An Imperfect Offering: Humanitarian Action in the Twenty-first Century


James Orbinski - 2008
    . . . The only crime equaling inhumanity is the crime of indifference, silence, and forgetting.—James OrbinskiIn 1988, James Orbinski, then a medical student in his twenties, embarked on a year-long research trip to Rwanda, a trip that would change who he would be as a doctor and as a man. Investigating the conditions of pediatric AIDS in Rwanda, James confronted widespread pain and suffering, much of it preventable, much of it occasioned by political and economic corruption. Fuelled by the injustice of what he had seen in Rwanda, Orbinski helped establish the Canadian chapter of Médecins Sans Frontières (Doctors Without Borders/MSF). As a member of MSF he travelled to Peru during a cholera epidemic, to Somalia during the famine and civil war, and to Jalalabad, Afghanistan.In April 1994, James answered a call from the MSF Amsterdam office. Rwandan government soldiers and armed militias of extremist Hutus had begun systematically to murder Tutsis. While other foreigners were evacuated from Rwanda, Orbinski agreed to serve as Chef de Mission for MSF in Kigali. As Rwanda descended into a hell of civil war and genocide, he and his team worked tirelessly, tending to thousands upon thousands of casualties. In fourteen weeks 800,000 men, women and children were exterminated. Half a million people were injured, and millions were displaced. The Rwandan genocide was Orbinski’s undoing. Confronted by indescribable cruelty, he struggled to regain his footing as a doctor, a humanitarian and a man. In the end he chose not to retreat from the world, but resumed his work with MSF, and was the organization’s president when it was awarded the Nobel Peace Prize in 1999.An Imperfect Offering is a deeply personal, deeply political book. With unstinting candor, Orbinski explores the nature of humanitarian action in the twenty-first century, and asserts the fundamental imperative of seeing as human those whose political systems have most brutally failed. He insists that in responding to the suffering of others, we must never lose sight of the dignity of those being helped or deny them the right to act as agents in their own lives. He takes readers on a journey to some of the darkest places of our history but finds there unimaginable acts of courage and empathy. Here he is doctor as witness, recording voices that must be heard around the world; calling on others to meet their responsibility.Ummera, ummera–sha is a Rwandan saying that loosely translated means ‘Courage, courage, my friend–find your courage and let it live.’ It was said to me by a patient at our hospital in Kigali. She was slightly older than middle aged and had been attacked with machetes, her entire body rationally and systematically mutilated. Her face had been so carefully disfigured that a pattern was obvious in the slashes. I could do little more for her at that moment than stop the bleeding with a few sutures. We were completely overwhelmed. She knew and I knew that there were so many others. She said to me in the clearest voice I have ever heard, “Allez, allez. Ummera, ummera-sha”–‘Go, go. Courage, courage, my friend–find your courage and let it live.’—From An Imperfect Offering

Dying of Whiteness: How the Politics of Racial Resentment Is Killing America's Heartland


Jonathan M. Metzl - 2019
    In the era of Donald Trump, many lower- and middle-class white Americans are drawn to politicians who pledge to make their lives great again. But as Dying of Whiteness shows, the policies that result actually place white Americans at ever-greater risk of sickness and death.Physician Jonathan M. Metzl's quest to understand the health implications of "backlash governance" leads him across America's heartland. Interviewing a range of everyday Americans, he examines how racial resentment has fueled pro-gun laws in Missouri, resistance to the Affordable Care Act in Tennessee, and cuts to schools and social services in Kansas. And he shows these policies' costs: increasing deaths by gun suicide, rising dropout rates, and falling life expectancies. White Americans, Metzl argues, must reject the racial hierarchies that promise to aid them but in fact lead our nation to demise.

The Hospital: Life, Death, and Dollars in a Small American Town


Brian Alexander - 2021
    Americans are dying sooner, and living in poorer health. Alexander argues that no plan will solve America’s health crisis until the deeper causes of that crisis are addressed. Bryan, Ohio's hospital, is losing money, making it vulnerable to big health systems seeking domination and Phil Ennen, CEO, has been fighting to preserve its independence. Meanwhile, Bryan, a town of 8,500 people in Ohio’s northwest corner, is still trying to recover from the Great Recession. As local leaders struggle to address the town’s problems, and the hospital fights for its life amid a rapidly consolidating medical and hospital industry, a 39-year-old diabetic literally fights for his limbs, and a 55-year-old contractor lies dying in the emergency room. With these and other stories, Alexander strips away the wonkiness of policy to reveal Americans’ struggle for health against a powerful system that’s stacked against them, but yet so fragile it blows apart when the pandemic hits. Culminating with COVID-19, this book offers a blueprint for how we created the crisis we're in.

