A very personal account written by an "old-fashioned" doctor who takes us into his world (both personal and professional). Dr. Reilly explains a lot about the state of the healthcare system and what works and what really could be improved. ( )

Slice of life story by a doctor involved in taking care of very sick patients at a major NYC hospital. Reilly contrasts this with the historical model in which a doctor followed a patient both in and out of the hospital, in sickness and in health, thus gaining vital information that can affect diagnosis and treatment (and cause really bad results when it’s absent). I enjoyed his stories and reflections on the flaws that the benefits of modern medicine and the profit motive have generated. ( )

Brendan Reilly an internist with 40 years of experience practicing medicine divides this memoir into three sections, Now, Then, and Now. In the two Now sections he discusses in real time from his personal view point, his experiences on call in New York City Hospital over a couple of days (the second Now section taking place a few weeks after the first). While dealing with seriously ill patients, and trying to diagnose patients with mystery conditions, he must also deal with his elderly parents who are facing end of life decisions themselves, his father blind and in the terminal phase of bladder cancer, his mother suffering dementia with a heart that is slowing down. In the Then section, Reilly discusses some of his experiences when he first began to practice medicine making house calls in rural Vermont. He focuses on a husband and wife whose diagnoses and treatments he is still second-guessing himself about all these years later. I loved the stories of the process he goes through in arriving at a diagnosis. His pacing is perfect, and many of his experiences read like a medical mystery.

Interspersed with his personal stories are discussions of many of the historical, ethical, financial, and other issues facing the practice of medicine. One overriding point I took from the book is that many people today who think they have adequate health care don't have "one doctor" in overall charge of their health care. Despite health care becoming more and more complex, there is frequently no continuity of care, as various specialist handle only their specialty. This can also raise problems since many hospitals today rely on hospitalists, and our primary care doctors do not provide in-hospital care to their patients. There is sometimes a lack of communication such that hospitalists sometimes have to diagnose and treat in a vacuum.

Another thing I learned from this book is that there are many, many things I never knew about that can kill you as you get older. Oh Well.

Recommended.

3 1/2 stars ( )

A throwback philosophy to the times when Doctors made house calls, and KNEW their patients. Reilly makes the case that Doctors today could do a much better job of tending to their patients' needs if they could take the time to actually follow their patients' lives.

Reilly is on staff at a large metropolitan hospital, and we follow him on his rounds. But, as he visits the various patients, he inserts his thoughts about the larger issues in medicine today.

Immensely readable. I recommend this to everyone ( )

I really liked ths book. Dr. Reilly is an experienced, thoughful, and intelligent physician. He allows us to see into his occupation and his head. After he discusses his cases he provides his thoughts on policy and present practice. I learned alot about how medical doctors think and about their jobs. This also helped me to see my role as a decision maker regarding the care appropriate for myself and my relatives. ( )