gross domestic product by 2020. In Drugs for Life, Joseph Dumit considers how our burgeoning consumption of medicine and cost of healthcare not only came to be, but also came to be taken for granted. For several years, Dumit attended pharmaceutical industry conferences; spoke with marketers, researchers, doctors, and patients; and surveyed the industry's literature regarding strategies to expand markets for prescription drugs. He concluded that underlying the continual growth in medications, disease categories, costs, and insecurity is a relatively new perception of ourselves as inherently ill and in need of chronic treatment. This perception is based on clinical trials that we have largely outsourced to pharmaceutical companies. Those companies in turn see clinical trials as investments and measure the value of those investments by the size of the market and profits that they will create. They only ask questions for which the answer is more medicine. Drugs for Life challenges our understanding of health, risks, facts, and clinical trials, the very concepts used by pharmaceutical companies to grow markets to the point where almost no one can imagine a life without prescription drugs.

    In this groundbreaking analysis, over thirty of the most popular treatments—acupuncture, homeopathy, aromatherapy, reflexology, chiropractic, and herbal medicines—are examined for their benefits and potential dangers. Questions answered include: What works and what doesn't? What are the secrets, and what are the lies? Who can you trust, and who is ripping you off? Can science decide what is best, or do the old wives' tales really tap into ancient, superior wisdom?In their scrutiny of alternative and complementary cures, authors Simon Singh and Edzard Ernst also strive to reassert the primacy of the scientific method as a means for determining public health practice and policy.

    In The Poisoner's Handbook Blum draws from highly original research to track the fascinating, perilous days when a pair of forensic scientists began their trailblazing chemical detective work, fighting to end an era when untraceable poisons offered an easy path to the perfect crime. Drama unfolds case by case as the heroes of The Poisoner's Handbook—chief medical examiner Charles Norris and toxicologist Alexander Gettler—investigate a family mysteriously stricken bald, Barnum and Bailey's Famous Blue Man, factory workers with crumbling bones, a diner serving poisoned pies, and many others. Each case presents a deadly new puzzle and Norris and Gettler work with a creativity that rivals that of the most imaginative murderer, creating revolutionary experiments to tease out even the wiliest compounds from human tissue. Yet in the tricky game of toxins, even science can't always be trusted, as proven when one of Gettler's experiments erroneously sets free a suburban housewife later nicknamed "America's Lucretia Borgia" to continue her nefarious work. From the vantage of Norris and Gettler's laboratory in the infamous Bellevue Hospital it becomes clear that killers aren't the only toxic threat to New Yorkers. Modern life has created a kind of poison playground, and danger lurks around every corner. Automobiles choke the city streets with carbon monoxide; potent compounds, such as morphine, can be found on store shelves in products ranging from pesticides to cosmetics. Prohibition incites a chemist's war between bootleggers and government chemists while in Gotham's crowded speakeasies each round of cocktails becomes a game of Russian roulette. Norris and Gettler triumph over seemingly unbeatable odds to become the pioneers of forensic chemistry and the gatekeepers of justice during a remarkably deadly time. A beguiling concoction that is equal parts true crime, twentieth-century history, and science thriller, The Poisoner's Handbook is a page-turning account of a forgotten New York.

    An epic, first-of-its-kind book, entwining leading-edge scientific discovery with the intimate stories of four individual lives, by the Pulitzer Prize–winning New York Times journalist.A terminal cancer patient rises from the grave. A medical marvel defies HIV. Two women with autoimmunity discover their own bodies have turned against them. Matt Richtel's An Elegant Defense uniquely entwines these intimate stories with science’s centuries-long quest to unlock the mysteries of sickness and health, and illuminates the immune system as never before.The immune system is our body’s essential defense network, a guardian vigilantly fighting illness, healing wounds, maintaining order and balance, and keeping us alive. Its legion of microscopic foot soldiers—from T cells to “natural killers”—patrols our body, linked by a nearly instantaneous communications grid. It has been honed by evolution over millennia to face an almost infinite array of threats.For all its astonishing complexity, however, the immune system can be easily compromised by fatigue, stress, toxins, advanced age, and poor nutrition—hallmarks of modern life—and even by excessive hygiene. Paradoxically, it is a fragile wonder weapon that can turn on our own bodies with startling results, leading today to epidemic levels of autoimmune disorders.Richtel effortlessly guides readers on a scientific detective tale winding from the Black Plague to twentieth-century breakthroughs in vaccination and antibiotics, to the cutting-edge laboratories that are revolutionizing immunology—perhaps the most extraordinary and consequential medical story of our time. The foundation that Richtel builds makes accessible revelations about cancer immunotherapy, the microbiome, and autoimmune treatments that are changing millions of lives. An Elegant Defense also captures in vivid detail how these powerful therapies, along with our behavior and environment, interact with the immune system, often for the good but always on a razor’s edge that can throw this remarkable system out of balance.Drawing on his groundbreaking reporting for the New York Times and based on extensive new interviews with dozens of world-renowned scientists, Matt Richtel has produced a landmark book, equally an investigation into the deepest riddles of survival and a profoundly human tale that is movingly brought to life through the eyes of his four main characters, each of whom illuminates an essential facet of our “elegant defense.”

