No-punches-pulled scrutiny of the flawed system that produces our nation's doctors. As the husband of an overstressed, overworked, and overtired resident in pediatrics, Duncan (Hernando de Sota, 1995, etc.) saw firsthand the impact our present residency system had on one doctor. Here he looks at the bigger picture: how it affects not just doctors but patients and society in general. For four years he followed hospital residents on call, keeping records of their actions, attitudes, hours, supervision, and patient outcomes; he also interviewed dozens of doctors, medical educators, patients, and nurses. The result is an anecdote-filled account of what's wrong with the system and how it came to be the way it is. Where statistics are available, he cites them, but one of the flaws of the present system is its failure to collect hard data on its own level of safety or effectiveness. Where reforms have been made— as in New York State, where the famous Libby Zion case led to legislation restricting the number of hours residents can work— he describes them, but these are few and far between. Duncan is persuasive in his argument that a system that once worked fairly well when medical knowledge was limited now drops inexperienced and minimally supervised young physicians into complex, difficult situations, that it overworks and underpays them, and that it too often fails to protect patients from the hazards of treatment by sleep-deprived and undersupervised residents. Concluding with a warning that the very survival of our nation's teaching hospitals is being threatened as managed care reshapes the medical marketplace, Duncan offers no solutions to that problem but has some practical suggestions for revamping residency programs. An up-close and sobering picture of medical education's imperfections. (Author tour)
Pub Date: June 1, 1996
ISBN: 0-684-19709-X
Page Count: 304
Publisher: Scribner
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: April 15, 1996
This is not the Nutcracker sweet, as passed on by Tchaikovsky and Marius Petipa. No, this is the original Hoffmann tale of 1816, in which the froth of Christmas revelry occasionally parts to let the dark underside of childhood fantasies and fears peek through. The boundaries between dream and reality fade, just as Godfather Drosselmeier, the Nutcracker's creator, is seen as alternately sinister and jolly. And Italian artist Roberto Innocenti gives an errily realistic air to Marie's dreams, in richly detailed illustrations touched by a mysterious light. A beautiful version of this classic tale, which will captivate adults and children alike. (Nutcracker; $35.00; Oct. 28, 1996; 136 pp.; 0-15-100227-4)
Pub Date: Oct. 28, 1996
ISBN: 0-15-100227-4
Page Count: 136
Publisher: Harcourt
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Aug. 15, 1996
BOOK REVIEW
BOOK REVIEW
An extravaganza in Bemelmans' inimitable vein, but written almost dead pan, with sly, amusing, sometimes biting undertones, breaking through. For Bemelmans was "the man who came to cocktails". And his hostess was Lady Mendl (Elsie de Wolfe), arbiter of American decorating taste over a generation. Lady Mendl was an incredible person,- self-made in proper American tradition on the one hand, for she had been haunted by the poverty of her childhood, and the years of struggle up from its ugliness,- until she became synonymous with the exotic, exquisite, worshipper at beauty's whrine. Bemelmans draws a portrait in extremes, through apt descriptions, through hilarious anecdote, through surprisingly sympathetic and understanding bits of appreciation. The scene shifts from Hollywood to the home she loved the best in Versailles. One meets in passing a vast roster of famous figures of the international and artistic set. And always one feels Bemelmans, slightly offstage, observing, recording, commenting, illustrated.
Pub Date: Feb. 23, 1955
ISBN: 0670717797
Page Count: -
Publisher: Viking
Review Posted Online: Oct. 25, 2011
Kirkus Reviews Issue: Feb. 1, 1955
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