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.”

    is the first deep-dive investigation of a hazardous and illicit industry that has created a worldwide epidemic, ravaging communities and overwhelming and confounding government agencies that are challenged to combat it. "A whole new crop of chemicals is radically changing the recreational drug landscape," writes Ben Westhoff. "These are known as Novel Psychoactive Substances (NPS) and they include replacements for known drugs like heroin, cocaine, ecstasy, and marijuana. They are synthetic, made in a laboratory, and are much more potent than traditional drugs"--and all-too-often tragically lethal. Drugs like fentanyl, K2, and Spice--and those with arcane acronyms like 25i-NBOMe-- were all originally conceived in legitimate laboratories for proper scientific and medicinal purposes. Their formulas were then hijacked and manufactured by rogue chemists, largely in China, who change their molecular structures to stay ahead of the law, making the drugs' effects impossible to predict. Westhoff has infiltrated this shadowy world, becoming the first journalist to report from inside an illicit Chinese fentanyls lab and providing startling and original reporting on how China's vast chemical industry operates, and how the Chinese government subsidizes it. He tracks down the little-known scientists who invented these drugs and inadvertently killed thousands, as well as a mysterious drug baron who turned the law upside down in his home country of New Zealand. Poignantly, Westhoff chronicles the lives of addicted users and dealers, families of victims, law enforcement officers, and underground drug awareness organizers in the U.S. and Europe. Together they represent the shocking and riveting full anatomy of a calamity we are just beginning to understand. From its depths, as Westhoff relates, are emerging new strategies that may provide essential long-term solutions to the drug crisis that has affected so many.

    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 physician-anthropologist with more than fifteen years in the field, Farmer writes from the front lines of the war against these modern plagues and shows why, even more than those of history, they target the poor. This "peculiarly modern inequality" that permeates AIDS, TB, malaria, and typhoid in the modern world, and that feeds emerging (or re-emerging) infectious diseases such as Ebola and cholera, is laid bare in Farmer's harrowing stories of sickness and suffering.Challenging the accepted methodologies of epidemiology and international health, he points out that most current explanatory strategies, from "cost-effectiveness" to patient "noncompliance," inevitably lead to blaming the victims. In reality, larger forces, global as well as local, determine why some people are sick and others are shielded from risk. Yet this moving account is far from a hopeless inventory of insoluble problems. Farmer writes of what can be done in the face of seemingly overwhelming odds, by physicians determined to treat those in need. Infections and Inequalities weds meticulous scholarship with a passion for solutions—remedies for the plagues of the poor and the social maladies that have sustained them.

    Marcia Angell had a front-row seat on the appalling spectacle of the pharmaceutical industry. She watched drug companies stray from their original mission of discovering and manufacturing useful drugs and instead become vast marketing machines with unprecedented control over their own fortunes. She saw them gain nearly limitless influence over medical research, education, and how doctors do their jobs. She sympathized as the American public, particularly the elderly, struggled and increasingly failed to meet spiraling prescription drug prices. Now, in this bold, hard-hitting new book, Dr. Angell exposes the shocking truth of what the pharmaceutical industry has become–and argues for essential, long-overdue change.Currently Americans spend a staggering $200 billion each year on prescription drugs. As Dr. Angell powerfully demonstrates, claims that high drug prices are necessary to fund research and development are unfounded: The truth is that drug companies funnel the bulk of their resources into the marketing of products of dubious benefit. Meanwhile, as profits soar, the companies brazenly use their wealth and power to push their agenda through Congress, the FDA, and academic medical centers.Zeroing in on hugely successful drugs like AZT (the first drug to treat HIV/AIDS), Taxol (the best-selling cancer drug in history), and the blockbuster allergy drug Claritin, Dr. Angell demonstrates exactly how new products are brought to market. Drug companies, she shows, routinely rely on publicly funded institutions for their basic research; they rig clinical trials to make their products look better than they are; and they use their legions of lawyers to stretch out government-granted exclusive marketing rights for years. They also flood the market with copycat drugs that cost a lot more than the drugs they mimic but are no more effective.The American pharmaceutical industry needs to be saved, mainly from itself, and Dr. Angell proposes a program of vital reforms, which includes restoring impartiality to clinical research and severing the ties between drug companies and medical education. Written with fierce passion and substantiated with in-depth research, The Truth About the Drug Companies is a searing indictment of an industry that has spun out of control.

