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.

    It killed more people in twenty-four months than AIDS killed in twenty-four years, more in a year than the Black Death killed in a century. But this was not the Middle Ages, and 1918 marked the first collision of science and epidemic disease. Magisterial in its breadth of perspective and depth of research and now revised to reflect the growing danger of the avian flu, The Great Influenza is ultimately a tale of triumph amid tragedy, which provides us with a precise and sobering model as we confront the epidemics looming on our own horizon. John M. Barry has written a new afterword for this edition that brings us up to speed on the terrible threat of the avian flu and suggest ways in which we might head off another flu pandemic.

    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.

     It is a remarkable portrait, too, of the life of a psychiatric asylum--the sort of community in which, for better and for worse, hundreds of thousands of people lived out their lives.More than four hundred abandoned suitcases filled with patients’ belongings were found when Willard Psychiatric Center closed in 1995 after 125 years of operation. They are skillfully examined here and compared to the written record to create a moving—and devastating—group portrait of twentieth-century American psychiatric care.

    One day he'll save a young mother's life as she gives birth, the next he watches a young schoolgirl die in front of him after a hit and run. In between he ferries drunken teenagers, drug addicts and timewasters and muses on modern life.

    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.

    Styron is perhaps the first writer to convey the full terror of depression's psychic landscape, as well as the illuminating path to recovery.

    With extensive treatment of the heart of epidemiology-from study designs to descriptive epidemiology to quantitative measures-this reader-friendly text is accessible and interesting to a wide range of beginning students in all health-related disciplines. A unique focus is given to real-world applications of epidemiology and the development of skills that students can apply in subsequent course work and in the field. The text is also accompanied by a complete package of instructor and student resources available through a companion Web site.

    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.

    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.

    A failed salesman turned local reporter, he wanted to test himself, see how he might respond to pressure and danger. He signed up for emergency medical training and became, at age twenty-six, a newly minted EMT running calls in the worst sections of Atlanta. His life entered a different realm—one of blood, violence, and amazing grace.Thoroughly intimidated at first and frequently terrified, he experienced on a nightly basis the adrenaline rush of walking into chaos. But in his downtime, Kevin reflected on how people’s facades drop away when catastrophe strikes. As his hours on the job piled up, he realized he was beginning to see into the truth of things. There is no pretense five beats into a chest compression, or in an alley next to a crack den, or on a dimly lit highway where cars have collided. Eventually, what had at first seemed impossible happened: Kevin acquired mastery. And in the process he was able to discern the professional differences between his freewheeling peers, what marked each—as he termed them—as “a tourist,” “true believer,” or “killer.”Combining indelible scenes that remind us of life’s fragile beauty with laugh-out-loud moments that keep us smiling through the worst, A Thousand Naked Strangers is an absorbing read about one man’s journey of self-discovery—a trip that also teaches us about ourselves.

    Robert Marion asked three of them to keep a careful diary over the course of a year. Andy, Mark, and Amy vividly describe their real-life lessons in treating very sick children; confronting child abuse and the awful human impact of the AIDS epidemic; skirting the indifference of the hospital bureaucracy; and overcoming their own fears, insecurities, and constant fatigue. Their stories are harrowing and often funny; their personal triumph is unforgettable.This updated edition of The Intern Blues includes a new preface from the author discussing the status of medical training in America today and a new afterword updating the reader on the lives of the three young interns who first shared their stories with readers more than a decade ago.

    Rick Hodes arrived in Africa more than two decades ago to help the victims of a famine, but he never expected to call this extremely poor continent his home. Twenty-eight years later, he is still there. This is a Soul tells the remarkable story of Rick Hodes’s journey from suburban America to Mother Teresa’s clinic in Addis Ababa, Ethiopia.As a boy, Rick was devoted to helping those in need, and eventually he determined that becoming a doctor would allow him to do the most good. When he heard about famine in Africa, that’s where he went, and when genocide convulsed Rwanda, he went into the refugee camps to minister to the victims. When he was told that Ethiopia was allowing its Jews to emigrate to Israel, he went to help. While there, he was drawn to Mother Teresa’s mission in Addis Ababa. It was there that Rick found his calling when he began caring for the sickest children in one of the world's poorest countries. But he did more than that—he began taking them into his home and officially adopted five of them.Marilyn Berger went to Africa to write about Dr. Hodes, but while there, she became involved with the story. When she came upon a small, deformed, and malnourished boy begging on the street, she recognized immediately that he had the exact disease Rick could cure. She took him to Rick, who eventually arranged for the boy to have a complicated and risky surgery, which turned out to be incredibly successful. The boy’s story—intertwined with Rick’s, and Marilyn's as well—is unforgettable in its pathos and subtle humor.This is a Soul is not just a story of the savior and the saved, it is a celebration of love and wisdom, and an exploration of how charity and devotion can actually change lives in an overcrowded, unjust, and often harsh world.

    That is until 1904, when the disease broke out in a household in Oyster Bay, Long Island. Authorities suspected the family cook, Mary Mallon, of being a carrier. But before she could be tested, the woman, soon to be known as Typhoid Mary, had disappeared. Over the course of the next three years, Mary worked at several residences, spreading her pestilence as she went. In 1907, she was traced to a home on Park Avenue, and taken into custody. Institutionalized at Riverside Hospital for three years, she was released only when she promised never to work as a cook again. She promptly disappeared.For the next five years Mary worked in homes and institutions in and around New York, often under assumed names. In February 1915, a devastating outbreak of typhoid at the Sloane Hospital for Women was traced to her. She was finally apprehended and reinstitutionalized at Riverside Hospital, where she would remain for the rest of her life.Typhoid Mary is the story of her infamous life. Anthony Bourdain reveals the seedier side of the early 1900s, and writes with his renowned panache about life in the kitchen, uncovering the horrifying conditions that allowed the deadly spread of typhoid over a decade. Typhoid Mary is a true feast for history lovers and Bourdain lovers alike.

    . . when it comes to the legacy of this country's war on drugs, we should all share his outrage." --The New York Times Book Review From one of the world's foremost experts on the subject, a powerful argument that the greatest damage from drugs flows from their being illegal, and a hopeful reckoning with the possibility of their use as part of a responsible and happy lifeDr. Carl L. Hart, Ziff Professor at Columbia University and former chair of the Department of Psychology, is one of the world's preeminent experts on the effects of so-called recreational drugs on the human mind and body. Dr. Hart is open about the fact that he uses drugs himself, in a happy balance with the rest of his full and productive life as a colleague, husband, father, and friend. In Drug Use for Grown-Ups, he draws on decades of research and his own personal experience to argue definitively that the criminalization and demonization of drug use--not drugs themselves--have been a tremendous scourge on America, not least in reinforcing this country's enduring structural racism.Dr. Hart did not always have this view. He came of age in one of Miami's most troubled neighborhoods at a time when many ills were being laid at the door of crack cocaine. His initial work as a researcher was aimed at proving that drug use caused bad outcomes. But one problem kept cropping up: the evidence from his research did not support his hypothesis. From inside the massively well-funded research arm of the American war on drugs, he saw how the facts did not support the ideology. The truth was dismissed and distorted in order to keep fear and outrage stoked, the funds rolling in, and Black and brown bodies behind bars.Drug Use for Grown-Ups will be controversial, to be sure: the propaganda war, Dr. Hart argues, has been tremendously effective. Imagine if the only subject of any discussion about driving automobiles was fatal car crashes. Drug Use for Grown-Ups offers a radically different vision: when used responsibly, drugs can enrich and enhance our lives. We have a long way to go, but the vital conversation this book will generate is an extraordinarily important step.