Betrayal of Trust: The Collapse of Global Public Health


Laurie Garrett - 2000
    Garrett also exposes the ungoverned world of biological terrorism.

Griftopia: Bubble Machines, Vampire Squids, and the Long Con That Is Breaking America


Matt Taibbi - 2010
    The stunning rise, fall, and rescue of Wall Street in the bubble-and-bailout era was the coming-out party for the network of looters who sit at the nexus of American political and economic power. The grifter class—made up of the largest players in the financial industry and the politicians who do their bidding—has been growing in power for a generation, transferring wealth upward through increasingly complex financial mechanisms and political maneuvers. The crisis was only one terrifying manifestation of how they’ve hijacked America’s political and economic life.Rolling Stone’s Matt Taibbi here unravels the whole fiendish story, digging beyond the headlines to get into the deeper roots and wider implications of the rise of the grifters. He traces the movement’s origins to the cult of Ayn Rand and her most influential—and possibly weirdest—acolyte, Alan Greenspan, and offers fresh reporting on the backroom deals that decided the winners and losers in the government bailouts. He uncovers the hidden commodities bubble that transferred billions of dollars to Wall Street while creating food shortages around the world, and he shows how finance dominates politics, from the story of investment bankers auctioning off America’s infrastructure to an inside account of the high-stakes battle for health-care reform—a battle the true reformers lost. Finally, he tells the story of Goldman Sachs, the “vampire squid wrapped around the face of humanity.” Taibbi has combined deep sources, trailblazing reportage, and provocative analysis to create the most lucid, emotionally galvanizing, and scathingly funny account yet written of the ongoing political and financial crisis in America. This is essential reading for anyone who wants to understand the labyrinthine inner workings of politics and finance in this country, and the profound consequences for us all.

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients


Ben Goldacre - 2012
    We like to imagine that it’s based on evidence and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature surrounding a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.All these problems have been protected from public scrutiny because they’re too complex to capture in a sound bite. But Dr. Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct on a global scale affects us. In his own words, “the tricks and distortions documented in these pages are beautiful, intricate, and fascinating in their details.” With Goldacre’s characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system and calls for something to be done. This is the pharmaceutical industry as it has never been seen before.

Our Malady: Lessons in Liberty from a Hospital Diary


Timothy Snyder - 2020
    Unable to stand, barely able to think, he waited for hours in an emergency room before being correctly diagnosed and rushed into surgery. Over the next few days, as he clung to life and the first light of a new year came through his window, he found himself reflecting on the fragility of health, not recognized in America as a human right but without which all rights and freedoms have no meaning.And that was before the pandemic. We have since watched American hospitals, long understaffed and undersupplied, buckling under waves of coronavirus patients. The federal government made matters worse through willful ignorance, misinformation, and profiteering. Our system of commercial medicine failed the ultimate test, and thousands of Americans died.In this eye-opening cri de coeur, Snyder traces the societal forces that led us here and outlines the lessons we must learn to survive. In examining some of the darkest moments of recent history and of his own life, Snyder finds glimmers of hope and principles that could lead us out of our current malaise. Only by enshrining healthcare as a human right, elevating the authority of doctors and medical knowledge, and planning for our children's future can we create an America where everyone is truly free.

Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth


Rachel Maddow - 2019
    That same year, a trove of Michael Jackson memorabilia—including his iconic crystal-encrusted white glove—was sold at auction for over $1 million to a guy who was, officially, just the lowly forestry minister of the tiny nation of Equatorial Guinea. And in 2014, Ukrainian revolutionaries raided the palace of their ousted president and found a zoo of peacocks, gilded toilets, and a floating restaurant modeled after a Spanish galleon. Unlikely as it might seem, there is a thread connecting these events, and Rachel Maddow follows it to its crooked source: the unimaginably lucrative and equally corrupting oil and gas industry. With her trademark black humor, Maddow takes us on a switchback journey around the globe, revealing the greed and incompetence of Big Oil and Gas along the way, and drawing a surprising conclusion about why the Russian government hacked the 2016 U.S. election. She deftly shows how Russia’s rich reserves of crude have, paradoxically, stunted its growth, forcing Putin to maintain his power by spreading Russia’s rot into its rivals, its neighbors, the West’s most important alliances, and the United States. Chevron, BP, and a host of other industry players get their star turn, most notably ExxonMobil and the deceptively well-behaved Rex Tillerson. The oil and gas industry has weakened democracies in developed and developing countries, fouled oceans and rivers, and propped up authoritarian thieves and killers. But being outraged at it is, according to Maddow, “like being indignant when a lion takes down and eats a gazelle. You can’t really blame the lion. It’s in her nature.” Blowout is a call to contain the lion: to stop subsidizing the wealthiest businesses on earth, to fight for transparency, and to check the influence of the world’s most destructive industry and its enablers. The stakes have never been higher. As Maddow writes, “Democracy either wins this one or disappears.”

