- Hardcover: 464 pages
- Publisher: Atria Books; 1 edition (September 3, 2013)
- Language: English
- ISBN-10: 1476726299
- ISBN-13: 978-1476726298
- Product Dimensions: 6 x 1.9 x 9 inches
- Shipping Weight: 13.6 ounces
- Average Customer Review: 132 customer reviews
- Amazon Best Sellers Rank: #363,380 in Books (See Top 100 in Books)
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One Doctor: Close Calls, Cold Cases, and the Mysteries of Medicine Hardcover – September 3, 2013
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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
“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 and)
“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)
"Dr. Brendan Reilly has done history a true service... He is a good, fluent writer with a fine ear for dialogue, and his excursions from the particulars of his cases to broad medical, social and economic principles are always on point. Dr. Reilly deserves a resounding bravo for telling it like it is (sometimes), like it should be (always) and, increasingly, like it never will be again." (The New York Times)
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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
For me, one of the most remarkable aspects of this book was that it is not a textbook. It is a true story that really happened to Dr. Reilly. The story is gripping and exciting; it is not a "dry" book of medicine by any means.
He also has interesting asides, or tangents and one reviewer called them. These asides try to explain some of the science or evidence behind what is happening in the book. He talks about diagnostic testing and how doctors need to understand the nature of the tests they are ordering and how they apply to their specific patient. He talks about resident work hours and how residency has changed as a result.
The overarching theme of the book, and an obvious theme for anybody working in medical practice today, is that the overwhelming DISCONTINUITY OF CARE is harmful to patients and their families. Dr. Reilly believes that what everyone really needs is ONE DOCTOR, not dozens of specialists, who really knows you and listens to you. He demonstrates that by discussing his hospitalized patients, his clinic patients from long-ago, and his own parents. (The part of the book about his parents is extremely moving.)
As a practicing hospitalist and a perpetual student of medicine, I will reexamine my practice and incorporate what I learned (again) from Dr. Reilly. I will also emphasize with my patients the need for them to go back to their primary care docs and I commit to communicating well with those docs.
The doctor writes in-depth about the U.S. health care system. Not surprising, many of his facts are disturbing and force readers to wonder what medical “care” will look like in the near future.
If readers are coping with elder care issues, as I am, Reilly’s book offers many questions to consider when making medical decisions for a loved one, and eventually, yourself (if you’re lucky). Thinking more seriously about the answers to these questions will better prepare patients and families for the ifs and whens.
Reading this book makes me want to find a physician such as Dr. Reilly! Unfortunately, from my own experiences, and as the doctor himself explains, that care is becoming increasingly harder to find.