Some of these drugs are truly transformative, offering major improvements in how long patients live or how they feel--but what is often missing from the popular narrative is that, far too often, these new drugs have marginal or minimal benefits. Some are even harmful. In Malignant, hematologist-oncologist Dr. Vinayak K. Prasad writes about the many sobering examples of how patients are too often failed by cancer policy and by how oncology is practiced. Throughout this work, Prasad illuminates deceptive practices which- promote novel cancer therapies long before credible data are available to support such treatment; and- exaggerate the potential benefits of new therapies, many of which cost thousands and in some cases hundreds of thousands of dollars.Prasad then critiques the financial conflicts of interest that pervade the oncology field, the pharmaceutical industry, and the US Food and Drug administration.This is a book about how the actions of human beings--our policies, our standards of evidence, and our drug regulation--incentivize the pursuit of marginal or unproven therapies at lofty and unsustainable prices. Prasad takes us through how cancer trials are conducted, how drugs come to market, and how pricing decisions are made, asking how we can ensure that more cancer drugs deliver both greater benefit and a lower price. Ultimately, Prasad says,- more cancer clinical trials should measure outcomes that actually matter to people with cancer;- patients on those trials should look more like actual global citizens;- we need drug regulators to raise, not perpetually lower, the bar for approval; and- we need unbiased patient advocates and experts.This well-written, opinionated, and engaging book explains what we can do differently to make serious and sustained progress against cancer--and how we can avoid repeating the policy and practice mistakes of the past.

    Warren Andiman, an HIV/AIDS researcher who has been on the front lines battling infectious diseases for over forty years. In Animal Viruses and Humans: A Narrow Divide, Andiman traces the history of eight zoonotic viruses —deadly microbes that have made the leap directly from animals to human populations: Middle East Respiratory Syndrome (MERS), Swine influenza, Hantavirus, Monkeypox, Severe Acute Respiratory Syndrome (SARS), Rabies, Ebola, and Henipaviruses (Nipah and Hendra). He also illustrates the labor intensive and fascinating detective work that infectious disease specialists must do to uncover the source of an outbreak.Andiman also looks to the future, envisioning the effects on zoonoses (diseases caused by zoonotic viruses) of climate change, microenvironmental damage, population shifts, and globalization. He reveals the steps that we can, and must, take to stem the spread of animal viruses, explaining, “The zoonoses I've chosen to write about . . . are meant to describe only a small sample of what is already out there but, more menacingly, what is inevitably on its way, in forms we can only imagine.” Warren Andiman, MD is professor emeritus of pediatrics and epidemiology at the Yale Schools of Medicine and Public Health.

    Sometimes Brilliant is the adventures of a philosopher, mystic, hippie, doctor, groundbreaking tech innovator, and key player in the eradication of one of the worst pandemics in human history. His story, of what happens when love, compassion and determination meet the right circumstances to effect positive change, is the kind that keeps hope and the sense of possibility alive.After sitting at the feet of Martin Luther King at the University of Michigan in 1963, Larry Brilliant was swept up into the civil rights movement, marching and protesting across America and Europe. As a radical young doctor he followed the hippie trail from London over the Khyber Pass with his wife Girija, Wavy Gravy and the Hog Farm commune to India. There, he found himself in a Himalayan ashram wondering whether he had stumbled into a cult. Instead, one of India’s greatest spiritual teachers, Neem Karoli Baba, opened Larry’s heart and told him his destiny was to work for the World Health Organization to help eradicate killer smallpox. He would never have believed he would become a key player in eliminating a 10,000-year-old disease that killed more than half a billion people in the 20th century alone.Brilliant’s unlikely trajectory, chronicled in Sometimes Brilliant, has brought him into close proximity with political leaders, spiritual masters, cultural heroes, and titans of technology around the world—from the Grateful Dead to Mikhail Gorbachev, from Ram Dass, the Dalai Lama, Lama Govinda, and Karmapa to Steve Jobs and the founders of Google, Salesforce, Facebook, Microsoft and eBay and Presidents Carter, Clinton, Bush and Obama. Anchored by the engrossing account of the heroic efforts of the extraordinary people involved in smallpox eradication in India, this is a riveting and fascinating epidemiological adventure, an honest reckoning of an entire generation, and a deeply moving spiritual memoir. It is a testament to faith, love, service, and what it means to engage with life’s most important questions in pursuit of a better, more brilliant existence.

