Being Mortal by Atul Gawande - A 20-minute Summary: Medicine and What Matters in the End


Instaread Summaries - 2014
    Being Mortal by Atul Gawande - A 20-minute Summary Inside this Instaread Summary: • Overview of the entire book• Introduction to the important people in the book• Summary and analysis of all the chapters in the book• Key Takeaways of the book• A Reader's Perspective Preview of this summary: Chapter 1 Gawande grew up in Ohio. His parents were immigrants from India and both were doctors. His grandparents stayed in India, and there were few older people in his neighborhood, so he had little experience with aging or death until he met his wife’s grandmother, Alice Hobson. Hobson was seventy-seven and living on her own in Virginia. She was a spirited widow who fixed her own plumbing and volunteered with Meals On Wheels. However, Hobson was losing strength and height steadily each year as her arthritis worsened.Gawande’s father enthusiastically adopted the customs of his new country, but he could not understand the way in which seniors were treated in the US. In India, the elderly were treated with great respect and lived out their lives with family.In the United States, Sitaram Gawande, Gawande’s grandfather, likely would have been sent to a nursing home like most of the elderly who cannot handle the basics of daily living by themselves. However, in India, Sitaram Gawande was able to live in his own home and manage his own affairs, with family constantly around him. He died at the age of one hundred and ten when he fell off a bus during a business trip.Until recently, most elderly people stayed with their families. Even as the nuclear family unit became predominant, replacing the multi-generational family unit, people cared for their elderly relatives. Families were large and one child, usually a daughter, would not marry in order to take care of the parents.This has changed in much of the world, where elderly people end up struggling to live alone, like Hobson, rather than living with dignity amid family, like Sitaram Gawande.One cause of this change can be found in the nature of knowledge. When few people lived to be very old, elders were honored. Their store of knowledge was greatly useful. People often portrayed themselves as older to command respect. Modern society’s emphasis on youth is a complete reversal of this attitude. Technological advances are perceived as the territory of the young, and everyone wants to be younger. High-tech job opportunities are all over the world, and young people do not hesitate to leave their parents behind to pursue them.In developed countries, parents embrace the concept of a retirement filled with leisure activities. Parents are happy to begin living for themselves once children are grown. However, this system only works for young, healthy retirees, but not for those who cannot continue to be independent. Hobson, for example, was falling frequently and suffering memory lapses. Her doctor did tests and wrote prescriptions, but did not know what to do about her deteriorating condition. Neither did her family… About the Author With Instaread Summaries, you can get the summary of a book in 30 minutes or less. We read every chapter, summarize and analyze it for your convenience.

Surgery, The Ultimate Placebo: A Surgeon Cuts through the Evidence


Ian Harris - 2016
    In this book you will see how commonly performed operations can be found to be useless or even harmful when properly evaluated. That these claims come from an experienced, practicing orthopedic surgeon who performs many of these operations himself, makes the unsettling argument particularly compelling. Of course no surgeon is recommending invasive surgery in bad faith, but Ian Harris argues that the evidence for the success for many common operations, including knee arthroscopies, back fusion or cardiac stenting, become current accepted practice without full examination of the evidence.

Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis


Lisa Sanders - 2009
    Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D.The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it–on some level–restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer.A healthy young man suddenly loses his memory–making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment–only to have their symptoms mysteriously return. A young woman lies dying in the ICU–bleeding, jaundiced, incoherent–and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis.Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness–the diagnosis–revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.

I Wasn't Strong Like This When I Started Out: True Stories of Becoming a Nurse


Lee Gutkind - 2013
    Here, nurses remember their first “sticks,” first births, and first deaths, and reflect on what gets them though long, demanding shifts, and keeps them in the profession. The stories reveal many voices from nurses at different stages of their careers: One nurse-in-training longs to be trusted with more “important” procedures, while another questions her ability to care for nursing home residents. An efficient young emergency room nurse finds his life and career irrevocably changed by a car accident. A nurse practitioner wonders whether she has violated professional boundaries in her care for a homeless man with AIDS, and a home care case manager is the sole attendee at a funeral for one of her patients. What connects these stories is the passion and strength of the writers, who struggle against burnout and bureaucracy to serve their patients with skill, empathy, and strength.

