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Thursday, March 1, 2012

Target: Pain Doc by Linda Cheek, MD

There are so many facets to a person's illness, and so many players on the stage. The patient has one view of what is wrong and how it is being addressed. The doctor has another view, and sometimes these two views conflict. The pharmaceutical companies have yet another view of what ought to be done. The government regulators who monitor drug safety and use have another view focusing again on safety but also on patient rights and patient privacy. And that same government also regulates rates that can be charged by both physicians and pharmaceuticals. The last piece of the puzzle are the insurance companies, all of which are monitored and some run by government agencies. So many facets of a patient's condition. So many ways it could all go wrong. So many people who could be blamed, and held responsible.

Dr. Linda Cheek has written a novel from the point of view of the doctor in this kaleidoscope of rights and responsibilities, obligations and opportunities. Dr. Cheek knows of what she writes. She realizes that every patient is different, but the common thread for many is invisibility of symptoms. Pain is often an invisible symptom in many conditions ... fibromyalgia,or widespread joint pain impeding motion and function, is one example of an illness that eludes some doctors' recognition, leaving the patients experiencing this condition with pain that is untreated. Pain treatment takes many forms ... opioids are the most risky form of treatment, as overuse and addiction are not results that are looked favorably on by either the medical community or by society at large, including the government agencies. A doctor who treats patients with opioids takes a risk in trusting that the patient will cooperate responsibly. Patients in pain who have been misdiagnosed or misunderstood or mistreated by doctors may have difficulty in finding a doctor who will establish that trust easily. In today's emphasis on seeing patients more efficiently to be cost effective, time to develop that trust is often forfeited.

Dr. Cheek's character, Dr. Ros Smart, spends time with her patients. She manages their pain through a series of emotional and cognitive training sessions, educating them about healthier lifestyles, toxins in their environment that contribute to painful conditions, and a plant-based diet rather than the typical American high protein high fat menu that she sees as harmful to their overall health. Her belief in these training sessions' power to reverse years of damage coupled with the use of opioids initially to relieve the pain enough to allow the patient to begin making wiser choices is seen by some medical characters in her book as working against the status quo, the system that earns money through expensive testing and medications, and so Dr. Smart is targeted for a governmental review of her practices.

There is a great deal to be considered and learned in Dr. Cheek's book; her Dr. Smart teaches the reader through her dialogue with her patients and family members. Dr. Smart does not talk condescendingly to her patients; rather, she gives them the knowledge and models the belief that they can change their lives by following a lifestyle more in tune with man's biological history rather than with today's commercial fast-food nation.

I give this five stars in a scale of five stars. The book is well written, carefully thought through, and presents reasonable emotions in the light of the difficulties encountered by Dr. Smart and her staff. It addresses many of the current issues being debated today in terms of a healthy menu, healthier lifestyle, and the question of being overly-hygienic in our lifestyle. While she presents the case for an alternative rather than mainstream approach for addressing pain conditions (some very interesting lines of logic regarding bone degeneration and nerve pain) she is firm in her belief that health care today may be overstepping its bounds in promoting pharmaceutical cures rather than promoting healthier options based on lifestyle changes.

Beyond the clearly defined medical information presented in this book, the novel itself is well focused. The characters are true and memorable, the incidents build on each other leading to a climax that, though predictable, results in a tension that delivers drama, and ends with an open door.

The author of the story, Dr. Cheek, has agreed to an interview here; this link will take you to the interview page.
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