Our Malady: Lessons in Liberty from a Hospital Diary
Timothy Snyder - 2020
Unable to stand, barely able to think, he waited for hours in an emergency room before being correctly diagnosed and rushed into surgery. Over the next few days, as he clung to life and the first light of a new year came through his window, he found himself reflecting on the fragility of health, not recognized in America as a human right but without which all rights and freedoms have no meaning.And that was before the pandemic. We have since watched American hospitals, long understaffed and undersupplied, buckling under waves of coronavirus patients. The federal government made matters worse through willful ignorance, misinformation, and profiteering. Our system of commercial medicine failed the ultimate test, and thousands of Americans died.In this eye-opening cri de coeur, Snyder traces the societal forces that led us here and outlines the lessons we must learn to survive. In examining some of the darkest moments of recent history and of his own life, Snyder finds glimmers of hope and principles that could lead us out of our current malaise. Only by enshrining healthcare as a human right, elevating the authority of doctors and medical knowledge, and planning for our children's future can we create an America where everyone is truly free.
Walk on Water: The Miracle of Saving Children's Lives
Michael Ruhlman - 2003
Drawing back the hospital curtain for a unique and captivating look at the extraordinary skill and dangerous politics of critical surgery in a pediatric heart center, Michael Ruhlman focuses on the world-renowned Cleveland Clinic, where a team of medical specialists led by idiosyncratic virtuoso Dr. Roger Mee work on the edge of disaster on a daily basis. Walk on Water offers a rare and dramatic glimpse into a world where the health of innocent children and the hopes of white-knuckled families rest in the hands of all-too-human doctors.
The Hacking of the American Mind: The Science Behind the Corporate Takeover of Our Bodies and Brains
Robert H. Lustig - 2017
Serotonin is the "contentment" neurotransmitter that tells our brains we don't need any more; yet its deficiency leads to depression. Ideally, both are in optimal supply. Yet dopamine evolved to overwhelm serotonin--because our ancestors were more likely to survive if they were constantly motivated--with the result that constant desire can chemically destroy our ability to feel happiness, while sending us down the slippery slope to addiction. In the last forty years, government legislation and subsidies have promoted ever-available temptation (sugar, drugs, social media, porn) combined with constant stress (work, home, money, Internet), with the end result of an unprecedented epidemic of addiction, anxiety, depression, and chronic disease. And with the advent of neuromarketing, corporate America has successfully imprisoned us in an endless loop of desire and consumption from which there is no obvious escape.With his customary wit and incisiveness, Lustig not only reveals the science that drives these states of mind, he points his finger directly at the corporations that helped create this mess, and the government actors who facilitated it, and he offers solutions we can all use in the pursuit of happiness, even in the face of overwhelming opposition. Always fearless and provocative, Lustig marshals a call to action, with seminal implications for our health, our well-being, and our culture.
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.
And the Band Played On: Politics, People, and the AIDS Epidemic
Randy Shilts - 1987
America faced a troubling question: What happened? How was this epidemic allowed to spread so far before it was taken seriously? In answering these questions, Shilts weaves the disparate threads into a coherent story, pinning down every evasion and contradiction at the highest levels of the medical, political, and media establishments. Shilts shows that the epidemic spread wildly because the federal government put budget ahead of the nation's welfare; health authorities placed political expediency before the public health; and scientists were often more concerned with international prestige than saving lives. Against this backdrop, Shilts tells the heroic stories of individuals in science and politics, public health and the gay community, who struggled to alert the nation to the enormity of the danger it faced. And the Band Played On is both a tribute to these heroic people and a stinging indictment of the institutions that failed the nation so badly.
Give Smart: Philanthropy that Gets Results
Thomas J. Tierney - 2011
The definitive guide for donors and those they fund, drawn from the experience of two prominent thinkers and extensive research by the premier nonprofit consulting group Bridgespan
Best Care Anywhere: Why VA Health Care Is Better Than Yours
Phillip Longman - 2007
This encouraging change not only has benefited veterans but also provides a blueprint for salvaging America's own deeply troubled healthcare system. "Best Care Anywhere" shows how a government bureaucracy, working with little notice, is setting the standard for best practices and cost reduction while the private sector is lagging in both areas. Author Phillip Longman challenges conventional wisdom by explaining exactly how market forces work to lower quality and raise prices in the healthcare sector, and how U.S. medical practices have a weak basis in science. The book, expanded from a widely praised article in the "Washington Monthly," mixes hard facts with author Philip Longmans' compelling human story of the loss of his wife to cancer. Part manifesto, part moving memoir, "Best Care Anywhere" offers new hope for addressing a major problem of contemporary society that affects all of us.
One by One by One: Making a Small Difference Amid a Billion Problems
Aaron Berkowitz - 2020
Aaron Berkowitz had just finished his neurology training when he was sent to Haiti on his first assignment with Partners In Health. There, he meets Janel, a 23-year-old man with the largest brain tumor Berkowitz or any of his neurosurgeon colleagues at Harvard Medical School have ever seen. Determined to live up to Partners In Health’s mission statement “to bring the benefits of modern medical science to those most in need,” Berkowitz tries to save Janel’s life by bringing him back to Boston for a 12-hour surgery. In One by One by One, Berkowitz traces what he learns and grapples with as a young doctor trying to bridge the gap between one of the world’s richest countries and one of the world’s poorest to make the first big save of his medical career.As Janel and Berkowitz travel back and forth between the high-tech neurosurgical operating rooms of Harvard’s hospitals and Janel’s dirt-floored hut in rural Haiti, they face countless heart-wrenching twists and turns. Janel remains comatose for months after his surgery. It’s not clear he will recover enough to return to Haiti and be able to survive there. So he goes for a second brain surgery, a third, a fourth. Berkowitz brings the reader to the front lines of global humanitarian work as he struggles to overcome the challenges that arise when well-meaning intentions give rise to unintended consequences, when cultures and belief systems clash, and when it’s not clear what the right thing to do is, let alone the right way to do it. One by One by One is a gripping account of the triumphs, tragedies, and confusing spaces in between as an idealistic young doctor learns the hard but necessary lessons of living by the Haitian proverb tout moun se moun—every person is a person.
