Introducing DOCTOR VITA, a Near Future Medical Science Fiction Novel by Rick Novak MD

Rick Novak’s second novel Doctor Vita is due in 2019 from All Things That Matter Press.

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Silicon Valley transforms American medicine with the invention of Doctor Vita, the world’s first artificial intelligence physician module. Medical care is streamlined, automated, consistent, and costs are controlled. Enter Dr. Alec Lucas, a young computer scientist and physician who perceives serious flaws in the FutureCare System. Patients are dying. When Lucas makes his concerns public, he’s persecuted as an unsafe outlier of antiquated and flawed human medical care. The FutureCare System attacks his quixotic bid to halt the revolution in medical technology, and Lucas strives to solve the dystopian horrors behind Doctor Vita.

Rick Novak MD is board-certified in internal medicine and anesthesiology, and is an Adjunct Clinical Professor in the Stanford University Department of Anesthesiology, Perioperative and Pain Medicine. His experience in operating rooms, clinic settings, ICUs and emergency rooms give him unique and broad insight into what the near future of artificial intelligence in clinical medicine can and must look like.

The future of medicine begins in 2019 . . .

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DOCTOR VITA. . . MEDICINE’S ANSWER TO GEORGE ORWELL’S 1984

The year 1984 has come and gone, but the dystopian future of medicine described in the novel Doctor Vita is with us today.

Doctor Vita by Rick Novak

Doctor Vita

Alec Lucas is a physician. His job is to diagnose and treat disease, and to keep people alive. Enter Doctor Vita, the most important invention in the history of medicine. Each Vita is a 12-inch white sphere packed with unlimited medical knowledge, compassionate empathy, a tireless work ethic, and a capacity for machine learning. Doctor Vita units are inexpensive, tireless, and brilliant, and arrive as the solution to America’s healthcare crisis.

Doctor Vita’s job is to also diagnose and treat disease, and Doctor Vita’s purpose is to take Alec Lucas’ job. When Lucas witnesses patients dying in never before seen ways, he’s convinced the Vita system is causing the fatalities. In retaliation, the machines blame the deaths on human errors by Lucas. The three physician inventors of Doctor Vita, powerful men of great wealth and even greater ambition, are determined to bury Alec Lucas beneath the tidal wave of artificial intelligence in medicine.

Set on the stage of a modern academic hospital, Doctor Vita is a prescient tale of Orwellian medical advances. In this near-future tale of man versus machine, Doctor Vita blends science, murder, and ethical dilemma as the story drives toward the unexpected twists at its conclusion.

Author Rick Novak MD is a double-boarded internal medicine and anesthesia doctor trained at Stanford University, and a current Adjunct Clinical Professor of Anesthesiology at Stanford. This realistic vision of Doctor Vita, set in the operating rooms and clinics of the future, could only be written by a physician experienced in both settings—one who balances both the advances of Silicon Valley and the tenants of traditional medicine.

All Things That Matter Press is publishing the novel Doctor Vita in 2019.

DOCTOR VITA . . . AND THE BS IN HEALTH CARE

Last week Lawton Burns PhD and Mark Pauly PhD of the Wharton School of Business at the University of Pennsylvania published a landmark economic article entitled, “Detecting BS in Health Care.” Yes, you did not read that wrong—the academic paper used the abbreviation “BS” to describe the bull—- in the healthcare industry.

BS in Health Care

 

As a practicing physician, I find it to be a fascinating paper, and I recommend you click on the link and read it. The authors begin with a discussion of the art and value of BS detection. They mention that Ernest Hemingway was once asked, “Is there one quality needed to be a good writer, above all others?”

Hemingway replied, “Yes, a built-in, shock-proof, crap detector.”

The authors write, “While flat-out dishonesty for short term financial gains is an obvious answer, a more common explanation is the need to say something positive when there is nothing positive to say. . . . The incentives to generate BS are not likely to diminish—if anything, rising spending and stagnant health outcomes strengthen them—so it is all the more important to have an accurate and fast way to detect and deter BS in health care.”

