Box of Birds: What New Zealand Taught Me about Life and the Practice of Medicine Book Review

Full disclosure: I was given a free PDF copy of this book by Stress Free Book Marketing in exchange for an honest review.

If I had a nickel for every time I review a memoir written by a doctor detailing their self-discovery journey by traveling to other countries and practicing more holistic-based medicine, I would have a dime, which is weird, but fascinating that it’s already happened twice. The first book that I encountered that fits that description was Open for Interpretation: A Doctor’s Journey into Astrology by Alicia Blando, M.D. The second and today’s subject is Box of Birds: What New Zealand Taught Me about Life and the Practice of Medicine by Stephen Stowers, M.D. The latter is a passionate and objective look at the author’s time working as a cardiologist in that country.

Box of Birds: What New Zealand Taught Me about Life and the Practice of Medicine spells out what the memoir is. Author and cardiologist Stephen Stowers wanted to become a doctor for many reasons. The main one was that when he was a child, he witnessed his grandfather, who worked as a medical professional, save a man’s life. He wanted to help patients in the best ways possible. Over time, however, he noticed how the American medical system became more about the profit than the patient. The author was so disillusioned by this that he accepted a job offer in New Zealand. This ultimately allowed him to practice medicine in a more ethical fashion and in ways that resulted in better patient outcomes despite the more limited resources. Doing more with less permitted him to become a better doctor.

Essentially, this memoir is how one doctor discovered a better medical system than the one in the United States, but he is balanced about it. When Stephen talks about the way New Zealand practices medicine as a whole, he acknowledges that even though the medical professions spend more time with their patients to find the best treatment for them, the system has limited resources. He also admits that while he had a great time in that country overall, it wasn’t idyllic by any means. For instance, he had a Nepali patient who needed catheterization because he was breathless, had an enlarged heart, had fluid in one of his lungs, and his blood pressure would lower any time he took a breath. Unfortunately, said patient had a complication since he “bled from the puncture wound, had to go to surgery, suffered a complication course, and ended up dying” (p.125). 

Stephen only mentions this part of the story in the Acknowledges section, but it would have been more effective if he included that in the main story to further balance out the perspective.

On the other hand, when he discusses the way the United States goes about that, he notes that while they contain the best resources in the whole medical field, they have become more profit-based because of how much the system encourages doctors to spend more money on their patients. While Alicia briefly touches on this in Open for Interpretation, Stephen gives hardcore specifics. For example, he mentions that the hospital administration that he was at in Florida right before he moved to New Zealand wanted him to generate more relative value units (RVUs). These are units of measurements to quantify every type of interaction the physician had with a customer, uh I mean, patient. He points out that currently, most doctors’ salaries are based on RVUs they generate each day. A physician inserting a stent into a patient with a heart condition will receive more RVUs than one encouraging the same person to exercise, to live a less stressful lifestyle, and to take cholesterol-lowering medication. In turn, the physician would get a higher reimbursement for said stent, and more money would go back to the hospital because of that procedure (p.5). It also doesn’t help that in the United States, doctors are more likely to get sued by patients in case anything goes wrong or is perceived that way. On top of that, when he returned to the United States permanently, physicians wanted to do an invasive procedure on his 95-year-old mother to prevent a blood clot traveling to her lung despite the evidence of how such a process could affect someone her age. This all blew my mind. 

While the critiques of the New Zealand and American medical systems make up a good chunk of the memoir, the bigger point was that the time in the former nation allowed him to become a better doctor. After he travels to New Zealand, each chapter illustrates how he was able to experience less burnout, more connection to his spiritual self, and more time to share his experiences with others as well as to conduct research that could help to save lives. Even in a chapter where he discusses the excursions that he and wife went on during his days off, he always incorporates a point about doctors and the medical field could do that too in the most natural way possible.

His passion for the practice of holistic medicine is clear in his writing, Stephen communicates his stories and ideas in a conversational manner. At the end of the book, he includes a list of Kiwi slang that he learned while he was working in the Southern Hemisphere. In case anyone is wondering, the title of the memoir Box of Birds means happy, joyful, or feeling good. In addition, since he is a physician, he includes a lot of medical terminology. While some of it flew over my head, he was able to explain them in a way that I didn’t need to look them up on the Internet. This is especially true when he was discussing the research he conducted in New Zealand. He wanted to measure the amount of calcium in a patient’s coronary arteries, which can determine the risk of developing a heart attack and the course of treatment. 

Overall, Box of Birds: What New Zealand Taught Me about Life and the Practice of Medicine by Stephen Stowers, M.D. is a passion advocate for the practice of more holistic medicine. While it’s clear what his opinions are on the American versus the New Zealand medical systems, he is pretty balanced. He also writes in a way that anybody can understand, even with the amount of terminology that he uses. I would recommend this memoir to anybody working and/or studying in the medical field. The book will be out this Friday, September 9, so go check it out! It’s a good argument for the need to put patients above profit.

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