Operations on the brain carry grave risks. Every day, leading neurosurgeon Henry Marsh must make agonizing decisions, often in the face of great urgency and uncertainty.If you believe that brain surgery is a precise and exquisite craft, practiced by calm and detached doctors, this gripping, brutally honest account will make you think again. With astonishing compassion and candor, Marsh reveals the fierce joy of operating, the profoundly moving triumphs, the harrowing disasters, the haunting regrets, and the moments of black humor that characterize a brain surgeon's life.Do No Harm provides unforgettable insight into the countless human dramas that take place in a busy modern hospital. Above all, it is a lesson in the need for hope when faced with life's most difficult decisions.

    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.

    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.

    The bill was for several hundred thousand dollars--and Medicare paid it. These circumstances left Goldhill angry and determined to understand how it was possible that world-class technology and well-trained personnel could result in such simple, inexcusable carelessness--and how a business that failed so miserably could be rewarded with full payment. Catastrophic Care is the eye-opening result. Goldhill explicates a health-care system that now costs nearly $2.5 trillion annually, bars many from treatment, provides inconsistent quality of care, offers negligible customer service, and in which an estimated 200,000 Americans die each year from errors. Above all, he exposes the fundamental fallacy of our entire system--that Medicare and insurance coverage make care cheaper and improve our health--and suggests a comprehensive new approach that could produce better results at more acceptable costs immediately by giving us, the patients, a real role in the process.

    Best of all, he's a gifted writer who possesses a delightfully devilish sense of humor. In these essays, which range widely but mostly focus on the relationships between biology and human behavior, hard and intricate science is handled with a deft touch that makes it accessible to the general reader. In one memorable piece, Sapolsky compares the fascination with tabloid TV to behavior he's observed among wild African baboons. "Rubber necks," notes the professor, "seem to be a common feature of the primate order." In the title essay of The Trouble with Testosterone, Sapolsky ruminates on the links, real or perceived, between that hormone and aggression.Covering such broad topics as science, politics, history, and nature, the author of Why Zebras Don't Get Ulcers writes accessible and interesting essays that explore the human struggle with moral and ethical problems in today's world. 20,000 first printing.

    From the start, the drug's manufacturer aggressively marketed its patented time-release formula as a breakthrough in the effort to reduce prescription drug abuse. It wasn't long, however, before thrill-seeking teenagers shattered that illusion of safety; by simply crushing an "Oxy," they were able to tap into a high so seductive it would come to dominate their lives. Some patients, seeking relief from pain, also found themselves drawn to the drug's dark side. Pain Killer takes readers on a journey of discovery that begins with the true story of Lindsay, a high-school cheerleader in Virginia who gets hooked on Oxys, and expands outward to explore the critical issues of legitimate pain management, prescription drug abuse, and how the misuse of science by the drug industry threatens the public good. With the fast-rising abuse of prescription drugs by young people ringing alarm bells within government, the how and why behind the OxyContin disaster is a gripping read not only for parents, but also for medical professionals, community leaders, business executives, and all those concerned with this crisis. The dangers described in Pain Killer also reverberate far beyond the threat from a single drug at a particular moment in time. The focus of our government's war on drugs has clearly misled many of us into thinking that only illegal drugs smuggled from beyond our borders can be abused. As Meier tells the dramatic story, some of the most deadly substances are produced and sold legally right here at home.THE EXTRAORDINARY AND TRUE STORY OF OXYCONTIN EQUAL PARTS crime thriller, medical detective story, and business exposé, Pain Killer takes a hard-hitting look at how a powerful drug touted as the salvation for millions triggered a national tragedy. At its inception, the legal narcotic OxyContin was seen as a pharmaceutical dream, a "wonder" drug that would herald a sea change in medical care while reaping vast profits for its maker. It did do that; but it also unleashed a public health crisis that cut a swath of despair and crime through unsuspecting small towns, suburbs, and cities across the country. As reports of OxyContin overdoses made front-page and network news, doctors, narcotics agents, regulators, industry executives, and lawmakers raced in, scrambling to slow the damage. Behind it all stood one of America's wealthiest families, and a drug company whose relentless promotion helped fuel the problem Written by award-winning journalist Barry Meier, whose special report in the New York Times triggered national interest in OxyContin, Pain Killer chronicles the rise of the multibillion dollar pain management industry and lays bare its excesses and abuses.

