The Heart of Caring

by Mark Vonnegut

Pediatrician Mark Vonnegut has spent forty years treating children for coughs, fevers, ear infections, and sometimes more serious complaints. In that time he has seen the American medical system change in ways he couldn't have imagined as a medical student--some of them good, others not so good. But what hasn't changed is his commitment to his young patients, whose stories fill the pages of this book. There's Anna Maria, a little girl with an incurable case of bone cancer; Adeline, who has a syndrome so rare none of Vonnegut's fellow doctors have seen it before; Marlowe, whose life-threatening anemia is cured by his just-born baby brother.

Whether recounting the cases that have stuck with him or detailing larger changes in medicine--the privatization of health care, innovations in cancer treatment, the rise of anti-vaxxers and HMOs--Vonnegut is a personable guide through what is often seen as an impersonal system, and his stories sparkle with humanity, candor, and wry wisdom. ("In pediatrics, and most medical care," he says, "if the doctor can just shut up and listen long enough, the patient will give him the diagnosis. Unfortunately, there's not a procedure code or template for how to shut up.") Vonnegut doesn't pull any punches in his criticisms of the medical-industrial complex, but The Heart of Caring isn't a diatribe. It's the story of a life lived in medicine, with all the heartbreak, hope, and everyday heroism that entails.

Genres: Pediatrics, Memoir, Medical, Nonfiction, Medicine

240 pages, Hardcover

Published January 18, 2022

About the author

Mark Twain Vonnegut is an American pediatrician and memoirist. He is the son of the late writer Kurt Vonnegut, Jr. and his first wife, Jane Cox. He is also the brother of Edith and Nanette Vonnegut. He described himself in the preface to his 1975 book as "a hippie, son of a counterculture hero, B.A. in religion, (with a) genetic disposition to schizophrenia."

Reviews

[Revell Cozzi · Rating 4 out of 5]

I recommend not reading this book while in the middle of applying to medical school. But I think literally any other time is probably a good time to read it.

[Mary Ellen · Rating 5 out of 5]

Through this well-written book, caring physician, Mark Vonnegut describes a real look at his 40 plus years as a pediatrician caring for our children through his stories that comes from the heart; sometimes heartbreaking; other times funny and witty. He also takes a look at our medical care system and insurance companies, and how over the years they are failing in the care and the needs of the patient. Truly a must read!

[Peter Van Os · Rating 4 out of 5]

Enjoyed despite (and also sometimes because of) the curmudgeonly writing style

[Hailey · Rating 5 out of 5]

This is a must read!

The Heart of Caring is a truly inspiring anthology exploring the importance of compassion and empathy in the healthcare system. With a plethora of stories and experiences throughout his 40 plus years in the profession, Mark Vonnegut touches on mental health and the various struggles of a doctor in a money hungry society. In a culture of HMO and PPO plans, copays, and deductibles, it’s no secret many patients have grown to fear the doctor’s office. He recognizes that insurance companies have lead to the downfall of doctor-patient relationships, hence the recent loss of respect and confidence in the industry. Patients have become less wary about their diagnosis and more about what it will cost them… but this is not “care” and this is not what students are entering the medical field for. Caring is listening and understanding, not calculating the cost/value per patient to survive as a “successful” doctor or practice.



“Without trust, it’s next to impossible to practice good medicine and absolutely impossible to enjoy it”.

[Maria Murphy · Rating 3 out of 5]

I really enjoyed some of these stories- they were inspiring and left me thinking- I can’t wait to become a pediatrician!

Then there’s the less “feel good” part of it- pointing out the issues with the healthcare system and insurance companies. At a certain point it just felt like he kept repeating himself over and over again and even though he “gave a solution” at the end it didn’t feel that way.

Also, don’t know if I vibed with the writing style/his use of humor.

[Jennifer · Rating 5 out of 5]

Laced with wisdom and an engaging sense of humor, Dr. Vonnegut offers a decades-spanning perspective on his career in pediatrics and the steady dismantling of patient care in favor of private profits. Told through a series of vignettes, the book is a fascinating memoir that offers many interesting personal reflections. It is also a heartfelt and impassioned plea for a return to the patient-centered care that will result in better outcomes for us all.

