Monday, September 10, 2012

"Monday Mornings": medical novel by CNN's Sanjay Gupta

Author: Sanjay Gupta, MD (Chief Medical Correspondent, CNN; a practicing neurosurgeon in Atlanta)

Title: “Monday Mornings: A Novel"

Publication: Grand Central Publishing, 2012, ISBN 978-0-446-58385-5, hardcover, 290 pages, 48 chapters

Amazon link

Medical schools tell incoming students that medicine (most of all, surgery) can become a unifocal existence for young doctors for years. 

So it’s great to see that Gupta, by his early 40s, has branched out from surgery, which he says he still practices, to medical journalism for CNN (sometimes talking about “jungle medicine” as in Haiti) to authoring fiction, which is tougher to do well than non-fiction, I think.  Gupta has always worked as an enthusiastic reporter for consumers, and is probably not quite so moralistic as Mehmet Oz, Oprah Winfrey’s find in medical journalism.

There isn’t a lot of plotting here, not the “beginning, middle and end” that English professors teach, and not quite the sensationalism of say Robin Cook (since his 1970’s novel “Coma” was recently a repeat cable miniseries – TV blog, Sept. 5).  Nevertheless, Gupta manages to get his doctors into trouble. One young female resident is fired after a poor surgical result results in aggressive litigation from the patient (and that sequence is quite well-written).   Then the doctor who fired her gets into serious trouble himself.  OK, that’s plotting.

Gupta does provide a lot of medical warnings along the way.  A sore hip that doesn’t improve might spontaneously fracture from metastatic tumor.  Persistent flatulence might be a sign of advanced colon cancer. An abscessed tooth could lead to a brain infection.  (Dentists love that warning;  I just came back from a visit about my own need for extractions and implants, with no “clear choice”.)  One of the most startling episodes involves an Asian surgeon who id diagnosed with an aggressive brain tumor after headaches, and undergoes surgery.  He then faces aggressive (if oral) chemotherapy, and wonders if his kids and wife will accept him after he becomes as hairless as a “newborn baby” (even though the surgery itself requires little scalp shaving, and the radiation is precise and uneventful).   From the chemo (more than from the tumor itself) he also faces loss of cognitive ability required of his profession and even needed interpersonally. The ability of people to sustain relationships where they can give and receive love after a medical catastrophe has always been a big issue with Dr. Oz (a heart surgeon), who (much more so than Gupta) says he doesn’t like to treat seriously ill patients who are socially isolated.  And, yes, near the end of the book, one of the major characters drops dead of a heart attack after exertion; Gupta describes what his last conscious moments are like in excruciating detail.

The title of the book (reminding me of a 1960s song) comes from the very early Monday morning sessions at hospitals where doctors review their mistakes.  (One mistake can deep-six your career.)  It must be pretty early. In 1999, my other mother had her coronary bypass surgery start at 7 AM on a Monday; she was aroused and showered at 5:30 AM.

I would have been interested in more details about nosocmial infection control, including issues ranging from MRSA and aggressive bacteria to the mechanics of scrubbing for surgery (and hand-washing all the time), which I think could become even more fastidious in the future.

The novel is set in Michigan. I like the line about counting states to Vermont. 

Readers might enjoy this MSN report of a "cell phone electrocardiogram" invented by teenager Catherine Wong.  I don't know how you would apply it to the body to get the 12 leads.  The link is here. 

Gupta is interviewed by “The New Doctors”:

I recall reading a non-fiction book “Five Patients”, by Michael Crichton, (published by Knopf in 1970) – based on his experiences treating patients at Massachusetts General.  Even then, Crichton explained how easily medical costs can get out of control.

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