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One Doctor: Close Calls, Cold Cases and the Mystery of Medicine
An epic story told by a unique voice in American medicine, One Doctor describes life-changing experiences in the career of a distinguished physician. In riveting first-person prose, Dr. Brendan Reilly takes us to the front lines of medicine today. Whipsawed by daily crises and frustrations, Reilly must deal with several daunting challenges simultaneously: the extraordinary patients under his care on the teeming wards of a renowned teaching hospital; the life-threatening illnesses of both of his ninety-year-old parents; and the tragic memory of a cold case from long ago that haunts him still.
As Reilly’s patients and their families survive close calls, struggle with heartrending decisions, and confront the limits of medicine’s power to cure, One Doctor lays bare a fragmented, depersonalized, business-driven health-care system where real caring is hard to find. Every day, Reilly sees patients who fall through the cracks and suffer harm because they lack one doctor who knows them well and relentlessly advocates for their best interests.
Filled with fascinating characters in New York City and rural New England — people with dark secrets, mysterious illnesses, impossible dreams, and many kinds of courage — One Doctor tells their stories with sensitivity and empathy, reminding us of professional values once held dear by all physicians. But medicine has changed enormously during Reilly’s career, for both better and worse, and One Doctor is a cautionary tale about those changes. It is also a hopeful, inspiring account of medicine’s potential to improve people’s lives, Reilly’s quest to understand the "truth" about doctoring, and a moving testament to the difference one doctor can make.
As Reilly’s patients and their families survive close calls, struggle with heartrending decisions, and confront the limits of medicine’s power to cure, One Doctor lays bare a fragmented, depersonalized, business-driven health-care system where real caring is hard to find. Every day, Reilly sees patients who fall through the cracks and suffer harm because they lack one doctor who knows them well and relentlessly advocates for their best interests.
Filled with fascinating characters in New York City and rural New England — people with dark secrets, mysterious illnesses, impossible dreams, and many kinds of courage — One Doctor tells their stories with sensitivity and empathy, reminding us of professional values once held dear by all physicians. But medicine has changed enormously during Reilly’s career, for both better and worse, and One Doctor is a cautionary tale about those changes. It is also a hopeful, inspiring account of medicine’s potential to improve people’s lives, Reilly’s quest to understand the "truth" about doctoring, and a moving testament to the difference one doctor can make.
448 pages, Hardcover
First published September 3, 2013
158 people are currently reading
5185 people want to read
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September 14, 2015
This book reads like part House, part Grey’s Anatomy and part diary, yet much, much more informative. By bringing us into his every day life and meeting his various patients at New York Presbyterian Hospital’s emergency department, Dr. Brendan Reilly explains, by example, why US healthcare, or more precise, ER care, has evolved into the complicated, hard-to-navigate maze that we see today; why most young med school graduates decide to to become specialists instead of primary physicians, which our country desperately needs.
The title, One Doctor, was used since all we need is this one doctor who's our advocate. Due to the regulation and involvement of the health insurance industry, most of us do not have a doctor who deeply concerns about us, who knows us well, who rallies for the right care in our behalf. On the other hand, we all have a battery of specialists. We have a cardiologist for our heart, a rheumatogist for our arthritis, an urologist for our prostates...and so on. Specialists make much more money, and where we are referred to once our ailment is out of our primary care’s scope. But, they usually do not know our complete health history since they only focus on a specific part of us. Dr. Reilly claimed that the patient with the one doctor that truly care for him, follows him over time and know him well would win this rat race of so-called American healthcare. It’s the difference between life and death sometimes…or worse, between death and insufferable life.
Sometimes when a patient or family says, “Do everything for me, doctor,” it unnecessarily that they want to try everything possible to live. Sometimes they do not want to hurt the family members who can’t let go, or they’re scared, or they have no idea hanging on could be worse than death. It’s the doctor, a good doctor’s job to find out what these patients really want, since some scenarios can be really worse than death. We all have a different trade-off limit between how much we are willing to suffer to prolong our life, it’s also a responsible doctor’s job to find out. From the various cases we encounter along with Dr. Reilly, we acquire a better understanding of the end of life, terminal illness, palliative care (which is not used enough), the quality of life, letting go, who to assign as surrogate and all other choices we might face in the future which we most likely never prepared ourselves for. We also will learn about the not perfect, but needed advanced directives as well.
As Dr. Reilly stated, “Most of the sad stories happen when this process doesn’t start until it’s too late. That’s how all those folks wind up comatose in nursing home and intensive care units, fogged with drugs and flogged by machines, not a prayer of getting better. It’s a living hell—and the only hyperbole in that phrase is the ‘living’ part.”
