White Coat, Black Hat: Adventures on the Dark Side of Medicine


Carl Elliott - 2010
    A writer for The New Yorker and The Atlantic Monthly, Carl Elliott ventures into the uncharted dark side of medicine, shining a light on the series of social and legislative changes that have sacrificed old-style doctoring to the values of consumer capitalism. Along the way, he introduces us to the often shifty characters who work the production line in Big Pharma: from the professional guinea pigs who test-pilot new drugs and the ghostwriters who pen “scientific” articles for drug manufacturers to the PR specialists who manufacture “news” bulletins. We meet the drug reps who will do practically anything to make quota in an ever-expanding arms race of pharmaceutical gift-giving; the “thought leaders” who travel the world to enlighten the medical community about the wonders of the latest release; even, finally, the ethicists who oversee all that commercialized medicine has to offer from their pharma-funded perches.   Taking the pulse of the medical community today, Elliott discovers the culture of deception that has become so institutionalized many people do not even see it as a problem. Head-turning stories and a rogue’s gallery of colorful characters become his springboard for exploring larger ethical issues surrounding money. Are there certain things that should not be bought and sold? In what ways do the ethics of business clash with the ethics of medical care? And what is wrong with medical consumerism anyway? Elliott asks all these questions and more as he examines the underbelly of medicine.

Doctoring the Mind: Is Our Current Treatment of Mental Illness Really Any Good?


Richard P. Bentall - 2009
    It lay in biological solutions, focusing on mental illness as a problem of the brain, to be managed or improved through drugs. We entered the Prozac Age and believed we had moved far beyond the time of frontal lobotomies to an age of good and successful mental healthcare. Biological psychiatry had triumphed.Except maybe it hadn't. Starting with surprising evidence from the World Health Organization that suggests that people recover better from mental illness in a developing country than in the first world, Doctoring the Mind asks the question: how good are our mental healthcare services, really? Richard P. Bentall picks apart the science that underlies our current psychiatric practice. He puts the patient back at the heart of treatment for mental illness, making the case that a good relationship between patients and their doctors is the most important indicator of whether someone will recover.Arguing passionately for a future of mental health treatment that focuses as much on patients as individuals as on the brain itself, this is a book set to redefine our understanding of the treatment of madness in the twenty-first century.

Dreamland: The True Tale of America's Opiate Epidemic


Sam Quinones - 2015
    Communities where heroin had never been seen before—from Charlotte, NC and Huntington, WVA, to Salt Lake City and Portland, OR—were overrun with it. Local police and residents were stunned. How could heroin, long considered a drug found only in the dense, urban environments along the East Coast, and trafficked into the United States by enormous Colombian drug cartels, be so incredibly ubiquitous in the American heartland? Who was bringing it here, and perhaps more importantly, why were so many townspeople suddenly eager for the comparatively cheap high it offered?With the same dramatic drive of El Narco and Methland, Sam Quinones weaves together two classic tales of American capitalism: The stories of young men in Mexico, independent of the drug cartels, in search of their own American Dream via the fast and enormous profits of trafficking cheap black-tar heroin to America’s rural and suburban addicts; and that of Purdue Pharma in Stamford, Connecticut, determined to corner the market on pain with its new and expensive miracle drug, Oxycontin; extremely addictive in its own right. Quinones illuminates just how these two stories fit together as cause and effect: hooked on costly Oxycontin, American addicts were lured to much cheaper black tar heroin and its powerful and dangerous long-lasting high. Embroiled alongside the suppliers and buyers are DEA agents, local, small-town sheriffs, and the US attorney from eastern Virginia whose case against Purdue Pharma and Oxycontin made him an enemy of the Bush-era Justice Department, ultimately stalling and destroying his career in public service.Dreamland is a scathing and incendiary account of drug culture and addiction spreading to every part of the American landscape.

Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Industry and Depression


David Healy - 2003
    Paxil. Zoloft. Turn on your television and you are likely to see a commercial for one of the many selective serotonin reuptake inhibitors (SSRIs) on the market. We hear a lot about them, but do we really understand how these drugs work and what risks are involved for anyone who uses them?Let Them Eat Prozac explores the history of SSRIs from their early development to their latest marketing campaigns and the controversies that surround them. Initially, they seemed like wonder drugs for those with mild to moderate depression patients take just one daily dose, and unlike the tranquilizers that were popular in the 1960s, they supposedly did not lead to addiction. When Prozac was released in the late 1980s, David Healy was among the psychiatrists who prescribed it. But he soon observed that some of these patients became agitated and even attempted suicide. Studies were soon published, citing numerous cases in which patients became anxious and reported increased suicidal thoughts while taking Prozac. Could the new wonder drug actually be making patients worse?Healy draws on his own research and expertise to demonstrate the potential hazards associated with these drugs. He intersperses case histories with insider accounts of the research leading to the development and approval of SSRIs as a treatment for depression. Let Them Eat Prozac clearly demonstrates that the problems go much deeper than a disturbing side-effect of a particular drug. Current FDA regulations encourage drug companies to patent a specific compound and market it effectively to a large population on the basis of minimal effectiveness in a handful of trials.The pharmaceutical industry would like us to believe that SSRIs can safely treat depression, anxiety, and a host of other mental problems. But as Let Them Eat Prozac reveals, this "cure" may be worse than the disease.

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.

Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again


Eric J. Topol - 2019
    The doctor-patient relationship--the heart of medicine--is broken: doctors are too distracted and overwhelmed to truly connect with their patients, and medical errors and misdiagnoses abound. In Deep Medicine, leading physician Eric Topol reveals how artificial intelligence can help. AI has the potential to transform everything doctors do, from notetaking and medical scans to diagnosis and treatment, greatly cutting down the cost of medicine and reducing human mortality. By freeing physicians from the tasks that interfere with human connection, AI will create space for the real healing that takes place between a doctor who can listen and a patient who needs to be heard.Innovative, provocative, and hopeful, Deep Medicine shows us how the awesome power of AI can make medicine better, for all the humans involved.

Being Mortal: Medicine and What Matters in the End


Atul Gawande - 2014
    But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering.Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified.

Unwell Women: Misdiagnosis and Myth in a Man-Made World


Elinor Cleghorn - 2021
     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.

Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital


David M. Oshinsky - 2016
    From its origins in 1738 as an almshouse and pesthouse, Bellevue today is a revered public hospital bringing first-class care to anyone in need. With its diverse, ailing, and unprotesting patient population, the hospital was a natural laboratory for the nation's first clinical research. It treated tens of thousands of Civil War soldiers, launched the first civilian ambulance corps and the first nursing school for women, pioneered medical photography and psychiatric treatment, and spurred New York City to establish the country's first official Board of Health. As medical technology advanced, "voluntary" hospitals began to seek out patients willing to pay for their care. For charity cases, it was left to Bellevue to fill the void. The latter decades of the twentieth century brought rampant crime, drug addiction, and homelessness to the nation's struggling cities problems that called a public hospital's very survival into question. It took the AIDS crisis to cement Bellevue's enduring place as New York's ultimate safety net, the iconic hospital of last resort.

Deadly Choices: How the Anti-Vaccine Movement Threatens Us All


Paul A. Offit - 2010
    On one side are parents, bombarded with stories about the dangers of vaccines, now wary of immunizing their sons and daughters. On the other side are doctors, scared to send kids out of their offices vulnerable to illnesses like whooping cough and measles--the diseases of their grandparents.How did anyone come to view vaccines with horror? The answer is rooted in one of the most powerful citizen activist movements in our nation's history. In Deadly Choices, infectious disease expert Paul Offit relates the shocking story of anti-vaccine America--its origins, leaders, influences, and impact. Offering strategies to keep us from returning to an era when children routinely died from infections, Deadly Choices is a vigorous and definitive rebuttal of the powerful anti-vaccine movement.

The Woman in the Body: A Cultural Analysis of Reproduction


Emily Martin - 1987
    Contrasting the views of medical science with those of ordinary women from diverse social and economic backgrounds, anthropologist Emily Martin presents unique fieldwork on American culture and uncovers the metaphors of economy and alienation that pervade women's imaging of themselves and their bodies. A new preface examines some of the latest medical ideas about women's reproductive cycles.

The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures


Anne Fadiman - 1997
    By 1988 she was living at home but was brain dead after a tragic cycle of misunderstanding, over-medication, and culture clash: "What the doctors viewed as clinical efficiency the Hmong viewed as frosty arrogance." The Spirit Catches You and You Fall Down is a tragedy of Shakespearean dimensions, written with the deepest of human feeling. Sherwin Nuland said of the account, "There are no villains in Fadiman's tale, just as there are no heroes. People are presented as she saw them, in their humility and their frailty—and their nobility.

The Red Market: On the Trail of the World's Organ Brokers, Bone Thieves, Blood Farmers, and Child Traffickers


Scott Carney - 2011
    As gripping as CSI and as eye-opening as Mary Roach’s Stiff, Carney’s The Red Market sheds a blazing new light on the disturbing, billion-dollar business of trading in human body parts, bodies, and child trafficking, raising issues and exposing corruptions almost too bizarre and shocking to imagine.

Trick or Treatment: The Undeniable Facts about Alternative Medicine


Simon Singh - 2008
    In this groundbreaking analysis, over thirty of the most popular treatments—acupuncture, homeopathy, aromatherapy, reflexology, chiropractic, and herbal medicines—are examined for their benefits and potential dangers. Questions answered include: What works and what doesn't? What are the secrets, and what are the lies? Who can you trust, and who is ripping you off? Can science decide what is best, or do the old wives' tales really tap into ancient, superior wisdom?In their scrutiny of alternative and complementary cures, authors Simon Singh and Edzard Ernst also strive to reassert the primacy of the scientific method as a means for determining public health practice and policy.

In the Realm of Hungry Ghosts: Close Encounters with Addiction


Gabor Maté - 2007
    Diligently treating the drug addicts of Vancouver's notorious Downtown Eastside with sympathy in his heart and legislative reform in mind can't be easy. But Maté never judges. His book is a powerful call-to-arms, both for the decriminalization of drugs and for a more sympathetic and informed view of addiction. As Maté observes, "Those whom we dismiss as 'junkies' are not creatures from a different world, only men and women mired at the extreme end of a continuum on which, here or there, all of us might well locate ourselves." In the Realm of Hungry Ghosts begins by introducing us to many of Dr. Maté's most dire patients who steal, cheat, sell sex, and otherwise harm themselves for their next hit. Maté looks to the root causes of addiction, applying a clinical and psychological view to the physical manifestation and offering some enlightening answers for why people inflict such catastrophe on themselves.Finally, he takes aim at the hugely ineffectual, largely U.S.-led War on Drugs (and its worldwide followers), challenging the wisdom of fighting drugs instead of aiding the addicts, and showing how controversial measures such as safe injection sites are measurably more successful at reducing drug-related crime and the spread of disease than anything most major governments have going. It's not easy reading, but we ignore his arguments at our peril. When it comes to combating the drug trade and the ravages of addiction, society can use all the help it can get. --Kim Hughes