[Emma McCarthy · Rating 3 out of 5]

ugh i LOVED so much about this. vonnegut touches on so much we healthcare professionals are so sick of when it comes to big-money, medicine-ignorant, tie-wearing fellas telling us how to do our jobs. his stories brought so many of my own patients to mind and felt so close to home. you can feel his passion through how he describes his patients and practice.

and yet... so much of how he proposes solutions to the problems we see in our current system are oversimplified, and, at times, a bit insensitive (zoom in on his chapter on self-harming adolescents and anorexics, who, and i quote, he wish "would just eat something", *GAG*). mental health is not a simple puzzle to tackle, but his recommendation to "go for a walk, eat more vegetables, and turn off the phone" is incredibly underwhelming and ignorant, especially for someone who claims to understand mental health given his own struggles.

i'd like to believe that his intensions and actual beliefs behind addressing mental health aren't quite that bland and simple, and it was rather an issue with his verbiage and prose... regardless, it was not well received by this reader.

[Leah Thomas · Rating 4 out of 5]

A book that argues what every physician knows- insurance companies are ruining healthcare in America. Physicians have to spend an inordinate amount of time on documentation and other tasks that are useless. Vonnegut writes well with a good sense of humor. He includes some meaningful patient stories. He writes one line that truly stuck with me, and that will likely become a mantra for me as a physician. Most of his patients would be fine without him "but not zero, not zero, not zero." As a medical student I have truly helped very few patients during my rotations- but not zero.

[Maryam ✨ · Rating 4 out of 5]

This books focuses on the changes in healthcare over the years. With a great emphasis on the damages insurance/privatizing healthcare has made.

[Stefanny Cong · Rating 5 out of 5]

The Heart of Caring feels like a quiet reminder of why medicine, and caring professions in general, exist in the first place. It’s not a loud or dramatic book, but that’s exactly its strength. It focuses on the emotional core of care: presence, empathy, and the often invisible labor of simply showing up for another human being.

What resonated with me most is how the book centers caring as something deeply human, not just a skill to be learned or a box to be checked. It captures the small moments–listening, noticing, staying–that are easy to overlook in a system driven by efficiency, protocols, and outcomes. Reading it feels a bit like slowing down in a world that constantly pushes you to move faster.

What I appreciated most is how the book subtly reframes caring as an act of courage. To care deeply is to risk being affected, changed, even hurt–and The Heart of Caring doesn’t shy away from that truth. It suggests that vulnerability isn’t a weakness in healthcare, but a foundation for meaningful connection.

[Brigid Hughes · Rating 3 out of 5]

After talking to my mom for years about the ways pediatrics has changed, the content and opinions in this book were interesting and very real experiences that my mom has mentioned. I did not however like the writing style and organization of the book and wish it offered more solutions rather than just outlining the problems

[Sarah · Rating 4 out of 5]

Each brief chapter reflects on a patient, friend, or experience that shaped the author’s career in peds. Learned how much insurance has changed our profession (for the worse). Luckily, kids are still hilarious & amazing.

[Gabriella Farneti · Rating 4 out of 5]

Super eye opening on the changes in health care. Kinda sad how much ur has changed.

[Diane Adams · Rating 5 out of 5]

I loved this book! Mark Vonnegut is a voice that needs to be heard, now more than ever! Cannot recommend this book enough!

[Tanner Randall-Gosselin · Rating 5 out of 5]

An important read for understanding the issues facing healthcare providers

[molly · Rating 4 out of 5]

“The needs and interests of patients have to come first. Always.”

[Ronald J. · Rating 5 out of 5]

We have Mark Vonnegut coming on The Soul of Enterprise on May 20th. Mark is the son of Kurt Vonnegut, and we will discuss this work that covers his life as a pediatrician. I found the book quite enjoyable. Here is the link to the show where you can listen:

https://www.thesoulofenterprise.com/t...

[Yasmina Ghadban · Rating 4 out of 5]

Must read for anyone hoping to work in the medical system, especially especially in the US but really anywhere.

[Carissa · Rating 3 out of 5]

Since I didn't read every essay in this one, I'm not counting it towards my books read for the year.