Robert A. Burton

Doc-In-A-Box

REVIEWS


NY TIMES April 28, 1991 By ELIZABETH FISHEL
Despite its flip title, "Doc-in-a-Box" is anything but cute. This first novel by a San Francisco neurologist is taut, blackly comic and unrelenting. In it, Dr. Robert A. Burton offers bitter insights into modern medicine -- its healers and its hype artists -- as well as softer glimpses into the lives of the down and out who need healing. His medical expertise gives the novel its authenticity, but his literary voice is also cool and confident; he is quick with the well-turned phrase -- and only occasionally too quick. At the center of the novel he puts an emotional triangle of people who have all seen better days. Webb Smith was once a successful plastic surgeon, a "self-ordained master of the superficial." Then there were too many wasted years of idle affairs and booze. Now his wife has left him, and he's lost his license after being framed in a drug bust. He has become a "quack-in-a-shack," working at a seedy walk-in clinic in Los Angeles. Joe Walker is his best buddy. Years before, they had been teamed together on ambulance duty; now Joe is dying of cancer and asks to move in with Webb. Jessica is a silky smooth jazz pianist in a neighborhood bar, a woman who drinks too much and has a patchy past. How these three broken but decent kindred souls shore one another up provides the novel's dramatic force. The pivotal narrative scene, in which Webb takes care of an abused boy, spares no details and is not for the fainthearted. But this novel, like its surgeon's scalpel, cuts close to the bone.

Los Angeles Reader March 8, 1991
This first novel by a San Francisco physician is wonderful—tightly written with a truly unique perspective. Dr. Webb Smith is the Doc-In-A-Box, a once successful L.A. plastic surgeon who, after losing his license, practices illegal, slash-and-burn health care from a Venice street clinic. Burton’s great sense of detail helps faithfully recreate the atmosphere of low-rent medicine, neither squeamish nor prurient. But the novel really takes off when Smith meets Booker, a four-year-old boy who has been stabbed in the cheek, and his mother, a prostitute with a coke habit and a need for secrecy. Things develop slowly, but this unlikely pair becomes responsible for getting Smith to reengage himself in the broad spectrum of events and make decisions based on ethics rather than expedience. Not your standard medical thriller, this book has real depth, a most promising debut.

LA Times BOOK REVIEW Judith Freeman March 1, 1991
There's a good deal to admire in this terse, hard-edged first novel, not least its pace and the clarity with which modern medical dilemmas are presented.The story is set in Los Angeles. In the course of the first few pages, Dr. Webb Smith, "a plastic surgeon in Tinseltown" specializing in facial reconstructions, treats a street kid with a gunshot wound. Webb makes two mistakes: he doesn't report the gunshot wound, and he rather haphazardly accepts a vial of cocaine from the victim. Webb's mistakes are discovered. In short time, the eight physicians who sit on the Board of Medical Quality Assurance pass judgment on him. His license is suspended for a year. When next seen, Dr. Webb Smith is picking up garbage along the L.A. River as part of a gang working off jail sentences in community service. Once Webb had "dreamed of being special; now he couldn't be more ordinary." But his "ordinariness" is, in fact, more complex. Webb isn't exactly a tragic figure or a martyr; he may be a good doctor, but he's the product of his own weaknesses. There's his compulsive womanizing, especially with nurses ("He used to love the sight of a nursing uniform tossed alongside his bed" and found they "smelled of optimism and a sense of duty"), which has caused his wife, Elizabeth, to leave him. He has an affection for alcohol and, occasionally, drugs. He suffers from fatalism, an inability to "enjoy what he had earned"--like a man who saves his good suit for the right occasion, only to watch his life slide by without the occasion arriving. Unable to envision himself as anything but a doctor, Webb decides to flout the rules; when he finishes up his community service, he applies for a job in a walk-in medical clinic called Instantcare, located in a former dress shop in a seedy Venice neighborhood. He doesn't mention his suspended medical license to Williams, the man who hires him. Williams isn't too concerned with certification anyway. At Instantcare, Williams explains, medicine is a business, health care is a product and generating word-of-mouth business matters much more than good, or even valid, credentials.The elderly, the sick and the poor--rather than wealthy women seeking face lifts--become Webb's new patients. Also the abused children of junkie-whores like Mrs. DeJonette, who brings in her 4-year-old son, Booker, with a steak knife stuck through his cheek. Webb is back at the bottom of the heap....
There's a "moral morass" lurking in the practice of medicine, says the author, and Dr. Webb Smith is drawn right into the center of it. Do you take a child away from a junkie-mother, condemning him to float thoughthe foster system, or do you try to save the mother and the child? Can you ethically spare your friend a few tortured last days, or weeks, and quietly assist his death?

San Francisco Chronicle Feb 22, 1991 Patricia Holt
…Compelling first novel of moral retrieval.
It may seem as though Webb and friends are a bunch of losers, but to Burton’s credit, they seem less fallen than human, struggling for moral balance among life’s unfairnesses....
Of course, Webb Smith is going to meet his destiny at Instantcare…. When that happens, don’t plan to talk to anyone for the next several hours; compulsive page-turning will then take over.

Publisher's Weekly Feb 1991
This promising first novel takes a hard-hitting look at the unsavory side of modern medicine as it charts the moral dilemmas of a committed surgeon who bucks an unresponsive health care system. Like his marriage, Webb Smith's career as a Los Angeles plastic surgeon is in ruins, thanks to an unopened vial of cocaine found in his desk, an unwanted gift forced on him by a patient. His license suspended, Smith treats strep throats and hemorrhoids at Instantcare, a seedy 24-hour clinic. In attending to a boy stabbed by his coke-addicted prostitute mother, Smith, his convictions challenged, will again violate statutes and further imperil his license. His personal life is at loose ends, too, as he embarks on a love affair with Jessica, an insecure jazz pianist, and helps Joe, his only friend, cope with terminal cancer. Burton, a California neurologist, writes with surgical precision about the marketing practices, exorbitant costs and unnecessary operations that blot the practice of medicine. The operating-room scenes are wrenching.