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One Doctor: Close Calls, Cold Cases, and the Mysteries of Medicine, by Brendan Reilly
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An epic story told by a unique voice in American medicine, One Doctor describes life-changing experiences in the career of a distinguished physician.
An epic story told by a unique voice in American medicine, One Doctor describes life-changing experiences in the career of a distinguished physician. In riveting first-person prose, Dr. Brendan Reilly takes us to the front lines of medicine today. Whipsawed by daily crises and frustrations, Reilly must deal with several daunting challenges simultaneously: the extraordinary patients under his care on the teeming wards of a renowned teaching hospital; the life-threatening illnesses of both of his ninety-year-old parents; and the tragic memory of a cold case from long ago that haunts him still. As Reilly’s patients and their families survive close calls, struggle with heartrending decisions, and confront the limits of medicine’s power to cure, One Doctor lays bare a fragmented, depersonalized, business-driven health-care system where real caring is hard to find. Every day, Reilly sees patients who fall through the cracks and suffer harm because they lack one doctor who knows them well and relentlessly advocates for their best interests.
Filled with fascinating characters in New York City and rural New England—people with dark secrets, mysterious illnesses, impossible dreams, and many kinds of courage—One Doctor tells their stories with sensitivity and empathy, reminding us of professional values once held dear by all physicians. But medicine has changed enormously during Reilly’s career, for both better and worse, and One Doctor is a cautionary tale about those changes. It is also a hopeful, inspiring account of medicine’s potential to improve people’s lives, Reilly’s quest to understand the “truth” about doctoring, and a moving testament to the difference one doctor can make.
- Sales Rank: #205948 in eBooks
- Published on: 2013-09-03
- Released on: 2013-09-03
- Format: Kindle eBook
From Booklist
Reilly’s medical narrative nicely intertwines true stories of challenging patients—difficult diagnoses, tough medical and ethical decisions, and the management of critically ill people—with valuable lessons on doctoring and patienthood. A fever of unknown origin, profound thyroid deficiency, severe hypoglycemia, chest pain, delirium, bleeding bladder cancer, and life-threatening infection of a heart valve are some of the medical problems encountered. Reilly, a hospital physician with 40 years of experience, also recounts caring for his elderly parents. He writes about the importance of grunt work in medicine, sustained doctor-patient relationships, and clinical instinct. The doctor confesses, Over the years I’ve learned to listen to my gut, but that doesn’t mean I can trust it. Indeed, medical decision making can be hard and hazardous. Risk and probability always factor into it. A medical problem can be handled in multiple ways, but outcomes are never guaranteed. Benefit and harm are both possibilities. Reilly admits that physicians know lots about regret but rarely discuss it. Empathy and thoughtfulness—One Doctor has oodles of it. --Tony Miksanek
Review
“A gripping memoir by a doctor’s doctor. Reilly’s career has taken him from inner city hospitals to remote rural practices. He writes movingly about what it is like on the front lines: the mysteries, the frustration and the rewards of his chosen calling. A must read for the general public and any young person contemplating a career in medicine.” (Abraham Verghese, author of Cutting for Stone )
“One Doctor contains the essence of all of it: our humanity and nobility – and why we are all entranced by medical dramas of every kind. A stunning book." (Christiane Northrup, M.D., ob/gyn physician and author of the New York Times bestsellers, Women's Bodies, Women's Wisdom )
“Extraordinary up-close story-telling. Brendan Reilly takes us bedside to witness the dramas and dilemmas of everyday medicine. One Doctor is a love story about a man and his lifelong passion for the mysteries and miracles of medicine.” (Lisa Sanders, New York Times columnist and author of Every Patient Tells a Story )
“Brendan Reilly has written a beautiful book about a forgotten subject – what it means for a physician to truly care for a patient. One Doctor shows why this matters today more than ever before.” (Malcolm Gladwell, author of Blink, The Tipping Point, and Outliers )