White Coat, Black Hat: Adventures on the Dark Side of Medicine


Carl Elliott - 2010
    A writer for The New Yorker and The Atlantic Monthly, Carl Elliott ventures into the uncharted dark side of medicine, shining a light on the series of social and legislative changes that have sacrificed old-style doctoring to the values of consumer capitalism. Along the way, he introduces us to the often shifty characters who work the production line in Big Pharma: from the professional guinea pigs who test-pilot new drugs and the ghostwriters who pen “scientific” articles for drug manufacturers to the PR specialists who manufacture “news” bulletins. We meet the drug reps who will do practically anything to make quota in an ever-expanding arms race of pharmaceutical gift-giving; the “thought leaders” who travel the world to enlighten the medical community about the wonders of the latest release; even, finally, the ethicists who oversee all that commercialized medicine has to offer from their pharma-funded perches.   Taking the pulse of the medical community today, Elliott discovers the culture of deception that has become so institutionalized many people do not even see it as a problem. Head-turning stories and a rogue’s gallery of colorful characters become his springboard for exploring larger ethical issues surrounding money. Are there certain things that should not be bought and sold? In what ways do the ethics of business clash with the ethics of medical care? And what is wrong with medical consumerism anyway? Elliott asks all these questions and more as he examines the underbelly of medicine.

The Price We Pay: What Broke American Health Care--and How to Fix It


Marty Makary - 2019
    Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of price-gouging, middlemen, and a series of elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable.The Price We Pay offers a roadmap for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.

What Really Happened in Wuhan: The Cover-Ups, the Conspiracies and the Classified Research


Sharri Markson - 2021
    Scientists and government officials insisted, for a year and a half, that the virus had a natural origin, ridiculing anyone who dared contradict this view. Tech giants swept the internet, censoring and silencing debate in the most extreme fashion. Yet it is undeniable that a secretive facility in Wuhan was immersed in genetically manipulating bat-coronaviruses in perilous experiments. And as soon as the news of an outbreak in Wuhan leaked, the Chinese military took control and gagged all laboratory insiders.Part-thriller, part-expose, What Really Happened in Wuhan is a ground-breaking investigation from leading journalist Sharri Markson into the origins of Covid-19, the cover-ups, the conspiracies and the classified research. It features never-before-seen primary documents exposing China's concealment of the virus, fresh interviews with whistleblower doctors in Wuhan and crucial eyewitness accounts that dismantle what we thought we knew about when the outbreak hit.With unprecedented access to Washington insiders, Markson takes you inside the White House, with senior Trump lieutenants revealing first-hand accounts of fiery Oval Office clashes and new stories of compromised government advisors and censored scientists.Bravely reported and chillingly laid out, Markson brings to light the stories of the pandemic from the people on the ground: the scientists and national security officials who raised uncomfortable truths and were labelled conspiracy theorists, until government agencies began to suspect they might have been right all along. These brave individuals persisted through bruising battles and played a crucial role in investigating the origins of Covid-19 to finally, in this book, bring us closer to the truth of what really happened in Wuhan.

Apollo's Arrow: The Profound and Enduring Impact of Coronavirus on the Way We Live


Nicholas A. Christakis - 2020
    Drawing on momentous (yet dimly remembered) historical epidemics, contemporary analyses, and cutting-edge research from a range of scientific disciplines, bestselling author, physician, sociologist, and public health expert Nicholas A. Christakis explores what it means to live in a time of plague—an experience that is paradoxically uncommon to the vast majority of humans who are alive, yet deeply fundamental to our species.Unleashing new divisions in our society as well as opportunities for cooperation, this 21st-century pandemic has upended our lives in ways that will test, but not vanquish, our already frayed collective culture. Featuring new, provocative arguments and vivid examples ranging across medicine, history, sociology, epidemiology, data science, and genetics, Apollo's Arrow envisions what happens when the great force of a deadly germ meets the enduring reality of our evolved social nature.

Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer


Shannon Brownlee - 2007
    Our health care is staggeringly expensive, yet one in six Americans has no health insurance. We have some of the most skilled physicians in the world, yet one hundred thousand patients die each year from medical errors. In this gripping, eye-opening book, award-winning journalist Shannon Brownlee takes readers inside the hospital to dismantle some of our most venerated myths about American medicine. Using vivid examples of real patients and physicians, Overtreated debunks the idea that most of medicine is based in sound science, and shows how our health care system delivers huge amounts of unnecessary care that is not only expensive and wasteful but can actually imperil the health of patients.The interests of politicians and the medical-industrial complex continually trump those of patients, seducing the wealthy with unnecessary procedures and leaving the poor with haphazard access to treatment. Backward economic incentives allow patients with chronic conditions to receive ineffective care, and roll after roll of red tape undermines even the best-intentioned doctors. Tens of thousands of patients die each year from overtreatment. American medicine is in desperate need of fixing.Nevertheless, Overtreated ultimately conveys a message of hope by reframing the debate over health care reform. Americans worry about rationing--that any effort to rein in the high cost of health care will result in limited access to life-saving treatments. Covering the uninsured seems like an insurmountable problem because it will drive up costs even more. Overtreated offers a way to control costs and cover the uninsured, while simultaneously improving the quality of American medicine. Shannon Brownlee's humane, intelligent, and penetrating analysis empowers readers to avoid the perils of overtreatment, as well as pointing the way to better health care for everyone.

Political Tribes: Group Instinct and the Fate of Nations


Amy Chua - 2018
    We need to belong to groups. In many parts of the world, the group identities that matter most - the ones that people will kill and die for - are ethnic, religious, sectarian, or clan-based. But because America tends to see the world in terms of nation-states engaged in great ideological battles - Capitalism vs. Communism, Democracy vs. Authoritarianism, the "Free World" vs. the "Axis of Evil" - we are often spectacularly blind to the power of tribal politics. Time and again this blindness has undermined American foreign policy.In the Vietnam War, viewing the conflict through Cold War blinders, we never saw that most of Vietnam's "capitalists" were members of the hated Chinese minority. Every pro-free-market move we made helped turn the Vietnamese people against us. In Iraq, we were stunningly dismissive of the hatred between that country's Sunnis and Shias. If we want to get our foreign policy right - so as to not be perpetually caught off guard and fighting unwinnable wars - the United States has to come to grips with political tribalism abroad.Just as Washington's foreign policy establishment has been blind to the power of tribal politics outside the country, so too have American political elites been oblivious to the group identities that matter most to ordinary Americans - and that are tearing the United States apart. As the stunning rise of Donald Trump laid bare, identity politics have seized both the American left and right in an especially dangerous, racially inflected way. In America today, every group feels threatened: whites and blacks, Latinos and Asians, men and women, liberals and conservatives, and so on. There is a pervasive sense of collective persecution and discrimination. On the left, this has given rise to increasingly radical and exclusionary rhetoric of privilege and cultural appropriation. On the right, it has fueled a disturbing rise in xenophobia and white nationalism.In characteristically persuasive style, Amy Chua argues that America must rediscover a national identity that transcends our political tribes. Enough false slogans of unity, which are just another form of divisiveness. It is time for a more difficult unity that acknowledges the reality of group differences and fights the deep inequities that divide us.

The Retreat of Western Liberalism


Edward Luce - 2017
    Luce argues that we are on a menacing trajectory brought about by ignorance of what it took to build the West, arrogance towards society's economic losers, and complacency about our system's durability--attitudes that have been emerging since the fall of the Berlin Wall. We cannot move forward without a clear diagnosis of what has gone wrong. Unless the West can rekindle an economy that produces gains for the majority of its people, its political liberties may be doomed. The West's faith in history teaches us to take democracy for granted. Reality tells us something troublingly different.Combining on-the-ground reporting with intelligent synthesis of the literature and economic analysis, Luce offers a detailed projection of the consequences of the Trump administration, the rise of European populism, and a forward-thinking analysis of what those who believe in enlightenment values must do to defend them from the multiple onslaughts they face in the coming years.