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.

    Braided with that history is the moving story of Powers's beloved son Kevin--spirited, endearing, and gifted--who triumphed even while suffering from schizophrenia until finally he did not, and the story of his courageous surviving son Dean, who is also schizophrenic.A blend of history, biography, memoir, and current affairs ending with a consideration of where we might go from here, this is a thought-provoking look at a dreaded illness that has long been misunderstood.

    But when a new admission to the critical care unit almost died his first night on call, he found himself scrambling. Visions of mastery quickly gave way to hopes of simply surviving hospital life, where confidence was hard to come by and no amount of med school training could dispel the terror of facing actual patients.This funny, candid memoir of McCarthy’s intern year at a New York hospital provides a scorchingly frank look at how doctors are made, taking readers into patients’ rooms and doctors’ conferences to witness a physician's journey from ineptitude to competence. McCarthy's one stroke of luck paired him with a brilliant second-year adviser he called “Baio” (owing to his resemblance to the Charles in Charge star), who proved to be a remarkable teacher with a wicked sense of humor. McCarthy would learn even more from the people he cared for, including a man named Benny, who was living in the hospital for months at a time awaiting a heart transplant. But no teacher could help McCarthy when an accident put his own health at risk, and showed him all too painfully the thin line between doctor and patient.The Real Doctor Will See You Shortly offers a window on to hospital life that dispenses with sanctimony and self-seriousness while emphasizing the black-comic paradox of becoming a doctor: How do you learn to save lives in a job where there is no practice?

    What is going on? Anatomy of an Epidemic challenges readers to think through that question themselves. First, Whitaker investigates what is known today about the biological causes of mental disorders. Do psychiatric medications fix “chemical imbalances” in the brain, or do they, in fact, create them? Researchers spent decades studying that question, and by the late 1980s, they had their answer. Readers will be startled—and dismayed—to discover what was reported in the scientific journals. Then comes the scientific query at the heart of this book: During the past fifty years, when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? Or did they find that these medications, for some paradoxical reason, increase the likelihood that people will become chronically ill, less able to function well, more prone to physical illness?  This is the first book to look at the merits of psychiatric medications through the prism of long-term results. Are long-term recovery rates higher for medicated or unmedicated schizophrenia patients? Does taking an antidepressant decrease or increase the risk that a depressed person will become disabled by the disorder? Do bipolar patients fare better today than they did forty years ago, or much worse? When the National Institute of Mental Health (NIMH) studied the long-term outcomes of children with ADHD, did they determine that stimulants provide any benefit?  By the end of this review of the outcomes literature, readers are certain to have a haunting question of their own: Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?  In this compelling history, Whitaker also tells the personal stories of children and adults swept up in this epidemic. Finally, he reports on innovative programs of psychiatric care in Europe and the United States that are producing good long-term outcomes. Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up.

    Yet somehow, this normal boy became one of the youngest people on whom Dr. Walter Freeman performed his barbaric transorbital—or ice pick—lobotomy.Abandoned by his family within a year of the surgery, Howard spent his teen years in mental institutions, his twenties in jail, and his thirties in a bottle. It wasn’t until he was in his forties that Howard began to pull his life together. But even as he began to live the “normal” life he had been denied, Howard struggled with one question: Why?“October 8, 1960. I gather that Mrs. Dully is perpetually talking, admonishing, correcting, and getting worked up into a spasm, whereas her husband is impatient, explosive, rather brutal, won’t let the boy speak for himself, and calls him numbskull, dimwit, and other uncomplimentary names.”There were only three people who would know the truth: Freeman, the man who performed the procedure; Lou, his cold and demanding stepmother who brought Howard to the doctor’s attention; and his father, Rodney. Of the three, only Rodney, the man who hadn’t intervened on his son’s behalf, was still living. Time was running out. Stable and happy for the first time in decades, Howard began to search for answers. “December 3, 1960. Mr. and Mrs. Dully have apparently decided to have Howard operated on. I suggested [they] not tell Howard anything about it.”Through his research, Howard met other lobotomy patients and their families, talked with one of Freeman’s sons about his father’s controversial life’s work, and confronted Rodney about his complicity. And, in the archive where the doctor’s files are stored, he finally came face to face with the truth.Revealing what happened to a child no one—not his father, not the medical community, not the state—was willing to protect, My Lobotomy exposes a shameful chapter in the history of the treatment of mental illness. Yet, ultimately, this is a powerful and moving chronicle of the life of one man. Without reticence, Howard Dully shares the story of a painfully dysfunctional childhood, a misspent youth, his struggle to claim the life that was taken from him, and his redemption.

