An epic, first-of-its-kind book, entwining leading-edge scientific discovery with the intimate stories of four individual lives, by the Pulitzer Prize–winning New York Times journalist.A terminal cancer patient rises from the grave. A medical marvel defies HIV. Two women with autoimmunity discover their own bodies have turned against them. Matt Richtel's An Elegant Defense uniquely entwines these intimate stories with science’s centuries-long quest to unlock the mysteries of sickness and health, and illuminates the immune system as never before.The immune system is our body’s essential defense network, a guardian vigilantly fighting illness, healing wounds, maintaining order and balance, and keeping us alive. Its legion of microscopic foot soldiers—from T cells to “natural killers”—patrols our body, linked by a nearly instantaneous communications grid. It has been honed by evolution over millennia to face an almost infinite array of threats.For all its astonishing complexity, however, the immune system can be easily compromised by fatigue, stress, toxins, advanced age, and poor nutrition—hallmarks of modern life—and even by excessive hygiene. Paradoxically, it is a fragile wonder weapon that can turn on our own bodies with startling results, leading today to epidemic levels of autoimmune disorders.Richtel effortlessly guides readers on a scientific detective tale winding from the Black Plague to twentieth-century breakthroughs in vaccination and antibiotics, to the cutting-edge laboratories that are revolutionizing immunology—perhaps the most extraordinary and consequential medical story of our time. The foundation that Richtel builds makes accessible revelations about cancer immunotherapy, the microbiome, and autoimmune treatments that are changing millions of lives. An Elegant Defense also captures in vivid detail how these powerful therapies, along with our behavior and environment, interact with the immune system, often for the good but always on a razor’s edge that can throw this remarkable system out of balance.Drawing on his groundbreaking reporting for the New York Times and based on extensive new interviews with dozens of world-renowned scientists, Matt Richtel has produced a landmark book, equally an investigation into the deepest riddles of survival and a profoundly human tale that is movingly brought to life through the eyes of his four main characters, each of whom illuminates an essential facet of our “elegant defense.”

    The DOs chronicles the development of this controversial medical movement from the nineteenth century to the present. Historian Norman Gevitz describes the philosophy and practice of osteopathy, as well as its impact on medical care. From the theories underlying the use of spinal manipulation developed by osteopathy's founder, Andrew Taylor Still, Gevitz traces the movement's early success, despite attacks from the orthodox medical community, and details the internal struggles to broaden osteopathy's scope to include the full range of pharmaceuticals and surgery. He also recounts the efforts of osteopathic colleges to achieve parity with institutions granting M.D. degrees and looks at the continuing effort by osteopathic physicians and surgeons to achieve greater recognition and visibility.In print continuously since 1982, The DOs has now been thoroughly updated and expanded to include two new chapters addressing recent and current challenges and to bring the history of the profession up to the beginning of the new millennium.

    Eyes wide open. I was standing at an open window, staring at the dizzying curve of Riverside Drive, five floors below. I’d stopped, somehow, poised, about to jump.Growing up the good girl in an Irish American family full of drinkers and terrible sleepers, Kathleen Frazier was twelve when her seemingly innocent sleepwalking turned dangerous. Over the next few years, she was a popular A+ student by day, the star of her high school musical. At night, she both longed for and dreaded sleep.Frazier moved to Manhattan in the 1980s, hoping for a life in the theater but getting a run of sleepwalking performances instead. Efforts to abate her malady with drinking failed miserably. She became promiscuous, looking for nighttime companionship. Could a bed partner save her from flinging herself down a flight of stairs or out an open window? Exhaustion stalked her, and rest and love were seemingly out of reach.This is the journey Frazier illuminates in her intimate memoir. While highlighting her quest to beat her sleep terrors and insomnia, this is ultimately a story of health, hope, and redemption.

