All the advances of modern life--the medical breakthroughs, the public health institutions, the rising standards of living--have given us each about twenty thousand extra days on average. There are few measures of human progress more astonishing than our increased longevity.This book is Steven Johnson's attempt to understand where that progress came from. How many of those extra twenty thousand days came from vaccines, or the decrease in famines, or seatbelts? What are the forces that now keep us alive longer? Behind each breakthrough lies an inspiring story of cooperative innovation, of brilliant thinkers bolstered by strong systems of public support and collaborative networks.But it is not enough simply to remind ourselves that progress is possible. How do we avoid decreases in life expectancy as our public health systems face unprecedented challenges? What current technologies or interventions that could reduce the impact of future crises are we somehow ignoring?

    A look at the workings of a modern day hospital through the lens of the pathologists department.

    In her travels, the doctor attends to terminal illness, AIDS, tuberculosis, and premature birth in small rural communities throughout the world.

    In 2005, Maimonides Hospital in Brooklyn, New York, unveiled a new state-of-theart, multimillion-dollar cancer center. Determined to understand the whole spectrum of factors that determine what kind of medical care people receive in this country, bestselling author Julie Salamon spent one year tracking the progress of the center and getting to know the characters who make the hospital run. Located in a community where sixty-seven different languages are spoken, Maimonides is a case study for the particular kinds of concerns that arise in institutions that serve an increasingly multicultural American demographic. Granted an astonishing “warts and all” level of access by the hospital higher-ups, Salamon followed the doctors, patients, administrators, nurses, ambulance drivers, cooks, and cleaning staff. She explored not just the action on the ground—what happens between doctors and patients—but also the financial, ethical, technological, sociological, and cultural matters that the hospital community encounters every day. Drawing on her skills as interviewer, observer, and social critic, Salamon presents the story of modern medicine, uniquely viewed from the vantage point of those who make it run. She draws out the internal and external political machinations that exist between doctors and staff as well as between hospital and community. And she grounds the science and emotion of medical drama in the financial realities of operating a huge, private institution that must contend with issues like adapting to the specific needs of immigrant groups that make up a large and growing portion of our society. Salamon exposes struggles of both the profound and humdrum variety. There are bitter internal feuds, warm personal connections, comedy, egoism, greed, love, and loss. There are rabbinic edicts to contend with as well as imams and herbalists and local politicians. There are system foul-ups that keep blood test results from being delivered on time, careless record keepers, shortages of everything except forms to fill, recalcitrant and greedy insurance reimbursement systems, and the surprising difficulty of getting doctors to wash their hands. This is the dynamic universe of small and large concerns and personalities that, taken together, determine the nature of our care and assume the utmost importance. As Martin Payson—chairman of the board at Maimonides and ex-Time-Warner vice chairman—puts it: “Hospitals have a lot in common with the movie business. You’ve got your talent, entrepreneurs, ambition, ego stroking, the business versus the creative part. The big difference is that in the hospital you don’t get second takes. Movies are make-believe. This is real life.”

    You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"—but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical.In The Patient Will See You Now, Eric Topol, one of the nation’s top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system.The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result—better, cheaper, and more human health care—will be worth it.Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.

    She is also a superbly gifted writer–witty, insightful, at once deeply humane and refreshingly wry. In Another Day in the Frontal Lobe, Dr. Firlik draws on this rare combination to create a neurosurgeon’s Kitchen Confidential–a unique insider’s memoir of a fascinating profession.Neurosurgeons are renowned for their big egos and aggressive self-confidence, and Dr. Firlik confirms that timidity is indeed rare in the field. “They’re the kids who never lost at musical chairs,” she writes. A brain surgeon is not only a highly trained scientist and clinician but also a mechanic who of necessity develops an intimate, hands-on familiarity with the gray matter inside our skulls. It’s the balance between cutting-edge medical technology and manual dexterity, between instinct and expertise, that Firlik finds so appealing–and so difficult to master. Firlik recounts how her background as a surgeon’s daughter with a strong stomach and a keen interest in the brain led her to this rarefied specialty, and she describes her challenging, atypical trek from medical student to fully qualified surgeon. Among Firlik’s more memorable cases: a young roofer who walked into the hospital with a three-inch-long barbed nail driven into his forehead, the result of an accident with his partner’s nail gun, and a sweet little seven-year-old boy whose untreated earache had become a raging, potentially fatal infection of the brain lining. From OR theatrics to thorny ethical questions, from the surprisingly primitive tools in a neurosurgeon’s kit to glimpses of future techniques like the “brain lift,” Firlik cracks open medicine’s most prestigious and secretive specialty. Candid, smart, clear-eyed, and unfailingly engaging, Another Day in the Frontal Lobe is a mesmerizing behind-the-scenes glimpse into a world of incredible competition and incalculable rewards.From the Hardcover edition.

