The Data Detective: Ten Easy Rules to Make Sense of Statistics


Tim Harford - 2020
    That’s a mistake, Tim Harford says in The Data Detective. We shouldn’t be suspicious of statistics—we need to understand what they mean and how they can improve our lives: they are, at heart, human behavior seen through the prism of numbers and are often “the only way of grasping much of what is going on around us.” If we can toss aside our fears and learn to approach them clearly—understanding how our own preconceptions lead us astray—statistics can point to ways we can live better and work smarter.As “perhaps the best popular economics writer in the world” (New Statesman), Tim Harford is an expert at taking complicated ideas and untangling them for millions of readers. In The Data Detective, he uses new research in science and psychology to set out ten strategies for using statistics to erase our biases and replace them with new ideas that use virtues like patience, curiosity, and good sense to better understand ourselves and the world. As a result, The Data Detective is a big-idea book about statistics and human behavior that is fresh, unexpected, and insightful.

Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans


Wendell Potter - 2010
    This former senior VP of CIGNA explained how health insurers make promises they have no intention of keeping, how they flout regulations designed to protect consumers, and how they skew political debate with multibillion-dollar PR campaigns designed to spread disinformation.Potter had walked away from a six-figure salary and two decades as an insurance executive because he could no longer abide the routine practices of an industry where the needs of sick and suffering Americans take a backseat to the bottom line. The last straw: when he visited a rural health clinic and saw hundreds of people standing in line in the rain to receive treatment in stalls built for livestock.In Deadly Spin, Potter takes readers behind the scenes to show how a huge chunk of our absurd healthcare spending actually bankrolls a propaganda campaign and lobbying effort focused on protecting one thing: profits. Whatever the fate of the current health care legislation, it makes no attempt to change that fundamental problem. Potter shows how relentless PR assaults play an insidious role in our political process anywhere that corporate profits are at stake-from climate change to defense policy. Deadly Spin tells us why-and how-we must fight back.

The Good Doctor: A Father, a Son, and the Evolution of Medical Ethics


Barron H. Lerner - 2014
    Barron Lerner thought he had heard it all. But in the mid-1990s, his father, an infectious diseases physician, told him a stunning story: he had physically placed his body over an end-stage patient who had stopped breathing, preventing his colleagues from performing cardiopulmonary resuscitation, even though CPR was the ethically and legally accepted thing to do. Over the next few years, the senior Dr. Lerner tried to speed the deaths of his seriously ill mother and mother-in-law to spare them further suffering.These stories angered and alarmed the younger Dr. Lerner—an internist, historian of medicine and bioethicist—who had rejected physician-based paternalism in favor of informed consent and patient autonomy. The Good Doctor is a fascinating and moving account of how Dr. Lerner came to terms with two very different images of his father: a revered clinician, teacher and researcher who always put his patients first, but also a physician willing to “play God,” opposing the very revolution in patients' rights that his son was studying and teaching to his own medical students.But the elder Dr. Lerner’s journals, which he had kept for decades, showed his son how his outdated paternalism had grown out of a fierce devotion to patient-centered medicine that was rapidly disappearing in a world of managed care, spiraling costs and health care reform. And they raised questions: Are paternalistic doctors just relics or should their expertise be used to overrule patients and families that make ill-advised choices? Does the growing use of personalized medicine—in which specific interventions may be best for specific patients—change the calculus between autonomy and paternalism? And how can we best use technologies that were invented to save lives but now too often prolong death? In an era of high-technology medicine, spiraling costs and healthcare reform, these questions could not be more relevant. As his father slowly died of Parkinson’s disease, Dr. Lerner faced these questions both personally and professionally. He found himself being pulled into his dad’s medical care, even though he had criticized his father for making medical decisions for his relatives. Did playing God—at least in some situations—actually make sense? Did doctors sometimes “know best?” A timely and compelling story of one family’s engagement with medicine over the last half century, The Good Doctor is an important book for those who treat illness—and those who struggle to overcome it.

Catastrophic Care: How American Health Care Killed My Father—and How We Can Fix It


David Goldhill - 2011
    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.

