Practice of medicine has changed from administering placebos and homilies to drugs which can have considerable consequences, both positive and negative. The incidence of iatrogenic illnesses is much more than earlier. Title of the book however is misleading. The book is a compilation of 57 short essays, each of which can be finished while waiting for red light to turn green at traffic signals. A jewish physicians and an internist, who, goes as Oscar London is a popular writer known for his wit and humour. He is an old time physician, at a time when clinical medicine was still alive and tele-medicine was yet to take shape. All the essays are about ‘to do, list for a physician to be successful and happy. This book was first published twenty years back. This is a new edition with a new introduction. The first one was published in 1987. Each essay starts with a rule which is further enunciated in brief essays. On reading the new introduction I thought essays will be critique of the present healthcare system. Sample this, “The past decade has brought about a not so bloodless revolution in American medicine known as managed care. The for- profit, publicly traded HMOS have wrested control of your health form Doctors of medicine and slipped into the hands of Masters of Business Administration. “ ………… Now it is the enhancement of HMO; profits at the lowest expenditure four well-being that they can get away with”. The book is full of anecdotes and advices. It starts with a suggestion for having a good looking office to grooming your secretary. Practicing medicine is high risk and low yield profession. One needs to be a stoic, which Dr. London calls as being Jewish. “Who else but a jew has the innate capacity for suffering that can get you through a working day in the medical office”. The present generation may find such a statement politically incorrect. Yet it seems to work in the context of the essay. Similarly, his exhortation to tell an addict to take a walk-sounds a tad insensitive. Yet, treating an addict for an internist can be exhausting. They are best referred to appropriate specialists. Dr. London finds the junkies as Doctor-destroyers. His way of dealing with them is to activate trapdoor beneath the patients’ chair. Hug a patient, hire a lawyer is another truism. ‘Doctor of modern medicine is no Shaman. A hug a pat may be reassuring for an anxious patient in the pits. It is a strict No’. As. Dr. London puts it eloquently. ‘If a malpractice lawyer should ever find out that I am a hugging doctor, he will be so happy he will want to hug me. My favourite anecdote is when he goes on a house visit to see a terminally ill cellist. Here was a cellist lying mute in pain while his wife proudly displayed deeply polished gorgeous cells next to him. Dr. London after a brief clinical examination sends his wife out of the room. While she was out of the room he carried the cells out of his room. Cellist finally had a big smile on his fare, thanked the doctor before passing away in peace. He never wanted to hurt his wife. Telemedicine with all those apps and technology can never do what Dr. London did to the dying cellist. Essays deal with topics related to stress, malpractice, egos, yo-yo practice, pressure of having appointment book full are all there. It is culturally embedded in America. This small book which has sold more than 2 lakhs of copies make an interesting read. Infact, it talks of the vanishing breed that is internists in a wittiest manner one can come across in the era of snowflakes.