    The book has the hallmark features for which Lippincott's Illustrated Reviews volumes are so popular: an outline format, over 600 full-color illustrations, end-of-chapter summaries, review questions, plus an entire section of clinical case studies with full-color illustrations. This edition's medical/clinical focus has been sharpened to provide a high-yield review. Five additional case studies have been included, bringing the total to nineteen. Review questions have been reformatted to comply with USMLE Step 1 style, with clinical vignettes.

    Instead, Guinan went to medical school and became a disease detective with the Centers for Disease Control and Prevention's Epidemic Intelligence Service. Selected to join India's Smallpox Eradication program, Guinan traveled to remote villages to isolate smallpox cases and then vaccinate all uninfected persons within a ten-mile radius. By May 1975, the World Health Organization declared Uttar Pradesh smallpox-free.During her barrier-breaking career, Dr. Guinan met arms-seeking Afghan insurgents in Pakistan and got caught in the crossfire between religious groups in Lebanon. She was one of the first medical detectives on the ground in San Francisco at the start of the AIDS crisis. And she served as an expert witness in a landmark decision that still protects HIV patients from workplace discrimination. Randy Shilts's best-selling book on the epidemic, And the Band Played On, features her AIDS work, as does the HBO movie of the same name.In Adventures of a Female Medical Detective, Guinan weaves together twelve vivid stories of her life in medicine, describing her individual experiences in controlling outbreaks, researching new diseases, and caring for patients the world over. Occasionally heartbreaking, sometimes hilarious, Guinan's account of her pathbreaking career will inspire public health students and future medical detectives--and give all readers insight into that part of the government exclusively devoted to protecting their health.

    

    That all changed in less than a generation with the discovery and development of a new category of medicine known as antibiotics. By 1955, the age-old evolutionary relationship between humans and microbes had been transformed, trivializing once-deadly infections. William Rosen captures this revolution with all its false starts, lucky surprises, and eccentric characters. He explains why, given the complex nature of bacteria—and their ability to rapidly evolve into new forms—the only way to locate and test potential antibiotic strains is by large-scale, systematic, trial-and-error experimentation. Organizing that research needs large, well-funded organizations and businesses, and so our entire scientific-industrial complex, built around the pharmaceutical company, was born. Timely, engrossing, and eye-opening, Miracle Cure is a must-read science narrative—a drama of enormous range, combining science, technology, politics, and economics to illuminate the reasons behind one of the most dramatic changes in humanity’s relationship with nature since the invention of agriculture ten thousand years ago.

    Nestled in the Smoky Mountains of eastern Tennessee, the town of Johnson City had always seemed exempt from the anxieties of modern American life. But when the local hospital treated its first AIDS patient, a crisis that had once seemed an urban problem had arrived in the town to stay. Working in Johnson City was Abraham Verghese, a young Indian doctor specializing in infectious diseases. Dr. Verghese became by necessity the local AIDS expert, soon besieged by a shocking number of male and female patients whose stories came to occupy his mind, and even take over his life. Verghese brought a singular perspective to Johnson City: as a doctor unique in his abilities; as an outsider who could talk to people suspicious of local practitioners; above all, as a writer of grace and compassion who saw that what was happening in this conservative community was both a medical and a spiritual emergency."