Amity and Prosperity: One Family and the Fracturing of America


Eliza Griswold - 2018
    This is an incredible true account of investigative journalism and a devastating indictment of energy politics in America.Stacey Haney, a lifelong resident of Amity, Pennsylvania, is struggling to support her children when the fracking boom comes to town. Like most of her neighbors, she sees the energy companies' payments as a windfall. Soon trucks are rumbling down her unpaved road and a fenced-off fracking site rises on adjacent land. But her annoyance gives way to concern and then to fear as domestic animals and pets begin dying and mysterious illnesses strike her family--despite the companies' insistence that nothing is wrong.Griswold masterfully chronicles Haney's transformation into an unlikely whistle-blower as she launches her own investigation into corporate wrongdoing. As she takes her case to court, Haney inadvertently reveals the complex rifts in her community and begins to reshape its attitudes toward outsiders, corporations, and the federal government. Amity and Prosperity uses her gripping and moving tale to show the true costs of our energy infrastructure and to illuminate the predicament of rural America in the twenty-first century.

Beating Back the Devil: On the Front Lines with the Disease Detectives of the Epidemic Intelligence Service


Maryn McKenna - 2004
    They always keep a bag packed. They seldom have more than twenty-four hours' notice before they are dispatched. The phone calls that tell them to head to the airport, sometimes in the middle of the night, may give them no more information than the country they are traveling to and the epidemic they will tackle when they get there.The universal human instinct is to run from an outbreak of disease. These doctors run toward it.They are the disease detective corps of the U.S. Centers for Disease Control and Prevention (CDC), the federal agency that tracks and tries to prevent disease outbreaks and bioterrorist attacks around the world. They are formally called the Epidemic Intelligence Service (EIS) -- a group founded more than fifty years ago out of fear that the Korean War might bring the use of biological weapons -- and, like intelligence operatives in the traditional sense, they perform their work largely in anonymity. They are not household names, but over the years they were first to confront the outbreaks that became known as hantavirus, Ebola virus, and AIDS. Now they hunt down the deadly threats that dominate our headlines: West Nile virus, anthrax, and SARS.In this riveting narrative, Maryn McKenna -- the only journalist ever given full access to the EIS in its fifty-three-year history -- follows the first class of disease detectives to come to the CDC after September 11, the first to confront not just naturally occurring outbreaks but the man-made threat of bioterrorism. They are talented researchers -- many with young families -- who trade two years of low pay and extremely long hours for the chance to be part of the group that has helped eradicate smallpox, push back polio, and solve the first major outbreaks of Legionnaires' disease, toxic shock syndrome, and "E. coli" O157.Urgent, exhilarating, and compelling, "Beating Back the Devil" goes with the EIS as they try to stop epidemics -- before the epidemics stop us.

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.

Crazy Like Us: The Globalization of the American Psyche


Ethan Watters - 2009
    But is it possible America's most troubling impact on the globalizing world has yet to be accounted for? In "Crazy Like Us," Ethan Watters reveals that the most devastating consequence of the spread of American culture has not been our golden arches or our bomb craters but our bulldozing of the human psyche itself: We are in the process of homogenizing the way the world goes mad. America has been the world leader in generating new mental health treatments and modern theories of the human psyche. We export our psychopharmaceuticals packaged with the certainty that our biomedical knowledge will relieve the suffering and stigma of mental illness. We categorize disorders, thereby defining mental illness and health, and then parade these seemingly scientific certainties in front of the world. The blowback from these efforts is just now coming to light: It turns out that we have not only been changing the way the world talks about and treats mental illness -- we have been changing the mental illnesses themselves.For millennia, local beliefs in different cultures have shaped the experience of mental illness into endless varieties." Crazy Like Us" documents how American interventions have discounted and worked to change those indigenous beliefs, often at a dizzying rate. Over the last decades, mental illnesses popularized in America have been spreading across the globe with the speed of contagious diseases. Watters travels from China to Tanzania to bring home the unsettling conclusion that the virus is us: As we introduce Americanized ways of treating mental illnesses, we are in fact spreading the diseases.In post-tsunami Sri Lanka, Watters reports on the Western trauma counselors who, in their rush to help, inadvertently trampled local expressions of grief, suffering, and healing. In Hong Kong, he retraces the last steps of the teenager whose death sparked an epidemic of the American version of anorexia nervosa. Watters reveals the truth about a multi-million-dollar campaign by one of the world's biggest drug companies to change the Japanese experience of depression -- literally marketing the disease along with the drug.But this book is not just about the damage we've caused in faraway places. Looking at our impact on the psyches of people in other cultures is a gut check, a way of forcing ourselves to take a fresh look at our own beliefs about mental health and healing. When we examine our assumptions from a farther shore, we begin to understand how our own culture constantly shapes and sometimes creates the mental illnesses of our time. By setting aside our role as the world's therapist, we may come to accept that we have as much to learn from other cultures' beliefs about the mind as we have to teach.

