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Title: A Taste of My Own Medicine: When the Doctor Is the Patient
Author: Dr. Edward E. Rosenbaum
Genre: Memoir

At age 70, Ed Rosenbaum has a long, proud career in medicine to look back on. He was able to make it into medical school at a time when those schools openly limited the number of Jewish students. In World War Two, he served in a mobile surgical unit that participated in the invasions of Africa, Sicily, and Normandy. After going into private practice, he became part of the volunteer faculty of what was later Oregon Health & Science University, heading its rheumatology division for thirty years. Throughout his career, he has maintained the utmost standard of empathy and care for his patients, or so he believes.

A bout of persistent hoarseness is the beginning of a saga that will show him he has a lot left to learn.

This book is best known for being the basis of the movie The Doctor, but it is the typical Hollywood usage of "based on" which means "has almost nothing to do with". Rosenbaum was a rheumatologist, not a surgeon, practicing in Portland, Oregon, not San Francisco, and all characters, symptoms, and even the results of treatment in the movie are entirely fictional.

The experience in the book is a series of small realizations, which begin even before the eventual diagnosis of throat cancer. First Rosenbaum delays seeing a doctor for his own problem, then dithers about getting a second opinion, which he recognizes as behavior he's seen in his own patients and previously never understood. Then, after drug treatments produce no result, he is sent to a speech clinic, where he has his first taste of the trouble with the power imbalance between doctor and patient:

"Here, feel how tight this muscle is in your neck." And [the speech therapist] placed my hand on a neck muscle.

"You're right," I said. I really didn't notice any difference in the muscles, but I didn't want to hurt her feelings. That was dumb, but it is a common reaction of patients: don't upset the doctor or he or she won't like you and won't take good care of you. I was startled by that insight. Had I known that before? Would it have changed my relationship with my patients? I wasn't sure.

Ultimately it turns out to be cancer, and Rosenbaum is sent for radiation therapy. The second and longest part of the book is a day-by-day chronicle of every radiotherapy session (and the agonizing weekend days in between). Interspersed with the session descriptions are his reflections and anecdotes about his childhood in Omaha and his past patients-- sometimes to explain how they shaped him, sometimes to look back and realize now that he could have done much better.

In addition to discovering the experience of the patient, Rosenbaum lets the reader in on the world of the doctor. Rivalries and quirks of the medical profession sometimes shape patient care in ways unrelated to the illness. And doctors become hypochondriacs, he says, because they know about all the worst possibilities. Part of what delays him at first is knowing that he might have cancer. Later, he has enormous anxiety about the radiotherapy because he knows the history of X-rays first being a fabulous new tool and then being discovered to cause cancer. He also knows the percentages about whether the treatment will work and all the errors that could be made along the way. But then on the weekends, he is consumed with fear about the cancer regrowing during the break in treatments and having a chance to metastasize.

It is not much of a spoiler to say that the author of this first-person narrative survives the experience. Rosenbaum's cancer is cured, and eventually he is back at work at his practice. But he has grown frustrated with the healthcare system, partly for longstanding reasons but partly also because his experience as a cancer patient has shown him a lot of way things could be improved. And even when he tries to improve himself, he finds his is holding himself to a standard he cannot achieve.

Rosenbaum would soon retire from his medical career and spend much of his remaining twenty-plus years as a writer and speaker, advocating for changes in the practice of medicine. This book is more than enough to explain why. For a look at the forces still shaping healthcare today, or just a positive story of a successful treatment and lessons learned, highly recommended.