    Moving up the Mississippi River in the late summer, in the span of just a few months the fever killed more than eighteen thousand people. The city of Memphis, Tennessee, was particularly hard hit: Of the approximately twenty thousand who didn’t flee the city, seventeen thousand contracted the fever, and more than five thousand died—the equivalent of a million New Yorkers dying in an epidemic today.Fever Season chronicles the drama in Memphis from the outbreak in August until the disease ran its course in late October. The story that Jeanette Keith uncovered is a profound–and never more relevant–account of how a catastrophe inspired reactions both heroic and cowardly. Some ministers, politicians, and police fled their constituents, while prostitutes and the poor risked their lives to nurse the sick. Using the vivid, anguished accounts and diaries of those who chose to stay and those who were left behind, Fever Season depicts the events of that summer and fall. In its pages we meet people of great courage and compassion, many of whom died for having those virtues. We also learn how a disaster can shape the future of a city.

    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.

     Elinor Cleghorn became an unwell woman ten years ago. She was diagnosed with an autoimmune disease after a long period of being told her symptoms were anything from psychosomatic to a possible pregnancy. As Elinor learned to live with her unpredictable disease she turned to history for answers, and found an enraging legacy of suffering, mystification, and misdiagnosis.In Unwell Women, Elinor Cleghorn traces the almost unbelievable history of how medicine has failed women by treating their bodies as alien and other, often to perilous effect. The result is an authoritative and groundbreaking exploration of the relationship between women and medical practice, from the wandering womb of Ancient Greece to the rise of witch trials across Europe, and from the dawn of hysteria as a catchall for difficult-to-diagnose disorders to the first forays into autoimmunity and the shifting understanding of hormones, menstruation, menopause, and conditions like endometriosis.Packed with character studies and case histories of women who have suffered, challenged, and rewritten medical orthodoxy--and the men who controlled their fate--this is a revolutionary examination of the relationship between women, illness, and medicine. With these case histories, Elinor pays homage to the women who suffered so strides could be made, and shows how being unwell has become normalized in society and culture, where women have long been distrusted as reliable narrators of their own bodies and pain. But the time for real change is long overdue: answers reside in the body, in the testimonies of unwell women--and their lives depend on medicine learning to listen.

    These “psychosurgeons,” as they called themselves, occupied a gray zone between medical research and medical practice, and ended up subjecting untold numbers of people to the types of surgical experiments once limited to chimpanzees.The most important test subject to emerge from this largely untold chapter in American history was a twenty-seven-year-old factory worker named Henry Molaison. In 1953, Henry—who suffered from severe epilepsy—received a radical new version of the lobotomy, one that targeted the most mysterious structures in the brain. The operation failed to eliminate Henry’s seizures, but it did have an unintended effect: Henry left the operating room profoundly amnesic, unable to create new long-term memories. Over the next sixty years, Patient H.M., as Henry was known, became the most studied individual in the history of neuroscience, a human guinea pig who would teach us much of what we know about memory today.Luke Dittrich uses the case of Patient H.M. as a starting point for a kaleidoscopic journey, one that moves from the first recorded brain surgeries in ancient Egypt to the cutting-edge laboratories of MIT. He takes readers inside the old asylums and operating theaters where psychosurgeons conducted their human experiments, and behind the scenes of a bitter custody battle over the ownership of the most important brain in the world. Throughout, Dittrich delves into the enduring mysteries of the mind while exposing troubling stories of just how far we’ve gone in our pursuit of knowledge. It is also, at times, a deeply personal journey. Dittrich’s grandfather was the brilliant, morally complex surgeon who operated on Molaison—and thousands of other patients. The author’s investigation into the dark roots of modern memory science ultimately forces him to confront unsettling secrets in his own family history, and to reveal the tragedy that fueled his grandfather’s relentless experimentation—experimentation that would revolutionize our understanding of ourselves.Patient H.M. combines the best of biography, memoir, and science journalism to create a haunting, endlessly fascinating story, one that reveals the wondrous and devastating things that can happen when hubris, ambition, and human imperfection collide.