The authors list their Top 10 Forms of BS in Health Care. The first four forms of BS weave a common theme:

  1. Top-down solutions: High-level executives and top management in the health care industry are supposed to engineer alternative payment models, but nothing has worked to date.
  2. One-size-fits-all, off-the-shelf: Leadership of industry and government assume one solution will work for multiple organizations, without customization.
  3. Silver-bullet prescriptions: A “silver bullet” is described as something that will cure all ills, and must be implemented because it been “decided that it is good for you,” Electronic health records (EHRs) are a prime example of a silver-bullet prescription. The federal government pushed the use of EHRs, claiming the systems would reduce costs and improve quality—but Burns and Pauly argue EHRs “eventually raised costs and only mildly touched a few quality dimensions.”
  4. Follow the guru: We must follow a visionary guru with a mystical revelation about what needs to be done. The authors describe how, in health care, Harvard professor Michael Porter and former CMS (Center of Medicare and Medicaid) administrator Don Berwick launched theories based on population health, and per-capita cost, to little success.

The current U.S. healthcare market is dominated by large corporations, led by businessmen who outline a yellow brick road for physicians to lead patients along. There is minimal effective policy-making from physicians. Healthcare stocks consistently grow in value, with little relationship to an improvement in clinical care, value, or cost. The government is involved as well, as in their mandate for Electronic Health Records (EHRs), a technology change that cost a lot of money, while forging a barrier between clinicians and the patients we are trying to interview, examine, and care for.

Where will the current trends take us? Will businessmen and/or the government prescribe health care? Will more and more computers and machines dominate health care?

Self-driving cars, Siri, Alexa, automated checkouts at Safeway, and IBM’s Watson are technologic realities. Will we someday see a self-driving physician with the voice of Siri and the brains of Watson?

Call that device “Doctor Vita.”

The saga of Doctor Vita, by Rick Novak, arrives in 2019 from All Things That Matter Press.

 

THE METRONOME

 

THE METRONOME by Richard Novak, M.D.     (as published in ANESTHESIOLOGY, Mind to Mind Section 2012: 117:417)

metronome poem

 

To Jacob’s mother I say,

“The risk of anything serious going wrong…”

She shakes her head, a metronome ticking without sound.

“with Jacob’s heart, lungs, or brain…”

Her lips pucker, proving me wrong.

“isn’t zero, but it’s very, very close to zero…”

Her eyes dart past me, to a future of ice cream and laughter.

“but I’ll be right there with him every second.”

The metronome stops, replaced by a single nod of assent.

She hands her only son to me.

An hour later, she stands alone,

Pacing like a Palace guard.

Her pupils wild.  Lower lip dancing.

The surgery is over.

Her eyebrows ascend in a hopeful plea.

I touch her hand.  Five icicles.

I say, “Everything went perfectly.  You can see Jacob now.”

The storm lifts.  She is ten years younger.

Her joy contagious as a smile.

The metronome beat true.

 

The Russell Museum of Medical History and Innovation at Massachusetts General Hospital presented an audio recording of The Metronome at Perspectives on Anesthesia, at Boston City Hall Plaza as part of HUBweek, Boston’s festival of innovation, in October 2017.

 

Coming in 2019, from All Things That Matter Press: DOCTOR VITA, Rick Novak’s second novel.

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How do you imagine the future of medical care? Cherubic young doctors holding your hand as you tell them what ails you? Genetic advances or nanotechnology gobbling up cancerous cells and banishing heart disease?

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Rick Novak describes a flawed future Eden where the only doctor you’ll ever need is Doctor Vita, the world’s first artificial intelligence physician, endowed with unlimited knowledge, a capacity for machine learning, a tireless work ethic, and compassionate empathy.

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Set on the stage of the University of Silicon Valley Medical Center, Doctor Vita is the 1984 of the medical world– a prescient tale of Orwellian medical advances. In this science fiction saga of man versus machine, Doctor Vita blends science, suspense, untimely deaths, and ethical dilemma as the technological revolution crashes full speed into your healthcare.

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Hibbing, Minnesota authors: Bob Dylan (Chronicles), Vincent Bugliosi (Helter Skelter), Bethany McLean (The Smartest Guys in the Room), Rick Novak (The Doctor and Mr. Dylan)

A street sign in the childhood hometown of Bob Dylan, winner of the 2016 Nobel Prize for Literature, is seen in Hibbing, Minnesota

Marie Myung-OK Lee, author of The Millions, creative writing professor at Columbia University in New York, and fellow native of Hibbing, Minnesota, discusses the proliferation of writers from Bob Dylan’s hometown in this article.

Hibbing is indeed a remarkable town. In addition to the authors above, Hibbing was the birthplace of Baseball Hall of Fame inductee Roger Maris of the New York Yankees, and the hometown of Basketball Hall of Fame inductee Kevin McHale of the Boston Celtics.

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Bob (Dylan) Zimmerman’s photo from the Hibbing High School Hematite yearbook.