“Heart-pounding pace and drama … remarkable … His book is about more than the joy of saving lives and the sadness of losing them – it’s an intimate exploration of modern medicine and the human condition.” (Publishers Weekly)
"Reilly provides valuable insight into modern medicine as he relates his most challenging cases up to the present. Gripping and compassionate." (New York Daily News)
“Reilly’s medical narrative nicely intertwines true stories of challenging patients with valuable lessons on doctoring and “patienthood.” Empathy and thoughtfulness—One Doctor has oodles of it.” (Booklist)
"Compassion, dedication, respect, professional competence, humility. All of these qualities shine through the many stories that make up the bulk of Brendan Reilly’s “One Doctor.’’ This book is much more than merely a gripping memoir written by an expert storyteller who also happens to be one of the nation’s most respected leaders of academic medicine. Spanning a 40-year career, the deftly woven tapestry of anecdotes and scholarly analysis...nimbly alternates between two time frames. Reilly’s moving and eloquently written book will be sure to interest not just those working in the medical professions. “One Doctor’’ is simply a terrific read." (Boston Globe)
"Powerful...Many of the diagnoses Dr. Reilly discusses begin as little more than gut feelings. But watching him piece together a diagnosis, scrap by scrap, makes for riveting scenes—part mystery, part thriller. The action is all the more intense because some patients, despite his brilliance, really will die." (WSJ)
“Empathy and thoughtfulness – ONE DOCTOR has oodles of it.” (Booklist)
One Doctor is gutsy and heartfelt, a recommended read for anyone interested not only in modern medicine but also one man's professional and personal journey, as instructive as it is inspirational....Reilly's insightful ruminations make for a fascinating read, further strengthened by fast-paced, first-person accounts of challenging cases." (BookBrowse Editor's Choice )
About the Author
Dr. Brendan Reilly is executive vice chair of medicine at New York-Presbyterian Hospital/Weill Cornell Medical Center. A widely published clinical researcher and educator, he has served as the chair of medicine and physician-in-chief at Chicago’s Cook County Hospital, which, during Reilly’s thirteen-year tenure there, was the inspiration (and setting) for the hit NBC television series ER.
Most helpful customer reviews
14 of 15 people found the following review helpful.
Rule One: Listen To The Patient
By prisrob
On this first day of 'The Affordable Care Act', I encourage everyone to read this book, we all need that 'One Doctor'.
In reading Dr Reilly's book I thought about a book I had read. Dr Jerome Groopman's, 'How Doctors Think'. Dr Groopman's explains that no one can expect a physician to be infallible, medicine is an uncertain science and every doctor sometimes makes mistakes with diagnoses and treatment. It is the frequency and seriousness of those errors that can be reduced by 'understanding how a doctor thinks and how he or she can think better'. Dr. Reilly goes one better and starts with the patient, listen to the patient, observe and examine the patient. Certainly all of the new technology is wonderful to help with diagnoses and treatment, but it can't always beat the one on one between patient and physician.
In flashbacks Dr. Reilly discusses his most recent challenging patients in 2010, while covering on-call for a two week interlude, in a large teaching hospital in New York City, and then to his career at Dartmouth Hitchcock Medical Center, in 1985 in New Hampshire. Hiram Hitchcock had given this hospital to the community in memory of his wife, Mary Hitchcock. In 1985, Dr Reilly had made house calls to his patients who needed them. He was their physician, he knew everything about them, and could see any minor abnormality. He did, however, miss the cause of one of his patient's delirium, and by the time he figured it out the patient had died. Dr Reilly discusses in detail the regrets and guilt physicians have when medical errors are made.
Reflecting on the way medicine was practiced 25 years ago and contrasting today's practice, Dr Reilly discusses some of the 19 patients he and his team round on, on a daily basis. Several critically ill, and Dr Reilly goes in early to makes his own rounds and meet and examine those patients on his own. During team rounds, the resident on call discusses the patient at the bedside, questions are asked, decisions are made. A lot of teaching is done by Dr Reilly and the team. But it is Dr. Reilly's experiences with his elderly parents that bring modern medicine home up close and personal.
