Some of these drugs are truly transformative, offering major improvements in how long patients live or how they feel--but what is often missing from the popular narrative is that, far too often, these new drugs have marginal or minimal benefits. Some are even harmful. In Malignant, hematologist-oncologist Dr. Vinayak K. Prasad writes about the many sobering examples of how patients are too often failed by cancer policy and by how oncology is practiced. Throughout this work, Prasad illuminates deceptive practices which- promote novel cancer therapies long before credible data are available to support such treatment; and- exaggerate the potential benefits of new therapies, many of which cost thousands and in some cases hundreds of thousands of dollars.Prasad then critiques the financial conflicts of interest that pervade the oncology field, the pharmaceutical industry, and the US Food and Drug administration.This is a book about how the actions of human beings--our policies, our standards of evidence, and our drug regulation--incentivize the pursuit of marginal or unproven therapies at lofty and unsustainable prices. Prasad takes us through how cancer trials are conducted, how drugs come to market, and how pricing decisions are made, asking how we can ensure that more cancer drugs deliver both greater benefit and a lower price. Ultimately, Prasad says,- more cancer clinical trials should measure outcomes that actually matter to people with cancer;- patients on those trials should look more like actual global citizens;- we need drug regulators to raise, not perpetually lower, the bar for approval; and- we need unbiased patient advocates and experts.This well-written, opinionated, and engaging book explains what we can do differently to make serious and sustained progress against cancer--and how we can avoid repeating the policy and practice mistakes of the past.

    But things changed dramatically when he began suffering from inexplicable fatigue. In a matter of weeks, his organs were failing and he was read his last rites. Doctors were baffled by his condition, which they had yet to even diagnose. Floating in and out of consciousness, Fajgenbaum prayed for a second chance, the equivalent of a dramatic play to second the game into overtime.Miraculously, Fajgenbaum survived--only to endure repeated near-death relapses from what would eventually be identified as a form of Castleman disease, an extremely deadly and rare condition that acts like a cross between cancer and an autoimmune disorder. When he relapsed while on the only drug in development and realized that the medical community was unlikely to make progress in time to save his life, Fajgenbaum turned his desperate hope for a cure into concrete action: Between hospitalizations he studied his own charts and tested his own blood samples, looking for clues that could unlock a new treatment. With the help of family, friends, and mentors, he also reached out to other Castleman disease patients and physicians, and eventually came up with an ambitious plan to crowdsource the most promising research questions and recruit world-class researchers to tackle them. Instead of waiting for the scientific stars to align, he would attempt to align them himself.More than five years later and now married to his college sweetheart, Fajgenbaum has seen his hard work pay off: A treatment he identified has induced a tentative remission and his novel approach to collaborative scientific inquiry has become a blueprint for advancing rare disease research. His incredible story demonstrates the potency of hope, and what can happen when the forces of determination, love, family, faith, and serendipity collide.

    The Allies won the war with it. It conquered diseases, changed laws, and single-handedly launched the era of antibiotics. This incredible discovery was sulfa, the first antibiotic. In The Demon Under the Microscope, Thomas Hager chronicles the dramatic history of the drug that shaped modern medicine.Sulfa saved millions of lives—among them those of Winston Churchill and Franklin Delano Roosevelt Jr.—but its real effects are even more far reaching. Sulfa changed the way new drugs were developed, approved, and sold; transformed the way doctors treated patients; and ushered in the era of modern medicine. The very concept that chemicals created in a lab could cure disease revolutionized medicine, taking it from the treatment of symptoms and discomfort to the eradication of the root cause of illness. A strange and colorful story, The Demon Under the Microscope illuminates the vivid characters, corporate strategy, individual idealism, careful planning, lucky breaks, cynicism, heroism, greed, hard work, and the central (though mistaken) idea that brought sulfa to the world. This is a fascinating scientific tale with all the excitement and intrigue of a great suspense novel. For thousands of years, humans had sought medicines with which they could defeat contagion, and they had slowly, painstakingly, won a few battles: some vaccines to ward off disease, a handful of antitoxins. A drug or two was available that could stop parasitic diseases once they hit, tropical maladies like malaria and sleeping sickness. But the great killers of Europe, North America, and most of Asia—pneumonia, plague, tuberculosis, diphtheria, cholera, meningitis—were caused not by parasites but by bacteria, much smaller, far different microorganisms. By 1931, nothing on earth could stop a bacterial infection once it started. . . .But all that was about to change. . . . —from The Demon Under the Microscope

