40 years in Quincy: Pediatrician Mark Vonnegut looks back at a life caring for children

Pediatrician Mark Vonnegut has loved taking care of children for the past 40 years in Quincy, but he also has experienced many changes in the health care system that will make it difficult for future doctors to do the same.

“There are absolutely wonderful things about devoting 40 years to the same community,” Vonnegut said.

Vonnegut, a Milton resident, summed up how the medical system was when he started, “It was much more cost efficient and more compassionate.”

He charged $20 a visit and everyone paid cash.

Sharing stories of his patients

In his latest book, “The Heart of Caring, A Life in Pediatrics,” Vonnegut writes a series of anecdotes about his patients and the changes that have occurred in the medical field in a thoughtful and sometimes humorous way.

“I have had an absolute ball taking care of babies and children,” Vonnegut writes in the book’s introduction. “There’s no greater honor than having people trust me with their children. I’m afraid more newly minted doctors won’t have the same choices, opportunities, and joy that I’ve had. I’ve been able to figure out how to take care of patients on my own terms, and it feels like getting away with something.”

Having spent most of his childhood and youth in Barnstable Village, Vonnegut remembered firsthand the kind of care he received as a child with a broken arm at Cape Cod Hospital. He recalled the “personable quality of care” from his family’s physician, the late Forrest Beam.

Son of author Kurt Vonnegut grew up in Barnstable

Vonnegut's sister, Edith Vonnegut, lives in the family home on Route 6A that his father, the famed author, Kurt Vonnegut, and his wife purchased for $19,000 in 1954 or 1955.

Mark Vonnegut recalled memories of his youth in the Barnstable schools, where he said he got a good education. He later went on to Harvard Medical School.

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The book, his third, is divided into short chapters  about diseases such as polio, bone cancer, ebola, anemia, lead poisoning, autism, addiction,  and COVID-19.

Other chapter titles include: "Hamburger Helper," "Frankie," "The Worst Mother in the World," "The Girl who was Allergic to Christmas," "The Mother Who Wouldn’t Let Me Touch Her Baby," "Marijuana is Not Your Friend," "Social Media is not Social," and "Psychiatrists by Default."

Healthcare should be about patients

In the chapter “Pediatrics,” Vonnegut writes, “In pediatrics, and most medical care, if the doctor can just shut up and listen long enough, the patient will reveal the diagnosis. Unfortunately, there’s not a procedure code or template for how to shut up.”

He said, “Health care is supposed to be about patients,” and compassion and caring, something he learned as a medical student but that the current system sometimes forgets.

Vonnegut has witnessed the privatization of healthcare, the barriers to mental health services, the skyrocketing cost of insurance and pharmaceutical drugs as well as the decreasing quality of care.

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“It’s awful,” he said. “Now money is the deciding factor. Patient care was 90-plus percent of what hospitals and doctors did. Now coding, billing and negotiating with insurers make up about half of what hospitals do.”

He also lamented the closing of half the community hospitals in the country, leaving huge areas without access to health care.

“Responsiveness is what you lose,” he said. “Local care is better for the community. It’s in everybody’s interest to get good care.”

Doctors should speak out on healthcare

Vonnegut said the pandemic showed we each have a stake in each other’s health. Copayments and deductibles, which he said account for the biggest costs, were dropped for COVID-19, saving patients and families millions of dollars and improved public health.

He said he  believes doctors should be speaking up more about the current healthcare conditions. He said nurses have shown more courage by striking and speaking out for their patients, not for more money.

Vonnegut has made his own efforts to talk about healthcare issues. In his 20s, he wrote in a memoir, “The Eden Express,” about life in the 1960s and his own struggles with psychosis and manic depression, which prompted him to go to medical school. He wrote another book about mental illness in 2010.

“I was trying to get through the stigma of mental health,” he said.

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He  finds he is taking care of more behavioral issues among children, something the pandemic made worse. He now employs five social worker therapists in his practice, something he said more doctors should provide since they are not trained in those areas.

At 75, Vonnegut is working two days a week, but is  the full-time backup provider for his longtime practice on Totman Street in Quincy.

“I’m feeling good about the providers I have hired," he said. "The goal is to keep the practice going the way it was.”

This article originally appeared on The Barnstable Patriot: Vonnegut looks back on four decades doctoring kids in new book