An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine


Howard Markel - 2011
    Markel writes of the physical and emotional damage caused by the then-heralded wonder drug, and how each man ultimately changed the world in spite of it—or because of it. One became the father of psychoanalysis; the other, of modern surgery. Both men were practicing medicine at the same time in the 1880s: Freud at the Vienna General Hospital, Halsted at New York’s Bellevue Hospital. Markel writes that Freud began to experiment with cocaine as a way of studying its therapeutic uses—as an antidote for the overprescribed morphine, which had made addicts of so many, and as a treatment for depression.  Halsted, an acclaimed surgeon even then, was curious about cocaine’s effectiveness as an anesthetic and injected the drug into his arm to prove his theory. Neither Freud nor Halsted, nor their colleagues, had any idea of the drug’s potential to dominate and endanger their lives. Addiction as a bona fide medical diagnosis didn’t even exist in the elite medical circles they inhabited.  In An Anatomy of Addiction, Markel writes about the life and work of each man, showing how each came to know about cocaine; how Freud found that the drug cured his indigestion, dulled his aches, and relieved his depression. The author writes that Freud, after a few months of taking the magical drug, published a treatise on it, Über Coca, in which he described his “most gorgeous excitement.” The paper marked a major shift in Freud’s work: he turned from studying the anatomy of the brain to exploring the human psyche.  Halsted, one of the most revered of American surgeons, became the head of surgery at the newly built Johns Hopkins Hospital and then professor of surgery, the hospital’s most exalted position, committing himself repeatedly to Butler Hospital, an insane asylum, to withdraw from his out-of control cocaine use.  Halsted invented modern surgery as we know it today: devising new ways to safely invade the body in search of cures and pioneering modern surgical techniques that controlled bleeding and promoted healing. He insisted on thorough hand washing, on scrub-downs and whites for doctors and nurses, on sterility in the operating room—even inventing the surgical glove, which he designed and had the Goodyear Rubber Company make for him—accomplishing all of this as he struggled to conquer his unyielding desire for cocaine.  An Anatomy of Addiction tells the tragic and heroic story of each man, accidentally struck down in his prime by an insidious malady: tragic because of the time, relationships, and health cocaine forced each to squander; heroic in the intense battle each man waged to overcome his affliction as he conquered his own world with his visionary healing gifts. Here is the full story, long overlooked, told in its rich historical context.

America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System


Steven Brill - 2015
    It’s a fly-on-the-wall account of the titanic fight to pass a 961-page law aimed at fixing America’s largest, most dysfunctional industry. It’s a penetrating chronicle of how the profiteering that Brill first identified in his trailblazing Time magazine cover story continues, despite Obamacare. And it is the first complete, inside account of how President Obama persevered to push through the law, but then failed to deal with the staff incompetence and turf wars that crippled its implementation.   But by chance America’s Bitter Pill ends up being much more—because as Brill was completing this book, he had to undergo urgent open-heart surgery. Thus, this also becomes the story of how one patient who thinks he knows everything about healthcare “policy” rethinks it from a hospital gurney—and combines that insight with his brilliant reporting. The result: a surprising new vision of how we can fix American healthcare so that it stops draining the bank accounts of our families and our businesses, and the federal treasury. Praise for America’s Bitter Pill   “A tour de force . . . a comprehensive and suitably furious guide to the political landscape of American healthcare . . . persuasive, shocking.”—The New York Times   “An energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy . . . [Brill] has pulled off something extraordinary.” —The New York Times Book Review   “A thunderous indictment of what Brill refers to as the ‘toxicity of our profiteer-dominated healthcare system.’ ”—Los Angeles Times  “A sweeping and spirited new book [that] chronicles the surprisingly juicy tale of reform.”—The Daily Beast  “One of the most important books of our time.”—Walter Isaacson   “Superb . . . Brill has achieved the seemingly impossible—written an exciting book about the American health system.”—The New York Review of Books

