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Requiem for Doctor Edward Browne by Richard Dean Smith iUniverse
book review by Deborah Straw
"A sense of security in his [Dr. Browne's] pursuits, confidence he was part of something greater than himself, a sense of history and beauty of his profession that had been his salvation was melting away."
Requiem for Doctor Edward Browne is appalling; it's heartbreaking. That is not to say its a bad book; it's quite enthralling. It is appalling and heartbreaking because it's about our current health care system, told from a doctor's perspective. Although the book is a novel, the author is a doctor, and this gives the book the ring of truth.
For the first half of the last century, doctors often worked with patients from birth to death. They made home visits. They sent cards and received presents. They got to how whom they helped. Welcome, managed health care, where doctors don't get to pick their patients, or vice versa, caseloads are often overwhelming, the paperwork load is staggering and patients sometimes have to wait, unless it's an emergency, for months to see a doctor, whoever is assigned to their case.
Dr. Edward Browne is an old-time doctor modeled on those kinds of physicians. Managed care becomes popular among most practices in his small town. Our hero has one older doctor friend, Dr. Kennes, who stands by him throughout all their attempts to stay independent. Reflects Kennes, "Blind faith in the wisdom of hospital administrators, the government and the insurance industry is what they want. When the blind lead the blind, both fall into chuck-holes."
Not only does the change to managed care affect Dr. Browne's practice, it affects his marriage. He is not willing to join a managed care office, his caseload keeps shrinking, he is unhappy and constantly worried. When his wife is offered work in her field, museum curating, out of town, she takes it. They stay in touch, but he is extremely lonely. Managed care has cost Browne almost everything.
We hear so much about the patient's side of the health care situation in the U.S., its good to hear from the other important side of the equation. In the end, our hero is a hero, and some good comes of his attempts to preserve pieces of the profession he loves. The novel is engaging but long at 566 pages. The characters are quite well developed, if not a bit stereotypical. The author shows immense knowledge of the painting and museums fields as well.