    It is essential reading for our times.In 28, Stephanie Nolen, the Globe and Mail’s Africa Bureau Chief, puts a human face to the crisis created by HIV-AIDS in Africa. She has achieved, in this amazing book, something extraordinary: she writes with a power, understanding and simplicity that makes us listen, makes us understand and care. Through riveting anecdotal stories – one for each of the million people living with HIV-AIDS in Africa – Nolen explores the effects of an epidemic that well exceeds the Black Plague in magnitude. It is a calamity that is unfolding just a 747-flight away, and one that will take the lives of these 28 million without the help of massive, immediate intervention on an unprecedented scale. 28 is a timely, transformative, thoroughly accessible book that shows us definitively why we continue to ignore the growth of HIV-AIDS in Africa only at our peril and at an intolerable moral cost.28’s stories are much more than a record of the suffering and loss in 28 emblematic lives. Here we meet women and men fighting vigorously on the frontlines of disease: Tigist Haile Michael, a smart, shy 14-year-old Ethiopian orphan fending for herself and her baby brother on the slum streets of Addis Ababa; Alice Kadzanja, an HIV-positive nurse in Malawi, where one in six adults has the virus, and where the average adult’s life expectancy is 36; and Zackie Achmat, the hero of South Africa’s politically fragmented battle against HIV-AIDS. 28 also tells us how the virus works, spreads and, ultimately, kills. It explains the connection of HIV-AIDS to conflict, famine and the collapse of states; shows us how easily treatment works for those lucky enough to get it and details the struggles of those who fight to stay alive with little support. It makes vivid the strong, desperate people doing all they can, and maintaining courage, dignity and hope against insurmountable odds. It is – in its humanity, beauty and sorrow – a call to action for all who read it.

    This is bad for patients, bad for doctors, and bad for business.In The Long Fix, physician and health care CEO Vivian S. Lee, MD, cuts to the heart of the health care crisis. The problem with the way medicine is practiced, she explains, is not so much who’s paying, it’s what we are paying for. Insurers, employers, the government, and individuals pay for every procedure, prescription, and lab test, whether or not it makes us better—and that is both backward and dangerous.Dr. Lee proposes turning the way we receive care completely inside out. When doctors, hospitals, and pharmaceutical companies are paid to keep people healthy, care improves and costs decrease. Lee shares inspiring examples of how this has been done, from physicians’ practices that prioritize preventative care, to hospitals that adapt lessons from manufacturing plants to make them safer, to health care organizations that share online how much care costs and how well each physician is caring for patients.Using clear and compelling language, Dr. Lee paints a picture that is both realistic and optimistic. It may not be a quick fix, but her concrete action plan for reform—for employers and other payers, patients, clinicians, and policy makers—can reinvent health care, and create a less costly, more efficient, and healthier system for all.

    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.

