Jerry Avorn has some sobering news. Drawing on more than twenty-five years of patient care, teaching, and research at Harvard Medical School, he shares his firsthand experience of the wide gap in our knowledge of the effectiveness of one medication as compared to another. In Powerful Medicines, he reminds us that every pill we take represents a delicate compromise between the promise of healing, the risk of side effects, and an increasingly daunting price. The stakes on each front grow higher every year as new drugs with impressive power, worrisome side effects, and troubling costs are introduced.This is a comprehensive behind-the-scenes look at issues that affect everyone: our shortage of data comparing the worth of similar drugs for the same condition; alarming lapses in the detection of lethal side effects; the underuse of life-saving medications; lavish marketing campaigns that influence what doctors prescribe; and the resulting upward spiral of costs that places vital drugs beyond the reach of many Americans.In this engagingly written book, Dr. Avorn asks questions that will interest every consumer: How can a product judged safe by the Food and Drug Administration turn out to have unexpectedly lethal side effects? Why has the nation’s drug bill been growing at nearly 20 percent per year? How can physicians and patients pick the best medication in its class? How do doctors actually make their prescribing decisions, and why do those decisions sometimes go wrong? Why do so many Americans suffer preventable illnesses and deaths that proper drug use could have averted? How can the nation gain control over its escalating drug budget without resorting to rationing or draconian governmental controls?Using clinical case histories taken from his own work as a practitioner, researcher, and advocate, Dr. Avorn demonstrates the impressive power of the well-conceived prescription as well as the debacles that can result when medications are misused. He describes an innovative program that employs the pharmaceutical industry’s own marketing techniques to reduce use of some of the most overprescribed and overpriced products. Powerful Medicines offers timely and practical advice on how the nation can improve its drug-approval process, and how patients can work with doctors to make sure their prescriptions are safe, effective, and as affordable as possible. This is a passionate and provocative call for action as well as a compelling work of clear-headed science.From the Hardcover edition.

    

    A fascinating and funny trip through humanity’s often misguided attempts to make us better.

    John Snow. It's the summer of 1854, and London is just emerging as one of the first modern cities in the world. But lacking the infrastructure—garbage removal, clean water, sewers—necessary to support its rapidly expanding population, the city has become the perfect breeding ground for a terrifying disease no one knows how to cure. As the cholera outbreak takes hold, a physician and a local curate are spurred to action—and ultimately solve the most pressing medical riddle of their time. In a triumph of multidisciplinary thinking, Johnson illuminates the intertwined histories and inter-connectedness of the spread of disease, contagion theory, the rise of cities, and the nature of scientific inquiry, offering both a riveting history and a powerful explanation of how it has shaped the world we live in.

    In three successive waves, from 1918 to 1919, influenza killed more than 50 million people. German soldiers termed it Blitzkatarrh, British soldiers referred to it as Flanders Grippe, but world-wide, the pandemic gained the notorious title of “Spanish Flu." Nowhere on earth escaped: the United States recorded 550,000 deaths (five times its total military fatalities in the war), while European deaths totaled more than two million.Amid the war, some governments suppressed news of the outbreak. Even as entire battalions were decimated, with both the Allies and the Germans suffering massive casualties, the details of many servicemen’s deaths were hidden to protect public morale. Meanwhile, civilian families were being struck down in their homes. Philadelphia ran out of gravediggers and coffins, and mass burial trenches had to be excavated with steam shovels. Spanish flu conjured up the specter of the Black Death of 1348 and the great plague of 1665, while the medical profession, shattered after five terrible years of conflict, lacked the resources to contain and defeat this new enemy. Through primary and archival sources, historian Catharine Arnold gives readers the first truly global account of this terrible epidemic.

    In July 1518 a terrifying and mysterious plague struck the medieval city of Strasbourg. Hundreds of men and women danced wildly, day after day, in the punishing summer heat. They did not want to dance, but could not stop. Throughout August and early September more and more were seized by the same terrible compulsion. By the time the epidemic subsided, heat and exhaustion had claimed an untold number of lives, leaving thousands bewildered and bereaved, and an enduring enigma for future generations. Drawing on fresh evidence, John Waller's account of the bizarre events of 1518 explains why Strasbourg's dancing plague took place. In doing so it leads us into a largely vanished world, evoking the sights, sounds, aromas, diseases and hardships, the fervent supernaturalism, and the desperate hedonism of the late medieval world. At the same time, the extraordinary story this book tells offers rich insights into how people behave when driven beyond the limits of endurance. Above all, this is an exploration into the strangest capabilities of the human mind and the extremes to which fear and irrationality can lead us.

    In his first two books, Dr. Dale Bredesen outlined the revolutionary treatments that are changing what had previously seemed like the inevitable outcome of cognitive decline and dementia. And in these moving narratives, you can hear directly from the first survivors of Alzheimer's themselves--their own amazing stories of hope told in their own words. These first person accounts honestly detail the fear, struggle, and ultimate victory of each patient's journey. They vividly describe what it is like to have Alzheimer's. They also drill down on how each of these patients made the program work for them--the challenges, the workarounds, the encouraging results that are so motivating. Dr. Bredesen includes commentary following each story to help point readers to the tips and tricks that might help them as well.Dr. Bredesen's patients have not just survived; they have thrived to rediscover fulfilling lives, rewarding relationships, and meaningful work. This book will give unprecedented hope to patients and their families.