The Naked Surgeon: the power and peril of transparency in medicine


Samer Nashef - 2015
    We all have one, but most of us will never see one. The heart surgeon now has that privilege but, for centuries, the heart was out of reach even for surgeons. So when a surgeon nowadays opens up a ribcage and mends a heart, it remains something of a miracle, even if, to some, it is merely plumbing. As with plumbers, the quality of surgeons’ work varies. As with plumbers, surgeons’ opinion of their own prowess and their own attitude to risk are not always reliable. Measurement is key. We’ve had a century of effective evidence-based medicine. We’ve had barely a decade of thorough monitoring of clinical outcomes. Thanks to the ground-breaking risk modelling of pioneering surgeons like Samer Nashef, we at last know how to judge whether an operation is in a patient’s best interest, which hospital and surgeon would be best for that operation, when it might best be performed and what the exact level of risk is. We have at last made what is important in surgery measurable. But how should surgeons, and their patients, use these newfound insights? Ever since his days as a medical student, Samer Nashef has challenged the medical profession to be more open and more accurate about the success of surgical procedures, for the sake of the patients. In The Naked Surgeon, he unclothes his own profession to demonstrate to his reader (and prospective patient) many revelations, such as the paradox at the heart of the cardiac surgeon’s craft: the more an operation is likely to kill you, the better it is for you. And he does so with absolute clarity, fluency and not a little wit.

Final Exam: A Surgeon's Reflections on Mortality


Pauline W. Chen - 2006
    What she did not count on was how much death would be a part of her work. Almost immediately, Chen found herself wrestling with medicine’s most profound paradox, that a profession premised on caring for the ill also systematically depersonalizes dying. Final Exam follows Chen over the course of her education, training, and practice as she grapples at strikingly close range with the problem of mortality, and struggles to reconcile the lessons of her training with her innate knowledge of shared humanity, and to separate her ideas about healing from her fierce desire to cure.From her first dissection of a cadaver in gross anatomy to the moment she first puts a scalpel to a living person; from the first time she witnesses someone flatlining in the emergency room to the first time she pronounces a patient dead, Chen is struck by her own mortal fears: there was a dying friend she could not call; a young patient’s tortured death she could not forget; even the sense of shared kinship with a corpse she could not cast aside when asked to saw its pelvis in two. Gradually, as she confronts the ways in which her fears have incapacitated her, she begins to reject what she has been taught about suppressing her feelings for her patients, and she begins to carve out a new role for herself as a physician and as human being. Chen’s transfixing and beautiful rumination on how doctors negotiate the ineluctable fact of death becomes, in the end, a brilliant questioning of how we should live.Moving and provocative, motored equally by clinical expertise and extraordinary personal grace, this is a piercing and compassionate journey into the heart of a world that is hidden and yet touches all of our lives. A superb addition to the best medical literature of our time.

The End of Alzheimer's: The First Program to Prevent and Reverse Cognitive Decline


Dale E. Bredesen - 2017
    Revealing that AD is not one condition, as it is currently treated, but three, The End of Alzheimer's outlines 36 metabolic factors (micronutrients, hormone levels, sleep) that can trigger "downsizing" in the brain. The protocol shows us how to rebalance these factors using lifestyle modifications like taking B12, eliminating gluten, or improving oral hygiene.The results are impressive. Of the first ten patients on the protocol, nine displayed significant improvement with 3-6 months; since then the protocol has yielded similar results with hundreds more. Now, The End of Alzheimer's brings new hope to a broad audience of patients, caregivers, physicians, and treatment centers with a fascinating look inside the science and a complete step-by-step plan that fundamentally changes how we treat and even think about AD.

Nurse


Peggy Anderson - 1978
    It is all here: the joy and pain, the death and drama, the mistakes, successes, and secrets. Nurse reads like a novel, but sticks in the memory like real experience-because it is.

Better: A Surgeon's Notes on Performance


Atul Gawande - 2007
    But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by arguably the best nonfiction doctor-writer around (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.

Operating Room Confidential: What Really Goes On When You Go Under


Paul Whang - 2010
    Personal stories combine with staff experiences to reveal hidden truths about the operating room and illustrate the quirky, strange, and bizarre occurrences that shape a regular hospital day. Answering questions such as What do doctors talk about during surgery? If a surgical instrument falls to the floor, is the five-second rule observed? and Is real life just like ER, Grey’s Anatomy, and House?, this is a must-read for the curiosity seeker and anyone who has or will be on the operating-room table.