Dr. Reilly is a brilliant storyteller and great writer, and also a rare doctor that deeply cares for his patients. I can feel his real concern and love for life and the world. I could also feel the empathy he has for his patients and their families by reading the way he put his thoughts on paper. Several of these stories were deeply moving: Mr. Gunther, who endured a progressive form of cancer earlier in life who now faces another one; Mr. Atkins with a rapidly progressive terminal illness, who does not have time to prepare his family for his death; Ms. Rhodik, who refused to speak, but her family’s decisions are endangering her health. Others were down right disturbing: Fred, who decided that “losing his marbles” was never an option…and many more. We also learn about the cost of a misdiagnosis, as well as the cost of doing too much.
This is a deeply moving book with many though-provoking stories, and lots of useful information from a good and genuinely caring doctor who has over 40 years of experience. Read this book, for your elders, for yourself, for your children…and for the hope of a better health care system in the near future. This book will make you a better patient, advocate, caretaker, healthcare consumer and....human.
Thanks to Netgalley and the publisher for providing an advance reading copy.
The title, One Doctor, was used since all we need is this one doctor who's our advocate. Due to the regulation and involvement of the health insurance industry, most of us do not have a doctor who deeply concerns about us, who knows us well, who rallies for the right care in our behalf. On the other hand, we all have a battery of specialists. We have a cardiologist for our heart, a rheumatogist for our arthritis, an urologist for our prostates...and so on. Specialists make much more money, and where we are referred to once our ailment is out of our primary care’s scope. But, they usually do not know our complete health history since they only focus on a specific part of us. Dr. Reilly claimed that the patient with the one doctor that truly care for him, follows him over time and know him well would win this rat race of so-called American healthcare. It’s the difference between life and death sometimes…or worse, between death and insufferable life.
Sometimes when a patient or family says, “Do everything for me, doctor,” it unnecessarily that they want to try everything possible to live. Sometimes they do not want to hurt the family members who can’t let go, or they’re scared, or they have no idea hanging on could be worse than death. It’s the doctor, a good doctor’s job to find out what these patients really want, since some scenarios can be really worse than death. We all have a different trade-off limit between how much we are willing to suffer to prolong our life, it’s also a responsible doctor’s job to find out. From the various cases we encounter along with Dr. Reilly, we acquire a better understanding of the end of life, terminal illness, palliative care (which is not used enough), the quality of life, letting go, who to assign as surrogate and all other choices we might face in the future which we most likely never prepared ourselves for. We also will learn about the not perfect, but needed advanced directives as well.
As Dr. Reilly stated, “Most of the sad stories happen when this process doesn’t start until it’s too late. That’s how all those folks wind up comatose in nursing home and intensive care units, fogged with drugs and flogged by machines, not a prayer of getting better. It’s a living hell—and the only hyperbole in that phrase is the ‘living’ part.”
Dr. Reilly is a brilliant storyteller and great writer, and also a rare doctor that deeply cares for his patients. I can feel his real concern and love for life and the world. I could also feel the empathy he has for his patients and their families by reading the way he put his thoughts on paper. Several of these stories were deeply moving: Mr. Gunther, who endured a progressive form of cancer earlier in life who now faces another one; Mr. Atkins with a rapidly progressive terminal illness, who does not have time to prepare his family for his death; Ms. Rhodik, who refused to speak, but her family’s decisions are endangering her health. Others were down right disturbing: Fred, who decided that “losing his marbles” was never an option…and many more. We also learn about the cost of a misdiagnosis, as well as the cost of doing too much.
This is a deeply moving book with many though-provoking stories, and lots of useful information from a good and genuinely caring doctor who has over 40 years of experience. Read this book, for your elders, for yourself, for your children…and for the hope of a better health care system in the near future. This book will make you a better patient, advocate, caretaker, healthcare consumer and....human.
Thanks to Netgalley and the publisher for providing an advance reading copy.
June 24, 2014
Dr. Reilly, a self-styled old-fashioned internist, gives the most vivid depiction of a real doctor's world. It's easy to read, and easy to follow his diagnostic process as he gathers clues from the patients, their behavior and their charts, offering a fascinating glimpse into the reality disguised by shows like E.R. and House.
He shares the cold, hard truth about parts of the industry, including the regrets and fears of doctors and nurses, and the truth behind the statistics and report cards governing the politics of healthcare.
Through his eyes, we see him teaching his students by observation, letting them analyze the situation and draw their own conclusions and gently correcting their course, if necessary, with some leading questions. We see the decision-making process and how it appears to the patient, and the crucial role their primary doctor plays, or should play, in determining which treatment or level of care would be best for that patient.