    News of both the Ice Man's discovery and his age, which was put at over five thousand years, fascinated scientists and newspapers throughout the world. But what made Sykes's story particularly revelatory was his successful identification of a genetic descendant of the Ice Man, a woman living in Great Britain today. How was Sykes able to locate a living relative of a man who died thousands of years ago?In The Seven Daughters of Eve, he gives us a firsthand account of his research into a remarkable gene, which passes undiluted from generation to generation through the maternal line. After plotting thousands of DNA sequences from all over the world, Sykes found that they clustered around a handful of distinct groups. Among Europeans and North American Caucasians, there are, in fact, only seven. This conclusion was staggering: almost everyone of native European descent, wherever they may live throughout the world, can trace their ancestry back to one of seven women, the Seven Daughters of Eve.Naming them Ursula, Xenia, Helena, Velda, Tara, Katrine, and Jasmine, Sykes has created portraits of their disparate worlds by mapping the migratory patterns followed by millions of their ancestors. In reading the stories of these seven women, we learn exactly how our origins can be traced, how and where our ancient genetic ancestors lived, and how we are each living proof of the almost indestructible strands of DNA, which have survived over so many thousands of years. Indeed, The Seven Daughters of Eve is filled with dramatic stories: from Sykes's identification, using DNA samples from two living relatives, of the remains of Tsar Nicholas and Tsaress Alexandra, to the Caribbean woman whose family had been sold into slavery centuries before and whose ancestry Sykes was able to trace back to the Eastern coast of central Africa. Ultimately, Sykes's investigation reveals that, as a race, what humans have in common is more deeply embedded than what separates us.

    In a clear and accessible style, Frank M. Snowden reveals the ways that diseases have not only influenced medical science and public health, but also transformed the arts, religion, intellectual history, and warfare. A multidisciplinary and comparative investigation of the medical and social history of the major epidemics, this volume touches on themes such as the evolution of medical therapy, plague literature, poverty, the environment, and mass hysteria. In addition to providing historical perspective on diseases such as smallpox, cholera, and tuberculosis, Snowden examines the fallout from recent epidemics such as HIV/AIDS, SARS, and Ebola and the question of the world’s preparedness for the next generation of diseases.

    Its presence in nature was dismissed as a desperate response to starvation or other life-threatening circumstances, and few spent time studying it. A taboo subject in our culture, the behavior was portrayed mostly through horror movies or tabloids sensationalizing the crimes of real-life flesh-eaters. But the true nature of cannibalism--the role it plays in evolution as well as human history--is even more intriguing (and more normal) than the misconceptions we've come to accept as fact. In Cannibalism: A Perfectly Natural History, zoologist Bill Schutt sets the record straight, debunking common myths and investigating our new understanding of cannibalism's role in biology, anthropology, and history in the most fascinating account yet written on this complex topic. Schutt takes readers from Arizona's Chiricahua Mountains, where he wades through ponds full of tadpoles devouring their siblings, to the Sierra Nevadas, where he joins researchers who are shedding new light on what happened to the Donner Party--the most infamous episode of cannibalism in American history. He even meets with an expert on the preparation and consumption of human placenta (and, yes, it goes well with Chianti). Bringing together the latest cutting-edge science, Schutt answers questions such as why some amphibians consume their mother's skin; why certain insects bite the heads off their partners after sex; why, up until the end of the twentieth century, Europeans regularly ate human body parts as medical curatives; and how cannibalism might be linked to the extinction of the Neanderthals. He takes us into the future as well, investigating whether, as climate change causes famine, disease, and overcrowding, we may see more outbreaks of cannibalism in many more species--including our own.Cannibalism places a perfectly natural occurrence into a vital new context and invites us to explore why it both enthralls and repels us.

    Within a few short decades the most hostile of the world’s environments had all been conquered. Likewise, in the twentieth century, medicine transformed human life. Doctors took what was routinely fatal and made it survivable. As modernity brought us ever more into different kinds of extremis, doctors pushed the bounds of medical advances and human endurance. Extreme exploration challenged the body in ways that only the vanguard of science could answer. Doctors, scientists, and explorers all share a defining trait: they push on in the face of grim odds. Because of their extreme exploration we not only understand our physiology better; we have also made enormous strides in the science of healing.Drawing on his own experience as an anesthesiologist, intensive care expert, and NASA adviser, Dr. Kevin Fong examines how cuttingedge medicine pushes the envelope of human survival by studying the human body’s response when tested by physical extremes. Extreme Medicine explores different limits of endurance and the lens each offers on one of the systems of the body. The challenges of Arctic exploration created opportunities for breakthroughs in open heart surgery; battlefield doctors pioneered techniques for skin grafts, heart surgery, and trauma care; underwater and outer space exploration have revolutionized our understanding of breathing, gravity, and much more. Avant-garde medicine is fundamentally changing our ideas about the nature of life and death.Through astonishing accounts of extraordinary events and pioneering medicine, Fong illustrates the sheer audacity of medical practice at extreme limits, where human life is balanced on a knife’s edge. Extreme Medicine is a gripping debut about the science of healing, but also about exploration in its broadest sense—and about how, by probing the very limits of our biology, we may ultimately return with a better appreciation of how our bodies work, of what life is, and what it means to be human.

