Guarded Prognosis

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From James Herriott to Oliver Sacks, from Sherwin Nuland to Lewis Thomas, doctors have taught us about illness and health by telling us stories about medicine. In Guarded Prognosis, Michael Lockshin -- a noted physician with broad experience in treating long-term, incurable patients -- has written an unforgettable testament to very sick people and the doctors who care for them. His stories also show us exactly how our health-care system could be more efficient, less costly, and more humane.In Lockshin's narratives, patients are at risk not only from fatal diseases but from health-care policies. Caught in heartrending, sometimes horrifying, sometimes hilarious situations, they and their doctors must form long-term partnerships to resolve tragic human dilemmas -- far from the cut-and-dried formulas used by insurance agents or HMO accountants. Various factors conflict: the patient's needs versus the hospital's resources, the technical means versus the money to pay for them, the doctor's skill versus the patient's expectations. And when individual and broad social values clash, who should determine the course of action?Lockshin believes that American medicine could be the best in the world and that present policies are endangering our health. He fears a future in which "human kindness is for sale". But, as his book makes eloquently clear, "it need not be this way".

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