License to Heal

An emergency room physician recalls his eventful career in this insightful, occasionally harrowing, memoir. Despite the subtitle, debut author Bentley''s reminiscences are hardly random. They have been selected to succinctly or dramatically convey the progression of a decades-long career. Leaving out personal details unless relevant to his anecdotes, Bentley emerges as a compassionate doctor who sympathizes with his patients, including those who have allowed their bodies to fall apart. He is also empathetic; for example, he rails against oncologists offering "the promise of ''more life''" without mentioning the horrible side effects that a patient might endure from a last-resort cancer treatment. Bentley, however, acknowledges that many ER admissions and treatments reflect the pressure from health care corporations to keep their hospitals as busy as possible-whether treatment or even, in some cases, admissions are justified. Sometimes, questionable admissions, like that of a patient who didn''t have any discernible blood pressure because he was dead, illustrate incompetence rather than corporate greed. But Bentley also encountered many "patients" seeking treatment for fictitious problems solely to obtain a particular painkiller or to avoid a court date or some other selfish motive, which only added to the burdens of a largely broken health care system. The horrors documented here include a lab tech discarding blood samples and returning to the magazine he was reading; the "wallet biopsies," in which insurance policies dictate treatment; and malpractice suits filed almost automatically when ER patients die.