Patients used to have one doctor who took care of them, in the clinic and hospital, sometimes at home. 15 years ago Hospitalists were born because of financial impediments. Primary Care Physicians still occur, but the bond of getting to really know the patient is no longer there. Fragmented care has been the result, but there are many signs that health care delivery is improving. Shared decision making, between the patient and physician is an up and comng improvement, and the work of 'The Dartmouth Atlas' by sharing the research of John Wennberg in looking at patient care variation in millions of Medicare patients across the country. Dr Reilly discusses in depth how medical care has changed, the negative and the positive outcomes. His hopes for medical care in the future, and where and how we got to the present.
Dr Reilly through his personal stories and experiences has shared his joy in medicine, his regrets, and his sadness. It is the stories of his patients that bring to us the compassion and medical competence inherent in Dr Reilly's medical care. The writing is superb, Dr Reilly's ability to explain medicine in terms that are understandable to all, gives us insight into the physician, our medical care and the questions we should ask our health care teams.
Highly Recommended. prisrob 10-01-13
21 of 26 people found the following review helpful.
A doctor's stories about what medicine does well, and what it doesn't
By James Hassett
If you want to understand what's wrong with US medicine, and what's right about it, buy this book. Brendan Reilly takes you inside two weeks of his practice as executive vice chair at New York Presbyterian Hospital making life and death decisions, working seventeen hours a day, educating the next generation of doctors, and dealing with patients and their families, some delightful, and others not so much. In his spare time he has to help make medical decisions for his own seriously ill mother and father, both in their 90s. Later, Dr. Reilly takes you back twenty years to his work as a small town primary care physician, where he practiced a personal brand of medicine which has nearly vanished as a result of economic pressures. The stories he tells illustrate how medicine has changed during his career, and what the future holds. To be honest, the only reason I bought this book is that the author has been a friend since college. When it comes to illness, I am a huge fan of denial. I have never before read a book about medicine, and I always turn to a different channel when doctors appear on the evening news. I planned to read the first few pages and send Brendan a nice email, but the book sucked me in. I ended up with greater insight into my own medical history, and even read some of his 55 pages of footnotes about how medicine got this way. And my wife, who is a nurse, liked it a lot more than I did.
10 of 12 people found the following review helpful.
The Case for NOT Specializing
By takingadayoff
One Doctor is author Brendan Reilly, who has spent his career as a general practitioner, treating the whole patient. His long career has had many successes, but there have been failures as well, mistakes, and regrets. He doesn't hold back and relates his most interesting cases.
One Doctor may also refer to Reilly's belief that medicine in the United States has moved too far away from the generalist, and too far towards specialization. Not only does specializing pay the doctor better, but it makes more money for the hospitals and protects against malpractice lawsuits. But it may not lead to better care for the individual. In Reilly's opinion, we each need one doctor who gets to know us over time, who sees us as a person rather than a symptom or a diseased body part.
Reilly brings up health care dilemmas throughout the book, but of course if you are an adult American, you already know the problems of health care in this country. We spend by far the most money per capita on health care in the world, but do not have (by far) the best health or longest lives. Too many people have little access to any health care at all. No real solutions are on the horizon.
More encouraging are the stories he tells, in cinematic detail, about current and past cases, leaving you on the edge of your seat. Mystery diseases, brilliant diagnoses, life and death situations. Even as Reilly makes a case for the medical community to see patients (not "consumers" or "clients") as individuals, he is making the reader see the doctors as individuals as well. His own personal drama concerns his aging parents, forcing the doctor to be both concerned advocate for them and dispassionate expert for patients in similar straits.
It all makes for gripping and thoughtful reading.
(Thanks to NetGalley and Atria Galley Alley for a digital review copy.)
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