An enlightening read, especially for someone who didn't grow up in the U.S. health system.
Disclaimer: I received a free ARC from Netgalley in exchange for an honest review.
He shares the cold, hard truth about parts of the industry, including the regrets and fears of doctors and nurses, and the truth behind the statistics and report cards governing the politics of healthcare.
Through his eyes, we see him teaching his students by observation, letting them analyze the situation and draw their own conclusions and gently correcting their course, if necessary, with some leading questions. We see the decision-making process and how it appears to the patient, and the crucial role their primary doctor plays, or should play, in determining which treatment or level of care would be best for that patient.
An enlightening read, especially for someone who didn't grow up in the U.S. health system.
Disclaimer: I received a free ARC from Netgalley in exchange for an honest review.
June 25, 2022
Д-р Брендан Райли е лекар от изчезващ вид - интернист и хоспиталист, т.е. грижещ се за пациенти с комплексни проблеми, които не могат просто да бъдат препратени към специалист. Дейността на д-р Райли привлича вниманието дори на популярния писател Малкълм Гладуел. Вземането на сложни медицински решения под огромно напрежение в болница Cook County е подробно описано в книгата Blink.
One Doctor е изповед за трудностите и ограниченията в медицината. Цялата първа глава е посветена на преглед на пациент - орган по орган, система по система със съответните разсъждения, генериране и отхвърляне на хипотези до достигане до окончателната диагноза. В книгата подробно са обсъдени проблеми на съвременната медицина, за които рядко се говори - прекомерното използване на модерни диагностични методи и загубата на човешка връзка с пациента, фалшиво положителни и фалшиво отрицателни резултати в реалната практика, психосоматични заболявания, грижи за терминално болни в последните им дни и какво ли още не. Д-р Райли ни напомня една неприятна истина - понякога грижите за един пациент се случват с цената на отказано лечение на друг. Как се взема решение да отпратиш пациент, защото няма свободни места поради претоварване на системата? Как да прецениш кога е нужен още един тест преди изписване? Ресурсите на системата са ограничени, което налага тежки избори.
Прочитайки книгата се почувствах тъжен, защото отново си припомних колко много има да учим като съсловие, за да стигнем колегите ни в развитите страни. Ригидната система у нас изисква съвсем други качества от лекарите и рядко си даваме сметка за истински важните въпроси в медицината.
Благодаря на д-р Стефан Чернодрински за прекрасния подарък. Оказва се, че д-р Райли е бил негов учител и ментор в болница Cook County, на чиято дейност е посветен и сериалът "Спешно отделение".
One Doctor е изповед за трудностите и ограниченията в медицината. Цялата първа глава е посветена на преглед на пациент - орган по орган, система по система със съответните разсъждения, генериране и отхвърляне на хипотези до достигане до окончателната диагноза. В книгата подробно са обсъдени проблеми на съвременната медицина, за които рядко се говори - прекомерното използване на модерни диагностични методи и загубата на човешка връзка с пациента, фалшиво положителни и фалшиво отрицателни резултати в реалната практика, психосоматични заболявания, грижи за терминално болни в последните им дни и какво ли още не. Д-р Райли ни напомня една неприятна истина - понякога грижите за един пациент се случват с цената на отказано лечение на друг. Как се взема решение да отпратиш пациент, защото няма свободни места поради претоварване на системата? Как да прецениш кога е нужен още един тест преди изписване? Ресурсите на системата са ограничени, което налага тежки избори.
Прочитайки книгата се почувствах тъжен, защото отново си припомних колко много има да учим като съсловие, за да стигнем колегите ни в развитите страни. Ригидната система у нас изисква съвсем други качества от лекарите и рядко си даваме сметка за истински важните въпроси в медицината.
Благодаря на д-р Стефан Чернодрински за прекрасния подарък. Оказва се, че д-р Райли е бил негов учител и ментор в болница Cook County, на чиято дейност е посветен и сериалът "Спешно отделение".
May 16, 2016
Dr. Brendan Reilly is the kind of doctor everyone should have. He is an internist, a doctor who specializes in the treatment and prevention of diseases in adults. He calls himself a dinosaur, in that there are few doctors left like him. But it's a shame that there are so few of these types of doctors left. Instead of concentrating on just one area, one specialty, Dr Reilly looks at the entire patient and sees how various ailments present themselves throughout the body, and how diseases and issues affect the patient. I found it fascinating that he was able to detect a serious problem with one of his patients doing it the old-fashioned, low-tech way with various external tests, while his younger colleague came to the same conclusions with the use of high-tech scans. To me, this proves that both ways of coming to a diagnosis are valuable. Sometimes things can be caught with the less-invasive method, but when that fails, having the high-tech tests and scans are invaluable for a patient's survival.
