How Doctors Think


Jerome Groopman - 2007
    In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong -- with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can -- with our help -- avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track.Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems.How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.

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.

Fevers, Feuds, and Diamonds: Ebola and the Ravages of History


Paul Farmer - 2020
    . . If what we want in this moment is insight from this brilliant doctor about pandemics, he wants us to see that they do not occur in isolation. --Carolyn Kellogg, The Boston GlobeIn 2014, Sierra Leone, Liberia, and Guinea suffered the worst epidemic of Ebola in history. The brutal virus spread rapidly through a clinical desert where basic health-care facilities were few and far between. Causing severe loss of life and economic disruption, the Ebola crisis was a major tragedy of modern medicine. But why did it happen, and what can we learn from it?Paul Farmer, the internationally renowned doctor and anthropologist, experienced the Ebola outbreak firsthand--Partners in Health, the organization he founded, was among the international responders. In Fevers, Feuds, and Diamonds, he offers the first substantive account of this frightening, fast-moving episode and its implications. In vibrant prose, Farmer tells the harrowing stories of Ebola victims while showing why the medical response was slow and insufficient. Rebutting misleading claims about the origins of Ebola and why it spread so rapidly, he traces West Africa's chronic health failures back to centuries of exploitation and injustice. Under formal colonial rule, disease containment was a priority but care was not - and the region's health care woes worsened, with devastating consequences that Farmer traces up to the present.This thorough and hopeful narrative is a definitive work of reportage, history, and advocacy, and a crucial intervention in public-health discussions around the world.

Complications: A Surgeon's Notes on an Imperfect Science


Atul Gawande - 2002
    Complications lays bare a science not in its idealized form but as it actually is--uncertain, perplexing, and profoundly human.Complications is a 2002 National Book Award Finalist for Nonfiction.

Ten Drugs: How Plants, Powders, and Pills Have Shaped the History of Medicine


Thomas Hager - 2019
    It could be an oddball researcher’s genius insight, a catalyzing moment in geopolitical history, a new breakthrough technology, or an unexpected but welcome side effect discovered during clinical trials. Piece together these stories, as Thomas Hager does in this remarkable, century-spanning history, and you can trace the evolution of our culture and the practice of medicine.  ​Beginning with opium, the “joy plant,” which has been used for 10,000 years, Hager tells a captivating story of medicine. His subjects include the largely forgotten female pioneer who introduced smallpox inoculation to Britain, the infamous knockout drops, the first antibiotic, which saved countless lives, the first antipsychotic, which helped empty public mental hospitals, Viagra, statins, and the new frontier of monoclonal antibodies. This is a deep, wide-ranging, and wildly entertaining book.

The Cancer Chronicles: Unlocking Medicine's Deepest Mystery


George Johnson - 2013
    What he discovered is a revolution under way—an explosion of new ideas about what cancer really is and where it comes from. In a provocative and intellectually vibrant exploration, he takes us on an adventure through the history and recent advances of cancer research that will challenge everything you thought you knew about the disease. Deftly excavating and illuminating decades of investigation and analysis, he reveals what we know and don’t know about cancer, showing why a cure remains such a slippery concept. We follow him as he combs through the realms of epidemiology, clinical trials, laboratory experiments, and scientific hypotheses—rooted in every discipline from evolutionary biology to game theory and physics. Cogently extracting fact from a towering canon of myth and hype, he describes tumors that evolve like alien creatures inside the body, paleo-oncologists who uncover petrified tumors clinging to the skeletons of dinosaurs and ancient human ancestors, and the surprising reversals in science’s comprehension of the causes of cancer, with the foods we eat and environmental toxins playing a lesser role. Perhaps most fascinating of all is how cancer borrows natural processes involved in the healing of a wound or the unfolding of a human embryo and turns them, jujitsu-like, against the body. Throughout his pursuit, Johnson clarifies the human experience of cancer with elegiac grace, bearing witness to the punishing gauntlet of consultations, surgeries, targeted therapies, and other treatments. He finds compassion, solace, and community among a vast network of patients and professionals committed to the fight and wrestles to comprehend the cruel randomness cancer metes out in his own family. For anyone whose life has been affected by cancer and has found themselves asking why?, this book provides a new understanding. In good company with the works of Atul Gawande, Siddhartha Mukherjee, and Abraham Verghese, The Cancer Chronicles is endlessly surprising and as radiant in its prose as it is authoritative in its eye-opening science.

