … he said as if he’d proved Pythagoras’s theorem, the sun’s central position in the solar system, the roundness of the earth, and [the hospital’s] precise location at its imagined corner.” Overwriting like this abounds in Cutting for Stone. One well-chosen example would have made the point better than four.

Recommendation? I read this Cutting for Stone for book club, and some members didn’t finish it because of its length and slow pace. Clubs that want to read it, regardless,  might read it over two months instead of one.

Published: February 2009 (Knopf hardcover), January 2010 (Vintage/Anchor paperback).

Furthermore: Verghese wrote the memoir My Own Country, a finalist for a National Book Critics Circle Award.

Janice Harayda is a novelist and award-winning journalist who has been the book editor of the Plain Dealer and the book columnist for Glamour. One-Minute Book reviews recently ranked among the Technorati’s top 40 book blogs and Alexa’s top 40 book-review sites. New Jersey Monthly named it one of the state’s best book blogs in 2011.

You can follow Jan on Twitter by clicking on the “Follow” button in the right sidebar. 

© 2012 Janice Harayda
www.janiceharayda.com

March 1, 2011

‘Early Diagnosis Is a Double-Edged Sword’ — Quote of the Day

Filed under: Quotes of the Day — 1minutebookreviewswordpresscom @ 9:29 pm
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Early diagnosis can hurt you, three doctors argue their new Overdiagnosed: Making People Sick in the Pursuit of Health (Beacon Press, 228 pp., $24.95). Too many Americans are being treated for conditions that will never cause symptoms, let alone death, say H. Gilbert Welch, Lisa Schwartz, and Steven Woolshin. Some people contend that no harm can come of the “epidemic of diagnosis”:

“But the truth is that early diagnosis is a double-edged sword. While it has the potential to help some, it always has a hidden danger: overdiagnosis—the detection of abnormalities that are not destined to ever bother us. …

“the conventional wisdom is that more diagnosis—particularly, more early diagnosis—means better medical care. The logic goes something like this: more diagnosis means more treatment, and more treatment means better health. This may be true for some. But there is another side to the story. More diagnosis may make healthy people feel more vulnerable—and, ironically, less healthy. In other words, excessive diagnosis can literally make you feel sick. And more diagnosis leads to excessive treatment—treatment for problems that either aren’t that bothersome or aren’t bothersome at all. Excessive treatment, of course, can really hurt you. Excessive diagnosis may lead to treatment that is worse than the disease.”

You can read the introduction to Overdiagnosed on Scribed.

© 2011 Janice Harayda. All rights reserved.

 

September 20, 2010

Funeral of a Small-Town Doctor / From the Memoir ‘The Good Times Are All Gone Now: Life, Death, and Rebirth in an Idaho Mining Town’

Filed under: Memoirs,Nonfiction — 1minutebookreviewswordpresscom @ 11:47 am
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Julie Whitesel Weston grew up in Kellogg, Idaho, in the 1940s and 1950s, when it was “a wide-open, Wild West town” with brothels and gambling dens that attracted men who worked for the Bunker Hill silver mine. Her father, a doctor, examined the prostitutes twice a month for venereal diseases. He also made middle-of-the-night house calls and received venison and elk steaks from patients, whom he asked, “How’s your body?” After setting up his practice, Glen Whitesel stayed in Kellogg until he died in 1978, and sometimes played the snare drum for Tommy’s Trio at the Sunshine Inn.

Julie Whitesel recalls her childhood in her recent memoir The Good Times Are All Gone Now: Life, Death, and Rebirth in an Idaho Mining Town (University of Oklahoma Press, 2009). In this excerpt, she describes her father’s funeral, attended by friends such as real-estate developer Jim Bening and attorney Bob Robson.

“An honor guard of nurses, each dressed in white starched cap, dress, and stockings, stood like wings on either side of the elaborate coffin at the front of the church. His doctor partners served as pallbearers, along with Jim Bening and Bob Robson, and an extra six of friends, a double ring of hands. Townspeople – miners, wives, businessmen and women, gambling and drinking buddies, Tommy’s Trio, my friends, their parents, teachers, coaches, patients, not-patients — filled the church, spilled out into the parking lot, sang hymns, shed tears. The Episcopal priest, Father McReynolds, who had been one of my father’s gin rummy partners and was shaking with Parkinson’s disease, eulogized him.

“‘How’s your body?’ he began. A low wave of laughter filled the church. ‘No one who knew Doc Whitesel would ever say he was without failings. But I like to think he earned a place in heaven in spite of those failings, common to us all, in one form or another. Glen was our doctor, our friend, and an irreplaceable man in Kellogg, Idaho.’ He faced the casket and added, ‘See you later, alligator.’”

