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.

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients


Ben Goldacre - 2012
    We like to imagine that it’s based on evidence and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature surrounding a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.All these problems have been protected from public scrutiny because they’re too complex to capture in a sound bite. But Dr. Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct on a global scale affects us. In his own words, “the tricks and distortions documented in these pages are beautiful, intricate, and fascinating in their details.” With Goldacre’s characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system and calls for something to be done. This is the pharmaceutical industry as it has never been seen before.

The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care


Eric J. Topol - 2011
    But the digital world has hardly pierced the medical cocoon. Until now. Beyond reading email and surfing the Web, we will soon be checking our vital signs on our phone. We can already continuously monitor our heart rhythm, blood glucose levels, and brain waves while we sleep. Miniature ultrasound imaging devices are replacing the icon of medicine—the stethoscope. DNA sequencing, Facebook, and the Watson supercomputer have already saved lives. For the first time we can capture all the relevant data from each individual to enable precision therapy, prevent major side effects of medications, and ultimately to prevent many diseases from ever occurring. And yet many of these digital medical innovations lie unused because of the medical community’s profound resistance to change. In The Creative Destruction of Medicine, Eric Topol—one of the nation’s top physicians and a leading voice on the digital revolution in medicine—argues that radical innovation and a true democratization of medical care are within reach, but only if we consumers demand it. We can force medicine to undergo its biggest shakeup in history. This book shows us the stakes—and how to win them.

Worried Sick: A Prescription for Health in an Overtreated America


Nortin M. Hadler - 2008
    Although necessary health care should be available to all who need it, he says, the current health-care debate assumes that everyone requires massive amounts of expensive care to stay healthy. Hadler urges that before we commit to paying for whatever pharmaceutical companies and the medical establishment tell us we need, American consumers need to adopt an attitude of skepticism and arm themselves with enough information to make some of their own decisions about what care is truly necessary. Each chapter of Worried Sick is an object lesson regarding the uses and abuses of a particular type of treatment, such as mammography, colorectal screening, statin drugs, or coronary stents. For consumers and medical professionals interested in understanding the scientific basis for Hadler's arguments, each topical chapter has an accompanying source chapter in which Hadler discusses the medical literature and studies that inform his critique. According to Hadler, a major stumbling block to rational health-care policy in the United States is contention over the very concept of what constitutes good health. By learning to distinguish good medical advice from persuasive medical marketing, consumers can make better decisions about their personal health and use that wisdom to inform their perspectives on health-policy issues.

Hope in Hell: Inside the World of Doctors Without Borders


Dan Bortolotti - 2004
    These professional men and women deliver emergency aid to victims of armed conflict, epidemics and natural disasters as well as to many others who lack reliable health care. Each year, more than 2,500 volunteer doctors, nurses and other professionals join locally hired staff to provide medical aid and health care in more than 80 countries.At the forefront of this organization and its work are the volunteer doctors and other health professionals who risk their lives to perform surgery, establish or rehabilitate hospitals and clinics, run nutrition and sanitation programs, and train local medical personnel. This book follows these men and women on location as they risk their own health, well-being and lives to treat patients in desperate need.These engaging true stories with dramatic color photographs examine the lives of individual volunteer medical professionals from around the world who:Perform emergency surgery in the war-torn regions of Africa and Asia Treat the homeless in the streets of Europe Understand cultural customs and societal differences that affect health care Witness and report genocidal atrocities. This new paperback edition is updated to include events that occurred following publication of the hardcover.Hope in Hell chronicles the raucous founding of Doctors Without Borders (MSF) and the awarding of the Nobel Peace Prize to the organization. If there is a horrific event, MSF will be there. This book tells why and how.

The Idealist: Jeffrey Sachs and the Quest to End Poverty


Nina Munk - 2013
    Jeffrey Sachs—celebrated economist, special advisor to the Secretary General of the United Nations, and author of the influential bestseller The End of Poverty—disagrees.  In his view, poverty is a problem that can be solved. With single-minded determination he has attempted to put into practice his theories about ending extreme poverty, to prove that the world's most destitute people can be lifted onto "the ladder of development." In 2006, Sachs launched the Millennium Villages Project, a daring five-year experiment designed to test his theories in Africa. The first Millennium village was in Sauri, a remote cluster of farming communities in western Kenya. The initial results were encouraging. With his first taste of success, and backed by one hundred twenty million dollars from George Soros and other likeminded donors, Sachs rolled out a dozen model villages in ten sub-Saharan countries. Once his approach was validated it would be scaled up across the entire continent. At least that was the idea. For the past six years, Nina Munk has reported deeply on the Millennium Villages Project, accompanying Sachs on his official trips to Africa and listening in on conversations with heads-of-state, humanitarian organizations, rival economists, and development experts. She has immersed herself in the lives of people in two Millennium villages: Ruhiira, in southwest Uganda, and Dertu, in the arid borderland between Kenya and Somalia. Accepting the hospitality of camel herders and small-hold farmers, and witnessing their struggle to survive, Munk came to understand the real-life issues that challenge Sachs's formula for ending global poverty.  The Idealist is the profound and moving story of what happens when the abstract theories of a brilliant, driven man meet the reality of human life.