    But from the moment President Obama signed the bill into law in 2010, a steady and mounting avalanche of misinformation about the ACA has left a growing majority of Americans confused about what it is, why it’s necessary, and how it works. If you’re one of them, buy this book. From how to tame the twin threats of rising costs and the increasing number of uninsured to why an insurance mandate is good for your health, Health Care Reform dispels false fears by arming you with facts.

    A bit of medical gallows humor, this simile illustrates the difficulties of finding signals (the snowball) against a background of noise (the blizzard). Doctors are faced with similar difficulties every day when sifting through piles of data from blood tests to X-rays to endless lists of patient symptoms. Diagnoses are often just educated guesses, and prognoses less certain still. There is a significant amount of uncertainty in the daily practice of medicine, resulting in confusion and potentially deadly complications. Dr. Steven Hatch argues that instead of ignoring this uncertainty, we should embrace it. By digging deeply into a number of rancorous controversies, from breast cancer screening to blood pressure management, Hatch shows us how medicine can fail--sometimes spectacularly--when patients and doctors alike place too much faith in modern medical technology. The key to good health might lie in the ability to recognize the hype created by so many medical reports, sense when to push a physician for more testing, or resist a physician's enthusiasm when unnecessary tests or treatments are being offered. Both humbling and empowering, Snowball in a Blizzard lays bare the inescapable murkiness that permeates the theory and practice of modern medicine. Essential reading for physicians and patients alike, this book shows how, by recognizing rather than denying that uncertainty, we can all make better health decisions.

    In The Demon in the Freezer, his first nonfiction book since The Hot Zone, a #1 New York Times bestseller, Richard Preston takes us into the heart of Usamriid, the United States Army Medical Research Institute of Infectious Diseases at Fort Detrick, Maryland, once the headquarters of the U.S. biological weapons program and now the epicenter of national biodefense.Peter Jahrling, the top scientist at Usamriid, a wry virologist who cut his teeth on Ebola, one of the world’s most lethal emerging viruses, has ORCON security clearance that gives him access to top secret information on bioweapons. His most urgent priority is to develop a drug that will take on smallpox-and win. Eradicated from the planet in 1979 in one of the great triumphs of modern science, the smallpox virus now resides, officially, in only two high-security freezers-at the Centers for Disease Control in Atlanta and in Siberia, at a Russian virology institute called Vector. But the demon in the freezer has been set loose. It is almost certain that illegal stocks are in the possession of hostile states, including Iraq and North Korea. Jahrling is haunted by the thought that biologists in secret labs are using genetic engineering to create a new superpox virus, a smallpox resistant to all vaccines.Usamriid went into a state of Delta Alert on September 11 and activated its emergency response teams when the first anthrax letters were opened in New York and Washington, D.C. Preston reports, in unprecedented detail, on the government’s response to the attacks and takes us into the ongoing FBI investigation. His story is based on interviews with top-level FBI agents and with Dr. Steven Hatfill.Jahrling is leading a team of scientists doing controversial experiments with live smallpox virus at CDC. Preston takes us into the lab where Jahrling is reawakening smallpox and explains, with cool and devastating precision, what may be at stake if his last bold experiment fails.

    The bill was for several hundred thousand dollars--and Medicare paid it. These circumstances left Goldhill angry and determined to understand how it was possible that world-class technology and well-trained personnel could result in such simple, inexcusable carelessness--and how a business that failed so miserably could be rewarded with full payment. Catastrophic Care is the eye-opening result. Goldhill explicates a health-care system that now costs nearly $2.5 trillion annually, bars many from treatment, provides inconsistent quality of care, offers negligible customer service, and in which an estimated 200,000 Americans die each year from errors. Above all, he exposes the fundamental fallacy of our entire system--that Medicare and insurance coverage make care cheaper and improve our health--and suggests a comprehensive new approach that could produce better results at more acceptable costs immediately by giving us, the patients, a real role in the process.

    All that changed with Josie. Sorrel King's eighteen-month-old daughter was badly burned by a faulty water heater in the family's new home, but was taken to the world-renowned Johns Hopkins Hospital, where she made a remarkable recovery. But as she was preparing to leave, the hospital's system of communication broke down and Josie was given a fatal shot of methadone, sending her into cardiac arrest. Within forty-eight hours, the King family went from planning a homecoming to planning a funeral. Dizzy with grief and close to ending her marriage, Sorrel slowly pulled herself and her life back together. Accepting Hopkins' settlement, she and her husband established the Josie King Foundation. They began to implement basic programs in hospitals emphasizing communication between patients, family, and medical staff--practices which can now be found in hospitals around the country. The account of one woman's unlikely path from full-time mom to nationally renowned patient advocate, Josie's Story is the inspirational chronicle of how a mother--and her unforgettable daughter--are transforming the face of American medicine.