You can learn more about The Good Times Are All Gone Now on the sites for the author and for University of Oklahoma Press.

You can also follow Jan Harayda on Twitter at twitter.com/janiceharayda.

© 2010 Janice Harayda. All rights reserved.
www.janiceharayda.com

May 29, 2010

Psychiatrist Daniel Carlat Diagnoses His Profession’s Ills in ‘Unhinged: The Trouble With Psychiatry’


“Psychiatry has become a proving ground for outrageous manipulations of science in the service of profit.” Unhinged

Unhinged: The Trouble With Psychiatry. By Daniel Carlat. Free Press, 256 pp., $25.

By Janice Harayda

Has the profession of psychiatry lost its mind? You might think so after reading this relentless and mostly successful assault on current practices in the field.

Daniel Carlat focuses in Unhinged on the harm that he believes has resulted from the march of psychiatry away from psychotherapy and toward the better-paying practice of prescribing drugs. And he forges links between that shift and many ills in his field, including scandals at top-flight hospitals, one-sided articles in medical journals, and pharmaceutical-company payments to doctors who hawk questionable drugs to their peers.

Some of the statistics in Unhinged are chilling. In 2006, an estimated 10 percent of all 10-year-old boys in the U.S. were taking the stimulant Ritalin or an equivalent each day, and shabby medicine often accounts for its use or that of other psychotropic drugs. Psychiatrists routinely write prescriptions after 15- or 20-minute consultations. They know so little about the biology of most mental illnesses that they prescribe based on little or no science. And they mislead patients by presenting as fact theories formed by working backward from the discovery that a drug seemed to ease the symptoms of a disease. One of the most popular of those theories holds that depression results from a “chemical imbalance” in the brain:

“… the fact that many antidepressants increase levels of serotonin has led to a serotonin deficiency theory of depression, even though direct evidence of such a deficiency is lacking. By this same logic one could argue that the cause of all pain conditions is a deficiency of opiates, since narcotic pain medications activate opiate receptors in the brain.”

Carlat delivers his indictment in a crisp, journalistic style that serves him well, though he writes with less depth and elegance than his fellow physician Atul Gawande. But he doesn’t take his critique of the profession as far as it warrants. He clearly wants psychiatrists to do more psychotherapy but doesn’t make a strong case that patients would benefit from this – only that they would benefit from fewer bad drugs. He seems to take for granted that psychotherapy “works.”

This view clashes with that of respected critics of the profession such as the social scientist Robyn Dawes, who drew on decades of research for his brilliant House of Cards, which argues that psychotherapy itself is a con game: There is no evidence that psychiatrists or psychologists are better at counseling than minimally trained civilians, and both types of professionals have strayed so far from their roots in the study of human behavior that they offer little more than glorified intuition.

Unhinged may have the worthy effect of prompting patients to demand better explanations for why certain drugs are recommended for them — and it would be welcome for that reason alone — but it has little to say to people who remain unconvinced that psychotherapy would be better than the cavalier prescribing of Prozac or Wellbutrin. If psychiatrists are as willing as Carlat suggests to pimp for drug companies, why should Americans trust them with their deepest secrets?

Best line: “ … psychiatry has become a proving ground for outrageous manipulations of science in the service of profit.”

Worst line: Carlat says that an Ambien drug rep named Valerie once gave him a gift worth about $25, and later that day, he saw a patient and thought, “Why not prescribe Valerie’s drug for this patient?” That phrasing is too neat. Carlat also appears to be rationalizing in some of his comments on why he served briefly as a paid drug-company rep for the maker of Effexor.

Caveat lector: This review of Unhinged was based on an advance reading copy. Some material in the finished book may differ, and some people in it are composites.

Furthermore: Carlat is a psychiatrist in Newburyport, MA, specializing in psychopharmacology, and an associate clinical professor of psychiatry at Tufts University School of Medicine.You can follow him on Twitter at a @dcarlat (www.twitter.com/dcarlat). Carlat tells why he quit giving paid talks for drug companies in the New York Times article “Dr. Drug Rep.” Some of the material in Unhinged about brain scans appeared in different form in an article he wrote for Wired, “Brain Scans as Mind Readers?”

Contrary to the date you see under the headline, this review was posted on May 31, 2010. WordPress appears to be having technical problems that have led to scrambled dates. For this reason, I’ve removed a May 30 post about my forthcoming review of the young-adult novel The Things a Brother Knows.

You can follow Jan Harayda (@janharayda) on Twitter at www.twitter.com/janiceharayda.

