“How We Do Harm: A Doctor Breaks Ranks About Being Sick in America,” Otis Webb Brawley, M.D., with Paul Goldberg. Don’t read this one at night because if, like me, you tend to bring the last-read-of-the-day with you into sleep, this book will bring you nightmares. Brawley (“Call me Otis”), an oncologist, is chief medical and scientific officer of the American Cancer Society. He has worked longtime in Grady Memorial Hospital in Atlanta, the largest public hospital in the U.S.
What propels you through his stories of real people in America are his anger, his humor, and his passion for giving every person the best possible care. I took away three things Brawley knows will improve those possibilities: 1. Insist that everyone in the position of giving medical care makes decisions based on the available science -- not on tradition, what-my-mentor-said, cost, or the best and newest drug pharmaceutical companies are pushing this week; 2. Make certain that methods and products of care selected will do the most good and the least harm – which sometimes means refusing to provide treatment that a patient wants but which the provider knows is inappropriate, useless, or even dangerous; 3. Eradicate the U.S. bifurcated healthcare system – one tier for the insured, another for the uninsured/or under-insured.
Brawley’s first story is of a middle-aged woman in Atlanta who, because she did not have access to screening, insurance, or good medical counsel, showed up in the Grady ER with her breast in a bag; it had fallen off her chest as her breast cancer advanced. See # 3 above.
I’m encouraged by the recent news of physicians who have publicized their concerns about unnecessary (and, sometimes harmful) medical tests; this is something Brawley would find hopeful.
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