For the seventeenth-century aristocratic Frenchman, it meant changing his shirt once a day, using perfume to obliterate both his own aroma and everyone else’s, but never immersing himself in – horrors! – water. By the early 1900s, an extraordinary idea took hold in North America – that frequent bathing, perhaps even a daily bath, was advisable. Not since the Roman Empire had people been so clean, and standards became even more extreme as the millennium approached. Now we live in a deodorized world where germophobes shake hands with their elbows and where sales of hand sanitizers, wipes and sprays are skyrocketing.The apparently routine task of taking up soap and water (or not) is Katherine Ashenburg’s starting point for a unique exploration of Western culture, which yields surprising insights into our notions of privacy, health, individuality, religion and sexuality.Ashenburg searches for clean and dirty in plague-ridden streets, medieval steam baths, castles and tenements, and in bathrooms of every description. She reveals the bizarre rescriptions of history’s doctors as well as the hygienic peccadilloes of kings, mistresses, monks and ordinary citizens, and guides us through the twists and turns to our own understanding of clean, which is no more rational than the rest. Filled with amusing anecdotes and quotations from the great bathers of history, The Dirt on Clean takes us on a journey that is by turns intriguing, humorous, startling and not always for the squeamish. Ashenburg’s tour of history’s baths and bathrooms reveals much about our changing and most intimate selves – what we desire, what we ignore, what we fear, and a significant part of who we are.

    A few (identities disguised) come from the author’s own clinical encounters.  Every scenario is followed by a brief reflection of how various modern thought leaders (ethicists, philosophers, courts, political commentators, research scientists, and medical professionals) have addressed the underlying issues.

    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.

    His passing on March 6, 1900, would have been unremarkable if a city health officer hadn’t noticed a swollen black lymph node on his groin—a sign of bubonic plague. Empowered by racist pseudoscience, officials rushed to quarantine Chinatown while doctors examined Wong’s tissue for telltale bacteria. If the devastating disease was not contained, San Francisco would become the American epicenter of an outbreak that had already claimed ten million lives worldwide.To local press, railroad barons, and elected officials, such a possibility was inconceivable—or inconvenient. As they mounted a cover-up to obscure the threat, ending the career of one of the most brilliant scientists in the nation in the process, it fell to federal health officer Rupert Blue to save a city that refused to be rescued. Spearheading a relentless crusade for sanitation, Blue and his men patrolled the squalid streets of fast-growing San Francisco, examined gory black buboes, and dissected diseased rats that put the fate of the entire country at risk.In the tradition of Erik Larson and Steven Johnson, Randall spins a spellbinding account of Blue’s race to understand the disease and contain its spread—the only hope of saving San Francisco, and the nation, from a gruesome fate.

    Kandel, The Age of Insight takes us to Vienna 1900, where leaders in science, medicine, and art began a revolution that changed forever how we think about the human mind—our conscious and unconscious thoughts and emotions—and how mind and brain relate to art.   At the turn of the century, Vienna was the cultural capital of Europe. Artists and scientists met in glittering salons, where they freely exchanged ideas that led to revolutionary breakthroughs in psychology, brain science, literature, and art. Kandel takes us into the world of Vienna to trace, in rich and rewarding detail, the ideas and advances made then, and their enduring influence today.   The Vienna School of Medicine led the way with its realization that truth lies hidden beneath the surface. That principle infused Viennese culture and strongly influenced the other pioneers of Vienna 1900. Sigmund Freud shocked the world with his insights into how our everyday unconscious aggressive and erotic desires are repressed and disguised in symbols, dreams, and behavior. Arthur Schnitzler revealed women’s unconscious sexuality in his novels through his innovative use of the interior monologue. Gustav Klimt, Oscar Kokoschka, and Egon Schiele created startlingly evocative and honest portraits that expressed unconscious lust, desire, anxiety, and the fear of death.   Kandel tells the story of how these pioneers—Freud, Schnitzler, Klimt, Kokoschka, and Schiele—inspired by the Vienna School of Medicine, in turn influenced the founders of the Vienna School of Art History to ask pivotal questions such as What does the viewer bring to a work of art? How does the beholder respond to it? These questions prompted new and ongoing discoveries in psychology and brain biology, leading to revelations about how we see and perceive, how we think and feel, and how we respond to and create works of art. Kandel, one of the leading scientific thinkers of our time, places these five innovators in the context of today’s cutting-edge science and gives us a new understanding of the modernist art of Klimt, Kokoschka, and Schiele, as well as the school of thought of Freud and Schnitzler. Reinvigorating the intellectual enquiry that began in Vienna 1900, The Age of Insight is a wonderfully written, superbly researched, and beautifully illustrated book that also provides a foundation for future work in neuroscience and the humanities. It is an extraordinary book from an international leader in neuroscience and intellectual history.

    But the president insisted there was nothing to worry about.Fortunately, we are still a nation of skeptics. Fortunately, there are those among us who study pandemics and are willing to look unflinchingly at worst-case scenarios. Michael Lewis’s taut and brilliant nonfiction thriller pits a band of medical visionaries against the wall of ignorance that was the official response of the Trump administration to the outbreak of COVID-19.The characters you will meet in these pages are as fascinating as they are unexpected. A thirteen-year-old girl’s science project on transmission of an airborne pathogen develops into a very grown-up model of disease control. A local public-health officer uses her worm’s-eye view to see what the CDC misses, and reveals great truths about American society. A secret team of dissenting doctors, nicknamed the Wolverines, has everything necessary to fight the pandemic: brilliant backgrounds, world-class labs, prior experience with the pandemic scares of bird flu and swine flu…everything, that is, except official permission to implement their work.Michael Lewis is not shy about calling these people heroes for their refusal to follow directives that they know to be based on misinformation and bad science. Even the internet, as crucial as it is to their exchange of ideas, poses a risk to them. They never know for sure who else might be listening in.

