Medical Catastrophe: Confessions of an Anesthesiologist - Hardcover

Have you ever wondered what goes on behind closed doors at your doctor's office or local hospital? The medical world is a mystery to those who don't work in health care, and Medical Catastrophe gives readers insight into the harrowing, humorous, and sometimes dehumanizing world of medicine. Dworkin is a practicing anesthesiologist and political philosophy instructor, and his 'confessions' delve into the sometimes unpleasant truths of hospital politics and industry standards. Exploring the question of what it means to be a doctor, Dworkin traces his experiences, from time spent in his father's medical practice as a child to his residency training, and, finally, as a part-time practitioner. Although the tone can at time seem self-important, Dworkin addresses key issues facing modern medicine, including how much autonomy doctors should have and how to improve practitioners' quality of life. A solid introduction to the hidden world of hospital medicine, Medical Catastrophe is sure to start thought-provoking conversations about complex topics, such as the balance between professional knowledge and patient-centered care. * Booklist * Dworkin's new book combines a variety of sensibilities: the savvy professional, the humanist conversant with the recurrent types and infinite variations of character, and the hardheaded observer of the everyday operations of complex organizations. It is built around harrowing autobiographical tales-transpiring in operating rooms, cramped and dingy sleeping quarters for on-call residents, hospital corridors, and medical conferences-illustrating the proliferation of impatience, overspecialization, cynicism, and alienation among physicians. It provides historical reflections-informed by the experience of his father and grandfather, both physicians-on the transformation of the medical profession over the last century. And it offers lyrical reflections on the hopes, fears, and wayward passions of doctors struggling to maximize profits and minimize overtime, save lives, avoid malpractice disaster, and comply with the imperatives of political correctness, all while maintaining self-respect in a profession that has undergone seismic changes that have been internalized but not understood. * RealClearPolitics * Despite the dramatic title, most of the book's content reflects something closer to the subtitle, Confessions of an Anesthesiologist. Indeed, it reads like a confession in the multivalent sense that Augustine used the term: it's the story of one doctor's search for vocational identity set alongside a critique (including plenty of self-critique) of the history, structures, and entanglements of modern medicine. Stories of 'medical catastrophes,' most of them near-misses due to a combination of human error and complex relationships in the operating room, frame the narrative. But underneath those dramatic stories is a deeper, well-articulated vocational question: what does it mean to balance the traditional roles of the doctor-gentleman, technician, scientist, benefactor-with the leadership required of doctors in today's world? These questions unfold with an escalating sense of urgency as the book proceeds. * The Christian Century * [A]nesthesiologists will find this examination of the problems facing doctors and medicine, from an anesthesiologist's perspective, to be informative, thoughtful, and thought-provoking. * California Society of Anesthesiologists * The only reason a reader might put down this medical memoir unfinished is because the dramatic moments of hope and risk and despair from Ronald Dworkin's career can be overwhelming - so a brisk walk or a nice cup of tea or some other restorative distraction is called for before plunging back in.... Dworkin should be praised for offering a book that somehow manages to unite hopeful idealism and clear-eyed realism; aspiring physicians will learn much from it. * The New Atlantis * Dr. Ron Dworkin's riveting Medical Catastrophe provides a revealing peek behind the curtain of the real business of medicine -- the ego clashes, the confusion, and the internal politics governing doctors' decisions. He may not have intended to scare patients, but he sure scared this reader. -- Tevi Troy, CEO of the American Health Policy Institute and former Deputy Secretary of the US Department of Health and Human Services Ronald Dworkin's Medical Catastrophe: Confessions of an Anesthesiologist provides a unique perspective on an important sector of modern medical practice. Versed in policy and politics as well as anesthesiology---a medical field many specialists take for granted but know little about but which makes contemporary painless medical miracles possible and safe ---Dworkin proves patient care delivered one patient at a time is still the heart of medicine. In a style reminiscent of a novelist he brings the "illuminating power of incidental detail" to the fore reveal the texture, complexity, and consequences of medical decisions as they are: good, bad, and at times, ugly. -- Vincent J. Kopp, MD, FAAP, Emeritus Professor of Anesthesiology and Pediatrics, Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill Medical Catastrophe: Confessions of an Anesthesiologist is an eloquent and informed reflection on the privilege and plight of being a doctor. Dworkin's personal narrative grips us with descriptions of critical life-threatening events framed within the complex health system that sets those catastrophes in motion. Dworkin writes with the fluid prose of a storyteller and the perceptive eye of a historian and philosopher. A must-read for anyone interested in the doctors and hospitals that take care of us. -- Carol Cassella, MD, author of Oxygen At its heart, Ronald Dworkin's Medical Catastrophe is a book about why well-meaning doctors often do not- or cannot- do the right thing. Patients and health professionals will benefit from Dworkin's candid and unsparing assessment of why innovations designed to provide improved and safer medical care may wind up doing the opposite. -- Barron H. Lerner, MD, PhD, author of The Good Doctor: A Father, A Son and the Evolution of Medical Ethics Medical Catastrophe is not another discussion of medical mistakes and preventable mix-ups, or a call for more teamwork, protocols, and "best practice" guidelines to avoid error. Ronald Dworkin, in this deeply personal and highly original book, is on to something more basic-a candid exploration of the largely unacknowledged but vital role that all-too-human relationships and qualities play in catastrophes and near-catastrophes and a fair assessment of the impact that the profound restructuring of medicine is having on such everyday interactions. Our deepest predicament, he argues, is in the confusion that now surrounds the very meaning of being a doctor. This is the calamity that has to be addressed, and Dworkin offers a nuanced and insightful way forward. -- Joseph E. Davis, Institute for Advanced Studies in Culture, University of Virginia A harrowing tale of how the personal and the political collide in the medical world, putting patient safety on thin ice. It's a page-turner, but the kind where you are almost too afraid to turn the page. Required reading for anyone concerned about medical error - doctors, patients, administrators, policymakers, and health insurance executives. -- Danielle Ofri, MD, PhD, author of What Patients Say, What Doctors Hear

Medical catastrophes, although rare, do happen. Ronald W. Dworkin suggests the cause often lies in the politics of medicine and the conflicting demands of colleagues, patients, bosses, and institutions. Using his own story and professional anecdotes, he builds the case for avoiding catastrophes through a casting off of the politics of today's medical environment.