A New York Times Notable Book
A Washington Post and Seattle Times Best Book of the Year
From the Pulitzer Prize-winning author of The Emperor of All Maladies—a fascinating history of the gene and “a magisterial account of how human minds have laboriously, ingeniously picked apart what makes us tick” (Elle).
“Dr. Siddhartha Mukherjee dazzled readers with his Pulitzer Prize-winning The Emperor of All Maladies in 2010. That achievement was evidently just a warm-up for his virtuoso performance in The Gene: An Intimate History, in which he braids science, history, and memoir into an epic with all the range and biblical thunder of Paradise Lost” (The New York Times). In this biography Mukherjee brings to life the quest to understand human heredity and its surprising influence on our lives, personalities, identities, fates, and choices.
“Mukherjee expresses abstract intellectual ideas through emotional stories…[and] swaddles his medical rigor with rhapsodic tenderness, surprising vulnerability, and occasional flashes of pure poetry” (The Washington Post). Throughout, the story of Mukherjee’s own family—with its tragic and bewildering history of mental illness—reminds us of the questions that hang over our ability to translate the science of genetics from the laboratory to the real world. In riveting and dramatic prose, he describes the centuries of research and experimentation—from Aristotle and Pythagoras to Mendel and Darwin, from Boveri and Morgan to Crick, Watson and Franklin, all the way through the revolutionary twenty-first century innovators who mapped the human genome.
“A fascinating and often sobering history of how humans came to understand the roles of genes in making us who we are—and what our manipulation of those genes might mean for our future” (Milwaukee Journal-Sentinel), The Gene is the revelatory and magisterial history of a scientific idea coming to life, the most crucial science of our time, intimately explained by a master. “The Gene is a book we all should read” (USA TODAY).
Ebola, SARS, Hendra, AIDS, and countless other deadly viruses all have one thing in common: the bugs that transmit these diseases all originate in wild animals and pass to humans by a process called spillover. In this gripping account, David Quammen takes the reader along on this astonishing quest to learn how, where from, and why these diseases emerge and asks the terrifying question: What might the next big one be?
Physician, researcher, and award-winning science writer, Siddhartha Mukherjee examines cancer with a cellular biologist’s precision, a historian’s perspective, and a biographer’s passion. The result is an astonishingly lucid and eloquent chronicle of a disease humans have lived with—and perished from—for more than five thousand years.
The story of cancer is a story of human ingenuity, resilience, and perseverance, but also of hubris, paternalism, and misperception. Mukherjee recounts centuries of discoveries, setbacks, victories, and deaths, told through the eyes of his predecessors and peers, training their wits against an infinitely resourceful adversary that, just three decades ago, was thought to be easily vanquished in an all-out “war against cancer.” The book reads like a literary thriller with cancer as the protagonist.
From the Persian Queen Atossa, whose Greek slave may have cut off her diseased breast, to the nineteenth-century recipients of primitive radiation and chemotherapy to Mukherjee’s own leukemia patient, Carla, The Emperor of All Maladies is about the people who have soldiered through fiercely demanding regimens in order to survive—and to increase our understanding of this iconic disease.
Riveting, urgent, and surprising, The Emperor of All Maladies provides a fascinating glimpse into the future of cancer treatments. It is an illuminating book that provides hope and clarity to those seeking to demystify cancer.
"The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
An eminently readable, entertaining romp through the history of our vain and valiant efforts to heal ourselves. Mankind's battle to stay alive and healthy for as long as possible is our oldest, most universal struggle. With his characteristic wit and vastly informed historical scope, Roy Porter examines the war fought between disease and doctors on the battleground of the flesh from ancient times to the present. He explores the many ingenious ways in which we have attempted to overcome disease through the ages: the changing role of doctors, from ancient healers, apothecaries, and blood-letters to today's professionals; the array of drugs, from Ayurvedic remedies to the launch of Viagra; the advances in surgery, from amputations performed by barbers without anesthetic to today's sophisticated transplants; and the transformation of hospitals from Christian places of convalescence to modern medical powerhouses. Cleverly illustrated with historic line drawings, the chronic ailments of humanity provide vivid anecdotes for Porter's enlightening story of medicine's efforts to prevail over a formidable and ever-changing adversary.
Over the past fifty years, more than three hundred infectious diseases have either newly emerged or reemerged, appearing in territories where they’ve never been seen before. Ninety percent of epidemiologists expect that one of them will cause a deadly pandemic sometime in the next two generations. It could be Ebola, avian flu, a drug-resistant superbug, or something completely new. While we can’t know which pathogen will cause the next pandemic, by unraveling the story of how pathogens have caused pandemics in the past, we can make predictions about the future. In Pandemic: Tracking Contagions, from Cholera to Ebola and Beyond, the prizewinning journalist Sonia Shah—whose book on malaria, The Fever, was called a “tour-de-force history” (The New York Times) and “revelatory” (The New Republic)—interweaves history, original reportage, and personal narrative to explore the origins of contagions, drawing parallels between cholera, one of history’s most deadly and disruptive pandemic-causing pathogens, and the new diseases that stalk humankind today.
