Review: Better Now by Danielle Martin

Better Now by Danielle MartinAuthor: Danielle Martin
Title: Better Now: Six Big Ideas to Improve Health Care for All Canadians
Format/Source: ebook/Netgalley
Published: 10 January 2017
Publisher: Allen Lane
Length: 368 pages
Genre: Non-fiction
Why I Read: Browsing NetGalley; topic I’m interested in
Rating: ★★★½
GoodReads | Indigo | IndieBound

I received a complimentary copy from the publisher via NetGalley in exchange for my honest review.

DR. DANIELLE MARTIN see the challenges in our health care system every day. As a family doctor and a hospital vice president, she observes how those deficiencies adversely affect patients. And as a health policy expert, she knows how to close those gaps. A passionate believer in the value of fairness that underpins the Canadian health care system, Dr. Martin is on a mission to improve medicare. In Better Now, she shows how bold fixes are both achievable and affordable. Her patients stories and her own family s experiences illustrate the evidence she presents about what works best to improve health care for all. Better Now outlines Six Big Ideas to bolster Canada s health care system. Each one is centred on a typical Canadian patient, making it clear how close to home these issues strike.

A few days ago, I came across an expose by the CBC’s The Fifth Estate on “The High Cost of Pharmaceuticals: Canada’s Big Drug Problem.” A lot of what that investigation discussed sounded familiar. I had just read all about it in this book, Better Now. I had originally decided to read this book because I thought it would a good supplement to the books I had read last year – books by life and death professionals (ex. family doctor, crematorium technician) about their work and how to improve their field through anecdotal stories about their patients and their own personal lives (is that specific enough? haha).  As described above, Better Now, written by a family doctor who believes ‘in the value of fairness that underpins the Canadian health care system’, presents the following ‘Six Big Ideas’ to improve the system:

  1. Ensure relationship-based primary health care for every Canadian
  2. Bring prescription drugs under Medicare
  3. Reduce unnecessary tests and interventions
  4. Reorganize health care delivery to reduce wait times and improve quality
  5. Implement a basic income guarantee
  6. Scale up successful solutions across the country.

This book turned out to be even more personally relevant than I expected. I am currently searching for a new family doctor, as I found my old one unsatisfactory. I couldn’t pintpoint exactly why, but after reading about these ideas and some of the issues with our system, I see my relationship with my previous doctor reflected in them.  Idea #5 surprised me in a good way. I appreciated how Dr. Martin considers the bigger picture and explores social factors, especially in ideas #5 and #6. Her proposals are indeed ‘big ideas’. She acknowledges the potential difficulties in implementing them, but also presents them as actionable realities. She strikes an appropriate balance between support for the current healthcare system and addressing its shortcomings, which can be improved upon. One area she doesn’t explicitly address is the education of medical professionals, which is an area I imagine could use some changes.

Better Now is written in an accessible style, with straightforward prose. These are complex ideas, but there isn’t too much technical jargon or infodump – just enough so the reader can understand the ideas being presented. This is a short book and therefore largely a starting point. If one concept intrigues you, Martin provides many resources for further reading at the end of the book.

The Bottom Line:

Is it too trite of me to say ‘I recommend this book to any Canadian’? I could say, ‘I recommend this book to any Canadian with a stake in our healthcare system’ – well, isn’t that the same thing? But seriously, if you have any interest or care for your healthcare, check out this book.

Further Reading:

  • Author’s Twitter
  • Book website
  • “The doctor on a mission to heal medicare” @ The Star
  • “Toronto doctor who gave U.S. Senator a lesson on healthcare outlines her ‘6 big ideas’ for Canada” @ CTV News Health

6 Books on Dying in Modern Times

This is a topic that has been cropping up in my life in unexpected areas. Physician-assisted suicide has been recently legalized in Canada, I taught about assisted suicide when I completed my ESL practicum last fall, and now I’ve unintentionally read three books on aging and dying that complement each other. I also remember being fascinated by this article (‘Why Doctors Die Differently’; I think it’s behind a paywall now) when it first appeared in 2012. I think the concept of how we die, or how we should die, in today’s day and age, captivates me because it’s something that affects literally everyone. Everyone goes through this eventually. Here are my thoughts on three books I’ve read and recommend, and suggestions of three more books I haven’t read yet.

Note the similar cover designs of these six books…

3 Books I’ve Read

 Smoke Gets in Your Eyes: And Other Lessons from the Crematory by Caitlin Doughty

Of the six books featured in this post, Doughty’s explores what happens at the very end of the road, after a person has died. She took on a job in a crematorium when she was 23 years old, motivated by a somewhat morbid interest in death. She describes her work and all it entails, including some gruesome details you might rather not know about. Doughty goes beyond just sharing her experiences at the crematorium, however. She explores how we have developed an unhealthy and even unnatural relationship with death. We try to avoid it. We don’t know how to behave around a body, we don’t know our options for what to do with the body, we don’t know how to accept mortality. You’ll definitely learn a thing or two from Doughty, and hopefully come away with an improved (read: more positive) opinion about death.

