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Author Ver Steeg grew up in a home with midwestern, middle-class American values. He didn't excel greatly at sports, though his coach father had high hopes, and after high school enrolled in pharmacy school at the University of Iowa. Reading Ayn Rand's Atlas Shrugged spurred him to think rationally and become a nonconformist on many levels. He ultimately became a surgeon, making high grades and demonstrating strong technical skills. He took on the persona of a cowboy, feeling it embodied his determination to work and live by his own rules. He battled the increasingly greedy insurance bureaucracy that began to dictate how doctors could practice. Then, after notable successes in private practice, he turned to the discipline of bariatric surgery, at which he excelled. His memoir is filled with the dramatic and often distressing situations in a surgeon's work, along with some triumphant "cowboy" moments, defying the overreach of medical insurance and regulatory schemes.
Now retired, Ver Steeg looks back at his career with a clear vision and the occasional injection of humor. He and his wife, who worked as an administrator in his various office settings, formed a vibrant team. They had to learn the hard way about dodging "slickmeisters" as well as heavy-handed managers. For Ver Steeg, the best times were those spent in a small-town, private practice with a cooperative team of trustworthy nurses and other essential workers. His well-told tales are enjoyable, revealing the way that medical systems work, or do not, to serve the public. His cowboy metaphor is an engaging thread that runs through the narrative, a reminder of his early and consistent determination to think for himself and stand up for his principles. His book can encourage younger medical students and practitioners to maintain their independence as they confront increasingly tangled, overbearing governmental structures.