To reveal how a new pandemic might develop, Sonia Shah tracks each stage of cholera’s dramatic journey, from its emergence in the South Asian hinterlands as a harmless microbe to its rapid dispersal across the nineteenth-century world, all the way to its latest beachhead in Haiti. Along the way she reports on the pathogens now following in cholera’s footsteps, from the MRSA bacterium that besieges her own family to the never-before-seen killers coming out of China’s wet markets, the surgical wards of New Delhi, and the suburban backyards of the East Coast.
By delving into the convoluted science, strange politics, and checkered history of one of the world’s deadliest diseases, Pandemic reveals what the next global contagion might look like— and what we can do to prevent it.
In Killer Fat, Natalie Boero examines how and why obesity emerged as a major public health concern and national obsession in recent years. Using primary sources and in-depth interviews, Boero enters the world of bariatric surgeries, Weight Watchers, and Overeaters Anonymous to show how common expectations of what bodies are supposed to look like help to determine what sorts of interventions and policies are considered urgent in containing this new kind of disease.
Boero argues that obesity, like the traditional epidemics of biological contagion and mass death, now incites panic, a doomsday scenario that must be confronted in a struggle for social stability. The “war” on obesity, she concludes, is a form of social control. Killer Fat ultimately offers an alternate framing of the nation’s obesity problem based on the insights of the “Health at Every Size” movement.
Witches, Midwives, and Nurses, first published by the Feminist Press in 1973, is an essential book about the corruption of the medical establishment and its historic roots in witch hunters. In this new edition, Barbara Ehrenreich and Deirdre English have written an entirely new chapter that delves into the current fascination with and controversies about witches, exposing our fears and fantasies. They build on their classic exposé on the demonization of women healers and the political and economic monopolization of medicine. This quick history brings us up-to-date, exploring today's changing attitudes toward childbirth, alternative medicine, and modern-day witches.
Little more than one hundred years ago, maps of the world still boasted white space: places where no human had ever trod. Within a few short decades the most hostile of the world’s environments had all been conquered. Likewise, in the twentieth century, medicine transformed human life. Doctors took what was routinely fatal and made it survivable. As modernity brought us ever more into different kinds of extremis, doctors pushed the bounds of medical advances and human endurance. Extreme exploration challenged the body in ways that only the vanguard of science could answer. Doctors, scientists, and explorers all share a defining trait: they push on in the face of grim odds. Because of their extreme exploration we not only understand our physiology better; we have also made enormous strides in the science of healing.
Drawing on his own experience as an anesthesiologist, intensive care expert, and NASA adviser, Dr. Kevin Fong examines how cuttingedge medicine pushes the envelope of human survival by studying the human body’s response when tested by physical extremes. Extreme Medicine explores different limits of endurance and the lens each offers on one of the systems of the body. The challenges of Arctic exploration created opportunities for breakthroughs in open heart surgery; battlefield doctors pioneered techniques for skin grafts, heart surgery, and trauma care; underwater and outer space exploration have revolutionized our understanding of breathing, gravity, and much more. Avant-garde medicine is fundamentally changing our ideas about the nature of life and death.
Through astonishing accounts of extraordinary events and pioneering medicine, Fong illustrates the sheer audacity of medical practice at extreme limits, where human life is balanced on a knife’s edge. Extreme Medicine is a gripping debut about the science of healing, but also about exploration in its broadest sense—and about how, by probing the very limits of our biology, we may ultimately return with a better appreciation of how our bodies work, of what life is, and what it means to be human.
· Downloadable data sets
· Library of computer programs in SAS, SPSS, Stata, HLM, MLwiN, and more
· Additional material for data analysis
From Russia to Bengal to Palm Beach, Randall Packard’s far-ranging narrative traces the natural and social forces that help malaria spread and make it deadly. He finds that war, land development, crumbling health systems, and globalization—coupled with climate change and changes in the distribution and flow of water—create conditions in which malaria's carrier mosquitoes thrive. The combination of these forces, Packard contends, makes the tropical regions today a perfect home for the disease.
Authoritative, fascinating, and eye-opening, this short history of malaria concludes with policy recommendations for improving control strategies and saving lives.
Relive the heartwarming true story of the discovery of insulin as it's never been told before. Written with authentic detail and suspense, and featuring walk-ons by William Howard Taft, Woodrow Wilson, and Eli Lilly himself, among many others.
The plague first sailed into San Francisco on the steamer Australia, on the day after New Year’s in 1900. Though the ship passed inspection, some of her stowaways—infected rats—escaped detection and made their way into the city’s sewer system. Two months later, the first human case of bubonic plague surfaced in Chinatown.