    However, in a country of more than 325 million people, addressing everyone's issues is challenging. How can we effect beneficial change for everyone so we all can thrive? What is the great equalizer?In this book, Daniel E. Dawes argues that political determinants of health create the social drivers--including poor environmental conditions, inadequate transportation, unsafe neighborhoods, and lack of healthy food options--that affect all other dynamics of health. By understanding these determinants, their origins, and their impact on the equitable distribution of opportunities and resources, we will be better equipped to develop and implement actionable solutions to close the health gap.Dawes draws on his firsthand experience helping to shape major federal policies, including the Affordable Care Act, to describe the history of efforts to address the political determinants that have resulted in health inequities. Taking us further upstream to the underlying source of the causes of inequities, Dawes examines the political decisions that lead to our social conditions, makes the social determinants of health more accessible, and provides a playbook for how we can address them effectively. A thought-provoking and evocative account that considers both the policies we think of as health policy and those that we don't, The Political Determinants of Health provides a novel, multidisciplinary framework for addressing the systemic barriers preventing the United States from becoming the healthiest nation in the world.

    Doctor, Harvard professor, renowned infectious-disease specialist, anthropologist, the recipient of a MacArthur "genius" grant, world-class Robin Hood, Farmer was brought up in a bus and on a boat, and in medical school found his life’s calling: to diagnose and cure infectious diseases and to bring the lifesaving tools of modern medicine to those who need them most.Mountains Beyond Mountains takes us from Harvard to Haiti, Peru, Cuba, and Russia as Farmer changes minds and practices through his dedication to the philosophy that "the only real nation is humanity"—a philosophy that is embodied in the small public charity he founded, Partners in Health. He enlists the help of the Gates Foundation, George Soros, the U.N.’s World Health Organization, and others in his quest to cure the world. At the heart of this book is the example of a life based on hope, and on an understanding of the truth of the Haitian proverb "Beyond mountains there are mountains": as you solve one problem, another problem presents itself, and so you go on and try to solve that one too.

    A classic comparative study of medicine and national culture, Medicine and Culture shows us that while doctors regard themselves as servants of science, they are often prisoners of custom.

    What is going on? Anatomy of an Epidemic challenges readers to think through that question themselves. First, Whitaker investigates what is known today about the biological causes of mental disorders. Do psychiatric medications fix “chemical imbalances” in the brain, or do they, in fact, create them? Researchers spent decades studying that question, and by the late 1980s, they had their answer. Readers will be startled—and dismayed—to discover what was reported in the scientific journals. Then comes the scientific query at the heart of this book: During the past fifty years, when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? Or did they find that these medications, for some paradoxical reason, increase the likelihood that people will become chronically ill, less able to function well, more prone to physical illness?  This is the first book to look at the merits of psychiatric medications through the prism of long-term results. Are long-term recovery rates higher for medicated or unmedicated schizophrenia patients? Does taking an antidepressant decrease or increase the risk that a depressed person will become disabled by the disorder? Do bipolar patients fare better today than they did forty years ago, or much worse? When the National Institute of Mental Health (NIMH) studied the long-term outcomes of children with ADHD, did they determine that stimulants provide any benefit?  By the end of this review of the outcomes literature, readers are certain to have a haunting question of their own: Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?  In this compelling history, Whitaker also tells the personal stories of children and adults swept up in this epidemic. Finally, he reports on innovative programs of psychiatric care in Europe and the United States that are producing good long-term outcomes. Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up.

    Sharon Moalem turns our current understanding of illness on its head and challenges us to fundamentally change the way we think about our bodies, our health, and our relationship to just about every other living thing on earth, from plants and animals to insects and bacteria.Through a fresh and engaging examination of our evolutionary history, Dr. Moalem reveals how many of the conditions that are diseases today actually gave our ancestors a leg up in the survival sweepstakes. When the option is a long life with a disease or a short one without it, evolution opts for disease almost every time.Everything from the climate our ancestors lived in to the crops they planted and ate to their beverage of choice can be seen in our genetic inheritance. But Survival of the Sickest doesn't stop there. It goes on to demonstrate just how little modern medicine really understands about human health, and offers a new way of thinking that can help all of us live longer, healthier lives..