He was struck with denial, fear, depression, and anger, and now he's battling back. Graced with strong values, courage, and hard-won wisdom, he shares his insights in this powerful book on the divergent roads a life can take, and recounts how he rose to meet the challenges he's faced. Surprising, searing, and deeply personal, Climbing Higher is as honest and inspiring as its author.

    Jerry Avorn has some sobering news. Drawing on more than twenty-five years of patient care, teaching, and research at Harvard Medical School, he shares his firsthand experience of the wide gap in our knowledge of the effectiveness of one medication as compared to another. In Powerful Medicines, he reminds us that every pill we take represents a delicate compromise between the promise of healing, the risk of side effects, and an increasingly daunting price. The stakes on each front grow higher every year as new drugs with impressive power, worrisome side effects, and troubling costs are introduced.This is a comprehensive behind-the-scenes look at issues that affect everyone: our shortage of data comparing the worth of similar drugs for the same condition; alarming lapses in the detection of lethal side effects; the underuse of life-saving medications; lavish marketing campaigns that influence what doctors prescribe; and the resulting upward spiral of costs that places vital drugs beyond the reach of many Americans.In this engagingly written book, Dr. Avorn asks questions that will interest every consumer: How can a product judged safe by the Food and Drug Administration turn out to have unexpectedly lethal side effects? Why has the nation’s drug bill been growing at nearly 20 percent per year? How can physicians and patients pick the best medication in its class? How do doctors actually make their prescribing decisions, and why do those decisions sometimes go wrong? Why do so many Americans suffer preventable illnesses and deaths that proper drug use could have averted? How can the nation gain control over its escalating drug budget without resorting to rationing or draconian governmental controls?Using clinical case histories taken from his own work as a practitioner, researcher, and advocate, Dr. Avorn demonstrates the impressive power of the well-conceived prescription as well as the debacles that can result when medications are misused. He describes an innovative program that employs the pharmaceutical industry’s own marketing techniques to reduce use of some of the most overprescribed and overpriced products. Powerful Medicines offers timely and practical advice on how the nation can improve its drug-approval process, and how patients can work with doctors to make sure their prescriptions are safe, effective, and as affordable as possible. This is a passionate and provocative call for action as well as a compelling work of clear-headed science.From the Hardcover edition.

    A new mother is admitted with incessant visions of harming her child. A recent graduate, dressed in a tunic and declaring that love emanates from everything around him, is brought to A&E by his alarmed girlfriend. These are among the patients new physician Christine Montross meets during rounds at her hospital’s locked inpatient ward – and who we meet as she struggles to understand the mysteries of the mind, most especially when the tools of modern medicine are failing us. Beautifully written and deeply felt, Falling into the Fire is an intimate portrait of psychiatry and a moving reminder, in the words of the New York Times, of 'our fragile, shared humanity'

    Robert Lesslie, whose routine faced him with times of grief or pain, relief or delight, life or death. Such everyday happenings and encounters gave rise to these vignettes—in which readers will meet up with the characters, coincidences, and complications common to the emergency room:characters like Freddy, who literally shoots himself in the footcoincidences like finally having the chance to hear what patients say to each other when doctors and nurses aren’t in the roomcomplications such as dealing with parents who buy lottery tickets and alcohol instead of medicine for their little boyThese heart-tugging, heart-lifting slices of life will prompt readers to search for opportunities to give the comfort of a touch, the grace of a kind word, or a prayer that brings hope and healing.

    Her sorrow and embarrassment at her outbursts were real, and her attempts to control her anger so earnest that I knew she was trying for me, for herself, and for us. I had to remind myself that I had known that she was intense to the extreme in her experience of life, and that her struggle was my struggle. We would share anger, but we would also share love.No one could ever love Michelle enough. Not her family, not her friends, and certainly not the men (and women) she so easily attracted, like moths to a flame. But when a final-year med student falls for her while she's recovering from a suicide attempt over her latest breakup, they both may be in for more than they bargained for. Hoping to help cure her of her debilitating fears and explosive rage, Anthony marries Michelle in a secret ceremony that alienates him from his family, and ultimately from himself. Initially mesmerized by her seductive smile, her surprising sensuality, and the why behind her wildly unpredictable behavior, the author comes to realize that he will have to sacrifice his career--and more--in order to be with her.This achingly honest and true account of Anthony and Michelle's whirlwind year-and-a-half together provides a window into the emotionally intense world of someone suffering from borderline personality disorder, a condition seen in an estimated 2 percent of the general population and 10 percent of mental health outpatients. It also offers the perspective of those most affected--the sufferer's loved ones, whom despite all the upheaval are still compelled to care. So concludes the author: "I hope that my story will be seen more as a case study in such a relationship than as a cautionary tale."

    Chapters cover cancer, infection, immune disorders, genetics, and disorders of each body system, highlighting pathophysiologic processes, resulting signs and symptoms, diagnostic test findings, and current treatments. Reader-friendly features include illustrations, checklists, and full-color miniguides illustrating the pathophysiology of specific disorders.This edition has new full-color miniguides on cancer pathophysiology and neuropathology. A new Focus on Genetics feature identifies gene-related discoveries and their implications for treatment or diagnosis. Review questions and answers follow current NCLEX-RN® requirements and alternate-format questions are included.

    But sometimes we don't know what to say or do and don't feel comfortable asking. With sensitive insights and thoughtful anecdotes, Help Me Live provides a personal yet thoroughly researched account of words and actions that are most helpful.