    . . . The only crime equaling inhumanity is the crime of indifference, silence, and forgetting.—James OrbinskiIn 1988, James Orbinski, then a medical student in his twenties, embarked on a year-long research trip to Rwanda, a trip that would change who he would be as a doctor and as a man. Investigating the conditions of pediatric AIDS in Rwanda, James confronted widespread pain and suffering, much of it preventable, much of it occasioned by political and economic corruption. Fuelled by the injustice of what he had seen in Rwanda, Orbinski helped establish the Canadian chapter of Médecins Sans Frontières (Doctors Without Borders/MSF). As a member of MSF he travelled to Peru during a cholera epidemic, to Somalia during the famine and civil war, and to Jalalabad, Afghanistan.In April 1994, James answered a call from the MSF Amsterdam office. Rwandan government soldiers and armed militias of extremist Hutus had begun systematically to murder Tutsis. While other foreigners were evacuated from Rwanda, Orbinski agreed to serve as Chef de Mission for MSF in Kigali. As Rwanda descended into a hell of civil war and genocide, he and his team worked tirelessly, tending to thousands upon thousands of casualties. In fourteen weeks 800,000 men, women and children were exterminated. Half a million people were injured, and millions were displaced. The Rwandan genocide was Orbinski’s undoing. Confronted by indescribable cruelty, he struggled to regain his footing as a doctor, a humanitarian and a man. In the end he chose not to retreat from the world, but resumed his work with MSF, and was the organization’s president when it was awarded the Nobel Peace Prize in 1999.An Imperfect Offering is a deeply personal, deeply political book. With unstinting candor, Orbinski explores the nature of humanitarian action in the twenty-first century, and asserts the fundamental imperative of seeing as human those whose political systems have most brutally failed. He insists that in responding to the suffering of others, we must never lose sight of the dignity of those being helped or deny them the right to act as agents in their own lives. He takes readers on a journey to some of the darkest places of our history but finds there unimaginable acts of courage and empathy. Here he is doctor as witness, recording voices that must be heard around the world; calling on others to meet their responsibility.Ummera, ummera–sha is a Rwandan saying that loosely translated means ‘Courage, courage, my friend–find your courage and let it live.’ It was said to me by a patient at our hospital in Kigali. She was slightly older than middle aged and had been attacked with machetes, her entire body rationally and systematically mutilated. Her face had been so carefully disfigured that a pattern was obvious in the slashes. I could do little more for her at that moment than stop the bleeding with a few sutures. We were completely overwhelmed. She knew and I knew that there were so many others. She said to me in the clearest voice I have ever heard, “Allez, allez. Ummera, ummera-sha”–‘Go, go. Courage, courage, my friend–find your courage and let it live.’—From An Imperfect Offering

    While it is one of the largest scientific projects ever attempted—as breathtaking as the first moon landing or the Human Genome Project—the questions it answers are meaningful for every one of us: What are the world’s health problems? Who do they hurt? How much? Where? Why?Murray argues that the ideal existence isn’t simply the longest but the one lived well and with the least illness. Until we can accurately measure how people live and die, we cannot understand what makes us sick or do much to improve it. Challenging the accepted wisdom of the WHO and the UN, the charismatic and controversial health maverick has made enemies—and some influential friends, including Bill Gates who gave Murray a $100 million grant.In Epic Measures, journalist Jeremy N. Smith offers an intimate look at Murray and his groundbreaking work. From ranking countries’ healthcare systems (the U.S. is 37th) to unearthing the shocking reality that world governments are funding developing countries at only 30% of the potential maximum efficiency when it comes to health, Epic Measures introduces a visionary leader whose unwavering determination to improve global health standards has already changed the way the world addresses issues of health and wellness, sets policy, and distributes funding.

    The year is 2005. A highly infectious, unidentified Ebola-like virus is sweeping through the slums and villages of northern Angola. Within months, more than 200 people have died, medical services have collapsed and aid workers are on the brink of exhaustion. At 23, Peter Apps was just starting out as a foreign correspondent when Reuters sent him into the heart of the outbreak to get the story. In “Before Ebola: Dispatches from a Deadly Outbreak” Apps recalls in vivid, unflinching detail the horrors of life in a hot zone, the compassion of those trying to contain it, and how a terrified young journalist came of age in a time of almost unbearable crisis. Peter Apps is a global defense correspondent for Reuters news, currently dividing his time between London and Washington, D.C. In September 2006, Apps broke his neck in a minibus crash while covering the Sri Lankan civil war, leaving him largely paralyzed from the shoulders down. Cover design by Kristen Radtke.

    Lewis's determination to bear witness to the desperate plight of so many in Africa and elsewhere is balanced by his unique, personal, and often searing insider's perspective on our ongoing failure to help.Lewis recounts how, in 2000, the United Nations Millennium Summit in New York introduced eight Millennium Development Goals, which focused on fundamental issues such as education, health, and cutting poverty in half by 2015. In audacious prose, alive with anecdotes ranging from maddening to hilarious to heartbreaking, Lewis shows why and how the international community is falling desperately short of these goals.This edition includes an afterword by Lewis, covering events after the lectures were delivered in fall 2005.

