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Upon taking up Where Remedies Lie, billed as a sequel to Doc Hollywood, the reader soon becomes aware that some things have changed. Not only has the town of Grady mysteriously loosed its moorings and drifted eastward into Georgia, but our hero, Dr. Otis Stone, who struggled through the previous novel without much support from his family, belatedly conjures up a sympathetic sister conveniently married to Otis's best friend and former medical school roommate.
Such inconsistencies aside, however, the saga we resume of our protagonist's life in the rural South is an altogether more complex one than before. The authors' achievement here is to move beyond the amusing idea of a small town full of colorful characters hijacking a much-needed physician. (Not that their tale lacks either humor or a string of cleverly crafted personalities. Hackamore Singletree, for example, is a brilliantly realized creation whose earthy, yet erudite speech enlivens the story throughout.) Rather they ambitiously interweave some of the most critical themes involving the delivery of health care today with the expanding awareness of a young doctor concerning the eternal verities of a life worth living.
The authors accurately capture the degree of naivete of modern medical graduates as our hero first confronts the tumultuous transformation of the healthcare system being wrought by the advance of for-profit medicine. Yet as Otis Stone reaches out to other physicians for help, we come to understand that they too are severely buffeted by the overlap of old prejudices and new pressures. Many of his peers are still fighting the old battle to keep government and its salaried doctors out of health care even as the "invisible hand" of the marketplace begins to tighten its grip on the network of services upon which they depend. In a statement I once heard that would be worthy of Hack Singletree, organized medicine was said to have been so preoccupied trying to keep "socialism" out of health care that they did not see capitalism creeping up until it had bitten them in the ass.
The depiction of physicians fighting on two fronts as they try to preserve an imagined "golden age" is revealing for we well know that memories of the past are seldom all they seem to be and so it is with health care. Physicians like to remember the first half of this century when theirs was the most respected profession without recollecting how little they were actually capable of doing for their patients. They like to recall the independence they enjoyed rather than the dependence on charity care a substantial portion of the population relied upon. And they still savor, whether most will admit it or not, the unquestioned authority they exercised over both their patients and the rest of the health care system. Physicians sincerely want to believe that the health care system that has been best for them is the one that is best for patients, but in a telling portrait of one subspecialist's complacency about this system's ability to address the needs of his community, we witness the scales falling from his eyes as he is exposed to disease whose extent and severity he could not believe still existed around him.
Played out against this backdrop to revolutionary change in medicine we follow as Dr. Otis Stone, principled and idealistic, yet blinkered culturally, professionally and interpersonally, battles his private demons and personal deficiencies while striving to make quality health care for everyone a reality. Help comes in various guises, among them the ambulance attendant, Shelly Farmer, with whom he is enamored. Shelly is never shy about addressing Otis's blind spots and in one particularly pointed lecture she contrasts his "Northern abrasiveness" with the "Southern procrastination" he finds so frustrating in his patients. She states, "People can tell you're about to rupture yourself to get to some point, which you think is more important than the people you're getting to the