Catching Breath: The Making and Unmaking of Tuberculosis


Kathryn Lougheed - 2017
    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 Hospital by the River


Catherine Hamlin - 2001
    But more than forty years later, the couple has operated on more than 20,000 women, most of whom suffer from obstetric fistula, a debilitating childbirth injury. In this awe-inspiring book, Dr. Catherine Hamlin recalls her life and career in Ethiopia. Her unyielding courage and solid faith will astound Christians worldwide as she talks about the people she has grown to love and the hospital that so many Ethiopian women have come to depend on. She truly is the Mother Teresa of our age.

To Err Is Human: Building a Safer Health System


Linda T. Kohn - 2000
    That's more than die from motor vehicle accidents, breast cancer, or AIDS--three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems.To Err Is Human breaks the silence that has surrounded medical errors and their consequence--but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agenda--with state and local implications--for reducing medical errors and improving patient safety through the design of a safer health system.This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes.Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errors--which begs the question, "How can we learn from our mistakes?"Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care.To Err Is Human asserts that the problem is not bad people in health care--it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocates--as well as patients themselves.First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back


Elisabeth Rosenthal - 2017
    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.

More Than Good Intentions: How a New Economics Is Helping to Solve Global Poverty


Dean Karlan - 2011
    At one extreme: We just need to invest more resources. At the other: We've thrown billions down a sinkhole over the last fifty years and accomplished almost nothing.Dean Karlan and Jacob Appel present an entirely new approach that blazes an optimistic and realistic trail between these two extremes.In this pioneering book Karlan and Appel combine behavioral economics with worldwide field research. They take readers with them into villages across Africa, India, South America, and the Philippines, where economic theory collides with real life. They show how small changes in banking, insurance, health care, and other development initiatives that take into account human irrationality can drastically improve the well-being of poor people everywhere.We in the developed world have found ways to make our own lives profoundly better. We use new tools to spend smarter, save more, eat better, and lead lives more like the ones we imagine. These tools can do the same for the impoverished. Karlan and Appel's research, and those of some close colleagues, show exactly how.In America alone, individual donors contribute over two hundred billion to charity annually, three times as much as corporations, foundations, and bequests combined. This book provides a new way to understand what really works to reduce poverty; in so doing, it reveals how to better invest those billions and begin transforming the well-being of the world.

Chasing Chaos: My Decade In and Out of Humanitarian Aid


Jessica Alexander - 2013
    But the world that she encountered in the field was dramatically different than anything she could have imagined. In this honest and irreverent memoir, she introduces readers to the reality of the life of an aid worker. We watch as she helps to resettle refugees in Rwanda, manages a 24,000-person camp in Darfur, and helps a former child soldier in Sierra Leone get rid of a tattoo that was carved into his skin by a rebel group. But we also see the alcoholic parties and fleeting romances, the burnouts and cyncism, the plans and priorities that constantly shift and change. Tracing her personal journey from idealistic and naïve newcomer to hardened cynic to hopeful but critical realist, Alexander transports readers to some of the most troubled locations and shows us not only the impossible challenges, but also the moments of hope and recovery.

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.

The Scalpel and the Silver Bear: The First Navajo Woman Surgeon Combines Western Medicine and Traditional Healing


Lori Arviso Alvord - 1999
    Alvord left a dusty reservation in New Mexico for Stanford University Medical School, becoming the first Navajo woman surgeon. Rising above the odds presented by her own culture and the male-dominated world of surgeons, she returned to the reservation to find a new challenge. In dramatic encounters, Dr. Alvord witnessed the power of belief to influence health, for good or for ill. She came to merge the latest breakthroughs of medical science with the ancient tribal paths to recovery and wellness, following the Navajo philosophy of a balanced and harmonious life, called Walking in Beauty. And now, in bringing these principles to the world of medicine, The Scalpel and the Silver Bear joins those few rare works, such as Healing and the Mind, whose ideas have changed medical practices-and our understanding of the world.

Rural Development: Putting the Last First


Robert Chambers - 1983
    Dr Chambers contends that researchers, scientists, administrators and fieldworkers rarely appreciate the richness and validity of rural people's knowledge or the hidden nature of rural poverty. This is a challenging book for all concerned with rural development, as practitioners, academics, students or researchers.