    But as costs levitate, that argument becomes more difficult to make. Today, we spend twice as much as Japan on health care—yet few would argue that our health care system is twice as good.Instead, startling new evidence suggests that one out of every three of our health care dollars is squandered on unnecessary or redundant tests; unproven, sometimes unwanted procedures; and overpriced drugs and devices that, too often, are no better than the less expensive products they have replaced.How did this happen? In Money-Driven Medicine, Maggie Mahar takes the reader behind the scenes of a $2 trillion industry to witness how billions of dollars are wasted in a Hobbesian marketplace that pits the industry's players against each other. In remarkably candid interviews, doctors, hospital administrators, patients, health care economists, corporate executives, and Wall Street analysts describe a war of "all against all" that can turn physicians, hospitals, insurers, drugmakers, and device makers into blood rivals. Rather than collaborating, doctors and hospitals compete. Rather than sharing knowledge, drugmakers and device makers divide value. Rather than thinking about long-term collective goals, the imperatives of an impatient marketplace force health care providers to focus on short-term fiscal imperatives. And so investments in untested bleeding-edge medical technologies crowd out investments in information technology that might, in the long run, not only reduce errors but contain costs.In theory, free market competition should tame health care inflation. In fact, Mahar demonstrates, when it comes to medicine, the traditional laws of supply and demand do not apply. Normally, when supply expands, prices fall. But in the health care industry, as the number and variety of drugs, devices, and treatments multiplies, demand rises to absorb the excess, and prices climb. Meanwhile, the perverse incentives of a fee-for-service system reward health care providers for doing more, not less.In this superbly written book, Mahar shows why doctors must take responsibility for the future of our health care industry. Today, she observes, "physicians have been stripped of their standing as professionals: Insurers address them as vendors ('Dear Health Care Provider'), drugmakers and device makers see them as customers (someone you might take to lunch or a strip club), while . . . consumers (aka patients) are encouraged to see their doctors as overpaid retailers. . . . Before patients can reclaim their rightful place as the center—and indeed as the raison d'être—of our health care system," Mahar suggests, "we must once again empower doctors . . . to practice patient-centered medicine—based not on corporate imperatives, doctors' druthers, or even patients' demands," but on the best scientific research available.

    Confusing messages from health authorities and ineffective treatments have left many people desperate for reliable solutions. An enormous alternative industry is filling the void, selling products that are often of questionable safety and totally unknown effectiveness.In Clean, doctor and journalist James Hamblin explores how we got here, examining the science and culture of how we care for our skin today. He talks to dermatologists, microbiologists, allergists, immunologists, aestheticians, bar-soap enthusiasts, venture capitalists, Amish people, theologians, and straight-up scam artists, trying to figure out what it really means to be clean. He even experiments with giving up showers entirely, and discovers that he is not alone.Along the way he realizes that most of our standards of cleanliness are less related to health than most people think. A major part of the picture has been missing: a little-known ecosystem known as the skin microbiome--the trillions of microbes that live on our skin and in our pores. These microbes are not dangerous; they're more like an outer layer of skin that no one knew we had, and they influence everything from acne, eczema, and dry skin to how we smell. The new goal of skin care will be to cultivate a healthy biome--and to embrace the meaning of "clean" in the natural sense. This can mean doing much less, saving time, money, energy, water, and plastic bottles in the process.Lucid, accessible, and deeply researched, Clean explores the ongoing, radical change in the way we think about our skin, introducing readers to the emerging science that will be at the forefront of health and wellness conversations in coming years.

