A Family of Doctors  by David Hellerstein.  Hill & Wang, New York, 1994, vi & 269 pp. $21.

Review by Del Meyer, MD

David Hellerstein, A.B. Harvard, M.D. Stanford 1980, Director of Out-patient Psychiatric Service, Beth Israel Medical Center, NY, chronicles the story of five generations of doctors in a family.  He begins with Dr. Marcus Rosenwasser in the middle of the nineteenth century and culminates with the author, the son of two doctors and brother of three.  In turn, A Family of Doctors details the rise of American medicine in all its diversity.

Hellerstein begins with his Cleveland childhood, recounting the stories of his father’s patients.  He recalls, among others, Victor Laugesen, and old-time newspaperman, who “had chain-smoked from one deadline to the next, until he was felled by a heart attack.  Doctors advised him to retire not only from journalism but from life, and so, utterly demoralized, he did.  Until Dad encountered him.  Then he cut out cigarettes, eggs, read meat…With Dad’s encouragement, he started a new life as a dairy farmer…”  Hellerstein reminisces about the family trips to the dairy farm to see newborn calves, demonstrations of stainless-steel milking machines, walks through high-grassed fields and pond fishing.  At this early age, he realized that many of his father’s patients, like Victor Laugesen, would have been dead or, if alive, condemned to a limbo of despair and ill health if it were not for the scientific progress of medicine in an era when the world news was threatening doom with mushroom clouds.  He mixes the events of the day, such as the call of “Dr. Paul Dudley White from the White House to consult with Dad…after President Eisenhower’s 1955 heart attack,” with discussions of the career choices of his brother into urology, his sisters into obstetrics and pediatrics, and his own into psychiatry, and why they all rejected their father’s field of cardiology, but still chose medicine.

Hellerstein takes us on a journey through medicine as he explores his family heritage from Marcus Rosenwasser’s medical-school diaries and obstetric logs, through various family member patient logs, with help from historical society records, interviews with the members of recent generations, and explorations of attic records.  He finds that Marcus Rosenwasser died with angina and that coronary artery disease was common in his family.  He was taken aback by the newspaper clipping of a maternal great grandfather, a surgeon in Denver which read, “G. R. Feil Fires Bullet in Mouth: ‘I don’t want to live as [a] sick man,’ he tells family.”

The chapter “Secret Rebels: The Women of ‘49,” is the story of the author’s mother and how the system did not know what to do with women when she started medical school in 1945.  The chapter describes how the war increased the number of women in each class from one or two per year to 10.  This provides interesting insight into the history and challenges of women in medicine.

After going through sections on “The golden age of medicine” and “The new generation of medicine,” Hellerstein concludes with an epilogue concerning the summer of 1992 when his father summoned all six children home to their belongings because it was time to “clean house after 40 years.”  His mother had left all their things in the rooms and attics and never had cleaned the house “according to Dad.”  “The real reason,” the grown children felt, “was Dad’s illness, and his desire to bring order and closure” to his life.  “Twice before, medical advances had prevented certain death – with his heart, [and] his pituitary.  Was there a third reprieve as well?”  The third reprieve would have been from prostate cancer, which, having been controlled for two years, began advancing with elevating PSAs.  Hellerstein concludes with an emotional interface of all six children, their spouses and grandchildren as “dad was revising his autobiography, which was almost completed – only the last chapter still to write.”

Sherwin Nuland, M.D., author of The Way We Die, summed up the book succinctly.  “A marvel of family, medical, and personal history interwoven into a seamless sage…using the careers of four young physicians to provide a crystal-clear overview of just what it is that today’s medical people are doing.”  This would be enlightening reading for all our critics and those physicians who have or are thinking about giving up their independence.