    From a fortress-like former bank building, American Pain's doctors distributed massive quantities of oxycodone to hundreds of customers a day, mostly traffickers and addicts who came by the vanload. Inked muscle-heads ran the clinic's security. Former strippers operated the pharmacy, counting out pills and stashing cash in garbage bags. Under their lab coats, the doctors carried guns and it was all legal sort of. American Pain was the brainchild of Chris George, a 27-year-old convicted drug felon. The son of a South Florida home builder, Chris George grew up in ultra-rich Wellington, where Bill Gates, Springsteen, and Madonna kept houses. Thick-necked from weightlifting, he and his twin brother hung out with mobsters, invested in strip clubs, brawled with cops, and grinned for their mug shots. After the housing market stalled, a local doctor clued in the brothers to the burgeoning underground market for lightly regulated prescription painkillers. In Florida, pain clinics could dispense the meds, and no one tracked the patients. Seizing the opportunity, Chris George teamed up with the doctor, and word got out. Just two years later Chris had raked in $40 million, and 90 percent of the pills his doctors prescribed flowed north to feed the rest of the country's insatiable narcotics addiction. Meanwhile, hundreds more pain clinics in the mold of American Pain had popped up in the Sunshine State, creating a gigantic new drug industry. American Pain chronicles the rise and fall of this game-changing pill mill, and how it helped tip the nation into its current opioid crisis, the deadliest drug epidemic in American history. The narrative swings back and forth between Florida and Kentucky, and is populated by a gaudy and diverse cast of characters. This includes the incongruous band of wealthy bad boys, thugs and esteemed physicians who built American Pain, as well as penniless Kentucky clans who transformed themselves into painkiller trafficking rings. It includes addicts whose lives were devastated by American Pain's drugs, and the federal agents and grieving mothers who labored for years to bring the clinic's crew to justice."

    Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D.The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it–on some level–restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer.A healthy young man suddenly loses his memory–making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment–only to have their symptoms mysteriously return. A young woman lies dying in the ICU–bleeding, jaundiced, incoherent–and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis.Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness–the diagnosis–revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.

    Operations on the brain carry grave risks. Every day, leading neurosurgeon Henry Marsh must make agonizing decisions, often in the face of great urgency and uncertainty.If you believe that brain surgery is a precise and exquisite craft, practiced by calm and detached doctors, this gripping, brutally honest account will make you think again. With astonishing compassion and candor, Marsh reveals the fierce joy of operating, the profoundly moving triumphs, the harrowing disasters, the haunting regrets, and the moments of black humor that characterize a brain surgeon's life.Do No Harm provides unforgettable insight into the countless human dramas that take place in a busy modern hospital. Above all, it is a lesson in the need for hope when faced with life's most difficult decisions.

    She was repeatedly hospitalized in excruciating pain, but the doctors insisted it was a urinary tract infection and sent her home with antibiotics. Unable to get out of bed, much less attend class, Norman dropped out of college and embarked on what would become a years-long journey to discover what was wrong with her. It wasn't until she took matters into her own hands--securing a job in a hospital and educating herself over lunchtime reading in the medical library--that she found an accurate diagnosis of endometriosis.In Ask Me About My Uterus, Norman describes what it was like to have her pain dismissed, to be told it was all in her head, only to be taken seriously when she was accompanied by a boyfriend who confirmed that her sexual performance was, indeed, compromised. Putting her own trials into a broader historical, sociocultural, and political context, Norman shows that women's bodies have long been the battleground of a never-ending war for power, control, medical knowledge, and truth. It's time to refute the belief that being a woman is a preexisting condition.

    When death is sudden or unexplained, it falls to Shepherd to establish the cause. Each post-mortem is a detective story in its own right - and Shepherd has performed over 23,000 of them. Through his skill, dedication and insight, Dr Shepherd solves the puzzle to answer our most pressing question: how did this person die?From serial killer to natural disaster, 'perfect murder' to freak accident, Shepherd takes nothing for granted in pursuit of truth. And while he's been involved in some of the most high-profile cases of recent times, it's often the less well known encounters that prove the most perplexing, intriguing and even bizarre. In or out of the public eye, his evidence has put killers behind bars, freed the innocent and turned open-and-shut cases on their heads.But a life in death, bearing witness to some of humanity's darkest corners, exacts a price and Shepherd doesn't flinch from counting the cost to him and his family.

