youngcheng

I began this book with a great deal of interest. The beginning of the preface proved compelling, arguing that a large part of the modern healthcare crisis is caused by doctors relying too much on expensive diagnostic tests and not enough on a thorough history and physical examination. From there, however, the book went downhill fast. Lown goes on to laud his many wonderful achievements in the course of his career, sounding quite proud of himself. His tone throughout the book is self-congratulatory, and he writes from a pedestal, looking down on all patients and seemingly most people who are not himself or one of his beloved mentors. In fact, Lown even uses the word “childish” to describe modern patients’ fascination with technology! Following a number of chapters filled with stories of his miraculous diagnoses and life saves, we reach a chapter called “Words that Maim.” This chapter is filled with stories of doctors scaring patients to death, literally, with words, or saying horrible and manipulative things. All are stories of other doctors, of course; not one story about himself. (There is actually one small anecdote about Lown himself, but no harm comes to the patient he mentions.) In many of the stories, Lown is in fact the one who has to repair the damage done by callous doctors. This chapter is followed immediately by “Words that Heal,” in which we are again treated to samples of Lown’s perfect clinical skills. He’s so perfect that patients “walk out of [his] office looking stoned, high, floating on air. When they’re from out of town, they ask for the best restaurant in Boston, because they want to celebrate.”Later he dishes out personal advice and reports with pride that a patient “anointed” him “a great guru;” he also lashes out with fury at a patient, yelling at him uncontrollably, but miraculously curing the patient of all of his family problems in the process. Because almost all medical problems are in fact emotional, caused by family tension, according to Lown. He suggests that medicines don’t work well because they are over-prescribed; all most patients need is a smack on the head (metaphorically speaking) to convince them to get their family life in shape, and then they’ll be all better! Magic! Thanks to him, an Indian man is un-dispossessed by his mother; an Orthodox Jewish man learns to love and accept his gay son and his lover, and even march in gay pride parades! Lown truly is a miracle worker! This book is a complaint about modern doctors for not being more like Lown himself (that is, perfect in every regard). He doesn’t even give consideration to the stresses put on doctors by insurance, malpractice, etc. Modern medical education is soulless and modern doctors are no better. He seems to indicate that he understands the push to do procedures because taking histories doesn’t pay, but he doesn’t consider that doctors (particularly primary care doctors) might actually WANT to do more thorough histories if they weren’t trying to struggle for enough money just to pay their malpractice insurance and make ends meet. There are interesting portions of this book, and it has some good advice for interacting with patients. Some of the claims about the origin of the healthcare crisis may even be partially correct, though I feel strongly that he ignores the many factors working against physicians in his question to blame it all on the failings of the modern doctor. (review edited to fit length requirement!)

2022-11-14 16:17