and i wonder if for sandeep that disillusionment seems to be that disillusionment of the american doctor is the through line. if you read in "demon camp" you hear jen write about something she referred to in the discussion of the language around the war. in the book she refers to a nation of a sterile war. the possibility that there is an allusion, that the nation is not real and in fact the disillusionment is what creates and generates the books. so anna anticipated my second question but i would like to offer jen and sandeep chance to speak to that. how is disillusionment of this kind you have felt than seen and written about how has that in fact if you can turn it on its head inspired you whether it's anger is anna talked about how do you produce work out of these issues? >> well, i think something that ms said really resonated with me which is just paraphrasing, i don't know what hetero normative means. >> in reference to the book it meant it's only focused on male-female male-female relationship and no acknowledgment of relationships. >> okay. is disillusionment such a bad thing? an

sandeep johar, author of the book, doctor, the dissolution of an american institution. >> i'm disillusionedh the way health care is done in this country. >> it's the for-profit model? >> there are a lot of reasons. i think money and sort of the commercial consciousness is pervading the profession and it has a corrupting influence. and you know, most doctors i'd say the vast vast majority of doctors go to medical school to be car caregivers. we want to be taking care of patients but the system is so diseased that it's created all these obstacles to creative care. >> there was an example of a fish bone, tell us about that. >> i had a patient that went to the er because she swallowed a fish bone and she came to me a couple of weeks later and told me about her experience. she said you know, they called, they did a cat scan, they did an mri, they called an ear nose throat specialist and they told me to follow up with my cardiologist. i said that's not it, it's the fish. that's emblematic, when doctors don't have enough time to talk to their patients and hear what they're saying. the system is su

. >> sandeep, not long ago discussing the time where it might be necessary to lie to a patient.you wrote about balancing various moral riches. sova to learn more about tensions and you were discussing autonomy purses the doctors obligation to do the best for his patient unit in debated a patient that ast never to do that but he said pinky when it saved his life. we have a choice is to go in many different directions. so this question is for all of you. can you say anything specific how you work as writers are critics or teachers to balance one moral virtue of for another? what strategies to use to tell of a reader that you try to work out this moral problem instead of positioning yourself as a moral authority? what happens when you do that? >> something that said that resonated with me was sometimes you think about something and it is complex don't necessarily come to the conclusion as a way to reorder your concept. i think that is especially true with madison. -- medicine. the other thing i want to say is the disillusionment is engendered by periods of change. and there are ama