    Organized conceptually around the major fields of medical endeavour - anatomy, physiology, pathology, pharmacology, surgery, obstetrics, psychiatry, pediatrics, and family medicine - this book is an accessible overview of medical history as a vibrant component of social, intellectual, and cultural history, and as a research discipline in its own right.Each chapter begins in antiquity and ends in the twentieth century. Throughout, Duffin shows that alternative interpretations can be found for most elements of our past and that topics of interest can go well beyond 'great men' and 'great discoveries' to include ideas, diseases, patients, institutions, and great mistakes. This approach does not mean that the 'great men' (and women) are neglected; rather they appear in context. Medical disasters such as chloramphenicol and thalidomide, are covered along with the triumphs, and examples from Canada's past, largely ignored in other medical histories, are included. A chapter on methodology, suggestions for further reading with special attention to Canadian sources, and a careful index make it possible to research a specific event or historical debate, or to satisfy a more general curiosity.By presenting the material in a structure that resonates with the broad outlines of medical training, and by focusing on the questions asked most often, this text is a relevant guide for students to the history of the profession they are about to embrace, and for those who would teach them, be they physicians or historians. Duffin's clear and entertaining prose and the many illustrations will help to demystify medicine for general readers and for students in other domains, such as history, philosophy, and sociology.

    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.

    The medical world has generally ignored these “near-death experiences,” dismissing them as “tricks of the brain” or wishful thinking. But after his patients started describing events that he could not just sweep under the rug, Dr. Bruce Greyson began to investigate.As a physician without a religious belief system, he approached near-death experiences from a scientific perspective. In After, he shares the transformative lessons he has learned over four decades of research. Our culture has tended to view dying as the end of our consciousness, the end of our existence—a dreaded prospect that for many people evokes fear and anxiety.But Dr. Greyson shows how scientific revelations about the dying process can support an alternative theory. Dying could be the threshold between one form of consciousness and another, not an ending but a transition. This new perspective on the nature of death can transform the fear of dying that pervades our culture into a healthy view of it as one more milestone in the course of our lives. After challenges us to open our minds to these experiences and to what they can teach us, and in so doing, expand our understanding of consciousness and of what it means to be human.

    Months later, several health professionals faced criminal allegations that they deliberately injected numerous patients with drugs to hasten their deaths. Five Days at Memorial, the culmination of six years of reporting, unspools the mystery of what happened in those days, bringing the reader into a hospital fighting for its life and into a conversation about the most terrifying form of health care rationing.In a voice at once involving and fair, masterful and intimate, Fink exposes the hidden dilemmas of end-of-life care and reveals just how ill-prepared we are in America for the impact of large-scale disasters—and how we can do better. A remarkable book, engrossing from start to finish, Five Days at Memorial radically transforms your understanding of human nature in crisis.

    Recently, however, serious scientists from a range of fields have been uncovering evidence that our thoughts, emotions and beliefs can ease pain, heal wounds, fend off infection and heart disease and even slow the progression of AIDS and some cancers.In Cure, award-winning science writer Jo Marchant travels the world to meet the physicians, patients and researchers on the cutting edge of this new world of medicine. We learn how meditation protects against depression and dementia, how social connections increase life expectancy and how patients who feel cared for recover from surgery faster. We meet Iraq war veterans who are using a virtual arctic world to treat their burns and children whose ADHD is kept under control with half the normal dose of medication. We watch as a transplant patient uses the smell of lavender to calm his hostile immune system and an Olympic runner shaves vital seconds off his time through mind-power alone.Drawing on the very latest research, Marchant explores the vast potential of the mind's ability to heal, lays out its limitations and explains how we can make use of the findings in our own lives. With clarity and compassion, Cure points the way towards a system of medicine that treats us not simply as bodies but as human beings.

    In Shapeshifters, physician and writer Gavin Francis considers the inevitable changes all of our bodies undergo -- such as birth, puberty, and death, but also laughter, sleeping, and healing-and those that only some of our bodies will: like getting a tattoo, experiencing psychosis, suffering anorexia, being pregnant, or undergoing a gender transition. In Francis's hands, each event becomes an opportunity to explore the meaning of identity and the natures-biological, psychological, and philosophical-of our selves. True to its own subject, Shapeshifters combines Francis's lyrical imagination and deep knowledge of medicine and the humanities for a life-altering read.

    Yet despite a century of medical progress, viral and bacterial disasters continue to take us by surprise, inciting panic and dominating news cycles. From the Spanish flu to the 1924 outbreak of pneumonic plague in Los Angeles to the 1930 “parrot fever” pandemic, through the more recent SARS, Ebola, and Zika epidemics, the last one hundred years have been marked by a succession of unanticipated pandemic alarms.In The Pandemic Century, a lively account of scares both infamous and less known, Mark Honigsbaum combines reportage with the history of science and medical sociology to artfully reconstruct epidemiological mysteries and the ecology of infectious diseases. We meet dedicated disease detectives, obstructive or incompetent public health officials, and brilliant scientists often blinded by their own knowledge of bacteria and viruses. We also see how fear of disease often exacerbates racial, religious, and ethnic tensions—even though, as the epidemiologists Malik Peiris and Yi Guan write, “‘nature’ remains the greatest bioterrorist threat of all.”Like man-eating sharks, predatory pathogens are always present in nature, waiting to strike; when one is seemingly vanquished, others appear in its place. These pandemics remind us of the limits of scientific knowledge, as well as the role that human behavior and technologies play in the emergence and spread of microbial 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.

    In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast?Breaking down this monolithic business into the individual industries--the hospitals, doctors, insurance companies, and drug manufacturers--that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw.The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.