PLUCK | Kirkus Reviews

Twin brothers reflect on their careers in working to improve health care in the United States.

In this dual memoir, identical twins Fred and Blair Sadler, authors of Emergency Medical Care: The Neglected Public Service(1977), recount the years they spent crafting aspects of the American medical system and related laws during the 1960s and ’70s. Fred, a physician, and Blair, an attorney, began working together as a “medical-legal team” shortly after finishing their graduate programs, serving at the National Institutes of Health, the Yale University School of Medicine, and other institutions. Their first project, beginning in 1967 and continuing into the early 1970s, was streamlining organ donation, working to establish a unified national system of managing donors and recipients, and helping state legislatures to follow a common framework for organ donation laws. They later helped to develop the role of the physician’s assistant and establish training programs and certification standards, an important tool in meeting the growing need for primary care providers. The brothers’ final joint project, spanning the early-to-mid-1970s, involved modernization of emergency medical care, in partnership with Yale University and the Robert Wood Johnson Foundation. Their careers diverged after nearly two decades of partnership, as Fred completed his clinical training and became a practicing physician, while Blair moved into health care administration and oversaw the growth of Rady Children’s Hospital in San Diego, California, among other projects. The book concludes with a retrospective look at the areas they worked on, assessing practical and ethical successes and ongoing challenges, and sharing lessons they learned throughout their long careers.

The Sadler brothers have an engaging story to tell and do so in an enlightening way in these pages. The book is largely written from their joint perspective, with occasional asides, labeled “Blair reflects” and “Fred reflects,” in which one of the brothers switches to first-person singular to detail his own experience. In addition to sharing credit with each other for the work they did together, they’re generous in detailing the roles played by mentors; in one memorable section, for example, Blair tells of meeting Chief Justice of the Supreme Court Earl Warren at a squash game, which led to several discussions about the brothers’ work on organ donation. The authors also refer to work of various colleagues, which makes for a personal narrative that’s remarkably devoid of ego. The book also does an effective job of showing how things many people take for granted, such as organ donor cards or well-equipped ambulances, are in fact rather recent innovations, without turning the work into a full-blown history of U.S. health care. In addition, the Sadlers are thoughtful about the expansive role of health care in people’s lives (“a homeless shelter is a healthcare organization; the integration of mental health experts into the local police force is healthcare activism; the funding of breakfast programs for elementary school children is healthcare policy”), which makes their book a welcome addition to conversations on a range of important issues.

An inspiring story of crucial and familiar aspects of the health care system.