An Imperfect Offering: Humanitarian Action in the Twenty-first Century


James Orbinski - 2008
    . . . 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

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.

Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again


Eric J. Topol - 2019
    The doctor-patient relationship--the heart of medicine--is broken: doctors are too distracted and overwhelmed to truly connect with their patients, and medical errors and misdiagnoses abound. In Deep Medicine, leading physician Eric Topol reveals how artificial intelligence can help. AI has the potential to transform everything doctors do, from notetaking and medical scans to diagnosis and treatment, greatly cutting down the cost of medicine and reducing human mortality. By freeing physicians from the tasks that interfere with human connection, AI will create space for the real healing that takes place between a doctor who can listen and a patient who needs to be heard.Innovative, provocative, and hopeful, Deep Medicine shows us how the awesome power of AI can make medicine better, for all the humans involved.

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.

Inside National Health Reform


John E. McDonough - 2011
    Dr. John E. McDonough, DPH, a health policy expert who served as an advisor to the late Senator Edward Kennedy, provides a vivid picture of the intense effort required to bring this legislation into law. McDonough clearly explains the ACA’s inner workings, revealing the rich landscape of the issues, policies, and controversies embedded in the law yet unknown to most Americans. In his account of these historic events, McDonough takes us through the process from the 2008 presidential campaign to the moment in 2010 when President Obama signed the bill into law. At a time when the nation is taking a second look at the ACA, Inside National Health Reform provides the essential information for Americans to make informed judgments about this landmark law.

Deadly Monopolies: The Shocking Corporate Takeover of Life Itself—and the Consequences for Your Health and Our Medical Future


Harriet A. Washington - 2011
    Think your body is your own to control and dispose of as you wish? Think again. The United States Patent Office has granted at least 40,000 patents on genes controlling the most basic processes of human life, and more are pending. If you undergo surgery in many hospitals you must sign away ownership rights to your excised tissues, even if they turn out to have medical and fiscal value. Life itself is rapidly becoming a wholly owned subsidiary of the medical- industrial complex. Deadly Monopolies is a powerful, disturbing, and deeply researched book that illuminates this “life patent” gold rush and its harmful, and even lethal, consequences for public health. It examines the shaky legal, ethical, and social bases for Big Pharma’s argument that such patents are necessary to protect their investments in new drugs and treatments, arguing that they instead stifle the research, competition, and innovation that can drive down costs and save lives. In opposing the commodification of the body, Harriet Washington provides a crucial human dimension to an often all-too-abstract debate. Like the bestseller The Immortal Life of Henrietta Lacks, Deadly Monopolies reveals in shocking detail just how far the profit motive has encroached in colonizing human life and compromising medical ethics. It is sure to stir debate—and instigate change.

The Cost Disease: Why Computers Get Cheaper and Health Care Doesn't


William J. Baumol - 2012
    Similarly, the upward spiral of college tuition fees is cause for serious concern. In this concise and illuminating book, the well-known economist William J. Baumol explores the causes of these seemingly intractable problems and offers a surprisingly simple explanation. Baumol identifies the "cost disease" as a major source of rapidly rising costs in service sectors of the economy. Once we understand that disease, he explains, effective responses become apparent.Baumol presents his analysis with characteristic clarity, tracing the fast-rising prices of health care and education in the United States and other major industrial nations, then examining the underlying causes, which have to do with the nature of providing labor-intensive services. The news is good, Baumol reassures us, because the nature of the disease is such that society will be able to afford the rising costs.

Heart: A History


Sandeep Jauhar - 2018
    It’s so bound up with our deepest feelings that emotional trauma causes it to change shape.Practising cardiologist Sandeep Jauhar beautifully weaves his own experiences with the defining discoveries of the past to tell the story of our most vital organ. He looks at some of the pioneers who risked their careers and their patients’ lives to better understand the heart. People like Daniel Hale Williams, who performed the world’s first documented heart surgery, and Wilson Greatbatch, who accidentally invented the pacemaker.Amid gripping scenes from the operating theatre, Jauhar interweaves stories about the patients he’s treated with the moving tale of his family’s own history of heart problems, from his grandfather’s sudden death in India – an event that sparked his life-long obsession – to the ominous signs of how he himself might die.He also confronts the limits of medical technology and argues that future progress will be determined more by how we choose to live rather than by any device we invent.

Complications: A Surgeon's Notes on an Imperfect Science


Atul Gawande - 2002
    Complications lays bare a science not in its idealized form but as it actually is--uncertain, perplexing, and profoundly human.Complications is a 2002 National Book Award Finalist for Nonfiction.