I was intrigued by how honest Dr Reilly is throughout this book, being very open and honest about his regrets and what he sees as his failures, and I do wonder what the children of Fred and Martha think of this book (though I'm going to assume they've read it before publication). But I think it shows us that medical professionals are people too, and most aren't suffering from a god complex, that they realize that sometimes they could have and should have done more. Yet sometimes we know that only as Monday morning quarterbacks. It can be a very difficult call to make in the moment.
Dr Reilly also discusses how broken the American health care system is, and it's difficult to read these passages without becoming very angry. I have been insulated from much of this, as I have been treated by military medicine my entire life. The bureaucracy inherent in the system makes the almighty dollar the be-all and the end-all of medical treatment, which is such a shame. Dr Reilly posits some ways of fixing the system, but considering how wealthy hospitals and insurance companies are getting thanks to the current system, I doubt anything will change soon. It's almost enough to make me want to move to a nation with universal health care.
At any rate, this is an excellent memoir by a thoughtful and intelligent doctor who simply wants to provide the best care possible to all of his patients. It's also a heart-wrenching look at a son trying to do his best by his aging mother and father, who have serious health issues and trust him to make the best decisions for them.
Highly recommended.
I was intrigued by how honest Dr Reilly is throughout this book, being very open and honest about his regrets and what he sees as his failures, and I do wonder what the children of Fred and Martha think of this book (though I'm going to assume they've read it before publication). But I think it shows us that medical professionals are people too, and most aren't suffering from a god complex, that they realize that sometimes they could have and should have done more. Yet sometimes we know that only as Monday morning quarterbacks. It can be a very difficult call to make in the moment.
Dr Reilly also discusses how broken the American health care system is, and it's difficult to read these passages without becoming very angry. I have been insulated from much of this, as I have been treated by military medicine my entire life. The bureaucracy inherent in the system makes the almighty dollar the be-all and the end-all of medical treatment, which is such a shame. Dr Reilly posits some ways of fixing the system, but considering how wealthy hospitals and insurance companies are getting thanks to the current system, I doubt anything will change soon. It's almost enough to make me want to move to a nation with universal health care.
At any rate, this is an excellent memoir by a thoughtful and intelligent doctor who simply wants to provide the best care possible to all of his patients. It's also a heart-wrenching look at a son trying to do his best by his aging mother and father, who have serious health issues and trust him to make the best decisions for them.
Highly recommended.
November 14, 2018
Medicine today is a coliseum for the phrenic to “monter et voler” and this new breed of physician is an astute businessman, eagle-eyeing clinical statistics and honing a future end game, yet while soaring something is lost---touch, words and patient interaction. Executive vice chairman of medicine at New York-Presbyterian Hospital/Weill Cornell Medical Center is a rare old school physician and his name is Brendan Reilly, MD.
“...spend more time with the damn computer than the patients:
Whether in the hospital or in outpatient settings, this issue is
ubiquitous, frustrating to many physicians and patients alike.”
---Brendan Reilly, MD
Some call him “Dinosaur” yet he fights battles by treating patients appearing to imitate Dickensian characters on oxycontin as they slide into ontological demise. Dr. Reilly is a gray-haired physician embracing medical complexity and sharing his observation of the mass suffering of old patients sliding into oblivion during a winter at his hospital. Patients are not forgotten and their memory haunts him in the details. Death instructs painfully.
Standard read for new doctors---one can look to the lessons of the past and apply them to the future. Arriving at the hospital before dawn, examinations by hand, and focusing his compulsive attention fully on his patient (his obsessive attention is measured in atoms). Detail always illuminates talent and I found this in Dr. Reilly evident in the banal task of listening to patient respirations. Brilliant. Read, learn and apply!
“...spend more time with the damn computer than the patients:
Whether in the hospital or in outpatient settings, this issue is
ubiquitous, frustrating to many physicians and patients alike.”
---Brendan Reilly, MD
Some call him “Dinosaur” yet he fights battles by treating patients appearing to imitate Dickensian characters on oxycontin as they slide into ontological demise. Dr. Reilly is a gray-haired physician embracing medical complexity and sharing his observation of the mass suffering of old patients sliding into oblivion during a winter at his hospital. Patients are not forgotten and their memory haunts him in the details. Death instructs painfully.