    How does the mind work? Where does madness lie, in the brain or in the mind? How should it be treated?Throughout the nineteenth century, syphilis--a disease of mad poets, musicians, and artists--swept through the highest and lowest rungs of European society like a plague. Known as the Great Imitator, it could produce almost any form of mental or physical illness, and it would bring down a host of famous and infamous characters--among them Guy de Maupassant, Vincent van Gogh, the Marquis de Sade, Friedrich Nietzsche, and Al Capone. It was the first truly psychiatric disease and it filled asylums to overflowing. At the same time, an outbreak of bizarre behaviors resembling epilepsy, but with no identifiable source in the body, strained the diagnostic skills of the great neurologists. It was referred to as hysteria.For more than a century, neurosyphilis stood out as the archetype of a brain-based mental illness, fully understood but largely forgotten, and today far from gone. Hysteria, under many different names, remains unexplained and epidemic. These two conditions stand at opposite poles of the current debate over the role of the brain in mental illness. Hysteria led Freud to insert sex into psychology. Neurosyphilis led to the proliferation of mental institutions. The problem of managing the inmates led to the abuse of lobotomy and electroshock therapy, and ultimately the overuse of psychotropic drugs.Today we know that syphilitic madness was a destructive disease of the brain while hysteria and, more broadly, many varieties of mental illness reside solely in the mind. Or do they? Afflictions once written off as hysterical continue to elude explanation. Addiction, alcoholism, autism, ADHD, Tourette syndrome, depression, and sociopathy, though regarded as brain-based, have not been proven to be so.In these pages, the authors raise a host of philosophical and practical questions. What is the difference between a sick mind and a sick brain? If we understood everything about the brain, would we understand ourselves? By delving into an overlooked history, this book shows how neuroscience and brain scans alone cannot account for a robust mental life, or a deeply disturbed one.

    In this sensational and macabre story, we meet the surgeon who counted not only luminaries Benjamin Franklin, Lord Byron, Adam Smith, and Thomas Gainsborough among his patients but also “resurrection men” among his close acquaintances. A captivating portrait of his ruthless devotion to uncovering the secrets of the human body, and the extraordinary lengths to which he went to do so—including body snatching, performing pioneering medical experiments, and infecting himself with venereal disease—this rich historical narrative at last acknowledges this fascinating man and the debt we owe him today.

    That is until 1904, when the disease broke out in a household in Oyster Bay, Long Island. Authorities suspected the family cook, Mary Mallon, of being a carrier. But before she could be tested, the woman, soon to be known as Typhoid Mary, had disappeared. Over the course of the next three years, Mary worked at several residences, spreading her pestilence as she went. In 1907, she was traced to a home on Park Avenue, and taken into custody. Institutionalized at Riverside Hospital for three years, she was released only when she promised never to work as a cook again. She promptly disappeared.For the next five years Mary worked in homes and institutions in and around New York, often under assumed names. In February 1915, a devastating outbreak of typhoid at the Sloane Hospital for Women was traced to her. She was finally apprehended and reinstitutionalized at Riverside Hospital, where she would remain for the rest of her life.Typhoid Mary is the story of her infamous life. Anthony Bourdain reveals the seedier side of the early 1900s, and writes with his renowned panache about life in the kitchen, uncovering the horrifying conditions that allowed the deadly spread of typhoid over a decade. Typhoid Mary is a true feast for history lovers and Bourdain lovers alike.

    Part autobiography, part mystery, the story is told by a man who was one of the architects of a radical vaccination scheme that became a key strategy in ending the horrible disease when it was finally contained in India. In House on Fire, William H. Foege describes his own experiences in public health and details the remarkable program that involved people from countries around the world in pursuit of a single objective—eliminating smallpox forever. Rich with the details of everyday life, as well as a few adventures, House on Fire gives an intimate sense of what it is like to work on the ground in some of the world’s most impoverished countries—and tells what it is like to contribute to programs that really do change the world.