|Photo by Sean Goss|
Dr. Mark Vonnegut is the author of the new book The Heart of Caring: A Life in Pediatrics. His other books include Just Like Someone Without Mental Illness Only More So. He is a longtime pediatrician in Massachusetts.
Q: What inspired you to write this book?
A: I was inspired by love, appreciation, and fear—love for medical care and the good it can do, appreciation for my patients, and fear that the training and choices available to me and my patients will soon disappear.
Q: You begin the book by stating, “I have had an absolute ball taking care of babies and children. There’s no greater honor than having people trust me with their children. I’m afraid more newly minted doctors won’t have the same choices, opportunities, and joy that I’ve had.” In your view, what are the key factors causing this change in the medical profession?
A: The mission of medical care and the mission of monetary profit are in inherent conflict--what’s best for the patient is not always what’s most profitable for the company. Right now, money is winning, and patients are taken advantage of by everything from copayments and deductibles to lousy care.
Q: You write about parents who refuse to get their children vaccinated--what do you think of the ongoing situation surrounding Covid vaccine refusal?
A: It’s much worse because Covid-19 is a clear and present danger. Vaccine refusal is one more symptom of how divided we are as a society and how little we trust science.
I try to work with parents to come to trust me and the fact that vaccines are going to help rather than hurt their children based on the science involved and not what social media or the internet has told them.
Q: In the book, you describe your experiences as a doctor, but also as a patient with mental illness, and you write, “The cost of not caring for the mentally ill dwarfs the cost of caring. The real pain and expense come from mental illness itself and what it does to families and patients.” How would you characterize the current approach to mental health care, and what do you see looking ahead?
A: Hospitals and psychiatrists and therapists are inaccessible. Emergency rooms are backed up. Family resources are depleted. I don’t expect mental health care to get better anytime soon until some real and profound changes are made to our health care system.
One of the best decisions I ever made was to hire social workers nine years ago to work in our office and they are an invaluable supportive presence for our patients and their families.
Q: What are you working on now?
A: I’m still practicing pediatrics. I’m also painting with watercolors, playing the saxophone, woodworking, playing with my dog, and reading whatever I can get my hands on. I continue to write as new ideas and stories come to me.
Q: Anything else we should know?
A: We are our brother’s keeper, and it is very expensive to claim otherwise. Just like with immunizations, your good health depends on my good health—and all of us need good health care. We are at a critical juncture in our country and we can and must do better.
--Interview with Deborah Kalb