    Our stories are marbled into their marrow.Drawing upon her years of research and a wealth of remarkable experience, the world-renowned forensic anthropologist Professor Dame Sue Black takes us on a journey of revelation. From skull to feet, via the face, spine, chest, arms, hands, pelvis and legs, she shows that each part of us has a tale to tell. What we eat, where we go, everything we do leaves a trace, a message that waits patiently for months, years, sometimes centuries, until a forensic anthropologist is called upon to decipher it.Some of this information is easily understood, some holds its secrets tight and needs scientific cajoling to be released. But by carefully piecing together the evidence, the facts of a life can be rebuilt. Limb by limb, case by case – some criminal, some historical, some unaccountably bizarre – Sue Black reconstructs with intimate sensitivity and compassion the hidden stories in what we leave behind.

    In college, I ran against Kenyans, and wondered whether endurance genes might have traveled with them from East Africa. At the same time, I began to notice that a training group on my team could consist of five men who run next to one another, stride for stride, day after day, and nonetheless turn out five entirely different runners. How could this be?We all knew a star athlete in high school. The one who made it look so easy. He was the starting quarterback and shortstop; she was the all-state point guard and high-jumper. Naturals. Or were they?The debate is as old as physical competition. Are stars like Usain Bolt, Michael Phelps, and Serena Williams genetic freaks put on Earth to dominate their respective sports? Or are they simply normal people who overcame their biological limits through sheer force of will and obsessive training?The truth is far messier than a simple dichotomy between nature and nurture. In the decade since the sequencing of the human genome, researchers have slowly begun to uncover how the relationship between biological endowments and a competitor’s training environment affects athleticism. Sports scientists have gradually entered the era of modern genetic research.In this controversial and engaging exploration of athletic success, Sports Illustrated senior writer David Epstein tackles the great nature vs. nurture debate and traces how far science has come in solving this great riddle. He investigates the so-called 10,000-hour rule to uncover whether rigorous and consistent practice from a young age is the only route to athletic excellence.Along the way, Epstein dispels many of our perceptions about why top athletes excel. He shows why some skills that we assume are innate, like the bullet-fast reactions of a baseball or cricket batter, are not, and why other characteristics that we assume are entirely voluntary, like an athlete’s will to train, might in fact have important genetic components.This subject necessarily involves digging deep into sensitive topics like race and gender. Epstein explores controversial questions such as:Are black athletes genetically predetermined to dominate both sprinting and distance running, and are their abilities influenced by Africa’s geography?Are there genetic reasons to separate male and female athletes in competition?Should we test the genes of young children to determine if they are destined for stardom?Can genetic testing determine who is at risk of injury, brain damage, or even death on the field?Through on-the-ground reporting from below the equator and above the Arctic Circle, revealing conversations with leading scientists and Olympic champions, and interviews with athletes who have rare genetic mutations or physical traits, Epstein forces us to rethink the very nature of athleticism.

    In this gripping, true account of the war against worldwide epidemics, one of medicine's frontline generals, Dr. Joseph McCormick, developer of the CDC's legendary hot zone, chronicles his decades as a virus hunter, working to combat the virus as predator. 16-pages of photos.

