Our health care is staggeringly expensive, yet one in six Americans has no health insurance. We have some of the most skilled physicians in the world, yet one hundred thousand patients die each year from medical errors. In this gripping, eye-opening book, award-winning journalist Shannon Brownlee takes readers inside the hospital to dismantle some of our most venerated myths about American medicine. Using vivid examples of real patients and physicians, Overtreated debunks the idea that most of medicine is based in sound science, and shows how our health care system delivers huge amounts of unnecessary care that is not only expensive and wasteful but can actually imperil the health of patients.The interests of politicians and the medical-industrial complex continually trump those of patients, seducing the wealthy with unnecessary procedures and leaving the poor with haphazard access to treatment. Backward economic incentives allow patients with chronic conditions to receive ineffective care, and roll after roll of red tape undermines even the best-intentioned doctors. Tens of thousands of patients die each year from overtreatment. American medicine is in desperate need of fixing.Nevertheless, Overtreated ultimately conveys a message of hope by reframing the debate over health care reform. Americans worry about rationing--that any effort to rein in the high cost of health care will result in limited access to life-saving treatments. Covering the uninsured seems like an insurmountable problem because it will drive up costs even more. Overtreated offers a way to control costs and cover the uninsured, while simultaneously improving the quality of American medicine. Shannon Brownlee's humane, intelligent, and penetrating analysis empowers readers to avoid the perils of overtreatment, as well as pointing the way to better health care for everyone.

    Jonathan B. Tucker traces the history of the smallpox virus from its first recorded outbreak around 3700 B.C. through its use as the first biological warfare agent in human history, and draws some decisively important lessons for the future. In a timely debate, Tucker addresses the ever-growing concerns about the proliferation of the deadly smallpox virus and its use by terrorist organizations. Explaining how the eradication of the disease in the late 1970s encouraged military research and production of the virus, he exposes the failure of the Russian government to secure its remaining cold-war stockpiles, and evaluates the past and present measures undertaken by the United States to counter the existing dangers of a smallpox attack. Ultimately, he passionately argues for the strengthening of the existing legal ban on the development and possession of biological weapons. Impeccably researched, Scourge is as arresting as it is indispensable, and as William Beatty in Booklist raves, Tucker has a sense of ... history that helps him make the story of smallpox as disease and ... weapon fascinating and frightening. Scourge has been acclaimed as a concise, suspenseful and scientifically accurate narrative. -- The New York Times Book Review Tucker's fascinating, revealing book affords the reader a sobering look at this new type of warfare.... -- Chris Patsilelis, Houston Chronicle -- [Tucker] reports the debate evenhandedly and with telling detail. -- David Brown, The Washington Post Book World

    But time in the wards is limited, and clerkship covers only a tiny sample of the surgical universe. Dr. Pestana's Surgery Notes, by distinguished surgery instructor Dr. Carlos Pestana, is a proven guide to ensure your surgical knowledge. With a concise, comprehensive review and 180 high-yield surgical vignettes for self-testing, it contains the surgery knowledge you need to excel on the Surgery shelf exam and USMLE Step 2 CK.Features:— Concise high-yield review of core surgery material— 180 vignettes for self-testing— Used by med students for over a decade— Fully up-to-date— Pocket-sized to carry with you in the wards

    People are healthier, wealthier, and live longer. Yet the escapes from destitution by so many has left gaping inequalities between people and nations. In "The Great Escape," Angus Deaton--one of the foremost experts on economic development and on poverty--tells the remarkable story of how, beginning 250 years ago, some parts of the world experienced sustained progress, opening up gaps and setting the stage for today's disproportionately unequal world. Deaton takes an in-depth look at the historical and ongoing patterns behind the health and wealth of nations, and addresses what needs to be done to help those left behind.Deaton describes vast innovations and wrenching setbacks: the successes of antibiotics, pest control, vaccinations, and clean water on the one hand, and disastrous famines and the HIV/AIDS epidemic on the other. He examines the United States, a nation that has prospered but is today experiencing slower growth and increasing inequality. He also considers how economic growth in India and China has improved the lives of more than a billion people. Deaton argues that international aid has been ineffective and even harmful. He suggests alternative efforts--including reforming incentives to drug companies and lifting trade restrictions--that will allow the developing world to bring about its own Great Escape.Demonstrating how changes in health and living standards have transformed our lives, "The Great Escape" is a powerful guide to addressing the well-being of all nations.