    Marcia Angell had a front-row seat on the appalling spectacle of the pharmaceutical industry. She watched drug companies stray from their original mission of discovering and manufacturing useful drugs and instead become vast marketing machines with unprecedented control over their own fortunes. She saw them gain nearly limitless influence over medical research, education, and how doctors do their jobs. She sympathized as the American public, particularly the elderly, struggled and increasingly failed to meet spiraling prescription drug prices. Now, in this bold, hard-hitting new book, Dr. Angell exposes the shocking truth of what the pharmaceutical industry has become–and argues for essential, long-overdue change.Currently Americans spend a staggering $200 billion each year on prescription drugs. As Dr. Angell powerfully demonstrates, claims that high drug prices are necessary to fund research and development are unfounded: The truth is that drug companies funnel the bulk of their resources into the marketing of products of dubious benefit. Meanwhile, as profits soar, the companies brazenly use their wealth and power to push their agenda through Congress, the FDA, and academic medical centers.Zeroing in on hugely successful drugs like AZT (the first drug to treat HIV/AIDS), Taxol (the best-selling cancer drug in history), and the blockbuster allergy drug Claritin, Dr. Angell demonstrates exactly how new products are brought to market. Drug companies, she shows, routinely rely on publicly funded institutions for their basic research; they rig clinical trials to make their products look better than they are; and they use their legions of lawyers to stretch out government-granted exclusive marketing rights for years. They also flood the market with copycat drugs that cost a lot more than the drugs they mimic but are no more effective.The American pharmaceutical industry needs to be saved, mainly from itself, and Dr. Angell proposes a program of vital reforms, which includes restoring impartiality to clinical research and severing the ties between drug companies and medical education. Written with fierce passion and substantiated with in-depth research, The Truth About the Drug Companies is a searing indictment of an industry that has spun out of control.

    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.

     Few people know much about stem cell research beyond the ethical questions raised by using embryos. But in the last decade, stem cell research has made huge advances toward eliminating some of our most intractable diseases. Now this sweeping and accessible book introduces us to this cutting-edge science that will revolutionize medicine and change the way we think about and treat disease. Alice Park takes us from stem cell's controversial beginnings to the recent electrifying promise of being able to create the versatile cells without using embryos at all. She shows us how stem cells give researchers an unprecedented ability to study disease while giving patients the promise of replacing diseased cells with healthy new ones. And she profiles the scientists and leaders-many with their own compelling stories-who have fueled the quest and will continue to shape the field in years to come.

    But it’s hardly surprising considering how long it’s had to hone its skills. Forty-thousand years ago, our ancestors set off from the cradle of civilization on their journey towards populating the planet. Tuberculosis hitched a lift and came with us, and it’s been there ever since; waiting, watching, and learning. The organism responsible, Mycobacterium tuberculosis, has had plenty of time to adapt to its chosen habitat--human lungs--and has learned through natural selection to be an almost perfect pathogen. Using our own immune cells as a Trojan Horse to aid its spread, it’s come up with clever ways to avoid being killed by antibiotics. But patience has been its biggest lesson--it can enter into a latent state when times are tough, only to come back to life when a host’s immune system is compromised. Today, more than one million people die of the disease every year and around one-third of the world’s population are believed to be infected. That’s more than two billion people. Throw in the compounding problems of drug resistance, the HIV epidemic, and poverty, and it’s clear that tuberculosis remains one of the most serious problems in world medicine. Catching Breath follows the history of TB through the ages, from its time as an infection of hunter-gatherers to the first human villages, which set it up with everything it needed to become the monstrous disease it is today, through to the perils of industrialization and urbanization. It goes on to look at the latest research in fighting the disease, with stories of modern scientific research, interviews with doctors on the TB frontline, and the personal experiences of those affected by the disease.

    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.