    A natural overachiever, Collins' success, in college and medical school led to a surgical residency at one of the most respected medical centers in the world, the famed Mayo Clinic. But compared to his fellow residents Collins feels inadequate and unprepared. All too soon, the euphoria of beginning his career as an orthopedic resident gives way to the feeling he is a counterfeit, an imposter who has infiltrated a society of brilliant surgeons.This story of Collins' four-year surgical residency traces his rise from an eager but clueless first-year resident to accomplished Chief Resident in his final year. With unparalleled humor, he recounts the disparity between people's perceptions of a doctor's glamorous life and the real thing: a succession of run down cars that are towed to the junk yard, long weekends moonlighting at rural hospitals, a family that grows larger every year, and a laughable income.Collins' good nature helps him over some of the rough spots but cannot spare him the harsh reality of a doctor's life. Every day he is confronted with decisions that will change people's lives-or end them-forever. A young boy's leg is mangled by a tractor: risk the boy's life to save his leg, or amputate immediately? A woman diagnosed with bone cancer injures her hip: go through a painful hip operation even though she has only months to live? Like a jolt to the system, he is faced with the reality of suffering and death as he struggles to reconcile his idealism and aspiration to heal with the recognition of his own limitations and imperfections.Unflinching and deeply engaging, Hot Lights, Cold Steel is a humane and passionate reminder that doctors are people too. This is a gripping memoir, at times devastating, others triumphant, but always compulsively readable.

    But it’s hardly surprising considering how long it’s had to hone its skills. Forty-thousand years ago, our ancestors set off from the cradle of civilization on their journey towards populating the planet. Tuberculosis hitched a lift and came with us, and it’s been there ever since; waiting, watching, and learning. The organism responsible, Mycobacterium tuberculosis, has had plenty of time to adapt to its chosen habitat--human lungs--and has learned through natural selection to be an almost perfect pathogen. Using our own immune cells as a Trojan Horse to aid its spread, it’s come up with clever ways to avoid being killed by antibiotics. But patience has been its biggest lesson--it can enter into a latent state when times are tough, only to come back to life when a host’s immune system is compromised. Today, more than one million people die of the disease every year and around one-third of the world’s population are believed to be infected. That’s more than two billion people. Throw in the compounding problems of drug resistance, the HIV epidemic, and poverty, and it’s clear that tuberculosis remains one of the most serious problems in world medicine. Catching Breath follows the history of TB through the ages, from its time as an infection of hunter-gatherers to the first human villages, which set it up with everything it needed to become the monstrous disease it is today, through to the perils of industrialization and urbanization. It goes on to look at the latest research in fighting the disease, with stories of modern scientific research, interviews with doctors on the TB frontline, and the personal experiences of those affected by the disease.

    Sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place." Now more than 133 million Americans live with chronic illness, accounting for nearly three-quarters of all health care dollars, and untold pain and disability.There has been an alarming rise in illnesses that defy diagnosis through clinical tests or have no known cure. Millions of people, especially women, with illnesses such as irritable bowel syndrome, chronic pain, and chronic fatigue syndrome face skepticism from physicians and the public alike. And people with diseases as varied as cardiovascular disease, HIV, certain cancers, and type 2 diabetes have been accused of causing their preventable illnesses through their lifestyle choices.We must balance our faith in medical technology with awareness of the limits of science, and confront our throwback beliefs that people who are sick have weaker character than those who are well. Through research and patient narratives, health writer Laurie Edwards explores patient rights, the role of social media in medical advocacy, the origins of our attitudes about chronic illness, and much more. What The Noonday Demon did for people suffering from depression, In the Kingdom of the Sick does for those who are chronically ill.

    A lyrical journey from hope to despair and back again, The First Cell explores cancer from every angle: medical, scientific, cultural, and personal. Indeed, Raza describes how she bore the terrible burden of being her own husband's oncologist as he succumbed to leukemia. Like When Breath Becomes Air, The First Cell is no ordinary book of medicine, but a book of wisdom and grace by an author who has devoted her life to making the unbearable easier to bear.