    Her marriage of more than thirty years was suffering, and she was virtually immobilized by fear and anxiety. As the daughter of parents who both died before she was thirty, Stern was terrified of illness and death, and despite the fact that her acclaimed career as a food and travel writer required her to spend a great deal of time on airplanes, she suffered from a persistent fear of flying and severe claustrophobia. But a strange thing happened one day on a plane that was grounded at the Minneapolis airport for six horrible, foodless, airless hours. A young man on a trip with his classmates suddenly became dizzy and pale because he hadn’t eaten in many hours, and there was no food left on the plane. Without thinking about it, Jane gave him the candy bar that she had in her purse. A short time later the color had returned to his cheeks, the boy was laughing again with his friends, and Jane realized that this one small act of kindness—helping another person who was suffering—had provided her with comfort and a sense of well-being.It was shortly thereafter that this fifty-two-year-old writer decided to become an emergency medical technician, eventually coming to be known as Ambulance Girl. Stern tells her story with great humor and poignancy, creating a wonderful portrait of a middle-aged, Woody Allen–ish woman who was “deeply and neurotically terrified of sick and dead people,” but who went out into the world to save other people’s lives as a way of saving her own. Her story begins with the boot camp of EMT training: 140 hours at the hands of a dour ex-marine who took delight in presenting a veritable parade of amputations, hideous deformities, and gross disasters. Jane—overweight and badly out of shape—had to surmount physical challenges like carrying a 250-pound man seated in a chair down a dark flight of stairs. After class she did rounds in the emergency room of a local hospital, where she attended to a schizophrenic kickboxer who had tried to kill his mother that morning and a stockbroker who was taken off the commuter train to Manhattan with delirium tremens so bad it killed him.Each call Stern describes is a vignette of human nature, often with a life in the balance. From an AIDS hospice to town drunks, yuppie wife beaters to psychopaths, Jane comes to see the true nature and underlying mysteries of a town she had called home for twenty years. Throughout the book we follow her as she gets her sea legs and finally bonds with the burly, handsome firefighters who become her colleagues. At the end, she is named the first woman officer of the department—a triumph we joyously share with her.Ambulance Girl is an inspiring story by a woman who found, somewhat late in life, that “in helping others I learned to help myself.” It is a book to be treasured and shared.

    It is an ideal reference for medical students in ICM courses, house officers, or anyone directly involved in patient care, whether student, teacher, or practitioner.The book features more than 200 facsimiles of EKG strips and numerous case studies and clinical examples. This Fifth Edition includes updated information on pacemakers and myocardial infarction treatment and more practice EKGs.

    

    It will inspire the necessary and difficult conversations we all need to have with loved ones as it illuminates a path to a better way of death.Like so many of us, award-winning writer Katy Butler always assumed her aging parents would experience healthy, active retire­ments before dying peacefully at home. Then her father suffered a stroke that left him incapable of easily finishing a sentence or showering without assistance. Her mother was thrust into full-time caregiving, and Katy became one of the 24 mil­lion Americans who help care for aging parents. In an effort to correct a minor and non–life threatening heart arrhythmia, doctors outfitted her father with a pacemaker. The device kept his heart beating but did nothing to prevent his slide into dementia, incontinence, near-muteness, and misery. After several years, he asked his wife for help, telling her, "I am living too long." Mother and daughter faced a series of wrench­ing moral questions: When does death cease being a curse and become a blessing? Where is the line between saving life and prolonging a dying? When is the right time to say to a doctor, "Let my loved one go"? When doctors refused to disable the pace­maker, sentencing her father to a protracted and agonizing death, Katy set out to understand why. Her quest had barely begun when her mother faced her own illness, rebelled against her doctors, refused open-heart surgery, and instead met death head-on. Knocking on Heaven's Door, a revolution­ary blend of memoir and investigative reporting, is the fruit of the Butler family's journey. With a reporter's skill, a poet's eye, and a daughter's love, Butler explores what happens when our terror of death collides with the tech­nological imperatives of modern medicine. Her provocative thesis is that advanced medicine, in its single-minded pursuit of maximum longevity, often creates more suffering than it prevents. Butler lays bare the tangled web of technology, medicine, and commerce that modern dying has become and chronicles the rise of Slow Medicine - a growing movement that promotes care over cure. Knocking on Heaven's Door is a visionary map through the labyrinth of a broken and morally adrift medical system. It will inspire the necessary and difficult conversations we all need to have with loved ones as it illuminates a path to a better way of death.