Overdosed America: The Broken Promise of American Medicine


John Abramson - 2004
    Before you see a doctor, you should read this book.” —Eric Schlosser, author of Fast Food NationUsing the examples of Vioxx, Celebrex, cholesterol-lowering statin drugs, and anti-depressants, Overdosed America shows that at the heart of the current crisis in American medicine lies the commercialization of medical knowledge itselfFor twenty years, John Abramson, M.D., cared for patients of all ages in a small town north of Boston. But increasingly his role as family doctor was undermined as pressure mounted to use the latest drugs and high-tech solutions for nearly every problem. Drawing on his background in statistics and health policy research, he began to investigate the radical changes that were quietly taking place in American medicine.At the heart of the crisis, he found, lies the changed purpose of medical knowledge—from seeking to optimize health to searching for the greatest profits. The lack of transparency that has become normal in commercially sponsored medical research now taints the scientific evidence published in even our most prestigious medical journals. And unlike the recent scandals in other industries that robbed Americans of money and jobs, this one is undermining our health.Commercial distortion pervades the information that doctors rely upon to guide the prevention and treatment of common health problems, from heart disease to stroke, osteoporosis, diabetes, and osteoarthritis. The good news, as Dr. Abramson explains, is that the real scientific evidence shows that many of the things that you can do to protect and preserve your own health are far more effective than what the drug companies' top-selling products can do for you—which is why the drug companies work so hard to keep this information under wraps.In what is sure to be one of the most important and eye-opening books you or your doctor will ever read, John Abramson offers conclusive evidence that American medicine has broken its promise to best improve our health and is squandering more than $500 billion each year in the process.

The Knife Man: Blood, Body Snatching, and the Birth of Modern Surgery


Wendy Moore - 2005
    In this sensational and macabre story, we meet the surgeon who counted not only luminaries Benjamin Franklin, Lord Byron, Adam Smith, and Thomas Gainsborough among his patients but also “resurrection men” among his close acquaintances. A captivating portrait of his ruthless devotion to uncovering the secrets of the human body, and the extraordinary lengths to which he went to do so—including body snatching, performing pioneering medical experiments, and infecting himself with venereal disease—this rich historical narrative at last acknowledges this fascinating man and the debt we owe him today.

Redefining Health Care: Creating Value-based Competition on Results


Michael E. Porter - 2006
    health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets.In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change.The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency.With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.

The End of Illness


David B. Agus - 2011
    David Agus tackles these fundamental questions and dismantles misperceptions about what “health” really means. Presenting an eye-opening picture of the human body and all the ways it works—and fails—Dr. Agus shows us how a new perspective on our individual health will allow us to achieve a long, vigorous life. Offering insights and access to powerful new technologies that promise to transform medicine, Dr. Agus emphasizes his belief that there is no “right” answer, no master guide that is “one size fits all.” Each one of us must get to know our bodies in uniquely personal ways, and he shows us exactly how to do that. A bold call for all of us to become our own personal health advocates, The End of Illness is a moving departure from orthodox thinking.

Which Country Has the World's Best Health Care?


Ezekiel J. Emanuel - 2020
    But which country does, and what can they teach us?Author, physician, and bioethicist, Ezekiel Emanuel has examined the world's leading providers of healthcare .Drawing from an analysis of the U.S. and ten other countries --- Australia, Canada, China, France, Germany, Netherlands, Norway, Switzerland, Taiwan, and the UK. --- the results are in. No health care system is perfect, whether the problem is too many hospital beds in Germany or treating chronic illness in France, and some problems are shared across many countries, from truly addressing mental healthcare to containing the rising costs of chronic care. But the lessons from the best healthcare practices allow us to adapt some of the good found in other countries and avoid making the same mistakes as others. Healthcare remains uniquely important to all Americans, and uniquely fraught: here is the best evidence from around the world of what excellence looks like and how we can deliver it here.

Teeth: Beauty, Inequality, and the Struggle for Oral Health in America


Mary Otto - 2017
    Otto’s subjects include the pioneering dentist who made Shirley Temple and Judy Garland’s teeth sparkle on the silver screen and helped create the all-American image of “pearly whites”; Deamonte Driver, the young Maryland boy whose tragic death from an abscessed tooth sparked congressional hearings; and a marketing guru who offers advice to dentists on how to push new and expensive treatments and how to keep Medicaid patients at bay.In one of its most disturbing findings, Teeth reveals that toothaches are not an occasional inconvenience, but rather a chronic reality for millions of people, including disproportionate numbers of the elderly and people of color. Many people, Otto reveals, resort to prayer to counteract the uniquely devastating effects of dental pain.Otto also goes back in time to understand the roots of our predicament in the history of dentistry, showing how it became separated from mainstream medicine, despite a century of growing evidence that oral health and general bodily health are closely related.Muckraking and paradigm-shifting, Teeth exposes for the first time the extent and meaning of our oral health crisis. It joins the small shelf of books that change the way we view society and ourselves—and will spark an urgent conversation about why our teeth matter.This is an alternate cover edition of ISBN 9781620971444.