I have never had an interest in practicing medicine (I faint at the sight of blood), but I love reading about doctors and medicine from afar. In Telltale Hearts, we are given insight into the unique relationship between practitioners and their patients, a perspective that is not easy to find. Nosy people like me will enjoy the detailed stories the author tells, but they aren't salacious. They are meant to demonstrate the larger picture as part of a larger narrative. Although much of the information was interesting, I was frustrated by some of the tangents the author took, especially the one about diabetes. Enough people have written enough books about that. Some people will find this book insightful, but for others I think it is too long and unwieldy to hold their attention.

Wow, this book will stay with me for a long time. Schillinger speaks with such humility and transparency it is inspiring. His stories about working in a public hospital really bring to light the brokenness in our world and country that I will be thinking about for a while. The "jumping around" in his chapters didn't really bother me, but the reason I am giving it four stars instead of five is because I felt like the chapters on legislating SSBs was long and drawn out. He could have synthesized better there for sure.

This book constantly went off the rails. I was expecting a narrative epidemiology to literally be the stories of the patients. Those who have been in the trenches of a bad health care system that kept them fighting for any scrap of help. Burdened by a public health care system that tries to make up for the larger well-insured populace and hospitals with their shiny floors and new equipment; Dean-David Schillinger tries to tell the stories of those most affected by a myopic system.

When the author can stay focused and not branch off on his narcissistic “I” narratives, there are fascinating stories being told. The people and what their environments subject them to, tell a shocking, but then again, the reader shouldn’t be shocked, by accounts of how poverty, skin color, lack of education, drug abuse, food deserts, and being held captive at the whims of big business, dictate their lives.

Schillinger tried to put too many books into this one novel. Tell the public health story, tell the big business story, tell the holocaust story, just don’t tell them all within the same book all the while peppering the reader with your self-aggrandizing side stories.

Telltale Hearts: A Public Health Doctor, His Patients, and the Power of Story begins with Dr. Schillinger discussing his deep depression and how through therapy—specifically, his therapist encouraging him to tell the psychiatrist his story—that he not only was able to get out of his depression, but Dr Schillinger came away with a profound insight into his relationship with his patients.

Or, as he put it, “This book reveals what my patients have taught me that the combination of stories and science holds the key to recovery.” He called this epiphany “narrative epidemiology,” which he believed could transform health care.

He specifically mentioned the work that John Snow did back in England during the Nineteenth Century. Snow is considered the first epidemiologist for his work discovering the cause of the cholera outbreak in London and coming up with a simple explanation. His solution, after extensive investigations including talking to victims and those who had not been affected, he was able to discern why some were infected and those who were not. His solution was simple: remove the handle of the Broad Street Pump where most of the victim’s had gotten their water. As a result, the number of cholera cases declined.

With this set up in mind, I had expected that most of the book would be the stories of individual patients and how Dr. Schillinger was able to help them, and for the most part it was, but what I wasn’t expecting was a very detailed discussion of working on the problem of the rising number of diabetes cases in the community as a diabetes czar in California.

If I have any complaint about the book, it is the fact that his work as the diabetes czar takes up a good portion of his book and he wrote what I would deem to be unnecessary details. For instance, was it necessary to publish that many poems or his efforts in getting a sugar sweetened beverage tax to be placed on the ballot? I am sure there are those who would find all this quite interesting, but it took up a third of the book, which I felt detracted from the overall focus of the book.

I also found that some of his tangents, even when the patient narratives were fascinating, sometimes detracted from the overall enjoyment of the book because they really did not add all that much.

I would recommend this book to anyone who is interested in patient narratives, and I would also recommend this book to anyone who is interested in the public health system and how to go about making effective changes.

4/5 stars

[Thank you to NetGalley and the author for the advanced ebook copy in exchange for my honest and objective opinion, which I have given here.]

This isn't just a collection of personal stories from a doctor working on the front lines; it's also the story of how those stories affected him. The stories are interesting in themselves, and we get to read about patients who came in for one thing that developed into something else, and other kinds of stories; we also get to learn about how the patients viewed their own health and their position in society. What kind of person you are can determine your quality of care (wealthy, minority, etc) and many people receiving poor care realize what they are facing. This book is inspiring in the sense that this doctor cares and tries hard to do the best for every patient, not just as far as medical care but emotionally. Dr. Schillinger has suffered from depression and talks honestly about how it affects him.
Thanks to NetGalley for letting me read this.

Thank you, NetGalley and PublicAffairs/Bold Type Books fur this advanced reader’s copy. As I work in medicine, I am drawn to personal experiences and stories from medicine and this book is no different. I greatly enjoyed this author’s personal story as well as all his patients stories told throughout the book as his journey working in internal medicine at San Francisco General. His continued pursuit to encourage public health and well-being showed in his career with care and the treatment of his patients. Thank you, Dr Shillinger for all your work and for sharing your stories and those of your patients.

Thoughtful exploration of narrative epidemiology. However, if you are expecting the tight stories of Every Patient Tells a Story or the like, seek elsewhere. There are some amazing stories but also deep dives into public health, science, and the author's own life experiences. For the most part this is positive and does not detract from the enjoyment although it does occasionally result in odd pacing.

Excellent book about the power of narrative in medicine. I really liked the patient stories and what he learned from each one. I got a little bored in the very long diabetes section—did we really need more than one poem from the students about sugar sweetened beverages in their communities? I think the author was so worried about leaving something or someone out that he lost his own narrator voice in parts. That said, really excellent overall and just a little too long. Highly recommended for anyone interested in medicine or public health. I can see a chapter or two as being a really valuable assignment in a sociology class, too.

Thanks to NetGalley and the publisher for a free early ebook in exchange for my honest review.

A fascinating look at the life of a doctor who has dedicated his career to public health and an important discussion of the biggest public health challenges that face our society. Highly recommended.

I've always been drawn to books about medicine especially those that recount true tales. This book interested me as it was written by a doctor who worked in a public hospital. I enjoyed most of the stories but sometimes felt they were geared for those in the field. The author is a huge advocate of the war on diabetes and the latter part of the book dealt primarily with that. If you enjoy books of this type you will this as well. Thanks to Netgalley, the author and publishers for an advanced copy in exchange for my honest opinion.

This was an interesting book and I appreciated Dr. Schillinger sharing his patients' stories and his approach to medicine. In a time when many of our healthcare interactions take place while the physician is typing into an electronic medical record, these stories show how important it is for the physician to build rapport with, and truly listen to their patients.
That you NetGalley and the publisher for access to this ARC.

Dr. Schillinger does a great job at "finding meaning in medicine" through the stories of patients he encounters as working as an internist at a public hospital in San Francisco. He tells stories of patients dealing with various ailments including testicular torsion, to a friend's uncle who was only able to walk on his knuckles, and a patient who was almost pronounced dead until he woke up following Dr. Schillinger's prayer. Dr. Schillinger expresses that "in the story lies the answers" but also shows how many doctors tend to not listen to these important stories, of which he is humble enough to say that he has also made this mistake. I would say the only negative of this great book, would be the tangents the author takes at times that seem to detract from his stories with verbosity. All in all, this was a fascinating account of the public health system and how it impacts those who receive care and provide care in this system.

Thank you to NetGalley and the publisher for access to this ARC!