© 2010 Janice Harayda. All rights reserved.
www.janiceharayda.com

May 24, 2010

Has Psychiatry Lost Its Mind? A Review of Daniel Carlat’s ‘Unhinged’ Coming Soon

Filed under: Nonfiction — 1minutebookreviewswordpresscom @ 9:36 am
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In late 2007 the psychiatrist Dan Carlat wrote a provocative article about why he quit giving paid talks for drug companies, many about Effexor, an anti-depressant that causes high blood pressure. Now he’s back with Unhinged: The Trouble With Psychiatry (Free Press, 256 pp., $256), a book that indicts his profession for shunning therapy for the more lucrative practice of prescribing medications. A review of the book will appear soon on One-Minute Book Reviews.

April 29, 2010

Does Acupuncture Work as Anesthesia? Quote of the Day / ‘Nothing to Envy’

Filed under: Quotes of the Day — 1minutebookreviewswordpresscom @ 12:08 am
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In Nothing to Envy, Barbara Demick tells the true stories six North Korean defectors, including a doctor she calls Kim Ji-eun, who worked in a small hospital during the devastating famine in the 1990s. Demick spoke with Kim about North Korean health care, including the use of acupuncture for anesthesia. She reports in her her book:

“For years, North Korean hospitals had been using herbal remedies in combination with Western medicine. Instead of painkillers, the doctors used cupping, a technique in which a suction cup is applied to stimulate circulation to parts of the body. Another technique borrowed from the Chinese involved lighting sticks of mugwort next to the afflicted area. With anesthesia in short supply, acupuncture would be used for simpler surgeries, such as appendectomies.

“‘When it works, it works very well,’ Dr. Kim told me years later. And when it didn’t? Patients would be strapped to the operating table to prevent them from flailing about.”

October 27, 2009

‘Smile or Die’ – Barbara Ehrenreich’s ‘Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America’

Taking aim at the “prosperity gospel,” “positive psychology” courses, and teddy bears designed for breast-cancer patients

Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America. By Barbara Ehrenreich. Holt/Metropolitan, 235 pp., $23.

By Janice Harayda

When I was a book editor, I often had to reassure freelancers that they had the right to give negative reviews. Critics never apologized for praising books, but they did apologize for panning them – even when they had done so brilliantly.

At first, I thought freelancers were worried that they would get fewer assignments if they wrote unfavorable reviews, because some editors do prefer to publish praise. But many seemed reluctant to criticize books even after I had explained that I didn’t care whether reviews were positive or negative: I cared whether they were fair, honest and well written.

Barbara Ehrenreich suggests a possible explanation for the reluctance in Bright-sided, a spirited broadside against enforced optimism in medicine, psychology, business, religion and other fields. She argues that faith in “positive thinking” has become so ingrained in American society “that ‘positive’ seems to us not only normal but normative – the way you should be.”

Ehrenreich found when she was diagnosed with breast cancer that a cult of optimism pervaded articles and books about the disease that made her feel isolated instead of supported. “No one among the bloggers and book writers seemed to share my sense of outrage over the disease and the available treatments,” she writes in a chapter ironically called “Smile or Die: The Bright Side of Cancer.” “What causes it and why is it so common, especially in industrialized societies? Why don’t we have treatments that distinguish between different forms of breast cancer or between cancer cells and normal dividing cells?”

Instead of finding answers, Ehrenreich kept coming across articles by women who claimed that they owed their survival to a “positive attitude” – even though the death rate from breast cancer has changed little since the 1930s and there is no consistent evidence that staying upbeat extends the life of those who have the disease, though it may have many other benefits. She also found that “positive thinking” can exact a terrible price in self-blame if a cancer defies treatment. As the oncology nurse Cynthia Rittenberg has written, the pressure to think positively is “an additional burden to an already devastated patient.”

“Smile or Die” recycles some of the material from Ehrenreich’s award-winning essay, “Welcome to Cancerland,” but is still the strongest chapter in Bright-sided. Other sections of the book describe the wholesale effects of “positive thinking” better than they show their retail cost to ordinary Americans. Ehrenreich argues cogently that the emerging field of “positive psychology” is based heavily on bad or no science. But the same is also true of some older forms of therapy that apply similar principles, as the Robyn Dawes documented in his superb indictment of the betrayal of scientific standards in psychotherapy, House of Cards (Free Press, 1996). So why focus on “positive psychology” when other types of therapy have done more damage, if only because they are more widely used? Ehrenreich describes an unflattering interview with the high priest of “positive psychology,” the psychologist Martin Seligman. But she seems to have talked to no one burned by his teachings – which shouldn’t have been hard to do, given that more than 200 schools and colleges offer courses in his field.