T: The Story of Testosterone, the Hormone that Dominates and Divides Us


Carole Hooven - 2021
    Mythologized. Controversial.A Harvard evolutionary biologist debunks the myths and cultural stereotypes surrounding testosterone and reveals its far-reaching effects on gender and sexuality, sports, relationships, and many more aspects of our everyday lives.The biological source of virility and masculinity has inspired fascination, investigation, and controversy since antiquity. From the eunuchs in the royal courts of ancient China to the booming market for “elixirs” of youth in nineteenth-century Europe, humans have been obsessed with identifying and manipulating what we now know as testosterone. And the trends show no signs of slowing down—the modern market for testosterone supplements is booming. Thanks to this history and the methods of modern science, today we have a rich body of research about testosterone’s effects in both men and women.The science is clear: testosterone is a major, invisible player in our relationships, sex lives, athletic abilities, childhood play, gender transitions, parenting roles, violent crime, and so much more. But there is still a lot of pushback to the idea that it does, in fact, cause sex differences and significantly influence behavior.Carole Hooven argues in T that acknowledging testosterone as a potent force in society doesn’t reinforce stifling gender norms or patriarchal values. Testosterone and evolution work together to produce a huge variety of human behavior, and that includes a multitude of ways to be masculine or feminine. Understanding the science sheds light on how we work and relate to one another, how we express anger and love, and how we can fight bias and problematic behavior to build a more fair society.

Immune: a Journey into the Mysterious System that Keeps You Alive


Philipp Dettmer - 2021
    Your head hurts. You're mildly annoyed as you get the kids ready for school and dress for work yourself. Meanwhile, an epic war is being fought, just below your skin. Millions are fighting and dying for you to be able to complain as you head out the door.So what, exactly, is your immune system?Second only to the human brain in its complexity, it is one of the oldest and most critical facets of life on Earth. Without it, you would die within days. In Immune, Philipp Dettmer, the brains behind the most popular science channel on YouTube, takes readers on a journey through the fortress of the human body and its defenses. There is a constant battle of staggering scale raging within us, full of stories of invasion, strategy, defeat, and noble self-sacrifice. In fact, in the time you've been reading this, your immune system has probably identified and eradicated a cancer cell that started to grow in your body.Each chapter delves into an element of the immune system, including defenses like antibodies and inflammation as well as threats like bacteria, allergies, and cancer, as Dettmer reveals why boosting your immune system is actually nonsense, how parasites sneak their way past your body's defenses, how viruses work, and what goes on in your wounds when you cut yourself.Enlivened by engaging graphics and immersive descriptions, Immune turns one of the most intricate, interconnected, and confusing subjects—immunology—into a gripping adventure through an astonishing alien landscape. Immune is a vital and remarkably fun crash course in what is arguably, and increasingly, the most important system in the body.

The Pot Book: A Complete Guide to Cannabis: Its Role in Medicine, Politics, Science, and Culture


Julie Holland - 2010
    Pierre (NORML), Tommy Chong, and others - Covers marijuana's physiological and psychological effects, its medicinal uses, the complex politics of cannabis law, pot and parenting, its role in creativity, business, and spirituality, and much more Exploring the role of cannabis in medicine, politics, history, and society, The Pot Book offers a compendium of the most up-to-date information and scientific research on marijuana from leading experts, including Lester Grinspoon, M.D., Rick Doblin, Ph.D., Allen St. Pierre (NORML), and Raphael Mechoulam. Also included are interviews with Michael Pollan, Andrew Weil, M.D., and Tommy Chong as well as a pot dealer and a farmer who grows for the U.S. Government. Encompassing the broad spectrum of marijuana knowledge from stoner customs to scientific research, this book investigates the top ten myths of marijuana; its physiological and psychological effects; its risks; why joints are better than water pipes and other harm-reduction tips for users; how humanity and cannabis have co-evolved for millennia; the brain's cannabis-based neurochemistry; the complex politics of cannabis law; its potential medicinal uses for cancer, AIDS, Alzheimer's, multiple sclerosis, and other illnesses; its role in creativity, business, and spirituality; and the complicated world of pot and parenting. As legalization becomes a reality, this book candidly offers necessary facts and authoritative opinions in a society full of marijuana myths, misconceptions, and stereotypes.