    In The Poisoner's Handbook Blum draws from highly original research to track the fascinating, perilous days when a pair of forensic scientists began their trailblazing chemical detective work, fighting to end an era when untraceable poisons offered an easy path to the perfect crime. Drama unfolds case by case as the heroes of The Poisoner's Handbook—chief medical examiner Charles Norris and toxicologist Alexander Gettler—investigate a family mysteriously stricken bald, Barnum and Bailey's Famous Blue Man, factory workers with crumbling bones, a diner serving poisoned pies, and many others. Each case presents a deadly new puzzle and Norris and Gettler work with a creativity that rivals that of the most imaginative murderer, creating revolutionary experiments to tease out even the wiliest compounds from human tissue. Yet in the tricky game of toxins, even science can't always be trusted, as proven when one of Gettler's experiments erroneously sets free a suburban housewife later nicknamed "America's Lucretia Borgia" to continue her nefarious work. From the vantage of Norris and Gettler's laboratory in the infamous Bellevue Hospital it becomes clear that killers aren't the only toxic threat to New Yorkers. Modern life has created a kind of poison playground, and danger lurks around every corner. Automobiles choke the city streets with carbon monoxide; potent compounds, such as morphine, can be found on store shelves in products ranging from pesticides to cosmetics. Prohibition incites a chemist's war between bootleggers and government chemists while in Gotham's crowded speakeasies each round of cocktails becomes a game of Russian roulette. Norris and Gettler triumph over seemingly unbeatable odds to become the pioneers of forensic chemistry and the gatekeepers of justice during a remarkably deadly time. A beguiling concoction that is equal parts true crime, twentieth-century history, and science thriller, The Poisoner's Handbook is a page-turning account of a forgotten New York.

    Full of extraordinary facts and astonishing stories, The Body: A Guide for Occupants is a brilliant, often very funny attempt to understand the miracle of our physical and neurological make up.A wonderful successor to A Short History of Nearly Everything, this book will have you marvelling at the form you occupy, and celebrating the genius of your existence, time and time again.

    . . . The only crime equaling inhumanity is the crime of indifference, silence, and forgetting.—James OrbinskiIn 1988, James Orbinski, then a medical student in his twenties, embarked on a year-long research trip to Rwanda, a trip that would change who he would be as a doctor and as a man. Investigating the conditions of pediatric AIDS in Rwanda, James confronted widespread pain and suffering, much of it preventable, much of it occasioned by political and economic corruption. Fuelled by the injustice of what he had seen in Rwanda, Orbinski helped establish the Canadian chapter of Médecins Sans Frontières (Doctors Without Borders/MSF). As a member of MSF he travelled to Peru during a cholera epidemic, to Somalia during the famine and civil war, and to Jalalabad, Afghanistan.In April 1994, James answered a call from the MSF Amsterdam office. Rwandan government soldiers and armed militias of extremist Hutus had begun systematically to murder Tutsis. While other foreigners were evacuated from Rwanda, Orbinski agreed to serve as Chef de Mission for MSF in Kigali. As Rwanda descended into a hell of civil war and genocide, he and his team worked tirelessly, tending to thousands upon thousands of casualties. In fourteen weeks 800,000 men, women and children were exterminated. Half a million people were injured, and millions were displaced. The Rwandan genocide was Orbinski’s undoing. Confronted by indescribable cruelty, he struggled to regain his footing as a doctor, a humanitarian and a man. In the end he chose not to retreat from the world, but resumed his work with MSF, and was the organization’s president when it was awarded the Nobel Peace Prize in 1999.An Imperfect Offering is a deeply personal, deeply political book. With unstinting candor, Orbinski explores the nature of humanitarian action in the twenty-first century, and asserts the fundamental imperative of seeing as human those whose political systems have most brutally failed. He insists that in responding to the suffering of others, we must never lose sight of the dignity of those being helped or deny them the right to act as agents in their own lives. He takes readers on a journey to some of the darkest places of our history but finds there unimaginable acts of courage and empathy. Here he is doctor as witness, recording voices that must be heard around the world; calling on others to meet their responsibility.Ummera, ummera–sha is a Rwandan saying that loosely translated means ‘Courage, courage, my friend–find your courage and let it live.’ It was said to me by a patient at our hospital in Kigali. She was slightly older than middle aged and had been attacked with machetes, her entire body rationally and systematically mutilated. Her face had been so carefully disfigured that a pattern was obvious in the slashes. I could do little more for her at that moment than stop the bleeding with a few sutures. We were completely overwhelmed. She knew and I knew that there were so many others. She said to me in the clearest voice I have ever heard, “Allez, allez. Ummera, ummera-sha”–‘Go, go. Courage, courage, my friend–find your courage and let it live.’—From An Imperfect Offering

