The author of The First Cell: And the Human Costs of Pursuing Cancer to the Last is an oncologist who believes that we do too much to try to stop cancer cells once they are already multiplying rapidly, and should instead focus on early intervention. What a great idea. What’s not so great is this book, which suffers from several weaknesses. The first one is that it frequently repeats the same themes. Yes, we do understand that vast sums of money are spent developing exorbitantly expensive drugs that prolong lives for a few weeks. Second, the parade of patients that are presented all seem to be highly intelligent, educated, rich, sensible folks, who trust the good doctor completely. Don’t regular or obstreperous folks get cancer too? And perhaps the most unsettling aspect is the touting of the author’s personal tissue repository. Since the problems are so complex, shouldn’t we be sharing resources and research ideas?
Tag Archives: medicine
*** A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812 by Laurel Thatcher Eldrick
Martha Ballard, of A Midwife’s Tale likely hand idea that her diary would one day be the object of learned discovery. She wrote it as a cross between a weather almanac, a recitation of the house chores she accomplished every day, the babies she delivered and patients she helped, complete with an accounting of payments, and a list of house guests. And a mass murder or two (really!) But patiently analyzed, the diary also revealed wedding customs (lots of very early babies!), her difficult relationship with her husband, her wayward son, the peril of the frozen river that separated her from half of her patients, the complicated relationships between midwives and doctors, and how overwhelming women’s chores could be, with lots of children and no appliances or read-bought anything. Highly recommended for a glimpse at the lives of everyday women in the late 18th century.
Written as a memoir, mostly by the scientist of the title, The Perfect Predator: A Scientist’s Race to Save Her Husband from a Deadly Superbug tells a spellbinding story of a very sick man, her husband and co-author, who endured months of severe illness, much of it in ICU, while fighting antibiotic-resistant strains of bacteria. In the end, an extremely experimental procedure involving a customized bacteriophage (the unlikely shape on the cover of the book) won the battle, propelled by a formidable phalanx of scientists with FDA connections, led or at least inspired by the first author. From a scientific perspective, it’s an amazing tale. From a societal perspective, it feels a little strange to see the deployment of such formidable tools being engineered solely through the connections of the principals–but reviving bacteriophage therapy may well serve many other patients in the future.
The Disordered Mind: What Unusual Brains Tell Us About Ourselves reads more like a textbook than a non-fiction book (sample sentence: “excessive action of dopamine in the mesolimbic pathway, resulting from an overabundance of D2 receptors, could be the main cause of schizophrenia cognitive symptoms-because this pathway connects to the prefrontal cortex, the site of the cognitive symptoms.”). Kandel earned his Nobel prize, but no Pulitzer.
The author of Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again, a cardiologist, is endlessly optimistic about how AI can not only help reach diagnoses that elude us today, but also help physicians spend more time, and more meaningful time, with patients. After reading the book, I’m skeptical about the latter claim (not that it’s not true; it’s not very much discussed in the book), but convinced about the former. Whether it’s patient-specific nutrition, mining electronic records, reading ECGs, or interpreting routine imaging, machines are just better at it than humans, and certainly better than tired or distracted humans who may fail to engage their deep troubleshooting skills. Let’s hope that medical schools can produce physicians who will deploy the empathy patients (including the author, when he is a patient) crave for, in addition to the wonderful diagnosing technology that is being developed.
Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness exposes the sorry state of psychiatry, a specialty that is still struggling to define diagnoses with more than uncertain bundles of often self-reported symptoms. The author shows how social and political movements, a mindless belief in Freudian theory, and big pharma have all conspired to slow down progress towards finding unequivocal biological markers for psychiatric diseases, and better treatments. Not a happy story, although there is hope.
Fat Nation: A History of Obesity in America recounts the rise of obesity since after WWII, relating it to city planning, the availability of fast food and processed food, and the disappearance of family meals. The author is a professor of health policy so is able to speak calmly about the topic, and he tries, bravely, to suggest some solutions. Will we all start eating spinach and walk everywhere?