Knocking on Heaven's Door: The Path to a Better Way of Death


Katy Butler - 2013
    It will inspire the necessary and difficult conversations we all need to have with loved ones as it illuminates a path to a better way of death.Like so many of us, award-winning writer Katy Butler always assumed her aging parents would experience healthy, active retire­ments before dying peacefully at home. Then her father suffered a stroke that left him incapable of easily finishing a sentence or showering without assistance. Her mother was thrust into full-time caregiving, and Katy became one of the 24 mil­lion Americans who help care for aging parents. In an effort to correct a minor and non–life threatening heart arrhythmia, doctors outfitted her father with a pacemaker. The device kept his heart beating but did nothing to prevent his slide into dementia, incontinence, near-muteness, and misery. After several years, he asked his wife for help, telling her, "I am living too long." Mother and daughter faced a series of wrench­ing moral questions: When does death cease being a curse and become a blessing? Where is the line between saving life and prolonging a dying? When is the right time to say to a doctor, "Let my loved one go"? When doctors refused to disable the pace­maker, sentencing her father to a protracted and agonizing death, Katy set out to understand why. Her quest had barely begun when her mother faced her own illness, rebelled against her doctors, refused open-heart surgery, and instead met death head-on. Knocking on Heaven's Door, a revolution­ary blend of memoir and investigative reporting, is the fruit of the Butler family's journey. With a reporter's skill, a poet's eye, and a daughter's love, Butler explores what happens when our terror of death collides with the tech­nological imperatives of modern medicine. Her provocative thesis is that advanced medicine, in its single-minded pursuit of maximum longevity, often creates more suffering than it prevents. Butler lays bare the tangled web of technology, medicine, and commerce that modern dying has become and chronicles the rise of Slow Medicine - a growing movement that promotes care over cure. Knocking on Heaven's Door is a visionary map through the labyrinth of a broken and morally adrift medical system. It will inspire the necessary and difficult conversations we all need to have with loved ones as it illuminates a path to a better way of death.

To Err Is Human: Building a Safer Health System


Linda T. Kohn - 2000
    That's more than die from motor vehicle accidents, breast cancer, or AIDS--three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems.To Err Is Human breaks the silence that has surrounded medical errors and their consequence--but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agenda--with state and local implications--for reducing medical errors and improving patient safety through the design of a safer health system.This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes.Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errors--which begs the question, "How can we learn from our mistakes?"Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care.To Err Is Human asserts that the problem is not bad people in health care--it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocates--as well as patients themselves.First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

The Health Gap: The Challenge of an Unequal World


Michael G. Marmot - 2015
    The same twenty-year avoidable disparity exists in the Calton and Lenzie neighborhoods of Glasgow, and in other cities around the world.In Sierra Leone, one in 21 fifteen-year-old women will die in her fertile years of a maternal-related cause; in Italy, the figure is one in 17,100; but in the United States, which spends more on healthcare than any other country in the world, it is one in 1,800. Why?Dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn't drive ill health, but inequality does. Indeed, suicide, heart disease, lung disease, obesity, and diabetes, for example, are all linked to social disadvantage. In every country, people at relative social disadvantage suffer health disadvantage and shorter lives. Within countries, the higher the social status of individuals, the better their health. These health inequalities defy the usual explanations. Conventional approaches to improving health have emphasized access to technical solutions and changes in the behavior of individuals, but these methods only go so far. What really makes a difference is creating the conditions for people to have control over their lives, to have the power to live as they want. Empowerment is the key to reducing health inequality and thereby improving the health of everyone. Marmot emphasizes that the rate of illness of a society as a whole determines how well it functions; the greater the health inequity, the greater the dysfunction.Marmot underscores that we have the tools and resources materially to improve levels of health for individuals and societies around the world, and that to not do so would be a form of injustice. Citing powerful examples and startling statistics ("young men in the U.S. have less chance of surviving to sixty than young men in forty-nine other countries"), The Health Gap presents compelling evidence for a radical change in the way we think about health and indeed society, and inspires us to address the societal imbalances in power, money, and resources that work against health equity.