    But for thousands of years, people have done things like this—and things that make radioactive underpants seem downright sensible! In their hit podcast, Sawbones, Sydnee and Justin McElroy breakdown the weird and wonderful way we got to modern healthcare. And some of the terrifying detours along the way.Every week, Dr. Sydnee McElroy and her husband Justin amaze, amuse, and gross out (depending on the week) hundreds of thousands of avid listeners to their podcast, Sawbones. Consistently rated a top podcast on iTunes, with over 15 million total downloads, this rollicking journey through thousands of years of medical mishaps and miracles is not only hilarious but downright educational. While you may never even consider applying  boiled weasel to your forehead (once the height of sophistication when it came to headache cures), you will almost certainly face some questionable medical advice in your everyday life (we’re looking at you, raw water!) and be better able to figure out if this is a miracle cure (it’s not) or a scam. Table of Contents:Part One: The Unnerving The Resurrection Men Fun w Galvanism Weird Weight Loss Miracle Cure: Opium Black Plague Heroes of Misguided Medicine: Pliny the Elder Erectile Dysfunction The Doctor Is In: Listener Questions Answered Don’t Drill a Hole in Your HeadPart Two: The Gross Mummy Medicine The Guthole Bromance The Unkillable Phineas Gage Max Drank Poopy Water Heroes of Misguided Medicine: Robert Liston Golden Showers of Health Miracle Cure-All: Radium Dr. John Romulus Brinkley The Doctor Is In Q&A Just (Four) Humour Me The Camel Dung MiraclePart Three: The Weird The Dancing Plague Bad Medicine: Tobacco for Health The Seasick-Proof Saloon Miracle Cure-All: Vinegar The Doctor Is In Q&A Heroes of Misguided MedicinePart Four: The Awesome The Poison Squad Bad Medicine: Self Experimentation Eat Your Chocolate! Heroes of Misguided Medicine Parrot Fever Miracle Cure-All: Honey The Miraculous Polio Vaccine The Doctor Is In

     Elinor Cleghorn became an unwell woman ten years ago. She was diagnosed with an autoimmune disease after a long period of being told her symptoms were anything from psychosomatic to a possible pregnancy. As Elinor learned to live with her unpredictable disease she turned to history for answers, and found an enraging legacy of suffering, mystification, and misdiagnosis.In Unwell Women, Elinor Cleghorn traces the almost unbelievable history of how medicine has failed women by treating their bodies as alien and other, often to perilous effect. The result is an authoritative and groundbreaking exploration of the relationship between women and medical practice, from the wandering womb of Ancient Greece to the rise of witch trials across Europe, and from the dawn of hysteria as a catchall for difficult-to-diagnose disorders to the first forays into autoimmunity and the shifting understanding of hormones, menstruation, menopause, and conditions like endometriosis.Packed with character studies and case histories of women who have suffered, challenged, and rewritten medical orthodoxy--and the men who controlled their fate--this is a revolutionary examination of the relationship between women, illness, and medicine. With these case histories, Elinor pays homage to the women who suffered so strides could be made, and shows how being unwell has become normalized in society and culture, where women have long been distrusted as reliable narrators of their own bodies and pain. But the time for real change is long overdue: answers reside in the body, in the testimonies of unwell women--and their lives depend on medicine learning to listen.