    This trend coincided with the addition of several new shots to the nation's already crowded vaccination schedule, grouped together and given soon after birth or in the early months of infancy. Most of these shots contained a little-known preservative called thimerosal, which includes a quantity of the toxin mercury.Evidence of Harm explores the heated controversy over what many parents, physicians, public officials, and educators have called an "epidemic" of afflicted children. Following several families, David Kirby traces their struggle to understand how and why their once-healthy kids rapidly descended into silence or disturbed behavior, often accompanied by severe physical illness. Alarmed by the levels of mercury in the vaccine schedule, these families sought answers from their doctors, from science, from pharmaceutical companies that manufacture vaccines, and finally from the Center for Disease Control and the Food and Drug Administration-to no avail. But as they dug deeper, the families also found powerful allies in Congress and in the small community of physicians and researchers who believe that the rise of autism and other disorders is linked to toxic levels of mercury that accumulate in the systems of some children.An important and troubling book, Evidence of Harm reveals both the public and unsung obstacles faced by desperate families who have been opposed by the combined power of the federal government, health agencies, and pharmaceutical giants. From closed meetings of the FDA, CDC, and drug companies, to the mysterious rider inserted into the 2002 Homeland Security Bill that would bar thimerosal litigation, to open hearings held by Congress, this book shows a medical establishment determined to deny "evidence of harm" that might be connected with thimerosal and mercury in vaccines. In the end, as research is beginning to demonstrate, the questions raised by these families have significant implications for all children, and for those entrusted to oversee our national health.

    Both disturbing and illuminating, it immerses readers in the lives of four generations of a poor, African-American family beset with the devastating illnesses that are all too common in America's inner-cities.The story takes place in North Lawndale, a neighborhood that lies in the shadows of Chicago's Loop. Although surrounded by some of the city's finest medical facilities, North Lawndale is one of the sickest, most medically underserved communities in the country. Headed by Jackie Banes, who oversees the care of a diabetic grandmother, a husband on kidney dialysis, an ailing father, and three children, the Banes family contends with countless medical crises. From visits to emergency rooms and dialysis units, to trials with home care, to struggles for Medicaid eligibility, Abraham chronicles their access (or lack of access) to medical care.Told sympathetically but without sentimentality, their story reveals an inadequate health care system that is further undermined by the direct and indirect effects of poverty. When people are poor, they become sick easily. When people are sick, their families quickly become poorer.Embedded in the family narrative is a lucid analysis of the gaps, inconsistencies, and inequalities the poor face when they seek health care. This book reveals what health care policies crafted in Washington, D. C. or state capitals look like when they hit the street. It shows how Medicaid and Medicare work and don't work, the Catch-22s of hospital financing in the inner city, the racial politics of organ transplants, the failure of childhood immunization programs, the vexed issues of individual responsibility and institutional paternalism. One observer puts it this way: "Show me the poor woman who finds a way to get everything she's entitled to in the system, and I'll show you a woman who could run General Motors."Abraham deftly weaves these themes together to make a persuasive case for health care reform while unflinchingly presenting the complexities that will make true reform as difficult as it is necessary. Mama Might Be Better Off Dead is a book with the power to change the way health care is understood in America. For those seeking to learn what our current system of health care promises and what it delivers, it offers a place for the debate to begin.

