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Multimedia: The Aesculapian

1999; BMJ; Volume: 318; Issue: 7195 Linguagem: Inglês

0959-8138

David Woods,

Empathy and Medical Education

Dan Cloud Frederic C Beil, £18.44, pp 359 ISBN 0 913720 98 4 ——————— Rating: ★★ The American Medical Association (AMA) has a propensity for what might be dubbed autopedicide—shooting itself in the foot. It recently had to extricate itself, at a cost of almost $10m, from an ill conceived promotional partnership with an electrical products company and then precipitately fired its long time journal editor for what seemed to be, at worst, a minor lapse of editorial judgment. But none of that compares with the antics of the fictional AMA portrayed in this first novel by Dan Cloud, a former president of the association. Here, a power hungry, paranoid chief executive officer is accused of murder and of stifling information about smoking hazards in return for the support of the tobacco industry and its political champions in staving off the dreaded “socialized medicine.” The chief financial officer is killed by a hit man, board members are on the take, and blackmail is rampant. Before the final denouement, there are multiple suicides, murders, and plot twists involving a Japanese crime syndicate. The book’s hero, Joe Hawkins, is a squeaky clean, all-American former marine who, like the author, is an Arizona surgeon. He steps into this mayhem when he is invited to rebut the US president’s public pronouncement that American doctors are “fat cats,” squeezing the healthcare system to line their own pockets. Shortly afterwards, he is coopted onto the AMA board and appointed president elect. Physicians might enjoy the “in” nature of the story, the cast of recognisable doctor types, and the descriptions of medical procedures and politics; lay readers might have to run to their dictionaries for “kyphotic,” “lucent pleura,” and “pedicles of C-2.” The dialogue in the first two thirds of the book is stilted, and some of the narrative passages would be strong contenders for the Bulmer-Lytton Award (named for Edward Robert Bulmer-Lytton, whose writing was characterised by affectation and prolixity). For example: “[He] crawled into the cockpit of his vintage Jag roadster and turned the key. The big V-12 ... quickly settled into a mellow purr [and] he gunned the impatient cat onto the narrow road.” But somehow the pace picks up and the writing improves—almost as if Dr Cloud had found himself an editor midway through. There is some excellent travel writing as widower Hawkins makes a round the world trip with his girlfriend, who also happens to be the AMA’s public relations whizz, and the description of a bullfight in Madrid is first class. Quibblers may find irritants in the misspellings of Tanqueray gin, the misuse of “hung” for “hanged,” the politically incorrect use of “Oriental” and “girl,” and the hero’s patronising translation of a French menu item when the author earlier refers to a “chaise lounge.” And the squeamish—though surely not BMJ readers, who must be used to it—may faint at the bucketfuls of blood that cascade through the story. But, overall, The Aesculapian is a good light read, a commendable first effort at fiction, and a likely candidate for a screen adaptation. It’s a shame that the real AMA can’t hire the peerless Dr Hawkins to help set its house in order.