    Louann Brizendine, the founder of the first clinic in the country to study gender differences in brain, behavior, and hormones, turns her attention to the male brain, showing how, through every phase of life, the "male reality" is fundamentally different from the female one. Exploring the latest breakthroughs in male psychology and neurology with her trademark accessibility and candor, she reveals that the male brain:     *is a lean, mean, problem-solving machine. Faced with a personal problem, a man will use his analytical brain structures, not his emotional ones, to find a solution.      *thrives under competition, instinctively plays rough and is obsessed with rank and hierarchy.      *has an area for sexual pursuit that is 2.5 times larger than the female brain, consuming him with sexual fantasies about female body parts.     *experiences such a massive increase in testosterone at puberty that he perceive others' faces to be more aggressive.The Male Brain finally overturns the stereotypes. Impeccably researched and at the cutting edge of scientific knowledge, this is a book that every man, and especially every woman bedeviled by a man, will need to own.Praise for The Female Brain:"Louann Brizendine has done a great favor for every man who wants to understand the puzzling women in his life. A breezy and enlightening guide to women and a must-read for men."—Daniel Goleman, author of Emotional Intelligence

    Recently, however, serious scientists from a range of fields have been uncovering evidence that our thoughts, emotions and beliefs can ease pain, heal wounds, fend off infection and heart disease and even slow the progression of AIDS and some cancers.In Cure, award-winning science writer Jo Marchant travels the world to meet the physicians, patients and researchers on the cutting edge of this new world of medicine. We learn how meditation protects against depression and dementia, how social connections increase life expectancy and how patients who feel cared for recover from surgery faster. We meet Iraq war veterans who are using a virtual arctic world to treat their burns and children whose ADHD is kept under control with half the normal dose of medication. We watch as a transplant patient uses the smell of lavender to calm his hostile immune system and an Olympic runner shaves vital seconds off his time through mind-power alone.Drawing on the very latest research, Marchant explores the vast potential of the mind's ability to heal, lays out its limitations and explains how we can make use of the findings in our own lives. With clarity and compassion, Cure points the way towards a system of medicine that treats us not simply as bodies but as human beings.

    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.

    By examining fossils and DNA, Shubin shows us that our hands actually resemble fish fins, our head is organized like that of a long-extinct jawless fish, and major parts of our genome look and function like those of worms and bacteria.Shubin makes us see ourselves and our world in a completely new light. Your Inner Fish is science writing at its finest-enlightening, accessible, and told with irresistible enthusiasm.

    She explores the culture of genealogy buffs, the science of DNA, and the business of companies like Ancestry and 23andMe, all while tracing the story of one woman, her unusual results, and a relentless methodical drive for answers that becomes a thoroughly modern genetic detective story.

    From Mary Lamb, sister of Charles, who in the throes of a nervous breakdown turned on her mother with a kitchen knife, to Freud, Jung, and Lacan, who developed the new women-centered therapies, Lisa Appignanesi’s research traces how more and more of the inner lives and emotions of women have become a matter for medics and therapists. Here too is the story of how over the years symptoms and diagnoses have developed together to create fashions in illness and how treatments have succeeded or sometimes failed. Mad, Bad, and Sad takes us on a fascinating journey through the fragile, extraordinary human mind.

    Yet despite a century of medical progress, viral and bacterial disasters continue to take us by surprise, inciting panic and dominating news cycles. From the Spanish flu to the 1924 outbreak of pneumonic plague in Los Angeles to the 1930 “parrot fever” pandemic, through the more recent SARS, Ebola, and Zika epidemics, the last one hundred years have been marked by a succession of unanticipated pandemic alarms.In The Pandemic Century, a lively account of scares both infamous and less known, Mark Honigsbaum combines reportage with the history of science and medical sociology to artfully reconstruct epidemiological mysteries and the ecology of infectious diseases. We meet dedicated disease detectives, obstructive or incompetent public health officials, and brilliant scientists often blinded by their own knowledge of bacteria and viruses. We also see how fear of disease often exacerbates racial, religious, and ethnic tensions—even though, as the epidemiologists Malik Peiris and Yi Guan write, “‘nature’ remains the greatest bioterrorist threat of all.”Like man-eating sharks, predatory pathogens are always present in nature, waiting to strike; when one is seemingly vanquished, others appear in its place. These pandemics remind us of the limits of scientific knowledge, as well as the role that human behavior and technologies play in the emergence and spread of microbial diseases.

    She spent ten years training and working as an Anatomical Pathology Technologist: where the mortuary slab was her desk, and that day's corpses her task list.Past Mortems tells Carla's stories of those years, as well as investigating the body alongside our attitudes towards death - shedding light on what the living can learn from dead and the toll the work can take on the living souls who carry it out. Fascinating and insightful, Past Mortems reveals the truth about what happens when the mortuary doors swing shut or the lid of the coffin closes . . .