In a chapter called “God Wants You to Be Rich,” Ehrenreich faults the so-called “prosperity gospel” preached by superstar pastors like Joel Osteen, whose churches offer “services that might, in more generous nations, be provided by the secular welfare state,” such as pre- and after-school programs. Certainly those ministries may foster self-blame. (If God wants you to be rich and you’re not, you don’t have enough faith.) But if the churches that promote the “prosperity gospel” are offering low- or no-cost day care that enables parents to seek prosperity by holding jobs, doesn’t that count for something? You sense that such programs are exactly kind of thing that Ehrenreich might love, if only they weren’t endorsed by pastors who wear too much gel in their mullets.

No less important: A blurred line exists between innate optimism – which may be genetic — and the enforced optimism of disciplines like “positive psychology” and the “prosperity gospel.” To what extent are advocates of “positive thinking” creating an attitude and to what extent are tapping or reinforcing one that’s already there? Ehrenreich sidesteps the question. But if optimism is in our genes, it may do little good to argue as she does that we need replace “positive thinking” with a “vigilant realism.” Joseph Hallinan takes a less extensive but more practical approach to the subject in his Why We Make Mistakes (Broadway, 2009), which deals in part with the research on errors based on overconfidence – a trait often indistinguishable from “positive thinking.”

Overall Bright-sided is much more theoretical than Nickled and Dimed, for which Ehrenreich took a series of low-wage jobs to show how corporations exploit blue-collar workers, or her more recent Bait and Switch. But it makes a needed assault on an idea that too often goes unchallenged in America: that “positive thinking” is always a good thing. Ehrenreich is right that a deep and unacknowledged anxiety often underlies efforts to block out unpleasant thoughts. “Positive thinking” requires a continual effort to deflect “negative” ideas, she notes, and it can be exhausting. “The truly self-confident, or those who have in some way made their peace with the world and their destiny within it, do not need to expend effort censoring or controlling their thoughts,” she writes. “Positive thinking may be a quintessentially American activity, associated in our minds with both individual and national success, but it is driven by a terrible insecurity.”

Best line: Ehrenreich notes that breast cancer has given rise to a highly commercialized industry of products for patients, including “infantilizing” teddy bears: “Certainly men diagnosed with prostate cancer do not receive gifts of Matchbox cars.”

Worst line: “All the motivators and gurus of positivity agree that it is a mistake to watch the news.” How does Ehrenreich know? Has she talked to them all? In my experience the self-styled motivators, with a few exceptions including Rhonda Byrne (The Secret), urge people to limit – not eliminate – exposure to bad news.

Editor: Sara Bershtel

Published: October 2009

Read an excerpt (the first pages) from Bright-sided or listen to an audio excerpt.

Furthermore: For more on optimism and illness, see the post “‘The Tyranny of Positive Thinking’ and Cancer Patients — A Physician-Author Says That It’s Not Always Best to Tell People to ‘Be Optimistic’.”

© 2009 Janice Harayda. All rights reserved.
www.janiceharayda.com

October 7, 2009

The Moral Failures of U.S. Health Care – T.R. Reid’s ‘The Healing of America’

A specialist in Tibetan herbal medicine wanted to taste T.R. Reid's urine.

The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. By T. R. Reid. Penguin, 277 pp., $25.95.

By Janice Harayda

This elegant polemic argues that the American health-care crisis is, above all, a moral one: Alone among well-off democracies, the U.S. has never made a moral choice to guarantee health care for all. Americans have decided that everybody has the right to an education and a legal defense, regardless of the cost or difficulty of providing these, T.R. Reid reminds us. But we’ve never decided that everybody has the right to health care. Because we haven’t, the U.S. is the only country in which medical bills can bankrupt people. It’s the only one in which patients who have paid their health insurance premiums for years can — and do — have their policies canceled while they’re fighting for life from a hospital bed.

Fewer than half of all Americans are satisfied with this state of affairs, according to a 2001 study by researchers at the Harvard School of Public Health. But many critics of the system believe that all the alternatives involve conditions too onerous to accept – long waiting lists, the rationing of care, no choice of doctors, or “socialized medicine.”

T.R. Reid offers a powerful rebuttal to that idea with fascinating and well-written portraits of the health-care systems in five countries that have universal coverage: France, Germany, Japan, the U.K. and Canada. Japan, for example, hardly has “socialized medicine.” Its widely admired approach to health care uses private doctors and hospitals and nonprofit insurers. The system involves no gatekeepers, no rationing, and no waiting lists. It offers high-quality care and ample choice for patients. People split the cost of insurance with their employers or if they are unemployed, with their local government. And the Japanese lead the world in life expectancy (85.5 years for women, 78.7 for men).