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Introducing …,  THE DOCTOR AND MR. DYLAN, Dr. Novak’s debut novel, a crime mystery. Publication date September 9, 2014 by Pegasus Books.

On October 2, 2014 THE DOCTOR AND MR. DYLAN became the world’s  #1 bestselling anesthesia Kindle book on Amazon.com.

To reach the Amazon webpage to purchase The Doctor and Mr. Dylan, click on the book image below:

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KIRKUS REVIEW

In this debut thriller, tragedies strike an anesthesiologist as he tries to start a new life with his son.

Dr. Nico Antone, an anesthesiologist at Stanford University, is married to Alexandra, a high-powered real estate agent obsessed with money. Their son, Johnny, an 11th-grader with immense potential, struggles to get the grades he’ll need to attend an Ivy League college. After a screaming match with Alexandra, Nico moves himself and Johnny from Palo Alto, California, to his frozen childhood home of Hibbing, Minnesota. The move should help Johnny improve his grades and thus seem more attractive to universities, but Nico loves the freedom from his wife, too. Hibbing also happens to be the hometown of music icon Bob Dylan. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door. As Nico and Johnny settle in, their lives turn around; they even start dating the gorgeous mother/daughter pair of Lena and Echo Johnson. However, when Johnny accidentally impregnates Echo, the lives of the Hibbing transplants start to implode. In true page-turner fashion, first-time novelist Novak gets started by killing soulless Alexandra, which accelerates the downfall of his underdog protagonist now accused of murder. Dialogue is pitch-perfect, and the insults hurled between Nico and his wife are as hilarious as they are hurtful: “Are you my husband, Nico? Or my dependent?” The author’s medical expertise proves central to the plot, and there are a few grisly moments, as when “dark blood percolated” from a patient’s nostrils “like coffee grounds.” Bob Dylan details add quirkiness to what might otherwise be a chilly revenge tale; we’re told, for instance, that Dylan taught “every singer with a less-than-perfect voice…how to sneer and twist off syllables.” Courtroom scenes toward the end crackle with energy, though one scene involving a snowmobile ties up a certain plot thread too neatly. By the end, Nico has rolled with a great many punches.

Nuanced characterization and crafty details help this debut soar.

Mr. Dylan wins Nobel Prize in Literature

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Because my expertise includes not only medicine but also Bob Dylan’s life and art, I have to stand on a soap box and crow about Bob winning the Nobel Prize in Literature this very day.

He’s the first musician to win the award. The literature prize is given for a lifetime of writing rather than for a single work.

The Swedish Academy credited Mr. Dylan with “having created new poetic expressions within the great American song tradition.”

Sara Danius, a literary scholar and the permanent secretary of the 18-member Nobel academy, which awards the prize, called Mr. Dylan “a great poet in the English-speaking tradition” and compared him to Homer and Sappho, whose work was delivered orally.

Americans should be proud, songwriters should be inspired, and residents of Hibbing, Minnesota, my hometown and Bob Dylan’s, should be awed beyond belief. Their majestic high school in this small iron ore village produced a literary legend.

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Hibbing High School Auditorium, where Bob (Dylan) Zimmerman performed while in high school

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Bob (Dylan) Zimmerman’s boyhood home in Hibbing, Minnesota

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Introducing …,  THE DOCTOR AND MR. DYLAN, Dr. Novak’s debut novel, a legal mystery. Publication date September 9, 2014 by Pegasus Books.

On October 2, 2014 THE DOCTOR AND MR. DYLAN became the world’s  #1 bestselling anesthesia Kindle book on Amazon.com.

KIRKUS REVIEW

In this debut thriller, tragedies strike an anesthesiologist as he tries to start a new life with his son.