Medical Physiology [with Student Consult Online Access]


Walter F. Boron - 2002
    The most up-to-date and beautifully illustrated text on the market, it has a strong molecular and cellular approach, firmly relating the molecular and cellular biological underpinnings of physiology to the study of human physiology and disease. Contributions from leading physiologists ensure authoritative, cutting-edge information, and thorough and consistent editing have produced a readable and student-friendly text.The smart way to study!Elsevier titles with STUDENT CONSULT will help you master difficult concepts and study more efficiently in print and online! Perform rapid searches. Integrate bonus content from other disciplines. Download text to your handheld device. And a lot more. Each STUDENT CONSULT title comes with full text online, a unique image library, case studies, USMLE style questions, and online note-taking to enhance your learning experience.

Never Enough: The Neuroscience and Experience of Addiction


Judith Grisel - 2019
    With more than one in every five people over the age of fourteen addicted, drug abuse has been called the most formidable health problem worldwide. If we are not victims ourselves, we all know someone struggling with the merciless compulsion to alter their experience by changing how their brain functions.Drawing on years of research--as well as personal experience as a recovered addict--researcher and professor Judy Grisel has reached a fundamental conclusion: for the addict, there will never be enough drugs. The brain's capacity to learn and adapt is seemingly infinite, allowing it to counteract any regular disruption, including that caused by drugs. What begins as a normal state punctuated by periods of being high transforms over time into a state of desperate craving that is only temporarily subdued by a fix, explaining why addicts are unable to live either with or without their drug. One by one, Grisel shows how different drugs act on the brain, the kind of experiential effects they generate, and the specific reasons why each is so hard to kick.Grisel's insights lead to a better understanding of the brain's critical contributions to addictive behavior, and will help inform a more rational, coherent, and compassionate response to the epidemic in our homes and communities.

Behave: The Biology of Humans at Our Best and Worst


Robert M. Sapolsky - 2017
    Sapolsky's storytelling concept is delightful but it also has a powerful intrinsic logic: he starts by looking at the factors that bear on a person's reaction in the precise moment a behavior occurs, and then hops back in time from there, in stages, ultimately ending up at the deep history of our species and its evolutionary legacy.And so the first category of explanation is the neurobiological one. A behavior occurs--whether an example of humans at our best, worst, or somewhere in between. What went on in a person's brain a second before the behavior happened? Then Sapolsky pulls out to a slightly larger field of vision, a little earlier in time: What sight, sound, or smell caused the nervous system to produce that behavior? And then, what hormones acted hours to days earlier to change how responsive that individual is to the stimuli that triggered the nervous system? By now he has increased our field of vision so that we are thinking about neurobiology and the sensory world of our environment and endocrinology in trying to explain what happened.Sapolsky keeps going: How was that behavior influenced by structural changes in the nervous system over the preceding months, by that person's adolescence, childhood, fetal life, and then back to his or her genetic makeup? Finally, he expands the view to encompass factors larger than one individual. How did culture shape that individual's group, what ecological factors millennia old formed that culture? And on and on, back to evolutionary factors millions of years old.The result is one of the most dazzling tours d'horizon of the science of human behavior ever attempted, a majestic synthesis that harvests cutting-edge research across a range of disciplines to provide a subtle and nuanced perspective on why we ultimately do the things we do...for good and for ill. Sapolsky builds on this understanding to wrestle with some of our deepest and thorniest questions relating to tribalism and xenophobia, hierarchy and competition, morality and free will, and war and peace. Wise, humane, often very funny, Behave is a towering achievement, powerfully humanizing, and downright heroic in its own right.

Better: A Surgeon's Notes on Performance


Atul Gawande - 2007
    But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by arguably the best nonfiction doctor-writer around (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.

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.

How We Decide


Jonah Lehrer - 2009
    But as scientists break open the mind’s black box with the latest tools of neuroscience, they’re discovering that this is not how the mind works. Our best decisions are a finely tuned blend of both feeling and reason—and the precise mix depends on the situation. When buying a house, for example, it’s best to let our unconscious mull over the many variables. But when we’re picking a stock, intuition often leads us astray. The trick is to determine when to use the different parts of the brain, and to do this, we need to think harder (and smarter) about how we think.Jonah Lehrer arms us with the tools we need, drawing on cutting-edge research as well as the real-world experiences of a wide range of “deciders”—from airplane pilots and hedge fund investors to serial killers and poker players.Lehrer shows how people are taking advantage of the new science to make better television shows, win more football games, and improve military intelligence. His goal is to answer two questions that are of interest to just about anyone, from CEOs to firefighters: How does the human mind make decisions? And how can we make those decisions better?

