July 21, 2010
BOOK REVIEW: 'The Kitchen Shrink'
How Doctors Became 'Health Care Providers' in the Brave New World of the Bottom-Line-Driven Medical-Industrial Complex
Reviewed By David M. Kinchen
If you've long envied your family doctor's social position and income level, reading Dora Calott Wang's "The Kitchen Shrink: A Psychiatrist's Reflections on Healing in a Changing World" (Riverhead Books, a member of the Penguin Group (USA), 368 pages, $25.95) is a sure-fire way to change your perspective from envy to sympathizing with him or her.
From her perspective of attending medical school at Yale in the late 1980s (she graduated in 1990), Wang, a psychiatrist and medical school professor in New Mexico, recounts the seismic shift that has occurred In the past two decades in our nation's hospitals and doctor's offices.
Once considered a sacred, cherished vocation, the medical profession has devolved into a business fiercely driven by a desire for profits -- and the proper completion of mountains of insurance company paperwork.
Even psychiatry -- once the mainstay of the human interaction between doctor and patient -- has fallen victim to rising costs and dictates by insurance companies, Wang writes. One doctor colleague described the change to her as the metamorphosis from "Marcus Welby to Meineke," referring to the beloved fictional family doctor in the TV series, Marcus Welby, M.D. to the car repair chain specializing in mufflers and brake jobs and other after-market auto repairs.
To tell how has medicine strayed so far from its roots, Wang explores what has happened since the 1980s, when for-profit corporations and private health insurance companies turned an almost sacred trust into a business motivated by a desire for profits that has veered many times into criminal activity involving for-profit hospital corporations and drug manufacturers alike. And, yes, she names the names of some of the perps!
Wang writes about key events in her professional life that show the medical profession's decline, including the declining state of hospitals and clinics, the advent of managed care, and the rise of profits at the expense of patient care.
She describes in detail the experiences of some of her patients in a career that included medical practice in Auburn, Alabama, San Francisco, where she was employed by Kaiser Permanente, the original managed-care provider, and finally in Albuquerque, New Mexico, where Wang lives with her architect husband Christopher Calott and their daughter Zoe.
Among her many patients is Selena, whose grief over her mother's death and lack of family support make it difficult for her to take the medicine that keeps her body from rejecting her new liver. And Leonard, a schizophrenic with no health insurance who develops peritonitis and falls into a coma for three months. There's Hank, who considers himself to be a woman, living with more than 100 cats whom he considers to be family.
Wang is involved personally with medical practitioners when she has back and neck problems from a car accident -- and when rambunctious Zoe cuts herself and is taken to the E.R. She describes how each new story brings additional compromises as the medical landscape shifts under Wang's feet. We see the humor in a daughter-parent relationship when Wang arranges the proper medical care for her octogenerian father, insisting on her mother and father abandoning a conveniently located doctor who provides free parking for one who's serious about her dad's medical issues.
Wang struggles with depression and exhaustion, witnesses the loss of top doctors who leave in frustration, and attempts to find a balance between work and home as it becomes ever clearer that she cannot untangle the uncertain future of her patients from her own.
The sea-change in her specialty has deadly consquences, as Albuquerque discovers when a man who has been denied psychiatric treatment goes on a deadly shooting spree. Wang even brings in the April 2007 Virginia Tech mass killing tragedy that sprang from a similar lack of psychiatric treatment for a troubled student.
Part personal story and part cri de coeur, "The Kitchen Shrink" is an unflinchingly honest, passionate, and humane inside look at the unsettling realities of free-market medicine in today's America. It should be read by everyone, especially those who mistakenly believe that the recently passed "health-care reform" legislation will actually change anything in our nation's dysfunctional health-care system. As long as the medical-industrial complex has a say in the matter, don't count on that happening!
About the Author: Dora Calott Wang, M.D., is a psychiatrist, a medical school professor, and the recipient of a prestigious Lannan Foundation Writer's Residency. She was born to Chinese immigrant parents in Sao Paulo, Brazil, and moved to the United States as a child.
She is a graduate of the Yale School of Medicine, the UCLA Neuropsychiatric Institute, and the University of California, Berkeley M.A. program in English literature. She has been a frequent participant at the Squaw Valley Community of Writers. "The Kitchen Shrink" is her first book. Her website is: www.doracalottwang.com.