Standard read for new doctors---one can look to the lessons of the past and apply them to the future. Arriving at the hospital before dawn, examinations by hand, and focusing his compulsive attention fully on his patient (his obsessive attention is measured in atoms). Detail always illuminates talent and I found this in Dr. Reilly evident in the banal task of listening to patient respirations. Brilliant. Read, learn and apply!
March 3, 2016
This book was published in 2013 but I am just getting around to reading it. Brendan Reilly, M.D. is an internist at a major academic medical center in Manhattan. He says he began his career as a primary care physician in a small town in New England. He apparently even made house calls.
Reilly complains that the vocation of being a physician and comforting patients has been devalued to a business culture and health care to a commodity. Reilly takes the reader along to work with him as he examines, diagnoses and treats patients (consumers). All the while, the author tosses in his opinions on the state of healthcare today. Reilly also takes the reader home with him and we watch him deal with his own parents. His father, also a physician, has bladder cancer and his mother is suffering from dementia.
The book is easy to read and provides the reader, with a better understand of the role and life of the physician and the state of health care in the United States today. I read this as an audiobook downloaded from Audible. Rob Shapiro does an excellent job narrating the book.
Reilly complains that the vocation of being a physician and comforting patients has been devalued to a business culture and health care to a commodity. Reilly takes the reader along to work with him as he examines, diagnoses and treats patients (consumers). All the while, the author tosses in his opinions on the state of healthcare today. Reilly also takes the reader home with him and we watch him deal with his own parents. His father, also a physician, has bladder cancer and his mother is suffering from dementia.
The book is easy to read and provides the reader, with a better understand of the role and life of the physician and the state of health care in the United States today. I read this as an audiobook downloaded from Audible. Rob Shapiro does an excellent job narrating the book.
July 24, 2017
I got bored, too much meandering and reminiscing. The cases were interspersed but I wasn't about to jump over the meandering more than three times. ugh. Everybody loves it, I do not.
February 8, 2019
I am endlessly interested in the many questions surrounding the current state of American health care. This book is a window into where we are now, written by a physician who is well-placed to comment. Reilly works as a hospitalist, caring for inpatients and training the next generation. He also includes stories from his early years in rural practice (house calls and all!), as well as care for his elderly parents.
He devotes particular attention to the fragmentation of care and the difficulty this poses in a crisis. If an individual has only specialist caring for him, or has a good internist who does not round in the local hospital, he may find himself receiving care from well meaning but uninformed physicians who see only the current crisis and not the human being whose life has been interrupted by it. Reilly aptly diagnoses this disease of modern health care.
He devotes particular attention to the fragmentation of care and the difficulty this poses in a crisis. If an individual has only specialist caring for him, or has a good internist who does not round in the local hospital, he may find himself receiving care from well meaning but uninformed physicians who see only the current crisis and not the human being whose life has been interrupted by it. Reilly aptly diagnoses this disease of modern health care.
August 5, 2016
As a nurse, I love to read books about medicine. I haven't found a lot out there that are really great without a lot of opining about politics, etc. This book was great. I love the patient stories, the mysteries, the way Dr. Reilly brings us into his thought process making difficult decisions for his patients and his parents. I really identified with a lot of the dilemmas that he brings up regarding end of life--wanting people to have choices, yet knowing that some treatments are futile (though not always knowing which treatments are futile except in a statistical sort of way--so there's always the small percentage of hope). He's not negative about medicine or about any particular people in the book and seems to be always trying to look at them in the best light possible, understanding their motivations and their stress. It was a very enjoyable read, recommended.
June 26, 2020
A very informative book.
Give very good insight about the internal medicine duty nature,
Also about the health care system , and also provide understanding of the doctors feeling and way of thinking and why it happend.
Written in diary style, by a very experienced honest good physician.
The describing of the characters is awesome here also.
Me as a medicine resident, will be very lucky if i got a chance to be in his team and training for some period.
There is little number of medicine educators like him.
Give very good insight about the internal medicine duty nature,
Also about the health care system , and also provide understanding of the doctors feeling and way of thinking and why it happend.
Written in diary style, by a very experienced honest good physician.
The describing of the characters is awesome here also.
Me as a medicine resident, will be very lucky if i got a chance to be in his team and training for some period.
There is little number of medicine educators like him.