The American Plague: The Untold Story of Yellow Fever, the Epidemic That Shaped Our History


Molly Caldwell Crosby - 2006
    Carried along the mighty Mississippi River, it ravaged towns from New Orleans to St. Louis. New York City lost 2,000 lives in one year alone. It even forced the nation's capital to relocate from Philadelphia to Washington, DC. "The American Plague" reveals the true story of yellow fever, recounting Memphis, Tennessee's near-destruction and resurrection from the epidemic-and the four men who changed medical history with their battle against an invisible foe that remains a threat to this very day.

Microbe Hunters


Paul de Kruif - 1926
    Gonzalez-Crussi, from the Introduction An international bestseller, translated into eighteen languages, Paul de Kruif’s classic account of the first scientists to see and learn about the microscopic world continues to fascinate new readers. This is a timeless dramatization of the scientists, bacteriologists, doctors, and medical technicians who discovered the microbes and invented the vaccines to counter them. De Kruif writes about how seemingly simple but really fundamental discovers of science—for instance, how a microbe was first viewed in a clear drop of rain water, and when, for the first time, Louis Pasteur discovered that a simple vaccine could save a man from the ravages of rabies by attacking the microbes that cause it.

Money-Driven Medicine: The Real Reason Health Care Costs So Much


Maggie Mahar - 2006
    But as costs levitate, that argument becomes more difficult to make. Today, we spend twice as much as Japan on health care—yet few would argue that our health care system is twice as good.Instead, startling new evidence suggests that one out of every three of our health care dollars is squandered on unnecessary or redundant tests; unproven, sometimes unwanted procedures; and overpriced drugs and devices that, too often, are no better than the less expensive products they have replaced.How did this happen? In Money-Driven Medicine, Maggie Mahar takes the reader behind the scenes of a $2 trillion industry to witness how billions of dollars are wasted in a Hobbesian marketplace that pits the industry's players against each other. In remarkably candid interviews, doctors, hospital administrators, patients, health care economists, corporate executives, and Wall Street analysts describe a war of "all against all" that can turn physicians, hospitals, insurers, drugmakers, and device makers into blood rivals. Rather than collaborating, doctors and hospitals compete. Rather than sharing knowledge, drugmakers and device makers divide value. Rather than thinking about long-term collective goals, the imperatives of an impatient marketplace force health care providers to focus on short-term fiscal imperatives. And so investments in untested bleeding-edge medical technologies crowd out investments in information technology that might, in the long run, not only reduce errors but contain costs.In theory, free market competition should tame health care inflation. In fact, Mahar demonstrates, when it comes to medicine, the traditional laws of supply and demand do not apply. Normally, when supply expands, prices fall. But in the health care industry, as the number and variety of drugs, devices, and treatments multiplies, demand rises to absorb the excess, and prices climb. Meanwhile, the perverse incentives of a fee-for-service system reward health care providers for doing more, not less.In this superbly written book, Mahar shows why doctors must take responsibility for the future of our health care industry. Today, she observes, "physicians have been stripped of their standing as professionals: Insurers address them as vendors ('Dear Health Care Provider'), drugmakers and device makers see them as customers (someone you might take to lunch or a strip club), while . . . consumers (aka patients) are encouraged to see their doctors as overpaid retailers. . . . Before patients can reclaim their rightful place as the center—and indeed as the raison d'être—of our health care system," Mahar suggests, "we must once again empower doctors . . . to practice patient-centered medicine—based not on corporate imperatives, doctors' druthers, or even patients' demands," but on the best scientific research available.

Epidemiology: An Introduction


Kenneth J. Rothman - 2002
    These areas of knowledge have converged into a modern theory of epidemiology that has been slow to penetrate into textbooks, particularly at the introductory level. Epidemiology: An Introduction closes the gap. It begins with a brief, lucid discussion of causal thinking and causal inference and then takes the reader through the elements of epidemiology, focusing on the measures of disease occurrence and causal effects. With these building blocks in place, the reader learns how to design, analyze and interpret problems that epidemiologists face, including confounding, the role of chance, and the exploration of interactions. All these topics are layered on the foundation of basic principles presented in simple language, with numerous examples and questions for further thought.