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BOOK REVIEW: 'The Kitchen Shrink'
How Doctors Became 'Health Care Providers' in the Brave New World of the Bottom-Line-Driven Medical-Industrial Complex
Reviewed By David M. Kinchen
If you've long envied your family doctor's social position and income level, reading Dora Calott Wang's "The Kitchen Shrink: A Psychiatrist's Reflections on Healing in a Changing World" (Riverhead Books, a member of the Penguin Group (USA), 368 pages, $25.95) is a sure-fire way to change your perspective from envy to sympathizing with him or her.
From her perspective of attending medical school at Yale in the late 1980s (she graduated in 1990), Wang, a psychiatrist and medical school professor in New Mexico, recounts the seismic shift that has occurred In the past two decades in our nation's hospitals and doctor's offices.
Once considered a sacred, cherished vocation, the medical profession has devolved into a business fiercely driven by a desire for profits -- and the proper completion of mountains of insurance company paperwork.
Even psychiatry -- once the mainstay of the human interaction between doctor and patient -- has fallen victim to rising costs and dictates by insurance companies, Wang writes. One doctor colleague described the change to her as the metamorphosis from "Marcus Welby to Meineke," referring to the beloved fictional family doctor in the TV series, Marcus Welby, M.D. to the car repair chain specializing in mufflers and brake jobs and other after-market auto repairs.
To tell how has medicine strayed so far from its roots, Wang explores what has happened since the 1980s, when for-profit corporations and private health insurance companies turned an almost sacred trust into a business motivated by a desire for profits that has veered many times into criminal activity involving for-profit hospital corporations and drug manufacturers alike. And, yes, she names the names of some of the perps!
Wang writes about key events in her professional life that show the medical profession's decline, including the declining state of hospitals and clinics, the advent of managed care, and the rise of profits at the expense of patient care.
She describes in detail the experiences of some of her patients in a career that included medical practice in Auburn, Alabama, San Francisco, where she was employed by Kaiser Permanente, the original managed-care provider, and finally in Albuquerque, New Mexico, where Wang lives with her architect husband Christopher Calott and their daughter Zoe.
Among her many patients is Selena, whose grief over her mother's death and lack of family support make it difficult for her to take the medicine that keeps her body from rejecting her new liver. And Leonard, a schizophrenic with no health insurance who develops peritonitis and falls into a coma for three months. There's Hank, who considers himself to be a woman, living with more than 100 cats whom he considers to be family.
Wang is involved personally with medical practitioners when she has back and neck problems from a car accident -- and when rambunctious Zoe cuts herself and is taken to the E.R. She describes how each new story brings additional compromises as the medical landscape shifts under Wang's feet. We see the humor in a daughter-parent relationship when Wang arranges the proper medical care for her octogenerian father, insisting on her mother and father abandoning a conveniently located doctor who provides free parking for one who's serious about her dad's medical issues.
Wang struggles with depression and exhaustion, witnesses the loss of top doctors who leave in frustration, and attempts to find a balance between work and home as it becomes ever clearer that she cannot untangle the uncertain future of her patients from her own.
The sea-change in her specialty has deadly consquences, as Albuquerque discovers when a man who has been denied psychiatric treatment goes on a deadly shooting spree. Wang even brings in the April 2007 Virginia Tech mass killing tragedy that sprang from a similar lack of psychiatric treatment for a troubled student.
Part personal story and part cri de coeur, "The Kitchen Shrink" is an unflinchingly honest, passionate, and humane inside look at the unsettling realities of free-market medicine in today's America. It should be read by everyone, especially those who mistakenly believe that the recently passed "health-care reform" legislation will actually change anything in our nation's dysfunctional health-care system. As long as the medical-industrial complex has a say in the matter, don't count on that happening!
About the Author: Dora Calott Wang, M.D., is a psychiatrist, a medical school professor, and the recipient of a prestigious Lannan Foundation Writer's Residency. She was born to Chinese immigrant parents in Sao Paulo, Brazil, and moved to the United States as a child.
She is a graduate of the Yale School of Medicine, the UCLA Neuropsychiatric Institute, and the University of California, Berkeley M.A. program in English literature. She has been a frequent participant at the Squaw Valley Community of Writers. "The Kitchen Shrink" is her first book. Her website is: www.doracalottwang.com.
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