    America has endured a century of rancorous debate on health insurance, and despite the passage of legislation in 2010, the battle is not yet over. This book is a history of how and why the United States became so stubbornly different in health care, presented by an expert with unsurpassed knowledge of the issues.Tracing health-care reform from its beginnings to its current uncertain prospects, Paul Starr argues that the United States ensnared itself in a trap through policies that satisfied enough of the public and so enriched the health-care industry as to make the system difficult to change.He reveals the inside story of the rise and fall of the Clinton health plan in the early 1990s—and of the Gingrich counterrevolution that followed. And he explains the curious tale of how Mitt Romney’s reforms in Massachusetts became a model for Democrats and then follows both the passage of those reforms under Obama and the explosive reaction they elicited from conservatives. Writing concisely and with an even hand, the author offers exactly what is needed as the debate continues—a penetrating account of how health care became such treacherous terrain in American politics.

    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.

    Despite its relatively narrow focus, it is chock full of the pearls of clinical wisdom that students and practitioners treasure, and many of these lessons apply to medicine in general. The book was well characterized by a reviewer of an earlier edition for The New England Journal of Medicine: If only one book about surgery could be made available to physicians from all specialties, it should probably be Silen's recent revision of Cope's Early Diagnosis of the Acute Abdomen. Since the book first appeared more than 30 years ago, it has remained the classic treatise on the initial approach to abdominal pain. Because acute, severe abdominal pain is still a common problem whose misdiagnosis can result in quick death, each generation of beginning physicians is faced with the urgency of learning to make a diagnosis in this high anxiety situation and they appreciate the wise, humane, precisely detailed guidance offered by Cope and Silen. For the 21st Edition, Dr. Silen has again updated the text in a respectful but significant way. He has strengthened its emphasis on pitfalls in the interpretation of CT and ultrasound scans, on misadventures caused by over-reliance on blood tests and radiographs, and on careful history-taking to avoid the costs of inappropriate lab tests. He has also reviewed the data from a randomized clinical trial indicating that patients should receive adequate analgesia while awaiting a definitive diagnosis, a dictum that is contrary to traditional teaching

    The age-old disease spread swiftly through an increasingly interconnected American landscape: from southern tobacco plantations to the dense immigrant neighborhoods of northern cities to far-flung villages on the edges of the nascent American empire. In Pox, award-winning historian Michael Willrich offers a gripping chronicle of how the nation's continentwide fight against smallpox launched one of the most important civil liberties struggles of the twentieth century.At the dawn of the activist Progressive era and during a moment of great optimism about modern medicine, the government responded to the deadly epidemic by calling for universal compulsory vaccination. To enforce the law, public health authorities relied on quarantines, pesthouses, and "virus squads"-corps of doctors and club-wielding police. Though these measures eventually contained the disease, they also sparked a wave of popular resistance among Americans who perceived them as a threat to their health and to their rights.At the time, anti-vaccinationists were often dismissed as misguided cranks, but Willrich argues that they belonged to a wider legacy of American dissent that attended the rise of an increasingly powerful government. While a well-organized anti-vaccination movement sprang up during these years, many Americans resisted in subtler ways-by concealing sick family members or forging immunization certificates. Pox introduces us to memorable characters on both sides of the debate, from Henning Jacobson, a Swedish Lutheran minister whose battle against vaccination went all the way to the Supreme Court, to C. P. Wertenbaker, a federal surgeon who saw himself as a medical missionary combating a deadly-and preventable-disease.As Willrich suggests, many of the questions first raised by the Progressive-era antivaccination movement are still with us: How far should the government go to protect us from peril? What happens when the interests of public health collide with religious beliefs and personal conscience? In Pox, Willrich delivers a riveting tale about the clash of modern medicine, civil liberties, and government power at the turn of the last century that resonates powerfully today.