April 20, 2014
This is an amazing book by the type of physician everyone would like to have: a compassionate, caring, knowledgeable person who genuinely cares about his patients and their well being. It's fascinating book about what a doctor is confronted with on a daily basis between the patients, their families, their decision points, the hospitals, communications, etc. It's all encompassing and gives the reader an incredible appreciation for what it takes to be a medical professional, let alone a good one. His patient stories are fascinating and his discussions about our health care system are thoughtfully presented. Many times during the book I paused to think about how I and my family feels about certain issues and what I needed to explore myself to further define my wishes and those of others. Anyone who had/has Dr. Reilly as a doctor should be thankful. I'm giving it 4 stars rather than 5 only because it's not a book for everyone. Anyone squeamish about medical procedures or unable to relate to medical issues past a cursory level is not a good candidate for reading this book.
November 16, 2019
One Doctor easily earns 3.5 stars for the basic premise that Dr. Reilly presents, that patients fare much better if they have one doctor managing their care, a doctor who knows them. This becomes especially important with end-of-life issues. Dr. Reilly is a Doctor of Internal Medicine, and he sees his patients for life – as outpatients and inpatients. This is a rarity, but also a very good idea that I've already tried to incorporate into my own health care.
I've never thought about this idea in detail, but it goes a long way towards explaining the endless delays, inefficiencies, and lack of communication that seems to be the norm in hospital care. There are hours spent waiting for cardiologists, neurologists, osteopathic physicians, urologists, endocrinologists, and pulmonologists. When these doctors do see the patient, it seems that far too often they are there for just a few minutes, give a few snippets of information, and then race out the door to see their next patient. I realize that doctors are overwhelmingly busy, but some time to communicate would be worthwhile. It seems like the person best suited to provide this communication may be an internal medicine doctor. Dr. Reilly wonders how a patient has reached the end stages of cancer without really understanding the seriousness of his disease but answers his own question when it becomes clear that the teams of doctors have each assumed that someone else has spoken with the patient when in reality no one has in any meaningful way.
The rest of the book relates details of his patients and the course of their diseases to more general health care issues today. While managing some very sick patients, Dr. Reilly is also dealing with the decline of his ailing parents. I think Dr. Reilly himself becomes spread far too thin, but I'm also not sure what the alternatives are. While all of these issues are relevant and important, I found these sections far too rambling and lengthy. The book would have been much improved if it had been more succinct, with fewer musings and diversions.
I've never thought about this idea in detail, but it goes a long way towards explaining the endless delays, inefficiencies, and lack of communication that seems to be the norm in hospital care. There are hours spent waiting for cardiologists, neurologists, osteopathic physicians, urologists, endocrinologists, and pulmonologists. When these doctors do see the patient, it seems that far too often they are there for just a few minutes, give a few snippets of information, and then race out the door to see their next patient. I realize that doctors are overwhelmingly busy, but some time to communicate would be worthwhile. It seems like the person best suited to provide this communication may be an internal medicine doctor. Dr. Reilly wonders how a patient has reached the end stages of cancer without really understanding the seriousness of his disease but answers his own question when it becomes clear that the teams of doctors have each assumed that someone else has spoken with the patient when in reality no one has in any meaningful way.
The rest of the book relates details of his patients and the course of their diseases to more general health care issues today. While managing some very sick patients, Dr. Reilly is also dealing with the decline of his ailing parents. I think Dr. Reilly himself becomes spread far too thin, but I'm also not sure what the alternatives are. While all of these issues are relevant and important, I found these sections far too rambling and lengthy. The book would have been much improved if it had been more succinct, with fewer musings and diversions.
September 19, 2018
Dr. Reilly offers incredible insights into some of the greatest benefits and greatest problems that emerge from the American health care system. He uses stories from his personal and professional life as gateways into larger system-wide commentary on important topics, such as medical error, unnecessary (and often harmful) care, professional values within medicine, the probabilistic nature of practicing medicine, our avoidance of end-of-life care conversations, etc. Overall, he points to our society's dire need to sit down and have an important discussion about health care in our country. We think that 'rationing' is a curse word in the medical context, and we refuse to acknowledge that there is any such thing as 'too much care,' proving this by our willingness to spend 17.9% (!!!) of our GDP on health care spending. And yet, care is absolutely rationed in the United States... it is rationed through insurance companies by ability to pay. Reilly deftly illuminates the need to let physicians (rather than insurance companies and politicians) take the lead in discussions of how to create a health care system that is just, effective, and sustainable.
September 4, 2018
This is a must read for anyone who receives health care in our country. Dr. Reilly addresses issues of health care rationing, doctor regret, payment for services, doctor-patient relationship, medical probability, our culture of medicine. We will never find a better and more equitable health care system without changing our culture and expectations. Should we really be doing open heart surgery on an 85 year old with terminal cancer? When is enough, enough?