    In this wise and passionate book, one of our most eminent physicians reacquaints us with a classic notion often overlooked in modern medicine: health care with a human face, in which the time-honored art of healing guides doctors in their approach to patient care and their use of medical technology.Drawing on four decades of practice as a cardiologist and a vast knowledge of literature and medical history, Dr. Lown probes the heart and soul of the doctor-patient relationship. Insightful and accessible to all, The Lost Art of Healing describes how true healers use sympathetic listening and touch to hone their diagnostic skills, how language affects the perception of illness, how doctors and patients can cultivate a relationship of trust, and how patients can obtain the most complete and beneficial care through a combination of healing techniques and conventional practices. As Dr. Lown explains, the art of healing does not mean abandoning the spectacular advances of modern science, but rather incorporating them into a sensitive, humane, enlightened approach to medical care. With its urgent message and poignant, fascinating vignettes, The Lost Art of Healing is a book of vital, universal importance.

    This elegant, humane, and engaging book "captures what we know of the development of what makes us human" (Nature).Visit Armand Marie Leroi on the web: http: //armandleroi.com/index.htmlStepping effortlessly from myth to cutting-edge science,

    Lieberman illuminates how these ongoing changes have brought many benefits, but also have created novel conditions to which our bodies are not entirely adapted, resulting in a growing incidence of obesity and new but avoidable diseases, including type-2 diabetes. He proposes that many of these chronic illnesses persist and in some cases are intensifying because of "dysevolution," a pernicious dynamic whereby only the symptoms rather than the causes of these maladies are treated. And finally—provocatively—he advocates the use of evolutionary information to help nudge, push, and sometimes oblige us to create a more salubrious environment.(With charts and line drawings throughout.)From the Hardcover edition.

    That scientist, David Hungerford, had no way of knowing that he had stumbled upon the starting point of modern cancer research—the Philadelphia chromosome. This book charts not only that landmark discovery, but also—for the first time, all in one place—the full sequence of scientific and medical discoveries that brought about the first-ever successful treatment of a lethal cancer at the genetic level.The significance of this mutant chromosome would take more than three decades to unravel; in 1990, it was recognized as the sole cause of a deadly blood cancer, chronic myeloid leukemia, or CML. This dramatic discovery launched a race involving doctors and researchers around the world, who recognized that in principle it might be possible to target CML at its genetic source.Science journalist Jessica Wapner brings extensive original reporting to this book, including interviews with more than thirty-five people with a direct role in this story. Wapner reconstructs more than forty years of crucial breakthroughs, clearly explains the science behind them, and pays tribute to the dozens of researchers, doctors, and patients whose curiosity and determination restored the promise of a future to the more than 70,000 people worldwide who are diagnosed with CML each year. Chief among them is researcher and oncologist Dr. Brian Druker, whose dedication to his patients fueled his quest to do everything within his power to save them.The Philadelphia Chromosome helps us to fully understand and appreciate just how pathbreaking, hard-won, and consequential are the achievements it recounts—and to understand the principles behind much of today’s most important cancer research, as doctors and scientists race to uncover and treat the genetic roots of a wide range of cancers.

    But why are they on the rise?     Science writer Moises Velasquez-Manoff offers a new and controversial way of thinking about autoimmune disease—one that may foster a paradigm shift in the way we think about health and hygiene.     In the early twentieth century, the dawn of improved hygiene, water treatment, vaccines, and antibiotics saved countless lives, eradicating diseases that had plagued humanity for millennia. But in the wake of this triumph, a new threat arose: The human immune system began to malfunction.     A growing body of evidence suggests that the very steps we took to cure these maladies have also eradicated organisms that once kept our bodies in balance. To combat this “epidemic of absence,” a group of scientists has begun deliberately reintroducing parasitic worms—helminthes—to calm the immune system of their hosts. This book takes a close look at the scientists at the vanguard of “worm therapy,” which has been proven to not only preempt immune malfunction, but to send a number of disorders—from Crohn’s Disease to multiple sclerosis to asthma—into remission.     Exploring the greater context of rampant immune system dysfunction in the developed world, and its implications for developing countries, Velasquez-Manoff offers an eye-opening and elegant portrait of science’s new view of the human organism.