The Real Anthony Fauci: Bill Gates, Big Pharma, and the Global War on Democracy and Public Health


Robert F. Kennedy Jr. - 2021
    Anthony Fauci is a hero. He is anything but. As director of the National Institute of Allergy and Infectious Diseases (NIAID), Dr. Anthony Fauci dispenses $6.1 billion in annual taxpayer-provided funding for scientific research, allowing him to dictate the subject, content, and outcome of scientific health research across the globe. Fauci uses the financial clout at his disposal to wield extraordinary influence over hospitals, universities, journals, and thousands of influential doctors and scientists—whose careers and institutions he has the power to ruin, advance, or reward. During more than a year of painstaking and meticulous research, Robert F. Kennedy Jr. unearthed a shocking story that obliterates media spin on Dr. Fauci . . . and that will alarm every American—Democrat or Republican—who cares about democracy, our Constitution, and the future of our children’s health. The Real Anthony Fauci reveals how “America’s Doctor” launched his career during the early AIDS crisis by partnering with pharmaceutical companies to sabotage safe and effective off-patent therapeutic treatments for AIDS. Fauci orchestrated fraudulent studies, and then pressured US Food and Drug Administration (FDA) regulators into approving a deadly chemotherapy treatment he had good reason to know was worthless against AIDS. Fauci repeatedly violated federal laws to allow his Pharma partners to use impoverished and dark-skinned children as lab rats in deadly experiments with toxic AIDS and cancer chemotherapies. In early 2000, Fauci shook hands with Bill Gates in the library of Gates’ $147 million Seattle mansion, cementing a partnership that would aim to control an increasingly profitable $60 billion global vaccine enterprise with unlimited growth potential. Through funding leverage and carefully cultivated personal relationships with heads of state and leading media and social media institutions, the Pharma-Fauci-Gates alliance exercises dominion over global health policy. The Real Anthony Fauci details how Fauci, Gates, and their cohorts use their control of media outlets, scientific journals, key government and quasi-governmental agencies, global intelligence agencies, and influential scientists and physicians to flood the public with fearful propaganda about COVID-19 virulence and pathogenesis, and to muzzle debate and ruthlessly censor dissent.

Crisis in the Red Zone: The Story of the Deadliest Ebola Outbreak in History, and of the Outbreaks to Come


Richard Preston - 2019
    Now comes a gripping account of the doctors and scientists fighting to protect us, an urgent wake-up call about the future of emerging viruses—from the #1 bestselling author of The Hot Zone, soon to be a National Geographic original miniseries.This time, Ebola started with a two-year-old child who likely had contact with a wild creature and whose entire family quickly fell ill and died. The ensuing global drama activated health professionals in North America, Europe, and Africa in a desperate race against time to contain the viral wildfire. By the end—as the virus mutated into its deadliest form, and spread farther and faster than ever before—30,000 people would be infected, and the dead would be spread across eight countries on three continents.In this taut and suspenseful medical drama, Richard Preston deeply chronicles the outbreak, in which we saw for the first time the specter of Ebola jumping continents, crossing the Atlantic, and infecting people in America. Rich in characters and conflict—physical, emotional, and ethical—Crisis in the Red Zone is an immersion in one of the great public health calamities of our time.Preston writes of doctors and nurses in the field putting their own lives on the line, of government bureaucrats and NGO administrators moving, often fitfully, to try to contain the outbreak, and of pharmaceutical companies racing to develop drugs to combat the virus. He also explores the charged ethical dilemma over who should and did receive the rare doses of an experimental treatment when they became available at the peak of the disaster. Crisis in the Red Zone makes clear that the outbreak of 2013–2014 is a harbinger of further, more severe outbreaks, and of emerging viruses heretofore unimagined—in any country, on any continent. In our ever more interconnected world, with roads and towns cut deep into the jungles of equatorial Africa, viruses both familiar and undiscovered are being unleashed into more densely populated areas than ever before.The more we discover about the virosphere, the more we realize its deadly potential. Crisis in the Red Zone is an exquisitely timely book, a stark warning of viral outbreaks to come.

