Second Opinions: 8 Clinical Dramas Intuition Decision Making Front Lines Medn

by Jerome Groopman

Book Overview

A unique insider's view of today's complex and often contentious world of medicine Anxious about the prognosis, lost in a blur of technical jargon, and fatigued from worry or pain, people who are ill are easily overwhelmed by treatment choices. Told through eight gripping clinical dramas, Second Opinions reveals the forces at play in making critical medical decisions. Dr. Jerome Groopman illuminates the world of medicine where knowledge is imperfect,...

• Format: Paperback
• Language: English
• ISBN: 0140298622
• ISBN13: 9780140298628
• Release Date: March 2001
• Publisher: Penguin Books
• Length: 256 Pages
• Weight: 0.40 lbs.
• Dimensions: 0.5" x 5.1" x 7.8"
• Age Range: 18 years and up
• Grade Range: Postsecondary and higher

Customer Reviews

Whom to trust . . .

This thought provoking and often disturbing book should come with a warning. It will make you question the judgment of your doctor if you or someone you know is ever faced with diagnosis and treatment of a life-threatening illness. Medical science and technology continue to make great strides forward, but following each of the case histories related by Dr. Groopman in this book, you realize how tenuous is the judgment of individual doctors who must advise patients and lead them to decisions affecting their health. Reason, in the delivery of health care, is balanced against intuition, and intuition can take many forms, including doubt, egoism, professional jealousy, impatience, resistance, and anger, all of which appear at one time or another in the stories Groopman tells. Or, as one of his patients says, intuition is reason operating below the level of awareness. Making life-saving decisions is, we realize, a matter of expert guess work, and if there's a lesson here it's that the best guess work comes from intimate knowledge of the patient, which the cost-saving constraints of managed health care often prohibit. I recommend this book for anyone wondering how much trust to put in the medical profession. A well trained and experienced doctor can still make the difference between life and death, but Groopman shows how patients need to play an active role in decisions about their own health, and that often involves seeking a second opinion and making a choice between incompatible courses of action.

Dr. Gideon, I presume

I've enjoyed Dr. Groopman's essays in the New Yorker and so was happy to learn about this book, which I found to be a highly compelling and instructive read. Groopman is no Tolstoy, but he writes with precision, clarity, compassion and great understanding about people struggling for their lives, usually against cancer, and the peculiarly intimate role a good doctor plays in that struggle. Of course, one of the unifying threads of the book is also the potentially life-threatening role a bad doctor can play in that struggle -- thus the need for second opinions and the difficulty many patients have in demanding them. Groopman is usually the good doctor here, saving his patients from the misguided diagnoses of others. But he doesn't entirely spare himself his sins. He forcefully highlights the way a doctor's inexperience, fatigue, ego, or momentary inattentiveness can have potentially fatal consequences. His deep experience as both clinician and researcher give the stories real authority.What really struck me, though, was how such a collection of case studies is like a fictional short story collection only more satisfying for the fact that these are classic beginning, middle and end stories that are in fact true. As important, Groopman begins with one of his own family's stories, which effectively draws you in to his own life. That's important because this is ultimately a portrait of the kind of super smart and caring physician we'd all like to have when facing a crisis. Gideon's Crossing owes a lot to this book, having already built a couple of episodes around case studies found here. The ultimate compliment, I guess, is that Groopman has created a vision powerful enough to deserve Andre Braugher.

Beautifully written

I'm somewhat amazed by the comments of the other reader reviewers (though less so by the self-identified physician, who seems to me to be suffering from sour grapes more than anything else in referring to Groopman's "ivory tower"). I found this books to be gripping and thought-provoking--as moving in its way as Tolstoy's "Death of Ivan Ilyich" or Chekhov's "Ward Six," two other classics of doctor-patient relationships). Groopman writes with passion, precision, and elegance. Only incidental to me was his powerful rhetorical point--urging all of us to be as proactive as he in taking active, questioning roles in our own health. Perhaps the physician-reviewer is put off by the fact that Groopman does not seem to subscribe to the "omerta" of too many in the medical profession, but places the patient first, even though he is a committed researcher. I also recommend Groopman's earlier book, "The Measure of Our Days" and the edited volume, "AIDS Doctors: An Oral History," which gives voice to Groopman and many other brave warriors of the hospitals.

The Art and Science of Medicine

This is an outstanding book. From Hipocrates to Avicena, from Maimonides to William Osler and so on to our days, leading physicians have wrote the same message about the core of medical practice and profession, using different words. This book is an actualized version of the same message. Physicians have the responsability to know and keep updated with the huge amount of scientific facts they should manage to treat patients properly. They should become real experts so on providing patients with the best possible quality of medical care. Nevertheless, a physician should never forget this is only a part of what medical practice should be. They treat individual persons, each of them with their own feelings, fears and expectations, with realities, relatives and responsabilities, with opinions, intuitons and hopes. A physician should give patients time, effort and dedication and should be there, even when the time has come to sweat, cry and die. Dr. Groopman give us a remembrance of this concept using eight vivid examples of his medical and personal life. In Second Opinions, Dr. Groopman give us also a voice of alert on how insurance companies and HMO's are dramatically changing the practice of medicine, and their influence on the deshumanization of the doctor-patient relationship. He writes about the need of doctors to remain being healers, taking care both for bodies and souls and he writes about how healers will thanks G-d for allowing them to do what they do every day. This is what this book is all about. Dr. Groopman has outstandingly succeded to show us what the practice of the art and science of medicine should be.

A thought provoking must read work

Dr. Jerome Groopman relates eight true-life short stories centering on medical care during a health crisis. He looks closely at the decision point when a patient encouraged by his doctor chooses the path he or she wants to take. Often ignored is the possibility of doing nothing, a legitimate decision in which the status quo might prove statistically to be the better response than the medical solution. Dr. Groopman also examines the aftermath of an improper diagnosis.The stories are well written, interesting, and though not all end happily, they do provide the reader with enough information to enable the audience to take control of the medical decision process. Any "solution including the status quo involves risk, but Dr. Groopman explains what factors the patient and his or her family should consider in deciding what they think is the right course for them. SECOND OPINIONS is a must read work consisting of simple, heart wrenching true-life stories that offer much insight into the emotional process used in making medical decisions. With this primer and his previous book (see THE MEASURE OF OUR DAYS), Dr. Groopman proves he is one of the leading writer on modern day health care.Harriet Klausner