Reflections from a life lived in medicine.

Pediatrician Mark Vonnegut has spent forty years treating children for coughs, fevers, ear infections, and sometimes more serious complaints. In that time he has seen the American medical system change in ways he couldn’t have imagined as a medical student–some of them good, others not so good. But what hasn’t changed is his commitment to his young patients, whose stories fill the pages of this book. There’s Anna Maria, a little girl with an incurable case of bone cancer; Adeline, who has a syndrome so rare none of Vonnegut’s fellow doctors have seen it before; Marlowe, whose life-threatening anemia is cured by his just-born baby brother.

Whether recounting the cases that have stuck with him or detailing larger changes in medicine–the privatization of health care, innovations in cancer treatment, the rise of anti-vaxxers and HMOs–Vonnegut is a personable guide through what is often seen as an impersonal system, and his stories sparkle with humanity, candor, and wry wisdom. ( In pediatrics, and most medical care, he says, if the doctor can just shut up and listen long enough, the patient will give him the diagnosis. Unfortunately, there’s not a procedure code or template for how to shut up. ) Vonnegut doesn’t pull any punches in his criticisms of the medical-industrial complex, but The Heart of Caring isn’t a diatribe. It’s the story of a life lived in medicine, with all the heartbreak, hope, and everyday heroism that entails.