    The Sackler name adorns the walls of many storied institutions: Harvard, the Metropolitan Museum of Art, Oxford, the Louvre. They are one of the richest families in the world, known for their lavish donations to the arts and sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing OxyContin, a blockbuster painkiller that was a catalyst for the opioid crisis.Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling.

    She has managed to achieve this in spite of being diagnosed as schizophrenic and given a "grave" prognosis—and suffering the effects of her illness throughout her life.Saks was only eight, and living an otherwise idyllic childhood in sunny 1960s Miami, when her first symptoms appeared in the form of obsessions and night terrors. But it was not until she reached Oxford University as a Marshall Scholar that her first full-blown episode, complete with voices in her head and terrifying suicidal fantasies, forced her into a psychiatric hospital.Saks would later attend Yale Law School where one night, during her first term, she had a breakdown that left her singing on the roof of the law school library at midnight. She was taken to the emergency room, force-fed antipsychotic medication, and tied hand-and-foot to the cold metal of a hospital bed. She spent the next five months in a psychiatric ward.So began Saks's long war with her own internal demons and the equally powerful forces of stigma. Today she is a chaired professor of law who researches and writes about the rights of the mentally ill. She is married to a wonderful man.In The Center Cannot Hold, Elyn Saks discusses frankly and movingly the paranoia, the inability to tell imaginary fears from real ones, and the voices in her head insisting she do terrible things, as well as the many obstacles she overcame to become the woman she is today. It is destined to become a classic in the genre.

    These “psychosurgeons,” as they called themselves, occupied a gray zone between medical research and medical practice, and ended up subjecting untold numbers of people to the types of surgical experiments once limited to chimpanzees.The most important test subject to emerge from this largely untold chapter in American history was a twenty-seven-year-old factory worker named Henry Molaison. In 1953, Henry—who suffered from severe epilepsy—received a radical new version of the lobotomy, one that targeted the most mysterious structures in the brain. The operation failed to eliminate Henry’s seizures, but it did have an unintended effect: Henry left the operating room profoundly amnesic, unable to create new long-term memories. Over the next sixty years, Patient H.M., as Henry was known, became the most studied individual in the history of neuroscience, a human guinea pig who would teach us much of what we know about memory today.Luke Dittrich uses the case of Patient H.M. as a starting point for a kaleidoscopic journey, one that moves from the first recorded brain surgeries in ancient Egypt to the cutting-edge laboratories of MIT. He takes readers inside the old asylums and operating theaters where psychosurgeons conducted their human experiments, and behind the scenes of a bitter custody battle over the ownership of the most important brain in the world. Throughout, Dittrich delves into the enduring mysteries of the mind while exposing troubling stories of just how far we’ve gone in our pursuit of knowledge. It is also, at times, a deeply personal journey. Dittrich’s grandfather was the brilliant, morally complex surgeon who operated on Molaison—and thousands of other patients. The author’s investigation into the dark roots of modern memory science ultimately forces him to confront unsettling secrets in his own family history, and to reveal the tragedy that fueled his grandfather’s relentless experimentation—experimentation that would revolutionize our understanding of ourselves.Patient H.M. combines the best of biography, memoir, and science journalism to create a haunting, endlessly fascinating story, one that reveals the wondrous and devastating things that can happen when hubris, ambition, and human imperfection collide.

    But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers--resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.

    Leslie Jamison deftly excavates the stories we tell about addiction--both her own and others'--and examines what we want these stories to do, and what happens when they fail us.All the while, she offers a fascinating look at the larger history of the recovery movement, and at the literary and artistic geniuses whose lives and works were shaped by alcoholism and substance dependence, including John Berryman, Jean Rhys, Raymond Carver, Billie Holiday, David Foster Wallace, and Denis Johnson, as well as brilliant figures lost to obscurity but newly illuminated here.For the power of her striking language and the sharpness of her piercing observations, Jamison has been compared to such iconic writers as Joan Didion and Susan Sontag. Yet her utterly singular voice also offers something new. With enormous empathy and wisdom, Jamison has given us nothing less than the story of addiction and recovery in America writ large, a definitive and revelatory account that will resonate for years to come.