The Wisdom of Whores: Bureaucrats, Brothels, and the Business of AIDS
Elizabeth Pisani - 2008
With swashbuckling wit and fierce honesty, she dishes on herself and her colleagues as they try to prod reluctant governments to fund HIV prevention for the people who need it most—drug injectors, gay men, sex workers, and johns.Pisani chats with flamboyant Indonesian transsexuals about their boob jobs and watches Chinese streetwalkers turn away clients because their SUVs aren't nice enough. With verve and clarity, she shows the general reader how her profession really works; how easy it is to draw wrong conclusions from "objective" data; and, shockingly, how much money is spent so very badly. "Exhibit A": the 45 billion taxpayer dollars the Bush administration is committing to international AIDS programs.
The Quest: Energy, Security, and the Remaking of the Modern World
Daniel Yergin - 2011
A master storyteller as well as a leading energy expert, Yergin shows us how energy is an engine of global political and economic change. It is a story that spans the energies on which our civilization has been built and the new energies that are competing to replace them. From the jammed streets of Beijing to the shores of the Caspian Sea, from the conflicts in the Mideast to Capitol Hill and Silicon Valley, Yergin takes us into the decisions that are shaping our future.The drama of oil-the struggle for access, the battle for control, the insecurity of supply, the consequences of use, its impact on the global economy, and the geopolitics that dominate it-continues to profoundly affect our world.. Yergin tells the inside stories of the oil market and the surge in oil prices, the race to control the resources of the former Soviet empire, and the massive mergers that transformed the landscape of world oil. He tackles the toughest questions: Will we run out of oil? Are China and the United States destined to come into conflict over oil? How will a turbulent Middle East affect the future of oil supply?Yergin also reveals the surprising and sometimes tumultuous history of nuclear and coal, electricity, and the "shale gale" of natural gas, and how each fits into the larger marketplace. He brings climate change into unique perspective by offering an unprecedented history of how the field of climate study went from the concern of a handful of nineteenth- century scientists preoccupied with a new Ice Age into one of the most significant issues of our times.He leads us through the rebirth of renewable energies and explores the distinctive stories of wind, solar, and biofuels. He offers a perspective on the return of the electric car, which some are betting will be necessary for a growing global economy.The Quest presents an extraordinary range of characters and dramatic stories that illustrate the principles that will shape a robust and flexible energy security system for the decades to come. Energy is humbling in its scope, but our future requires that we deeply understand this global quest that is truly reshaping our world.
Beating Back the Devil: On the Front Lines with the Disease Detectives of the Epidemic Intelligence Service
Maryn McKenna - 2004
They always keep a bag packed. They seldom have more than twenty-four hours' notice before they are dispatched. The phone calls that tell them to head to the airport, sometimes in the middle of the night, may give them no more information than the country they are traveling to and the epidemic they will tackle when they get there.The universal human instinct is to run from an outbreak of disease. These doctors run toward it.They are the disease detective corps of the U.S. Centers for Disease Control and Prevention (CDC), the federal agency that tracks and tries to prevent disease outbreaks and bioterrorist attacks around the world. They are formally called the Epidemic Intelligence Service (EIS) -- a group founded more than fifty years ago out of fear that the Korean War might bring the use of biological weapons -- and, like intelligence operatives in the traditional sense, they perform their work largely in anonymity. They are not household names, but over the years they were first to confront the outbreaks that became known as hantavirus, Ebola virus, and AIDS. Now they hunt down the deadly threats that dominate our headlines: West Nile virus, anthrax, and SARS.In this riveting narrative, Maryn McKenna -- the only journalist ever given full access to the EIS in its fifty-three-year history -- follows the first class of disease detectives to come to the CDC after September 11, the first to confront not just naturally occurring outbreaks but the man-made threat of bioterrorism. They are talented researchers -- many with young families -- who trade two years of low pay and extremely long hours for the chance to be part of the group that has helped eradicate smallpox, push back polio, and solve the first major outbreaks of Legionnaires' disease, toxic shock syndrome, and "E. coli" O157.Urgent, exhilarating, and compelling, "Beating Back the Devil" goes with the EIS as they try to stop epidemics -- before the epidemics stop us.
Empire of Pain: The Secret History of the Sackler Dynasty
Patrick Radden KeefePatrick Radden Keefe - 2021
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.
The End of Poverty
Jeffrey D. Sachs - 2005
Sachs is renowned for his work around the globe advising economies in crisis. Now a classic of its genre, The End of Poverty distills more than thirty years of experience to offer a uniquely informed vision of the steps that can transform impoverished countries into prosperous ones. Marrying vivid storytelling with rigorous analysis, Sachs lays out a clear conceptual map of the world economy. Explaining his own work in Bolivia, Russia, India, China, and Africa, he offers an integrated set of solutions to the interwoven economic, political, environmental, and social problems that challenge the world's poorest countries. Ten years after its initial publication, The End of Poverty remains an indispensible and influential work. In this 10th anniversary edition, Sachs presents an extensive new foreword assessing the progress of the past decade, the work that remains to be done, and how each of us can help. He also looks ahead across the next fifteen years to 2030, the United Nations' target date for ending extreme poverty, offering new insights and recommendations.
Betrayal of Trust: The Collapse of Global Public Health
Laurie Garrett - 2000
Garrett also exposes the ungoverned world of biological terrorism.
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.