    There is every reason to believe that, within a few weeks of its onset, the infection was universally present in the nose and throat of the people, disseminated by mouth spray given off on talking by innumerable carriers and, in addition, by the coughing and sneezing of the sick. Susceptibility was very general, though it varied greatly in degree. Among those who escaped well marked sickness there are few who could not recall having had an occluded or running nose, or a raw feeling in the throat, or a cough, or aches and pains, at some time during the period of the prevalence of the disease, these probably representing the price such persons paid for their immunization." - Dr. Bernard Fantus In many ways, it is hard for modern people living in First World countries to conceive of a pandemic sweeping around the world and killing millions of people, and it is even harder to believe that something as common as influenza could cause such widespread illness and death. Although the flu still takes hundreds of lives each year, most of those lost are very young or old or ill with something else that had already weakened them. In fact, most people contract influenza at least once, and many suffer from the flu several times in their lives and survive it with a minimum amount of medical attention. In 1918, the world was still in the throes of the Great War, the deadliest conflict in human history at that point, but while World War I would be a catastrophic war surpassed only by World War II, an unprecedented influenza outbreak that same year inflicted casualties that would make both wars pale in comparison. An illness, or more likely a collection of illnesses, Spanish influenza quickly spread across the world and may have killed upwards of 100 million people, decimating populations across developed nations and possibly wiping out as much as 5% of the world’s population. If anything, the ongoing war and the censorship maintained by the countries fighting it may have resulted in the actual toll of the outbreak being underestimated based on the way soldiers’ deaths were categorized. World War I may have distracted people about the unprecedented nature of the outbreak, but the most alarming aspect of the outbreak in 1918 was the indiscriminate nature in which the scourge attacked young and old, healthy and unhealthy, and rich and poor alike. In fact, the popular name for the outbreak was a reference to the fact that Spain’s own king was stricken with the disease. While he and President Woodrow Wilson ended up surviving it, former First Lady Rose Cleveland did not. The staggering number of fatalities, and the way in which seemingly anybody could suffer during the outbreak, taught people in the early 20th century that regardless of the tremendous strides made by technology, and no matter how stalemated the war was, nobody was safe from nature itself. Of course, it also demonstrated how much more work could be done to prevent similar occurrences. The 1918 pandemic was neither the first nor the last outbreak of the flu, but it was by far the worst, and it forever changed the face of medicine and public health care in both North America and Europe. The 1918 Spanish Flu Pandemic: The History and Legacy of the World’s Deadliest Outbreak chronicles the devastating disease and the damage it wrought across the globe.

    But sometimes, when obsession gets the better of scientists, they twist a noble pursuit into something sinister. Under this spell, knowledge isn’t everything, it’s the only thing—no matter the cost. Bestselling author Sam Kean tells the true story of what happens when unfettered ambition pushes otherwise rational men and women to cross the line in the name of science, trampling ethical boundaries and often committing crimes in the process.The Icepick Surgeon masterfully guides the reader across two thousand years of history, beginning with Cleopatra’s dark deeds in ancient Egypt. The book reveals the origins of much of modern science in the transatlantic slave trade of the 1700s, as well as Thomas Edison’s mercenary support of the electric chair and the warped logic of the spies who infiltrated the Manhattan Project. But the sins of science aren’t all safely buried in the past. Many of them, Kean reminds us, still affect us today. We can draw direct lines from the medical abuses of Tuskegee and Nazi Germany to current vaccine hesitancy, and connect icepick lobotomies from the 1950s to the contemporary failings of mental-health care. Kean even takes us into the future, when advanced computers and genetic engineering could unleash whole new ways to do one another wrong.Unflinching, and exhilarating to the last page, The Icepick Surgeon fuses the drama of scientific discovery with the illicit thrill of a true-crime tale. With his trademark wit and precision, Kean shows that, while science has done more good than harm in the world, rogue scientists do exist, and when we sacrifice morals for progress, we often end up with neither.

    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.

    It is a waste product and a commodity pricier than oil. It can save lives and transmit deadly infections. Each one of us has roughly nine pints of it, yet many don’t even know their own blood type. And for all its ubiquity, the few tablespoons of blood discharged by 800 million women are still regarded as taboo; menstruation is perhaps the single most demonized biological event.Rose George, author of The Big Necessity, is renowned for her intrepid work on topics that are invisible but vitally important. In Nine Pints, she takes us from ancient practices of bloodletting to modern “hemovigilance” teams that track blood-borne diseases. She introduces Janet Vaughan, who set up the world’s first system of mass blood donation during the Blitz, and Arunachalam Muruganantham, known as “Menstrual Man” for his work on sanitary pads for developing countries. She probes the lucrative business of plasma transfusions, in which the U.S. is known as the “OPEC of plasma.” And she looks to the future, as researchers seek to bring synthetic blood to a hospital near you.Spanning science and politics, stories and global epidemics, Nine Pints reveals our life's blood in an entirely new light.