Cory Franklin

Parts of this book were quite interesting, but it really came off as a lot of braggadocio. Franklin occasionally admits mistakes (especially when he was a student) and spends a lot of time criticizing other doctors' treatment of medical students and patients--while then bragging about his own treatment, especially of patients he has deemed less intelligent than he. I do think the narrator's voice made this bragging more distinct, as that is how the book is read. Maybe it would not feel the same on the page?

He is quite harsh on the for-profit health system in the US, yet interestingly he never mentions insurance (health or malpractice) or lawsuits. He also hates HIPAA with a passion--which, while suggesting he is very honest (or just doesn't care), also shows extreme naivete on how patients are often treated by various medical staff, who spread diagnoses and details throughout communities and families.… (mehr)

I loved this book. It was like having your own TV medical drama without all of the over-the-top or bad acting. Along with the anecdotes he includes, he provides interesting medical information such as chapter 8 concerning alcoholism. You walk along with Dr. Franklin as he does his rounds and get in first hand on his interesting cases, meeting his fascinating patients. Some will make you laugh and some will make you cry. Dr. Franklin doesn't use this book to make himself out to be the perfect doctor. You will see him at his worst and you will see him at his best. But most importantly you will walk away from this book with a good feeling and a little bit more information than you had when you began it.… (mehr)

Cory Franklin, MD, spent most of his thirty-year career as a doctor in the Intensive Care Unit at Chicago’s Cook County Hospital. This book presented vignettes of incidents that happened to him there as well as at other hospitals in other cities while he studied to be a doctor. Through his stories, the reader can gain some insight into how the medical profession works and how and why it has changed.
One point that he raised several times was the way medical students, interns, and residents were often bullied by their superiors. While the results could have major effects–not getting admitted to a hospital’s training program or not learning another cause for a medical situation–no explanation was offered for why this happened, how it started, how it permeated the system, or what benefits, if any, it produced. He also discussed the turf wars between internists and surgeons.
He also discussed the way hospital personnel, especially doctors, do not see patients as people but as diseases. They miss important information because of that, e.g., stereotyping a patient rather than considering that a condition may be caused by medication. Later on he mentioned how modern medical practices have distanced the doctor and the patients. Underlings do much of the prep work that the doctors used to do. Much work, such as diagnosing, is done with a computer which causes the doctor to be looking at the screen rather than at the patient for much of the examination.
COOK COUNTY ICU explained some of the feelings and experiences hospital patients experience. In order for hospitals to run smoothly, patients become infantilized.: They lose control of their environment and freedom and may rebel or react in ways to regain control, e.g., become argumentative or demanding; women may become flirtatious, men may become sexually suggestive. Doctors and nurses who become patients are often the worst offenders because they are more aware of what is happening to them.
People or people thought to be poor, confused or had language barriers, had less chance of receiving the same quality of care as did their more respectable counterparts. There is no information about how the Affordable Care Act (Obamacare) has or has not changed that.
The book is filled with examples of problems caused by numerous illnesses, some quite difficult to diagnose. It also briefly addressed the HIV-AIDS beginning when patients with the disease began showing up in the emergency room. Extraneous experiences included being the medical consultant for the movie “The Fugitive” and speaking with the doctor in charge of the emergency room in Memphis when Elvis was brought in.
Before World War II, most wealthy people were treated at home. Only the less wealthy went to hospitals and at least half could not pay their bills. The slack was picked up by philanthropic groups and the government. That changed after the war when employers began offering medical insurance to their employees. Medicare entered the picture in the 1960s and in the 1980s, private donors were sought to pay for expansion and new construction. The 2000s brought in mergers and consolidations. Independent community hospitals disappeared. The effect the change became evident on the walls of the corridors. Instead of portraits of prominent doctors who were involved with patient care they were replaced by portraits of administrators and board members and plaques with the names of donors and focused on money.
One segment of the medical community did not change: Free clinics. They still faced the same medical and medicinal care problems. But they also had more intrastaff congeniality and more appreciation from their patients.
Franklin explains why more doctors consider leaving the profession today and some of the problems caused by more government oversight (e.g. HIPAA rules) and electronic record keeping,
The vignettes were interesting and brief. The technical jargon was kept to a minimum and was written so the lay reader could understand it. I found the attempts at writing accents, primarily for New Yorkers and Black people, insulting, condescending, and unnecessary.
Franklin made it very clear that he did not like the people he met when he went to New York City for interviews. But his statement that “Saul Steinberg’s famous New Yorker cover, “View of the World from Ninth Avenue” is not without some basis assumes that all the readers will be familiar with that cover.
I hoped for more content from the book than I found.
I received a copy of this book from Goodreads Giveaways.… (mehr)