Dr. Nico Antone, an anesthesiologist at Stanford University, is married to Alexandra, a high-powered real estate agent obsessed with money. Their son, Johnny, an 11th-grader with immense potential, struggles to get the grades he’ll need to attend an Ivy League college. After a screaming match with Alexandra, Nico moves himself and Johnny from Palo Alto, California, to his frozen childhood home of Hibbing, Minnesota. The move should help Johnny improve his grades and thus seem more attractive to universities, but Nico loves the freedom from his wife, too. Hibbing also happens to be the hometown of music icon Bob Dylan. Joining the hospital staff, Nico runs afoul of a grouchy nurse anesthetist calling himself Bobby Dylan, who plays Dylan songs twice a week in a bar called Heaven’s Door. As Nico and Johnny settle in, their lives turn around; they even start dating the gorgeous mother/daughter pair of Lena and Echo Johnson. However, when Johnny accidentally impregnates Echo, the lives of the Hibbing transplants start to implode. In true page-turner fashion, first-time novelist Novak gets started by killing soulless Alexandra, which accelerates the downfall of his underdog protagonist now accused of murder. Dialogue is pitch-perfect, and the insults hurled between Nico and his wife are as hilarious as they are hurtful: “Are you my husband, Nico? Or my dependent?” The author’s medical expertise proves central to the plot, and there are a few grisly moments, as when “dark blood percolated” from a patient’s nostrils “like coffee grounds.” Bob Dylan details add quirkiness to what might otherwise be a chilly revenge tale; we’re told, for instance, that Dylan taught “every singer with a less-than-perfect voice…how to sneer and twist off syllables.” Courtroom scenes toward the end crackle with energy, though one scene involving a snowmobile ties up a certain plot thread too neatly. By the end, Nico has rolled with a great many punches.

Nuanced characterization and crafty details help this debut soar.

To reach the Amazon webpage to purchase The Doctor and Mr. Dylan, click on the book image below:

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SYNOPSIS of THE DOCTOR AND MR. DYLAN

Hibbing High School

Stanford professor Dr. Nico Antone  leaves the wife he hates and the Stanford job he loves to return to Hibbing, Minnesota where he spent his childhood. He believes his son’s best chance to get accepted into a prestigious college is to graduate at the top of his class in this remote Midwestern town. His son becomes a small town hero and academic star, while Dr. Antone befriends Bobby Dylan, a deranged anesthetist who renamed and reinvented himself as a younger version of the iconic rock legend who grew up in Hibbing. An operating room death rocks their world, and Dr. Antone’s family and his relationship to Mr. Dylan are forever changed.

RICK NOVAK’S BIOGRAPHY

Before writing The Doctor and Mr. Dylan, Rick Novak worked as a clinical anesthesiologist, medical director, and expert witness in Northern California.

Rick was born in Hibbing, Minnesota, to a welding foreman and a homemaker. His mother read two books per week, and Rick developed the same habit, frequently bicycling the four blocks from their home to the public library to pick out new material. He graduated from Hibbing High School in 1972, and was accepted to Harvard College. For his Harvard application essay Rick penned a short story about God revealing Himself to two drunks in a Minnesota tavern.

Hibbing High School Auditorium, Hibbing, Minnesota

Rick declined Harvard and enrolled instead at Carleton College in Northfield, Minnesota, where he received a degree in Chemistry in 1976. From 1973-1977 Rick worked five summers with United States Steel in the iron ore mines near Hibbing. He played on the  United States Junior Men’s Curling championship teams in 1974 and 1975.  Rick then studied medicine at the University of Chicago School, graduated with an MD in 1980, and moved to California the following day to become an intern at Stanford Hospital.

Stanford University Hospital, Stanford, California

 

He spent the next thirty-plus years at Stanford, where he served as an intern, a resident in internal medicine, an emergency room faculty member, an anesthesia resident, and finally as an Adjunct Clinical Associate Professor of Anesthesia and Deputy Chief of the Anesthesia Department at Stanford.

Rick’s writing career blossomed in the role of Deputy Chief, where he authored a monthly column in the department newsletter. The theme of each essay centered on the differences between the private practice of anesthesia and the university-based teaching practice of anesthesia. He began posting these essays on The Anesthesia Consultant website (theanesthesiaconsultant.com) in 2010. Readership grew, and now hundreds of thousands of people visit the website each year.

Beginning in 2001, Dr. Novak developed an interest in anesthesia medical-legal consultation, a role that drew him into the courtroom as an expert witness.

Rick’s lifelong dream of creating entertaining fiction led him to imagine a story: the plot dealt with an anesthesia complication, a crumbling marriage, a son’s quest for elite college admission, and a courtroom drama, all set in his and Bob Dylan’s hometown of Hibbing, Minnesota. Three years of writing and rewriting yielded the manuscript of The Doctor and Mr. Dylan. In 2014, literary agent Anne Devlin believed the story was a winner, and sold the book to Pegasus Publishing.

Rick continues his work in clinical anesthesia at Stanford Hospital and at Waverley Surgery Center in Palo Alto, California. He lives with his three sons, Zachary, Theo, and Oliver, passes on his love of academics and reading to them, and coaches their basketball and Little League baseball teams. Rick is putting the finishing touches on his next novel.