Reid also evaluates the health care systems in India, Taiwan, Switzerland and other countries. And he found an ingenious way to dramatize some of their differences after an American orthopedist suggested that he have surgery on an injured shoulder. As he traveled around the world, Reid asked foreign doctors how they would treat the problem. In Nepal, he met a specialist in Tibetan herbal medicine who wanted to taste his urine before making a diagnosis. At an Ayurvedic hospital known as “the Mayo Clinic of traditional Indian medicine,” he submitted three times a day to massages of “warm sesame oil laced with forty-six herbs and medications.” These encounters add color and suspense to The Health of America without taking its focus off the moral imperatives of health care reform.

Reid doesn’t urge Americans to adopt any country’s model or a “public option” of care paid for by the government (although he notes that we have a public option in Medicare, a system that its beneficiaries generally like). But he appears to believe we can’t reform the system if we continue to allow insurers to make a profit on basic health care, something no other first-world country permits: The solution lies in a nonprofit model, whether run by the government or a nonprofit group. Reid has suggested in interviews that if Congress can’t enact the needed changes, Americans may have to reform the system on a state-by-state basis, though he damns the Massachusetts approach with faint praise.

The most admirable aspect of The Healing of America is that – like any skilled polemicist
– Reid has an exceptional ability to keep his eye on the ball. He deals forthrightly with the economic and other realities that health care reform would involve, such as controlling costs and creating an effective delivery system. But Reid never allows such issues to transcend the moral dimension of allowing tens of thousands of people each year to die and countless others to suffer needlessly. His powerful indictment shows why health care reform is ultimately not about politics or economics: It is about fairness, justice, and doing what is right for all Americans.

Best line: No. 1: “All developed countries except the United States have decided that every human has a basic right to health care.” No. 2: “ … foreign health insurance plans exist only to pay people’s medical bills, not to make a profit. The United States is the only nation that lets insurance companies extract a profit from basic health coverage.” No. 3: “The design of any nation’s health care system involves political economic, and medical decisions. But the primary issue for any health care system is a moral one.”

Worst line: “British women tend to have their babies at home; Japanese women, in contrast, almost always give birth in the hospital – and mother and child remain there an average of ten days after delivery.” The National Childbirth Trust says that in the U.K., 2.7 percent of women give birth at home.

Editor: Ann Godoff

Published: September 2009

About the author: Reid is a former foreign correspondent for the Washington Post.

Further comments on The Healing of America appeared in the posts “Excuses Aetna, Prudential and Blue Shield Have Used to Deny Claims” and “Going to the Doctor in Japan — Please Don’t Tip the Proctologist.”

Listen to a podcast of T.R. Reid talking about The Healing of America.

© 2009 Janice Harayda. All rights reserved.
www.janiceharayda.com and www.twitter.com/janiceharayda

September 30, 2009

Going to the Doctor in Japan – Please Don’t Tip the Proctologist – From T. R. Reid’s ‘The Healing of America’

Filed under: News,Quotes of the Day — 1minutebookreviewswordpresscom @ 9:53 pm
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Another memorable quote from T. R. Reid’s elegant indictment of health care in the U.S., The Healing of America (Penguin, 277 pp., $25.95), this one dealing with the high regard that the Japanese have for doctors:

“The high esteem for doctors is reflected in a traditional cultural practice in Japan that is officially frowned on these days but still seems to exist: Patients tend to bring a present for their doctor, ranging from a box of golf balls to a magnum of sake to a tasteful white envelope with the physician’s name brushed on the outside and a packet of cash inside. In the better stationery stores, you can buy a special envelope for this purpose, in soft, thick paper the color of heavy cream with ‘the honorable physician’ written on them in elaborate calligraphy. The tradition dates back to premodern times, when a physician in China or Japan had a Confucian obligation to use his skills to treat people and was not expected to demand a fee. To express their gratitude, patients provided a more-or-less voluntary gratuity. …

“In my doctor’s office in Tokyo, there was a sign on the wall clearly stating that the doctor’s fee for each treatment, and the share of the fee that I had to co-pay, were set by law: HONORABLE PATIENTS ARE RESPECTFULLY REQUESTED TO PAY NO MORE THAN THE FEE, it said. But I sometimes did see a patient, particularly an older one, carrying one of those cream-colored envelopes into the doctor’s office.”

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