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2 comments about Saving the Heart: The Battle to Conquer Coronary Disease.

1. Stephen Klaidman has provided us with a very interesting, easy reading book that I recommend to anyone who has a heart condition or is interested in the subject. The major portion of the book discloses chronologically how heart conditions were treated from its earliest practitioners to the present day. Biographical sketches of medical developers, practitioners, entrepreneurs, etc. provide human interest to the emerging history.

   All major surgical developments, most of which occurred in the twentieth century, are explained in detail. The struggles of medical pioneers to gain acceptance of what at the time were radical innovations are amply explored. Among these innovations are angiography (imaging technology), heart-lung machine, coronary bypass surgery (with and without the heart-lung machine), angioplasty, and minimally invasive bypass surgery.

   Hi-tech heart surgery-an extremely complex and difficult subject-is explained for the layman to understand. The benefits and problems of each of the current procedures are explained.

   Klaidman explores hi-tech surgical instruments, a highly profitable multi-billion dollar business. His biographical profiles of some developers (doctor-engineer-inventors) and entrepreneurs disclose how the competitive race of developers to market first and the rivalry of entrepreneurs for market share may be detrimental to the best interests of patients.

   None of the many present sophisticated treatments provide a cure! They just alleviate symptoms. The pioneers of today are searching for cures. Their approaches are described and are not only fascinating but also innovative.

   The final chapter discusses the ethical questions raised by our current medical system: conflicts of interest between practitioners with financial stakes in various treatments; competition between advocates of various treatment options; competition between various surgical equipment manufacturers for market share; the pressure to reduce costs by HMOs; etc.

   If there is one fault to the book, it is that the title "Saving the Heart: The Battle to Conquer Coronary Disease" led me to believe that it would be more comprehensive. The drugs-nitroglycerin, Coumadin, beta-blockers, calcium channel blockers, statins--were mentioned only as they pertained to a topic then being explored, not in the detail the surgical treatments were given. Not even mentioned are life style changes--diet, exercise and meditation--that Dean Ornish has proposed. A book on these topics written as well as this one would definitely be welcomed.

   But for what this book does it does it so well a five star rating is most appropriate.




2. I am a medical student/researcher with plans to become a cardiac surgeon or cardiologist. I enjoyed learning some of the history of the Cleveland Clinic and am personally involved in some of the new developments that the author mentioned in the last chapter. My only problem is that the book was not representative of american cardiology or cardiac surgery as a whole. It seems that the author did all of his research in Ohio and the Northeast, whereas significant advances have taken place in other parts of the country (U. of Alabama, Mayo, Texas Medical Center). Two of the most famous cardiac surgeons the world has known - Michael Debakey and Denton Cooley were only mentioned in a few short sentences. The reader gets the impression that some less important surgeons (that happen to work at the Cleveland Clinic) invented cardiac bypass surgery when it was actually the work of hundreds. In the last chapter, the author mentions a technique called OCT. Yes, this technique shows promise (I work with it) but it was only mentioned because someone at Harvard is working on it. I can think of 10 examples of techniques that show as much promise. I wish writers that wanted to tell the world about American medicine would search all of America before they sat down to write. In sum, it was readable but had some holes that made me feel incomplete after I read it.

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No comments about La Clinica: A Doctor's Journey Across Borders (Literature and Medicine Series).

5 comments about In the Foothills of Medicine: A Young Doctor's Journey from the Inner City of Chicago to the Mountains of Nepal.

1. In the Foothills of Medicine is a 'must-read' for all who are starting out in the field of medicine, and all those who care about human health in our global future. Dr. McKersie takes us on a journey, with humility and passion, that will pave the way for a better, healthier, happier world.



2. McKersie shares the ups and downs of being an older student in medical training and his descriptions of interacting with patients are heartwarming and charming. As a volunteer doctor in Nepal he illustrates that there are indeed two very different worlds of medicine and yet there are common problems. A good read that places you in both locations with the doctor.



3. McKersie, M.D., Rob. In the Foodhills of Medicine: A Young Doctor's Journey from the Inner City of Chicago to the Mountains of Nepal. Lincoln, Nebraska: iUniverse, 2005. 229 pages. $19.95
   
   Reviewed by Regis Schilken
   Educator: Pittsburgh Public School System
   Author: The Oculi Incident and The Island of Stony Point; also "The Stars," published in Dan River Anthology 2005, various magazine articles
   
   ___________________________________________________________________________
   In the Foothills of Medicine
   
   From the Prologue to its final Dedication, Dr. Robert McKersie's book, In the Foothills of Medicine is not just a story of one man's legacy to heal his fellow man on opposite sides of the globe. It is an epic of courage, passion, enlightenment, inspiration and above all, a tale of human love.
   
   Throughout each inspiring page, the reader can see an unspoken virtue in Dr. McKersie that he could never attribute to himself. Persons of his caliber are blind to their own goodness. He is a physician in love with the beauty of human existence.
   