    These dramatic first-person essays detail spectacular serendipities, impossible cures, breathtaking resuscitations, extraordinary awakenings, and recovery from unimaginable disasters. Still other essays give voice to cases in which the physical aspects were less dramatic than the emotional aspects, yet miraculous and transformational for everyone involved. Positive impacts left in the wake of even the gravest of tragedies, profound triumphs of heart and spirit. Preeminent physicians in many specialties, including deans and department heads on the faculties of the top university medical schools in the country describe, in everyday language and with moving testimony, their very personal reactions to these remarkable clinical experiences. Among the extraordinary cases poignantly recounted by the physicians witnessing them: A priest visiting a hospitalized patient went into cardiac arrest on the elevator, which opened up on the cardiac floor, right at the foot of the cardiac specialist, at just the right moment.A tiny premature baby dying from irreversible lung disease despite the most intensive care who recovered almost immediately after being taken from his hospital bed and placed on his mother's chest.President John F. Kennedy's son Patrick, who died shortly after birth, and whose disease eventually led to research that saved generations of babies.A nine-year-old boy who was decapitated in a horrific car accident but survived without neurological damage.A woman who conceived and delivered a healthy baby—despite having had both of her fallopian tubes surgically removed.A young man whose only hope for survival was a heart transplant, but just at the moment he developed a potentially fatal complication making a transplant impossible, his own heart began healing itself.A teenage girl near death after contracting full-blown rabies who became the first patient ever to recover from that disease after an unexpected visit by Timothy Dolan, the man who would go on to become the Archbishop of New York.A Manhattan window-washer who fell 47 stories—and not only became the only person ever to survive a fall from that height, but went on to make a full recovery. Miracles We Have Seen is a book of inspiration and optimism, and a compelling glimpse into the lives of physicians—their humanity and determined devotion to their patients and their patients' families. It reminds us that what we don't know or don't understand isn‘t necessarily cause for fear, and can even be reason for hope

    Deeply researched revelation of escalating danger of drug-resistant bacteria, MRSA.

    Includes timelines, boxed features on significant medical breakthroughs, fascinating case histories, anecdotes and medical curiosities. Contains 150 color photographs.

    Why are so many RNs dropping out of health care's largest profession? How will the lack of skilled, experienced caregivers affect patients? These are some of the questions addressed by Suzanne Gordon's definitive account of the world's nursing crisis. In Nursing against the Odds, one of North America's leading health care journalists draws on in-depth interviews, research studies, and extensive firsthand reporting to help readers better understand the myriad causes of and possible solutions to the current crisis.Gordon examines how health care cost cutting and hospital restructuring undermine the working conditions necessary for quality care. She shows how the historically troubled workplace relationships between RNs and physicians become even more dysfunctional in modern hospitals. In Gordon's view, the public image of nurses continues to suffer from negative media stereotyping in medical shows on television and from shoddy press coverage of the important role RNs play in the delivery of health care.Gordon also identifies the class and status divisions within the profession that hinder a much-needed defense of bedside nursing. She explains why some policy panaceas--hiring more temporary workers, importing RNs from less-developed countries--fail to address the forces that drive nurses out of their workplaces. To promote better care, Gordon calls for a broad agenda that includes safer staffing, improved scheduling, and other policy changes that would give nurses a greater voice at work. She explores how doctors and nurses can collaborate more effectively and what medical and nursing education must do to foster such cooperation. Finally, Gordon outlines ways in which RNs can successfully take their case to the public while campaigning for health care system reform that actually funds necessary nursing care.

    Difficult as the regimen may be, for those who don't fit the traditional mold—white, male, middle-to-upper class, and heterosexual—medical school can be that much more harrowing. This riveting book tells the tales of a new generation of medical students—students whose varied backgrounds are far from traditional. Their stories will forever alter the way we see tomorrow's doctors. In these pages, a black teenage mother overcomes seemingly insurmountable odds, an observant Muslim dons the hijab during training, an alcoholic hides her addiction. We hear the stories of an Asian refugee, a Mexican immigrant, a closeted Christian, an oversized woman—these once unlikely students are among those who describe their medical school experiences with uncommon candor, giving a close-up look at the inflexible curriculum, the pervasive competitive culture, and the daunting obstacles that come with being "different" in medical school. Their tales of courage are by turns poignant, amusing, eye-opening—and altogether unforgettable.