“You have to read this book,” my friend Rebecca urged, handing me back an advanced review copy I had loaned her. “Everyone needs to read this book. We need to get this book in front of every member of Congress. This is exactly what happened to me. This is why I left medicine.”
Even though I’m an avid reader, I have stacks and stacks of unread review copies, sent to me by authors or by their nice PR folks. It was one of these books, Maggie Kozel’s The Color of Atmosphere: One Doctor’s Journey In and Out of Medicine that I loaned to Rebecca. After her wholehearted endorsement, I put Kozel’s book on the top of the stack. I read it in two days.
In the book, Kozel describes growing up one of four children of often sloppy drunk and shouting parents. She escapes the depressed town of Point Lookout, New York to become a pediatrician. She meets her husband, Randy, in medical school (there’s nothing like dissecting a cadaver to spark a romance). Randy chooses a career as a neurologist. Eager to travel and see the world, they both find work at the US Navy Hospital in Yokosuka, Japan.
During her medical training, Kozel is at first resistant to becoming a pediatrician. “…[T]he last think I wanted to do was spend my time locked in mortal combat with screaming kids, digging wax out of their ears while their deranged parents hovered over me, wringing their hands,” she writes. “I had hated pediatrics in medical school.”
But become a pediatrician she does, learning how to intubate a premature baby and distinguish between a life-threatening childhood illness and a simple viral infection. Providing medical care to active duty military personnel and their families, Kozel and her colleagues “saw illnesses we never saw back in the States–typhoid fever, malaria, tuberculosis and many more … There were expert subspecialists a phone call and twelve time zones away, but we were the front line, doing what we were trained to do, and being a doctor was wonderful.”
After working for the Navy for ten years, Kozel, her husband and their two small daughters head back to America. They end up in Rhode Island, where she joins a pediatric practice. Used to the government’s single-payer health system, Kozel has to adjust to the system in the States. It’s demoralizing: Because pediatricians have to bill insurance companies in order to get paid, Kozel details how much of her practice’s decisions on treatment have more to do with how to make sure they will get paid than with what’s in the best interests of the patients. She finds herself working exhausting hours, rushing patients through appointments as fast as she can, and being pressured by parents to prescribe unnecessary medications.
So when a job opportunity at her daughter’s school opens up, Kozel acts precipitously and does the unthinkable: she quits her job as a doctor and becomes instead a high school science teacher.
She’s energetic and funny and the gum-chewing ponytail-wearing 14- and 15-year-olds love her. She works regular hours, is no longer exhausted, and does not have to decide her curriculum based on what the medical insurance companies will reimburse her for.
The Color of Atmosphere tells a gripping story. It’s an important book. It shows, firsthand, what’s wrong with our healthcare system. Kozel has been called a “traitor” by her colleagues on doctors-only Internet sites. I’m not surprised she’s struck a chord. Though so many doctors in America feel demoralized and burnt out, and though most feel that they are no longer delivering an adequate standard of care, it’s totally taboo, and a betrayal of the profession, to admit as much in public.
I applaud Kozel’s courage in writing such an honest book. I hope you’ll read it. And send a copy to Congress.
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