Being Mortal: Illness, Medicine, and What Matters in the End by Atul Gawande
 GoodReads | IndieBound | Chapters | Amazon

Working a step backward from Doughty, we have Gawande’s book about how we live out our final days as we age. Gawande’s work as a surgeon and relationship with his dying father qualify his writing on the topic. He highlights the problems with widely spread and accepted systems of health care (such as depressing nursing homes and futile medical procedures), and explores alternatives to these systems. A great read that had me thinking a lot about how I’ll treat my parents when they are elderly.

Good Medicine: The Art of Ethical Care in Canada by Philip Hébert
GoodReads | IndieBound | Chapters | Amazon

Good Medicine caught my eye because of the Canadian perspective. Similar to Gawande, Hebert makes his case through anecdotes about his own patients, commentary on publicly known cases, and his own experience with Parkinson’s. Hebert takes a more general approach than Gawande, focusing not only death in old age but general medical practices. (He writes about a different subject in each chapters – focuses include elderly care and physician-assisted suicide). Hébert emphasizes the importance and life-changing significance of doctors asking tough questions and of patients making their explicit wishes known before finding themselves in a tragic situation. This is a valuable book I hope more people read.

How much better it would be if we knew there were certain states in which each patient would not want to be kept alive, if hospitals asked patients, especially patients facing major surgery, clear and pointed questions in advance: If you were in a non-responsive or minimally responsive state, how would you want to be treated? If you also had only the remotest prospect of even partial recovery, would you wish to be kept going by expensive and prolonged measures? And what if, on account of that care, others were deprived of truly effective care? Would you still want to be kept alive? (107)

3 Books I Want to Read

 When Breath Becomes Air by Paul Kalanithi
GoodReads | IndieBound | Chapters | Amazon

At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor making a living treating the dying, and the next he was a patient struggling to live. Just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air […] chronicles Kalanithi’s transformation from a naïve medical student “possessed,” as he wrote, “by the question of what, given that all organisms die, makes a virtuous and meaningful life” into a young neurosurgeon at Stanford, guiding patients toward a deeper understanding of death and illness, and finally into a patient and a new father to a baby girl, confronting his own mortality. What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.

A Good Death: Making the Most of Our Final Moments by Sandra Martin
GoodReads | Chapters | Amazon

We can’t avoid death, but the prospect is a lot less terrifying since the Supreme Court of Canada legalized physician-assisted death. Competent adults, suffering grievously from intolerable medical conditions, will have the right to ask for a doctor’s help in ending their lives. That much is clear. The challenge now is to pass legislation that reflects this landmark decision and develop regulations that reconcile the Charter rights of both doctors and patients. If we get the balance right between compassion for the suffering and protection of the vulnerable, between individual choice and social responsibility, we can set an example for the world. A Good Death is timely, engaging and inspiring. In taking on our ultimate human right, award-winning journalist Sandra Martin charts the history of the right to die movement here and abroad through the personal stories of brave campaigners like Sue Rodriguez, Brittany Maynard and Gloria Taylor. Martin weighs the evidence from permissive jurisdictions such as the Netherlands, Oregon, California, Switzerland and Quebec and portrays her own intellectual and emotional journey through the tangled legal, medical, religious and political documentation concerning terminal sedation, slippery slopes, and the sanctity of life.

Knocking on Heaven’s Door: The Path to a Better Way of Death by Katy Butler
GoodReads | IndieBound | Chapters | Amazon

Katy Butler was living thousands of miles from her vigorous and self-reliant parents when the call came: a crippling stroke had left her proud seventy-nine-year-old father unable to fasten a belt or complete a sentence. Tragedy at first drew the family closer: her mother devoted herself to caregiving, and Butler joined the twenty-four million Americans helping shepherd parents through their final declines. Then doctors outfitted her father with a pacemaker, keeping his heart going but doing nothing to prevent his six-year slide into dementia, near-blindness, and misery. When he told his exhausted wife, “I’m living too long,” mother and daughter were forced to confront a series of wrenching moral questions. When does death stop being a curse and become a blessing? […] When doctors refused to disable the pacemaker, condemning her father to a prolonged and agonizing death, Butler set out to understand why. Her quest had barely begun when her mother took another path. Faced with her own grave illness, she rebelled against her doctors, refused open-heart surgery, and met death head-on. With a reporter’s skill and a daughter’s love, Butler explores what happens when our terror of death collides with the technological imperatives of medicine. Her provocative thesis is that modern medicine, in its pursuit of maximum longevity, often creates more suffering than it prevents.

Have you read any of these books? Is this a morbid topic or does it interest you?