    She recounts the travails of growing up in a large, affluent family where there was a paucity of love and of basics such as food and clothing despite the presence of a chauffeur and a cook. She goes on to recount her early hospitalization for depression in poignant detail, as well as her complex relationship with her mercurial, withholding mother.Along the way Merkin also discusses her early, redemptive love of reading and gradual emergence as a writer. She eventually marries, has a child, and suffers severe postpartum depression, for which she is again hospitalized. Merkin also discusses her visits to various therapists and psychopharmocologists, which enables her to probe the causes of depression and its various treatments. The book ends in the present, where the writer has learned how to navigate her depression, if not “cure” it, after a third hospitalization in the wake of her mother’s death.

    The late-night passing of a beloved aunt summons a childhood bully who shows up minutes later, after twenty-five years, to be forgiven and to heal a broken doctor. This ER doctor finds God's opposite in: a battered child's bruises covered over by make-up, a dying patient whose son finally shows up at the end to reclaim the man's high-top sneakers, the rich or celebrity patients loaded with prescription drugs from doctor friends who end up addicted. But, his real outrage is directed at our cavalier treatment of the elderly, If you put a G-tube in your 80-year-old mother with Alzheimer's because she's no longer eating, you will probably have a fast track to hell.

    These beautifully rendered tales illuminate the fundamental pathways of life from birth to death.A woman finds herself daydreaming as she returns home from a business trip; a young man loses his wallet. We learn, too, from more extreme examples: the patient who points an unloaded gun at a police officer, the compulsive liar who convinces his wife he's dying of cancer. The stories invite compassionate understanding, suggesting answers to the questions that compel and disturb us most about love and loss, parents and children, work and change. The resulting journey will spark new ideas about who we are and why we do what we do.

    We may feel tired, cynical, numb, or like we can never do enough. These, and other symptoms, affect us individually and collectively, sapping the energy and effectiveness we so desperately need if we are to benefit humankind, other animals, and the planet itself. Through Trauma Stewardship, we are called to meet these challenges in an intentional way--not by becoming overwhelmed but by developing a quality of mindful presence. Joining the wisdom of ancient cultural traditions with modern psychological research, Lipsky offers a variety of simple and profound practices that will allow us to remake ourselves--and ultimately the world.

    It demonstrates the vicious cycle of habitual responses that lead to debilitating attacks, teaches how to halt this self-destructive process, and guides people along a proven path that promotes recovery. Dr. David Carbonell outlines such cognitive behavioral methods as diaphragmatic breathing, progressive exposure, desensitization, relaxation, keeping a panic diary, and much more. He shows how to cultivate a personal attitude that facilitates solutions rather than placing blame. He clearly explains how the very nature of panic leads people into a chronic cycle of anticipation, panic, and helplessness, and details how to overcome this pattern with innovative responses and an attitude of acceptance. Charts, worksheets, and program outlines help point the way through the workbook and on to recovery.

    Take away the pedigreed and the prodigies—you know the people who are going to succeed no matter what—and the brown-nosers and right-time-right-place lottery winners and who do you have left? The people who succeeded on purpose. Study these folks carefully and you’ll find common themes around their path to the top. This book exposes the career strategies of the ultra-successful and analyzes them in detail. You’ll learn about personal strategies for identifying high-payoff activities and gain insight into being more effective as an individual contributor, manager and leader. You will learn how to identify and interact with the right set of career mentors and role models. Being successful doesn’t have to be an accident. Read this book and learn how to succeed on purpose.

    We all have one, but most of us will never see one. The heart surgeon now has that privilege but, for centuries, the heart was out of reach even for surgeons. So when a surgeon nowadays opens up a ribcage and mends a heart, it remains something of a miracle, even if, to some, it is merely plumbing. As with plumbers, the quality of surgeons’ work varies. As with plumbers, surgeons’ opinion of their own prowess and their own attitude to risk are not always reliable. Measurement is key. We’ve had a century of effective evidence-based medicine. We’ve had barely a decade of thorough monitoring of clinical outcomes. Thanks to the ground-breaking risk modelling of pioneering surgeons like Samer Nashef, we at last know how to judge whether an operation is in a patient’s best interest, which hospital and surgeon would be best for that operation, when it might best be performed and what the exact level of risk is. We have at last made what is important in surgery measurable. But how should surgeons, and their patients, use these newfound insights? Ever since his days as a medical student, Samer Nashef has challenged the medical profession to be more open and more accurate about the success of surgical procedures, for the sake of the patients. In The Naked Surgeon, he unclothes his own profession to demonstrate to his reader (and prospective patient) many revelations, such as the paradox at the heart of the cardiac surgeon’s craft: the more an operation is likely to kill you, the better it is for you. And he does so with absolute clarity, fluency and not a little wit.

    It is the thing that snarls at us when we think about making a change in our lives and stops us developing and achieving our potential. In Taming Tigers Jim Lawless shares his proven and inspirational training programme to help you achieve your dreams by taming the Tigers in your life.Now for the first time, you can learn how to use these highly practical rules to overcome your fears and do things you never thought you could - in both your professional and private life.1.Act boldly today - time is limited2.Re-write your rulebook - challenge it hourly3.Head in the direction of where you want to arrive, every day4.It's all in the mind5.The tools for Taming Tigers are all around you6.There is no safety in numbers7.Do something scary everyday8.Understand and control your time to create change9.Create disciplines - do the basics brilliantly10.Never, never give up!Read case studies from people who have changed their lives by following the rules, and hear about Jim's experience of grabbing his own Tiger by the tail, as he went from a thirty-six-year-old overweight non-riding consultant, to a fully-fledged jockey and UK freediving record holder in 12 months - proof that Taming Tigers works!