When Blood Breaks Down: Life Lessons from Leukemia


Mikkael A. Sekeres - 2020
    Your brain can't function. You are asked to make decisions about treatment almost immediately, when you are not in your right mind. And yet you pull yourself together and start asking questions. Beside you is your doctor, whose job it is to solve the awful puzzle of bone marrow gone wrong. The two of you are in it together. In When Blood Breaks Down, Mikkael Sekeres, a leading cancer specialist, takes readers on the journey that patient and doctor travel together.Sekeres, who writes regularly for the Well section of the New York Times, tells the compelling stories of three people who receive diagnoses of adult leukemia within hours of each other: Joan, a 48-year-old surgical nurse, a caregiver who becomes a patient; David, a 68-year-old former factory worker who bows to his family's wishes and pursues the most aggressive treatment; and Sarah, a 36-year-old pregnant woman who must decide whether to undergo chemotherapy and put her fetus at risk. We join the intimacy of the conversations Sekeres has with his patients, and watch as he teaches trainees. Along the way, Sekeres also explores leukemia in its different forms and the development of drugs to treat it--describing, among many other fascinating details, the invention of the bone marrow transplant (first performed experimentally on beagles) and a treatment that targets the genetics of leukemia.The lessons to be learned from leukemia, Sekeres shows, are not merely medical; they teach us about courage and grace and defying the odds.

Duty of Care: One NHS Doctor's Story of the COVID-19 Crisis


Dominic Pimenta - 2020
    Dominic Pimenta encountered his first suspected case of coronavirus. Within a week, he began wearing a mask on the tube and within a month, he was moved over to the Intensive Care Unit to help fight this virus.'DUTY OF CARE' is the first book to tell the full story of the COVID-19 pandemic from someone on the frontline, working in one of NHS's hardest hit areas. From the initial whispers coming out of China and the collective hesitation to class this as a pandemic to full lockdown and the continued battle to treat whoever came through the doors. Dr. Pimenta tells the heroic stories of how the entire system shifted to tackle this outbreak and how, ultimately, the staff managed to save lives.KINDLE AND PAPERBACK ⇒ 320 pagesAUDIBLE RUNNING TIME ⇒ 10hrs. and 4mins.©2020 Dr. Dominic Pimenta (P)2020 W.F. Howes Ltd

Chasing My Cure: A Doctor's Race to Turn Hope into Action


David Fajgenbaum - 2019
    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.

Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World


Tracy Kidder - 2003
    Doctor, Harvard professor, renowned infectious-disease specialist, anthropologist, the recipient of a MacArthur "genius" grant, world-class Robin Hood, Farmer was brought up in a bus and on a boat, and in medical school found his life’s calling: to diagnose and cure infectious diseases and to bring the lifesaving tools of modern medicine to those who need them most.Mountains Beyond Mountains takes us from Harvard to Haiti, Peru, Cuba, and Russia as Farmer changes minds and practices through his dedication to the philosophy that "the only real nation is humanity"—a philosophy that is embodied in the small public charity he founded, Partners in Health. He enlists the help of the Gates Foundation, George Soros, the U.N.’s World Health Organization, and others in his quest to cure the world. At the heart of this book is the example of a life based on hope, and on an understanding of the truth of the Haitian proverb "Beyond mountains there are mountains": as you solve one problem, another problem presents itself, and so you go on and try to solve that one too.

Dr. Mütter's Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine


Cristin O'Keefe Aptowicz - 2014
    This was the world of medicine when Thomas Dent Mütter began his trailblazing career as a plastic surgeon in Philadelphia during the middle of the nineteenth century.Although he died at just forty-eight, Mütter was an audacious medical innovator who pioneered the use of ether as anesthesia, the sterilization of surgical tools, and a compassion-based vision for helping the severely deformed, which clashed spectacularly with the sentiments of his time.   Brilliant, outspoken, and brazenly handsome, Mütter was flamboyant in every aspect of his life. He wore pink silk suits to perform surgery, added an umlaut to his last name just because he could, and amassed an immense collection of medical oddities that would later form the basis of Philadelphia’s Mütter Museum. Cristin O’Keefe Aptowicz chronicles how Mütter’s efforts helped establish Philadelphia as a global mecca for medical innovation—despite intense resistance from his numerous rivals.