An expert bottoms-up examination of our diseased health care system.
A fierce denunciation of American medicine in which physicians are the heroes—mostly.
Doctors Dean and Talbot, founders of a nonprofit called The Moral Injury of Healthcare, explain that “moral injury” occurs when we experience something that transgresses our beliefs. For doctors, that means the oath to put patients’ needs first. It’s no secret that doctors must now comply with powerful stakeholders in the system, including insurers, hospital administrators, and oppressive regulators, as well as lugubrious electronic medical records. Stories of health care workers suffering “burnout” fill the media, but most blame overwork aggravated by the pandemic. Not so, maintain the authors. The culprit is moral injury, the result of applying aggressive, modern business methods to medical practice. In the introduction, the authors describe a dynamic entrepreneur whose massive hospital earned huge profits by minimizing staff and maximizing testing and services whether necessary or not, and perhaps breaking the law. Finally sent away with a golden parachute, he was replaced by another entrepreneur who promised “significant value for our shareholders.” As the authors demonstrate consistently, hospital executives see themselves as responsible to stockholders, not to physicians or patients. This includes many nonprofits, whose administrators give profits priority and benefit from them. Dean and Talbot profile the work of physicians forced to endure moral injury who then try, sometimes successfully, to find a practice more to their liking. In the final chapter, they deliver a passionate plea for more sensible and better enforced government regulation and more generous reimbursement from public and private insurance. Neither seems on the horizon. Sadly, heartless, assembly-line health care is more profitable than the good kind and, despite lurid stories, only slightly less effective. Doctors and patients hate it, but in a nation that worships the free market, profit is evidence of a well-run institution. Pair this powerful book with an equally painful yet important view from the top: Brian Alexander’s The Hospital.
An expert bottoms-up examination of our diseased health care system.Pub Date: April 4, 2023
ISBN: 9781586423544
Page Count: 306
Publisher: Steerforth
Review Posted Online: Jan. 11, 2023
Kirkus Reviews Issue: Feb. 1, 2023
Alternately admiring and critical, unvarnished, and a closely detailed account of a troubled innovator.
A warts-and-all portrait of the famed techno-entrepreneur—and the warts are nearly beyond counting.
To call Elon Musk (b. 1971) “mercurial” is to undervalue the term; to call him a genius is incorrect. Instead, Musk has a gift for leveraging the genius of others in order to make things work. When they don’t, writes eminent biographer Isaacson, it’s because the notoriously headstrong Musk is so sure of himself that he charges ahead against the advice of others: “He does not like to share power.” In this sharp-edged biography, the author likens Musk to an earlier biographical subject, Steve Jobs. Given Musk’s recent political turn, born of the me-first libertarianism of the very rich, however, Henry Ford also comes to mind. What emerges clearly is that Musk, who may or may not have Asperger’s syndrome (“Empathy did not come naturally”), has nurtured several obsessions for years, apart from a passion for the letter X as both a brand and personal name. He firmly believes that “all requirements should be treated as recommendations”; that it is his destiny to make humankind a multi-planetary civilization through innovations in space travel; that government is generally an impediment and that “the thought police are gaining power”; and that “a maniacal sense of urgency” should guide his businesses. That need for speed has led to undeniable successes in beating schedules and competitors, but it has also wrought disaster: One of the most telling anecdotes in the book concerns Musk’s “demon mode” order to relocate thousands of Twitter servers from Sacramento to Portland at breakneck speed, which trashed big parts of the system for months. To judge by Isaacson’s account, that may have been by design, for Musk’s idea of creative destruction seems to mean mostly chaos.
Alternately admiring and critical, unvarnished, and a closely detailed account of a troubled innovator.Pub Date: Sept. 12, 2023
ISBN: 9781982181284
Page Count: 688
Publisher: Simon & Schuster
Review Posted Online: Sept. 12, 2023
Kirkus Reviews Issue: Oct. 15, 2023
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The lessons to draw are obvious: Smoke more dope, eat less meat. Like-minded readers will dig it.
The chef, rapper, and TV host serves up a blustery memoir with lashings of self-help.
“I’ve always had a sick confidence,” writes Bronson, ne Ariyan Arslani. The confidence, he adds, comes from numerous sources: being a New Yorker, and more specifically a New Yorker from Queens; being “short and fucking husky” and still game for a standoff on the basketball court; having strength, stamina, and seemingly no fear. All these things serve him well in the rough-and-tumble youth he describes, all stickball and steroids. Yet another confidence-builder: In the big city, you’ve got to sink or swim. “No one is just accepted—you have to fucking show that you’re able to roll,” he writes. In a narrative steeped in language that would make Lenny Bruce blush, Bronson recounts his sentimental education, schooled by immigrant Italian and Albanian family members and the mean streets, building habits good and bad. The virtue of those habits will depend on your take on modern mores. Bronson writes, for example, of “getting my dick pierced” down in the West Village, then grabbing a pizza and smoking weed. “I always smoke weed freely, always have and always will,” he writes. “I’ll just light a blunt anywhere.” Though he’s gone through the classic experiences of the latter-day stoner, flunking out and getting arrested numerous times, Bronson is a hard charger who’s not afraid to face nearly any challenge—especially, given his physique and genes, the necessity of losing weight: “If you’re husky, you’re always dieting in your mind,” he writes. Though vulgar and boastful, Bronson serves up a model that has plenty of good points, including his growing interest in nature, creativity, and the desire to “leave a legacy for everybody.”
The lessons to draw are obvious: Smoke more dope, eat less meat. Like-minded readers will dig it.Pub Date: April 20, 2021
ISBN: 978-1-4197-4478-5
Page Count: 184
Publisher: Abrams
Review Posted Online: May 5, 2021
Kirkus Reviews Issue: June 1, 2021
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