By David R. Slavitt

Doubleday. 268 pp. $17.95


By Edward Ziegler

In cooperation with

Lewis R. Goldfrank, M.D.

Harper & Row. 352 pp. $17.95


Exploring the Medical

Ways of the World

By Ted Kaptchuk and Michael Croucher

Summit. 176 pp. $17.95; paperback, $7.95

I OBSERVE the physician with the same diligence as he the disease," John Donne wrote, and curiosity about physicians and their work shows no sign of abating yet. The first of this season's offerings -- three new studies by a poet, a physician/anthropologist and a journalist -- approach the profession from quite different angles. David Slavitt, the poet, attributes the feelings physicians elicit in us -- of admiration, fear and envy -- to their power: doctors preside over our births and most likely will preside over our deaths.

Slavitt's book, Physicians Observed, is a well-rounded examination of contemporary physicians, beginning appropriately with medical school admissions procedures and an analysis of the relationship between admissions requirements and the types of doctors being produced. Sympathetic but frank, Slavitt discusses such topics as how the pressures of medical training can cause personal difficulties later for doctors; the positive effect of increased numbers of women in the field; and the effects of greater restrictions by government and business on medical practice. He urges physicians to change with the times by forming union-like organizations to ensure they maintain some say in the delivery of medical care. This is a thoughtful if rambling work with a clear overview of major issues being discussed within the profession.

Emergency Doctor, by journalist Edward Ziegler with Dr. Lewis Goldfrank, gives a dramatic close-up look at the practice of medicine in New York's legendary Bellevue Hospital. For 250 years Bellevue has taken all comers, the ragged and the rich, and it continues to do so. In this fine piece of writing, we first meet Goldfrank, the Emergency Department director, as he checks on a young girl who has been hit by a taxi. He is interrupted by the news that a 35-ton crane has just collapsed on a Manhattan sidewalk, pinning a woman beneath. A patient arrives who has fallen off a subway platform. He confronts another patient, an airline pilot who has suffered an epileptic attack but refuses to be admitted to the hospital. The pilot pleads that he has a family to support with two children in college. But patient confidentiality will be breached in this case, Goldfrank and his staff tell him, and the airline's flight surgeon is notified.

AND SO IT goes, with some 300 patients a day coming through the doors. Goldfrank's motto is from Through the Looking Glass: "We are able to believe six impossible things before breakfast." The woman trapped by the crane, balanced perilously between death and life, must be sustained while a larger crane is brought in from the Bronx at a speed of four miles per hour. When Goldfrank climbs down to see the woman, she says "I know I'm doing okay . . . I'm more worried about you."

Without breaking the riveting narrative flow, the author manages to probe the interstices of medical and social problems. We learn that the Emergency Department budget could be cut by 25 percent if it weren't for alcohol; another 25 percent if it weren't for cocaine, heroin and tobacco; and another 25 if it weren't for the homeless. At times in the emergency room, treatment entails the use of a simple hospital blanket.

Author and doctor also discuss the regulation of health care, from the perspective of a thoughtful practitioner. Goldfrank notes that "the rise of HMOs -- health maintenance organizations -- which goes hand in hand with the DRG {standardized system of diagnosis} development, gives the doctor the job of getting the patient in and out as quickly as possible. It's fast medicine just the way McDonald's is fast food . . . " And, he says, this just might not always be good for the patient. Lest this sound like self-interest speaking, Goldfrank refers to a 1986 report in The Wall Street Journal that none of the top Reagan Administration officials or congressmen who advocated prepaid health insurance was a member of a prepaid health maintenance organization.

Illuminating and knock-down thrilling enough to leave readers exhausted, this is the best emergency room writing I have seen.

For a longer view of the medical profession, there is The Healing Arts by Ted Kaptchuk, who studied traditional medicine in China and now directs the Pain and Stress Relief Clinic at Boston's Lemuel Shattuck Hospital. He and co-author Michael Croucher, who produced the television series from which this book was developed, analyze the great healing systems through history and extract meaning from each of them. While cautioning that ultimately every healing art falls in love with itself, Kaptchuk envisions a system that is greater than any individual system, one that takes into account the fact that the human body is more than the sum of its parts; thus, the art of healing must also involve the unknown. He cites Heisenberg's principle that, "In the history of human thinking the most fruitful developments frequently take place at those points where two different lines of thought meet."

He sees value, therefore, in understanding the ancient origin of the concept of "healing hands"; the Navajo chanters' vision of intactness, a sense of self that is so often violated, albeit inadvertently, when we are ill; and the deep roots of the belief that sickness and pain were punishment for sin by angry gods and demons, a belief found in both ancient China and India.

The Healing Arts is both provocative and filled with delightful detail. One can't help but be grateful to the authors for telling us that, in China prior to the 5th century B.C., the health care workers were sorcerers dressed in bird costumes.

Carol Eron is an editor and the author of books and articles on medical subjects.