    Having studied at Yale and Dartmouth, Dr. Emily Transue arrives in Seattle to start her internship in Internal Medicine just after graduating from medical school. This series of loosely interconnected scenes from the author's medical training concludes her residency three years later.During her first week as a student on the medical wards, Dr. Transue watched someone come into the emergency room in cardiac arrest and die. Nothing like this had ever happened to her before-it was a long way from books and labs. So she began to record her experiences as she gained confidence putting her book knowledge to work.The stories focus on the patients Dr. Transue encountered in the hospital, ER and clinic; some are funny and others tragic. They range in scope from brief interactions in the clinic to prolonged relationships during hospitalization. There is a man newly diagnosed with lung cancer who is lyrical about his life on a sunny island far away, and a woman, just released from a breathing machine after nearly dying, who sits up and demands a cup of coffee.Though the book has a great deal of medical content, the focus is more on the stories of the patients' lives and illnesses and the relationships that developed between the patients and the author, and the way both parties grew in the course of these experiences.Along the way, the book describes the life of a resident physician and reflects on the way the medical system treats both its patients and doctors. On Call provides a window into the experience of patients at critical junctures in life and into the author's own experience as a new member of the medical profession.

    Cohen show us that the antidote to our ever-growing rates of obesity and chronic diseases, such as heart disease and diabetes, lies not in our medical care system or in more health education but rather in how our environment affects our behavior.

    But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers--resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.

    Communities where heroin had never been seen before—from Charlotte, NC and Huntington, WVA, to Salt Lake City and Portland, OR—were overrun with it. Local police and residents were stunned. How could heroin, long considered a drug found only in the dense, urban environments along the East Coast, and trafficked into the United States by enormous Colombian drug cartels, be so incredibly ubiquitous in the American heartland? Who was bringing it here, and perhaps more importantly, why were so many townspeople suddenly eager for the comparatively cheap high it offered?With the same dramatic drive of El Narco and Methland, Sam Quinones weaves together two classic tales of American capitalism: The stories of young men in Mexico, independent of the drug cartels, in search of their own American Dream via the fast and enormous profits of trafficking cheap black-tar heroin to America’s rural and suburban addicts; and that of Purdue Pharma in Stamford, Connecticut, determined to corner the market on pain with its new and expensive miracle drug, Oxycontin; extremely addictive in its own right. Quinones illuminates just how these two stories fit together as cause and effect: hooked on costly Oxycontin, American addicts were lured to much cheaper black tar heroin and its powerful and dangerous long-lasting high. Embroiled alongside the suppliers and buyers are DEA agents, local, small-town sheriffs, and the US attorney from eastern Virginia whose case against Purdue Pharma and Oxycontin made him an enemy of the Bush-era Justice Department, ultimately stalling and destroying his career in public service.Dreamland is a scathing and incendiary account of drug culture and addiction spreading to every part of the American landscape.

    In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compelling vision to become The Quality Leader and to fulfill that vision, adopted the Toyota Production System as its management method.Transforming Health Care: Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience takes you on the journey of of Virginia Mason Medical Center's pursuit of the perfect patient experience through the application of lean principles, tools, and methodology. Over the last several years Virginia Mason has become internationally known for its journey towards perfection by applying the Toyota Production System to healthcare. The book takes readers step by step through Virginia Mason's journey as it seeks to provide perfection to its customer - the patient. This book shows you how you use this system to transform your own organization.

    Lara, a superstar nurse who tries to battle her way back from a near-ruinous prescription-drug addiction. The outspoken but compassionate Juliette, a fierce advocate for her patients. And Sam, a first-year nurse, struggling to find her way in a gossipy mean-girl climate she likens to “high school, except for the dying people.”The result is a riveting page-turner, insightful and thought-provoking, that will leave readers feeling smarter about their healthcare and undeniably appreciative of the incredible nurses who provide it.