July 28, 2019
Reilly recounts stories of specific cases/patients interwoven with personal history and commentary on the weaknesses of the U. S. healthcare system. There are poignant parts, especially when he talks about helping is frail, elderly parents navigate their health issues. At times a little dry but a worthy read overall.
February 16, 2017
Can Dr. Reilly be a.) my doctor, or b.) the Secretary of Health and Human Services instead? Pretty please.
An absolutely fantastic memoir that mixes Dr. Reilly's experiences as a primary care physician with a sober analysis of the health care issues that continue to bedevil the United States.
An absolutely fantastic memoir that mixes Dr. Reilly's experiences as a primary care physician with a sober analysis of the health care issues that continue to bedevil the United States.
March 9, 2021
An interesting book about what doctors go through in the US health care system, the types of patients they deal with and the struggles and frustrations. But the author goes too much into a tangent too often which makes it hard to keep up with some of the cases.
September 17, 2013
this book made me realize the importance of primary care and the hard work of primary care physicians and the vast improvement in care that they provide
February 9, 2022
I thought that this novel was really great and amazing in engaging readers by addressing ethical and pressing questions in healthcare while encountering them in patient interactions and past and current events of his life. He articulately attacks each of these problems with precision and shows how to critically think about life and progress.
October 3, 2018
Loved this book. It was a fabulous combination of storytelling weaved together with Dr. Reilly's profound insights on the Healthcare system, illness, family, and life. I couldn't put this book down.
December 6, 2019
This was so good--both the medical stories and the resulting reflection on medicine and where it is going were fascinating and sounded very valid to me.
June 30, 2021
Audible version
Read
February 13, 2022A bit long for me. I guess it could be depressing but I like to see that there are smart, caring, incredibly compassionate medical professionals out there that I’ll meet when I need them (I’m talkin’ bout you too Kari and Rav and Mitch and Kelsey and Sarah and Kyle and so many others ❤️)
June 28, 2025
Excellent story about a real doctor. He tells the real story about a physician’s life, showing that they are people too. I learned several new things about how healthcare works. It is not so easy to maneuver as some would think.
September 4, 2013
One Doctor: Close Calls, Cold Cases, and Mysteries of Medicine by Brendan Reilly MD (Atria Books - Random House, 2013, 464 pages, $28.00) is an important, substantive, gripping story about the inner life and challenging medical practice of one of the country's leading medical clinicians, teachers, and administrators. Drawing on over forty years of practice in top hospitals undertaking the toughest cases and jobs, Brendan Reilly accomplishes what few people who write doctor books for the general reader can or are willing to do. He takes an on-call period in his current job as Executive Vice Chair of Medicine at New York Presbyterian Hospital (one of the finest teaching hospitals in the world) to frame the challenges faced by the nation in its medical system, by individuals doctors seeking to practice medicine within this new world of changing technology and economics in medicine, and his own personal experiences as he faces intractable medical problems with his students and the impending deaths of his own parents. During a harrowing week on call, doing rounds with his students while he manages his parent's illnesses and infirmities, Reilly explores with courage and insight his own life and learning experience in medicine and the medical crises faced by key patients. He does this with a style of personally exploring his own reactions, feelings, and actions which is rare among doctors. The result is a gripping story that often reads like a novel (or, for those with a visual imagination, looks like the TV program ER, which was conceived and filmed during his tenure at Cook County Hospital) while examining issues facing the larger medical community and the nation. If you consider purchasing this important book, please use the Amazon portal found on my blog. To be posted 9/5/2013
July 30, 2018
Reilly mixes story with great insight into healthcare policy that physicians navigate in order to provide the best possible care for their patients. I found his discussion on end of life to be fascinating—why is it that our healthcare system makes it so difficult to have frank discussions about “how much” we should do to keep us alive (are you willing to endure great suffering for two extra months?). Why are we pushing out great family doctors who know their patients in favor of more disjointed specialists who see only a small piece of the whole person?
As insightful as this book was, I found it to be somewhat disjointed and redundant. I had a hard time keeping track of all the cases he discussed. The cases I most connected to were not the ones he spent the most time on—the cases initially discussed were never resolved which left me wondering what happened.
Despite the issues, it was clear that certain cases are very deeply personal for Reilly and he continues to carry those patients with him in his daily work. Reilly comes across as a physician who cares about the whole person and takes the time to understand them and their symptoms. This was a worthwhile read, especially for those interested in healthcare policy.
As insightful as this book was, I found it to be somewhat disjointed and redundant. I had a hard time keeping track of all the cases he discussed. The cases I most connected to were not the ones he spent the most time on—the cases initially discussed were never resolved which left me wondering what happened.