Medical Bondage: Race, Gender, and the Origins of American Gynecology


Deirdre Cooper Owens - 2017
    It is also no secret that these nineteenth-century gynecologists performed experimental caesarean sections, ovariotomies, and obstetric fistula repairs primarily on poor and powerless women. Medical Bondage breaks new ground by exploring how and why physicians denied these women their full humanity yet valued them as "medical superbodies" highly suited for medical experimentation.In Medical Bondage, Cooper Owens examines a wide range of scientific literature and less formal communications in which gynecologists created and disseminated medical fictions about their patients, such as their belief that black enslaved women could withstand pain better than white "ladies." Even as they were advancing medicine, these doctors were legitimizing, for decades to come, groundless theories related to whiteness and blackness, men and women, and the inferiority of other races or nationalities. Medical Bondage moves between southern plantations and northern urban centers to reveal how nineteenth-century American ideas about race, health, and status influenced doctor-patient relationships in sites of healing like slave cabins, medical colleges, and hospitals. It also retells the story of black enslaved women and of Irish immigrant women from the perspective of these exploited groups and thus restores for us a picture of their lives.

Which Country Has the World's Best Health Care?


Ezekiel J. Emanuel - 2020
    But which country does, and what can they teach us?Author, physician, and bioethicist, Ezekiel Emanuel has examined the world's leading providers of healthcare .Drawing from an analysis of the U.S. and ten other countries --- Australia, Canada, China, France, Germany, Netherlands, Norway, Switzerland, Taiwan, and the UK. --- the results are in. No health care system is perfect, whether the problem is too many hospital beds in Germany or treating chronic illness in France, and some problems are shared across many countries, from truly addressing mental healthcare to containing the rising costs of chronic care. But the lessons from the best healthcare practices allow us to adapt some of the good found in other countries and avoid making the same mistakes as others. Healthcare remains uniquely important to all Americans, and uniquely fraught: here is the best evidence from around the world of what excellence looks like and how we can deliver it here.

The Shift: One Nurse, Twelve Hours, Four Patients' Lives


Theresa Brown - 2015
    In the span of twelve hours, lives can be lost, life-altering medical treatment decisions made, and dreams fulfilled or irrevocably stolen. In Brown’s skilled hands--as both a dedicated nurse and an insightful chronicler of events--we are given an unprecedented view into the individual struggles as well as the larger truths about medicine in this country, and by shift’s end, we have witnessed something profound about hope and healing and humanity. Every day, Theresa Brown holds patients' lives in her hands. On this day there are four. There is Mr. Hampton, a patient with lymphoma to whom Brown is charged with administering a powerful drug that could cure him--or kill him; Sheila, who may have been dangerously misdiagnosed; Candace, a returning patient who arrives (perhaps advisedly) with her own disinfectant wipes, cleansing rituals, and demands; and Dorothy, who after six weeks in the hospital may finally go home. Prioritizing and ministering to their needs takes the kind of skill, sensitivity, and, yes, humor that enable a nurse to be a patient’s most ardent advocate in a medical system marked by heartbreaking dysfunction as well as miraculous success.

