Fragmented
FRAGMENTED: A DOCTOR’S QUEST
TO PIECE TOGETHER AMERICAN HEALTH CARE
Ilana Yurkiewicz, MD
W.W. Norton, July 11, 2023, Hardcover $30.00, Kindle $14.99
ISBN-13: 978-0393881196
ASIN: B0BHPRM3Y4
Yurkiewicz reports:
It may sound cheesy, but my book found me. I’ve been a practicing doctor for nearly a decade. I fully expected that medicine would involve uncertainty because human life is uncertain. Instead, I battle a different kind of uncertainty: having to take care of patients without knowing their complete medical history. I’ve spent countless hours hovering over fax machines and sleuthing through charts, grasping at bits and pieces of a patient’s narrative to try to craft a coherent whole.
Ilana Yurkiewicz, MD Photo by Elizabeth Freeman
A few years before I wrote my book, I published an article on fragmented medical record-keeping. I realized then that records are just the tip of the iceberg. There is a broader story: Our medical system keeps doctors from seeing their patients’ full narratives. I began listing the obstacles: Clunky electronic patient charts. An insurance maze that deprioritizes follow-up. A culture of specialization. Fragmentation undermines health care.
A few literary agents had contacted me during my medical journalism career, so I reached back out and connected with one of them. I wrote my book interspersing patient narratives, critical analysis, and research. I am fortunate that my job gave me a front-row seat to the narrative component, based on real medical scenarios with details changed to protect privacy.
My first piece of advice to anyone writing a science book is to look into hiring a fact checker. When you write over 75,000 words, you likely will make mistakes. I thought it crucial to have another set of eyes verifying my statistics and re-interviewing my sources. Publishers typically do not provide fact checking. I believe it’s worth it to hire a fact checker and pay from your advance.
A second bit of advice is to do the hard work of organizing your book upfront. Don’t gloss over your book proposal as simply your passport to the book deal. Your first book is probably your longest writing by far. It’s easy to get lost. I gave a lot of thought in my proposal to structure. I decided to group my chapters into three sections, outlined what each chapter would say, and deliberated how they would fit together. A year later, I was glad I gave myself that blueprint.
Contact info:
- Ilana Yurkiewicz: ilana.yurkiewicz@gmail.com, https://ilanayurkiewicz.com/, @ilanayurkiewicz
- Book: https://wwnorton.com/books/9780393881196, https://ilanayurkiewicz.com/book
- Publicist: Gabby Nugent, gnugent@wwnorton.com
- Agent: William Callahan, william@inkwellmanagement.com
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Banner image adapted from original photo by Ilana Yurkiewicz.
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