Five Patients

Michael Crichton, creator of many a blockbuster, began his writing career while still a student at Harvard Medical School. Though he never practiced medicine, the education was enough to put a gloss of verisimilitude on works like The Andromeda Strain and the long-running television hit ER. Five Patients is ER in real life--circa 1969, when Crichton graduated from medical school. Five different patients are examined at Massachusetts General Hospital; each patient's story illustrates some larger aspect of the hospital system. Thus, Ralph Orlando's death from cardiac arrest engenders a brief history of the modern hospital and emergency ward. John O'Connor, who has an unexplained high fever and infection, spends a month in the hospital, leading to a discourse on the cost of medical care (perhaps the most eye-opening chapter of the book--or the most unintentionally funny one from a 1999 perspective). The saga of Peter Luchesi, a worker whose hand is nearly severed in an industrial accident, leads to a discussion of 20th-century surgical advances. Sylvia Thompson, a traveler with chest pains who is seen by a doctor via closed-circuit TV at an airport, benefits from new (at the time) diagnostic and therapeutic technologies that have altered irrevocably the doctor's role. Finally, the case of Edith Murphy, diagnosed with systemic lupus erythematosus, serves quite literally to educate the medical students and interns who take on much of her care, as the hospital staff hierarchy is dissected and explained. Crichton's style here tends to the sober and bureaucratic--reading it is much more like brain surgery than hanging out in the staff room with George Clooney and Noah Wyle--but for the industrious it's a fascinating glimpse of pre-HMO medicine. --Barrie Trinkle