Ruined by Design: How Designers Destroyed the World, and What We Can Do to Fix It


Mike Monteiro - 2019
    Guns, which lead to so much death, work exactly as they’re designed to work. And every time we “improve” their design, they get better at killing. Facebook’s privacy settings, which have outed gay teens to their conservative parents, are working exactly as designed. Their “real names” iniative, which makes it easier for stalkers to re-find their victims, is working exactly as designed. Twitter’s toxicity and lack of civil discourse is working exactly as it’s designed to work.The world is working exactly as designed. And it’s not working very well. Which means we need to do a better job of designing it. Design is a craft with an amazing amount of power. The power to choose. The power to influence. As designers, we need to see ourselves as gatekeepers of what we are bringing into the world, and what we choose not to bring into the world. Design is a craft with responsibility. The responsibility to help create a better world for all.Design is also a craft with a lot of blood on its hands. Every cigarette ad is on us. Every gun is on us. Every ballot that a voter cannot understand is on us. Every time social network’s interface allows a stalker to find their victim, that’s on us. The monsters we unleash into the world will carry your name.This book will make you see that design is a political act. What we choose to design is a political act. Who we choose to work for is a political act. Who we choose to work with is a political act. And, most importantly, the people we’ve excluded from these decisions is the biggest (and stupidest) political act we’ve made as a society.If you’re a designer, this book might make you angry. It should make you angry. But it will also give you the tools you need to make better decisions. You will learn how to evaluate the potential benefits and harm of what you’re working on. You’ll learn how to present your concerns. You’ll learn the importance of building and working with diverse teams who can approach problems from multiple points-of-view. You’ll learn how to make a case using data and good storytelling. You’ll learn to say NO in a way that’ll make people listen. But mostly, this book will fill you with the confidence to do the job the way you always wanted to be able to do it. This book will help you understand your responsibilities.

The Great Influenza: The Story of the Deadliest Pandemic in History


John M. Barry - 2004
    It killed more people in twenty-four months than AIDS killed in twenty-four years, more in a year than the Black Death killed in a century. But this was not the Middle Ages, and 1918 marked the first collision of science and epidemic disease. Magisterial in its breadth of perspective and depth of research and now revised to reflect the growing danger of the avian flu, The Great Influenza is ultimately a tale of triumph amid tragedy, which provides us with a precise and sobering model as we confront the epidemics looming on our own horizon. John M. Barry has written a new afterword for this edition that brings us up to speed on the terrible threat of the avian flu and suggest ways in which we might head off another flu pandemic.

The Tyranny of Metrics


Jerry Z. Muller - 2017
    But in our zeal to instill the evaluation process with scientific rigor, we've gone from measuring performance to fixating on measuring itself. The result is a tyranny of metrics that threatens the quality of our lives and most important institutions. In this timely and powerful book, Jerry Muller uncovers the damage our obsession with metrics is causing--and shows how we can begin to fix the problem.Filled with examples from education, medicine, business and finance, government, the police and military, and philanthropy and foreign aid, this brief and accessible book explains why the seemingly irresistible pressure to quantify performance distorts and distracts, whether by encouraging "gaming the stats" or "teaching to the test." That's because what can and does get measured is not always worth measuring, may not be what we really want to know, and may draw effort away from the things we care about. Along the way, we learn why paying for measured performance doesn't work, why surgical scorecards may increase deaths, and much more. But metrics can be good when used as a complement to--rather than a replacement for--judgment based on personal experience, and Muller also gives examples of when metrics have been beneficial.Complete with a checklist of when and how to use metrics, The Tyranny of Metrics is an essential corrective to a rarely questioned trend that increasingly affects us all.

The Emperor of All Maladies: A Biography of Cancer


Siddhartha Mukherjee - 2010
    Physician, researcher, and award-winning science writer, Siddhartha Mukherjee examines cancer with a cellular biologist’s precision, a historian’s perspective, and a biographer’s passion. The result is an astonishingly lucid and eloquent chronicle of a disease humans have lived with - and perished from - for more than five thousand years. The story of cancer is a story of human ingenuity, resilience, and perseverance, but also of hubris, paternalism, and misperception. Mukherjee recounts centuries of discoveries, setbacks, victories, and deaths, told through the eyes of his predecessors and peers, training their wits against an infinitely resourceful adversary that, just three decades ago, was thought to be easily vanquished in an all-out “war against cancer.” The book reads like a literary thriller with cancer as the protagonist. From the Persian Queen Atossa, whose Greek slave cut off her malignant breast, to the nineteenth-century recipients of primitive radiation and chemotherapy to Mukherjee’s own leukemia patient, Carla, The Emperor of All Maladies is about the people who have soldiered through fiercely demanding regimens in order to survive—and to increase our understanding of this iconic disease. Riveting, urgent, and surprising, The Emperor of All Maladies provides a fascinating glimpse into the future of cancer treatments. It is an illuminating book that provides hope and clarity to those seeking to demystify cancer.