   In the beginning pages of In the Foothills of Medicine, Dr. McKersie writes of the nine hour automobile ride into India's magnificent Ganesh Mountains to a camp, from whence a hike of several days would walk him to the first medical clinic of Tipling. Mostly, he dismisses the discomforts endured himself, but consistently writes of the trials and courage of those carrying heavy clinical supplies and equipment over steeply inclined, seldom-trekked mountain footpaths. These precipitous ascents and descents in some places were so hazardous, that a misplaced footstep or loss of balance could result in a death-tumble of hundreds of feet.
   
   So why does he travel regularly to these remote medical outposts and leave his practice in the United States? McKersie is a thorough idealist. In these remote mountains of Nepal he can practice medicine as it should be practiced. He can establish a relationship with patients, because they need help and because they are human and beautiful. Here, he does not worry about salary. Rather, he worries about curing infection, controlling tuberculosis, stabilizing diabetes or a failing heart, or epilepsy.
   
   In Nepal he does not hassle over medical insurance. The mountains provide no such aid. Instead, he labors to mend a broken arm or leg, or to deliver a baby. Nor does he obsess about begging specialists to see poor or underprivileged patients free of charge. Instead, he and a handful of doctors and nurses are the "general" specialists. They provide what help they can, then counsel village family members on continuing care.
   
   A half world away during part of each year, Dr. McKersie is a regular family physician doing his utmost to provide the same kind of personal health care to patients on the South Side of Chicago as in distant Nepal village medical clinics. But should that statement not be reversed? McKersie would say, "No!" He often feels frustrated here in the United States attempting to arrange needed health care for seriously ill patients lacking insurance. In addition, there is the ongoing struggle for affordable medicines for those without big bucks. In the end, people who cannot pay for health care in this country are tantamount to a Nepalese villager.
   
   In the Foothills of Medicine is a fascinating story - an adventure that leaps from its pages as you follow one doctor's efforts to heal the sick and promote social change in two vastly different cultures: Nepal and the United States. His vision of the latter is simple: the US needs a vital health care system now, for every citizen regardless of income.
   
   Dr. McKersie's tell-it-like-it-is memoir will grab your interest from its first page. This book is an outstanding read for everyone, but has a special message to those involved in health care. It is a critical document for every politician. It is my hope that readers of In the Foothills of Medicine will urge their congress women and men to live up to their social responsibility and not rest until vital health care is available to every United States citizen. Hats off to Doctor McKersie for his remarkable story.



4. My brother has written this book that I have shared with numerous colleagues, professionals and friends. Most are quite surprized by his experiences and the journeys he has created. He has always brought a passion to everything since he trailed me at 15 months of age. There were parts of his life that I had not been privy to until it went to print - all true and heartfelt experiences. My hope is that this book inspires each of us to follow our personal and professional endeavors, and that medicine for all is readily available.



5. In his book "In the Foothills of Medicine," Dr. Robert McKersie takes the reader through his days training as a resident in Chicago. His descriptions of meaningful patient encounters illustrate the rigors of medical training, and its toll on the human psyche. Dr. McKersie's openness with his personal emotions during these encounters is in stark contrast to the clinical discussions of anatomy, disease progression, and health statistics. The dichotomy of these two styles gives the reader a unique insight into the mind of a physician, who must be systematic, rational, and detached in their medical diagnosing, all the while struggling with their own humanity and frailty. It is clear that Dr. McKersie learned not only how to heal patients more effectively during this time, but also learned how to heal his own wounds, and how to reconcile the conflicting emotions. These lessons were learned not just in the ICU, but in the waiting room and in the community at large.
   These vignettes are bookended by descriptions of the author's travels in Nepal to support and train native medical providers. While those of us who live in the U.S. think of how underdeveloped many third-world nations are, the practice of medicine is not all that dissimilar. In fact, these Nepalese have greater access to healthcare services than many Americans do, as the socialized nature of Nepal's national health care system is open to all its citizens In contrast, Dr. McKersie's experiences detail how fractured the U.S. health care system truly is. For those who are earn too much to qualify for public assistance (in the form of Medicaid), not old enough for Medicare, or are too poor to afford private insurance, the system is tragically difficult to navigate. With so-called safety net facilities, like the one in Chicago Dr. McKersie trained in, these patients can seek care without concern for cost. Unfortunately, the preventive care and continuity of care necessary for disease management is not available to many. While the Nepalese struggle with supply, proximity, and availability of medical care, many Americans are surrounded by abundant supply that cannot be tapped without the requisite finances.
   This book would be a good read not only for those contemplating entering the medical field and those already practicing medicine, but for anyone who has ever had to interact with the health care system. The author's insights give the reader an appreciation of the struggles of practicing medicine in the current environment, where red tape and financial concerns often take precedent over appropriate medical care. It is refreshing to see a physician continue to struggle with these conflicts, and strive to engender a desire in future physicians to continue the struggle as well.

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1 comments about A Beautiful Boy.

1. What a great read! Inspirational! Afterward it seemed I knew the Author, Barry Hanson II. His writing style draws you into the story and you feel like you are sitting beside him and his family at each turn. Little bits of wisdom are sprinkled throughout in a tasteful and contemplative manner that challenged me to think. The concluding epilogue was masterful, of which you must read for yourself. I give it five stars.

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