    Drawing on momentous (yet dimly remembered) historical epidemics, contemporary analyses, and cutting-edge research from a range of scientific disciplines, bestselling author, physician, sociologist, and public health expert Nicholas A. Christakis explores what it means to live in a time of plague—an experience that is paradoxically uncommon to the vast majority of humans who are alive, yet deeply fundamental to our species.Unleashing new divisions in our society as well as opportunities for cooperation, this 21st-century pandemic has upended our lives in ways that will test, but not vanquish, our already frayed collective culture. Featuring new, provocative arguments and vivid examples ranging across medicine, history, sociology, epidemiology, data science, and genetics, Apollo's Arrow envisions what happens when the great force of a deadly germ meets the enduring reality of our evolved social nature.

    But doctors’ emotional responses to the life-and-death dramas of everyday practice have a profound impact on medical care. And while much has been written about the minds and methods of the medical professionals who save our lives, precious little has been said about their emotions. In What Doctors Feel, Dr. Danielle Ofri has taken on the task of dissecting the hidden emotional responses of doctors, and how these directly influence patients.How do the stresses of medical life—from paperwork to grueling hours to lawsuits to facing death—affect the medical care that doctors can offer their patients? Digging deep into the lives of doctors, Ofri examines the daunting range of emotions—shame, anger, empathy, frustration, hope, pride, occasionally despair, and sometimes even love—that permeate the contemporary doctor-patient connection. Drawing on scientific studies, including some surprising research, Dr. Danielle Ofri offers up an unflinching look at the impact of emotions on health care.With her renowned eye for dramatic detail, Dr. Ofri takes us into the swirling heart of patient care, telling stories of caregivers caught up and occasionally torn down by the whirlwind life of doctoring. She admits to the humiliation of an error that nearly killed one of her patients and her forever fear of making another. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. But doctors don’t only feel fear, grief, and frustration. Ofri also reveals that doctors tell bad jokes about “toxic sock syndrome,” cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness.  The stories here reveal the undeniable truth that emotions have a distinct effect on how doctors care for their patients. For both clinicians and patients, understanding what doctors feel can make all the difference in giving and getting the best medical care.

    She is also a superbly gifted writer–witty, insightful, at once deeply humane and refreshingly wry. In Another Day in the Frontal Lobe, Dr. Firlik draws on this rare combination to create a neurosurgeon’s Kitchen Confidential–a unique insider’s memoir of a fascinating profession.Neurosurgeons are renowned for their big egos and aggressive self-confidence, and Dr. Firlik confirms that timidity is indeed rare in the field. “They’re the kids who never lost at musical chairs,” she writes. A brain surgeon is not only a highly trained scientist and clinician but also a mechanic who of necessity develops an intimate, hands-on familiarity with the gray matter inside our skulls. It’s the balance between cutting-edge medical technology and manual dexterity, between instinct and expertise, that Firlik finds so appealing–and so difficult to master. Firlik recounts how her background as a surgeon’s daughter with a strong stomach and a keen interest in the brain led her to this rarefied specialty, and she describes her challenging, atypical trek from medical student to fully qualified surgeon. Among Firlik’s more memorable cases: a young roofer who walked into the hospital with a three-inch-long barbed nail driven into his forehead, the result of an accident with his partner’s nail gun, and a sweet little seven-year-old boy whose untreated earache had become a raging, potentially fatal infection of the brain lining. From OR theatrics to thorny ethical questions, from the surprisingly primitive tools in a neurosurgeon’s kit to glimpses of future techniques like the “brain lift,” Firlik cracks open medicine’s most prestigious and secretive specialty. Candid, smart, clear-eyed, and unfailingly engaging, Another Day in the Frontal Lobe is a mesmerizing behind-the-scenes glimpse into a world of incredible competition and incalculable rewards.From the Hardcover edition.