Despite the issues, it was clear that certain cases are very deeply personal for Reilly and he continues to carry those patients with him in his daily work. Reilly comes across as a physician who cares about the whole person and takes the time to understand them and their symptoms. This was a worthwhile read, especially for those interested in healthcare policy.
July 16, 2017
First, the book was an easy to listen -well written, good narration at a good pace (Audible). Next, it gives you a sense of the life of a physician and the state of health care in the United States today. Or at least how it plays out in a major medical center in NYC and I'm absolutely sure that is quite different than how it plays out in rural, poor areas of the U.S. Take what you read and reduce the options for care by 200%.
Reilly experiences the shortcomings of the US healthcare system both as a provider and as a consumer who is taking care of his parents who are both experiencing major health challenges. Although he is doubly privileged by knowing the system and having the income needed to optimize outcomes within the system, he still sees and experiences some of the shortcomings. If he experiences them, surely we're all doomed.
Holy crap, can we just move to single payer already? Clearly our current system sucks for EVERYONE (except the corporations who are making the money). But both the providers and the consumers think it sucks and when everyone bails, there won't be money to be made anyway... Let's join the rest of the developed world already.
Reilly experiences the shortcomings of the US healthcare system both as a provider and as a consumer who is taking care of his parents who are both experiencing major health challenges. Although he is doubly privileged by knowing the system and having the income needed to optimize outcomes within the system, he still sees and experiences some of the shortcomings. If he experiences them, surely we're all doomed.
Holy crap, can we just move to single payer already? Clearly our current system sucks for EVERYONE (except the corporations who are making the money). But both the providers and the consumers think it sucks and when everyone bails, there won't be money to be made anyway... Let's join the rest of the developed world already.
April 8, 2014
I enjoyed this book, perhaps not as much as the more purely clinical ones of the genre, but still - a good read. The author clearly has a deep understanding of the politics and economics of modern medicine, in addition to his clinical skills. In particular I was struck by the discussion of medical error and asymmetric regret (a new concept for me, but definitely one I intuitively agree with), and I also particularly enjoyed the section of the book in which the author's attention was divided between his busy hospital caseload and his parents' critical illnesses.
Important quote: "Most diagnoses are probable, not certain, something most laypersons don't know and some doctors don't appreciate." I have been trying to explain this to my own mother for years...
Favorite imagery: "...a place where sniveling crack addicts from East Harlem and doubled-over undocumented Dominicans from Queens wait on gurneys alongside wide-eyed, terrified Park Avenue matrons."
Important quote: "Most diagnoses are probable, not certain, something most laypersons don't know and some doctors don't appreciate." I have been trying to explain this to my own mother for years...
Favorite imagery: "...a place where sniveling crack addicts from East Harlem and doubled-over undocumented Dominicans from Queens wait on gurneys alongside wide-eyed, terrified Park Avenue matrons."
April 7, 2015
I thought this would simply be a book about a doctor's experiences with his patients but it is so much more. Brendan Reilly masterfully weaves together so many threads--yes, experiences with patients and hospital life, but also solid essays into the world of medical care that the average healthcare "consumer" would do well to read. Meanwhile, as he is writing the book, his father is dying of cancer and his mother is fading away with Alzheimer's, complicated by cardiac disease. Dr. Reilly's very personal struggles with making decisions for his elderly parents will ring true with any reader who has dealt with the same situation. To top it off, the story of Fred and Martha intertwines through this tapestry; Dr. Reilly will always wonder if he could have done more to save Fred. Rarely does an author deal with numerous topics so seamlessly and keep the reader turning the pages faster and faster.
March 21, 2015
Probably not the best book for a hypochondriac to read. It's full of alarming statistics and stories of mistakes doctors have made. It just confirmed what I have known for a long time - there are a lot of medical errors out there and everything a doctor says shouldn't be taken for absolute truth. But there are also good doctors and Brendan Reilly is one of them (though he too, makes mistakes).
Dr. Reilly is a hospitalists, solely taking care of his caseload in the hospital. He goes back and forth a lot between the patients, sometimes skipping one for chapters and suddenly their name will come up again and I have to search back trying to find who it is he is talking about and what their initial problem was. So it was a little difficult to keep track of who's who, but otherwise a very interesting read.
Dr. Reilly is a hospitalists, solely taking care of his caseload in the hospital. He goes back and forth a lot between the patients, sometimes skipping one for chapters and suddenly their name will come up again and I have to search back trying to find who it is he is talking about and what their initial problem was. So it was a little difficult to keep track of who's who, but otherwise a very interesting read.
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