The Vaccine Race: Science, Politics, and the Human Costs of Defeating Disease


Meredith Wadman - 2017
    In June 1962, a young biologist in Philadelphia, using tissue extracted from an aborted fetus from Sweden, produced safe, clean cells that allowed the creation of vaccines against rubella and other common childhood diseases. Two years later, in the midst of a devastating German measles epidemic, his colleague developed the vaccine that would one day wipe out homegrown rubella. The rubella vaccine and others made with those fetal cells have protected more than 150 million people in the United States, the vast majority of them preschoolers. The new cells and the method of making them also led to vaccines that have protected billions of people around the world from polio, rabies, chicken pox, measles, hepatitis A, shingles and adenovirus. Meredith Wadman’s masterful account recovers not only the science of this urgent race, but also the political roadblocks that nearly stopped the scientists. She describes the terrible dilemmas of pregnant women exposed to German measles and recounts testing on infants, prisoners, orphans, and the intellectually disabled, which was common in the era. These events take place at the dawn of the battle over using human fetal tissue in research, during the arrival of big commerce in campus labs, and as huge changes take place in the laws and practices governing who “owns” research cells and the profits made from biological inventions. It is also the story of yet one more unrecognized woman whose cells have been used to save countless lives. With another frightening virus imperiling pregnant women on the rise today, no medical story could have more human drama, impact, or urgency today than The Vaccine Race.

Bad Blood: Secrets and Lies in a Silicon Valley Startup


John Carreyrou - 2018
    Backed by investors such as Larry Ellison and Tim Draper, Theranos sold shares in a fundraising round that valued the company at $9 billion, putting Holmes's worth at an estimated $4.7 billion. There was just one problem: The technology didn't work.For years, Holmes had been misleading investors, FDA officials, and her own employees. When Carreyrou, working at The Wall Street Journal, got a tip from a former Theranos employee and started asking questions, both Carreyrou and the Journal were threatened with lawsuits. Undaunted, the newspaper ran the first of dozens of Theranos articles in late 2015. By early 2017, the company's value was zero and Holmes faced potential legal action from the government and her investors. Here is the riveting story of the biggest corporate fraud since Enron, a disturbing cautionary tale set amid the bold promises and gold-rush frenzy of Silicon Valley.

Confessions of a Surgeon: The Good, the Bad, and the Complicated...Life Behind the O.R. Doors


Paul A. Ruggieri - 2012
    Paul A. Ruggieri has seen the good, the bad, and the ugly of his profession. In Confessions of a Surgeon, he pushes open the doors of the O.R. and reveals the inscrutable place where lives are improved, saved, and sometimes lost. He shares the successes, failures, remarkable advances, and camaraderie that make it exciting. He uncovers the truth about the abusive, exhaustive training and the arduous devotion of his old-school education. He explores the twenty-four-hour challenges that come from patients and their loved ones; the ethics of saving the lives of repugnant criminals; the hot-button issues of healthcare, lawsuits, and reimbursements; and the true cost of running a private practice. And he explains the influence of the white coat code of silence and why patients may never know what really transpires during surgery. Ultimately, Dr. Ruggieri lays bare an occupation that to most is as mysterious and unfamiliar as it is misunderstood. His account is passionate, illuminating, and often shocking-an eye-opening, never- before-seen look at real life, and death, in the O.R.

The Next Pandemic: On the Front Lines Against Humankind's Gravest Dangers


Ali S. Khan - 2016
    We ignore this reality most of the time, but when a new threat (Ebola, SARS, Zika) seems imminent, we send our best and bravest doctors to contain it--people like Dr. Ali S. Khan.In his long career as a public health first responder—protected by a thin mask from infected patients, napping under nets to keep out scorpions, making life-and-death decisions on limited, suspect information—Khan has found that rogue microbes will always be a problem, but outbreaks are often caused by people. We make mistakes, politicize emergencies, and, too often, fail to imagine the consequences of our actions.The Next Pandemic is a firsthand account of disasters like anthrax, bird flu, and others and how we could do more to prevent their return. It's both a gripping story of our brushes with fate and an urgent lesson on how we can keep ourselves safe from the inevitable next pandemic.