Initially in charge of the government’s response was Quarantine Officer Dr. Joseph Kinyoun. An intellectually astute but autocratic scientist, Kinyoun lacked the diplomatic skill to manage the public health crisis successfully. He correctly diagnosed the plague, but because of his quarantine efforts, he was branded an alarmist and a racist, and was forced from his post. When a second epidemic erupted five years later, the more self-possessed and charming Dr. Rupert Blue was placed in command. He won the trust of San Franciscans by shifting the government’s attack on the plague from the cool remove of the laboratory onto the streets, among the people it affected. Blue preached sanitation to contain the disease, but it was only when he focused his attack on the newly discovered source of the plague, infected rats and their fleas, that he finally eradicated it—truly one of the great, if little known, triumphs in American public health history.
With stunning narrative immediacy fortified by rich research, Marilyn Chase transports us to the city during the late Victorian age—a roiling melting pot of races and cultures that, nearly destroyed by an earthquake, was reborn, thanks in no small part to Rupert Blue and his motley band of pied pipers.
From the Hardcover edition.
What these strange conditions–including fatal familial insomnia, kuru, scrapie, and mad cow disease–share is their cause: prions. Prions are ordinary proteins that sometimes go wrong, resulting in neurological illnesses that are always fatal. Even more mysterious and frightening, prions are almost impossible to destroy because they are not alive and have no DNA–and the diseases they bring are now spreading around the world.
In The Family That Couldn’t Sleep, essayist and journalist D. T. Max tells the spellbinding story of the prion’s hidden past and deadly future. Through exclusive interviews and original archival research, Max explains this story’s connection to human greed and ambition–from the Prussian chemist Justus von Liebig, who made cattle meatier by feeding them the flesh of other cows, to New Guinean natives whose custom of eating the brains of the dead nearly wiped them out. The biologists who have investigated these afflictions are just as extraordinary–for example, Daniel Carleton Gajdusek, a self-described “pedagogic pedophiliac pediatrician” who cracked kuru and won the Nobel Prize, and another Nobel winner, Stanley Prusiner, a driven, feared self-promoter who identified the key protein that revolutionized prion study.
With remarkable precision, grace, and sympathy, Max–who himself suffers from an inherited neurological illness–explores maladies that have tormented humanity for centuries and gives reason to hope that someday cures will be found. And he eloquently demonstrates that in our relationship to nature and these ailments, we have been our own worst enemy.
Award-winning medical historian Victoria A. Harden approaches the AIDS virus from philosophical and intellectual perspectives in the history of medical science, discussing the process of scientific discovery, scientific evidence, and how laboratories found the cause of AIDS and developed therapeutic interventions. Similarly, her book places AIDS as the first infectious disease to be recognized simultaneously worldwide as a single phenomenon.
After years of believing that vaccines and antibiotics would keep deadly epidemics away, researchers, doctors, patients, and the public were forced to abandon the arrogant assumption that they had conquered infectious diseases. By presenting an accessible discussion of the history of HIV/AIDS and analyzing how aspects of society advanced or hindered the response to the disease, AIDS at 30 illustrates for both medical professionals and general readers how medicine identifies and evaluates new infectious diseases quickly and what political and cultural factors limit the medical community’s response.
Rosen, writing in the 1950s, may have had good reason to believe that infectious diseases would soon be conquered. But as Dr. Pascal James Imperato writes in the new foreword to this edition, infectious disease remains a grave threat. Globalization, antibiotic resistance, and the emergence of new pathogens and the reemergence of old ones, have returned public health efforts to the basics: preventing and controlling chronic and communicable diseases and shoring up public health infrastructures that provide potable water, sewage disposal, sanitary environments, and safe food and drug supplies to populations around the globe.
A revised introduction by Elizabeth Fee frames the book within the context of the historiography of public health past, present, and future, and an updated bibliography by Edward T. Morman includes significant books on public health history published between 1958 and 2014. For seasoned professionals as well as students, A History of Public Health is visionary and essential reading.
When Freud and Halsted began their experiments with cocaine in the 1880s, neither they, nor their colleagues, had any idea of the drug's potential to dominate and endanger their lives. An Anatomy of Addiction tells the tragic and heroic story of each man, accidentally struck down in his prime by an insidious malady: tragic because of the time, relationships, and health cocaine forced each to squander; heroic in the intense battle each man waged to overcome his affliction. Markel writes of the physical and emotional damage caused by the then-heralded wonder drug, and how each man ultimately changed the world in spite of it—or because of it. One became the father of psychoanalysis; the other, of modern surgery. Here is the full story, long overlooked, told in its rich historical context.
PKU (phenylketonuria) is a genetic disorder that causes severe cognitive impairment if it is not detected and treated with a strict and difficult diet. Programs to detect PKU and start treatment early are deservedly considered a public health success story. Some have traded on this success to urge expanded newborn screening, defend basic research in genetics, and confront proponents of genetic determinism. In this context, treatment for PKU is typically represented as a simple matter of adhering to a low-phenylalanine diet. In reality, the challenges of living with PKU are daunting.
In this first general history of PKU, a historian and a pediatrician explore how a rare genetic disease became the object of an unprecedented system for routine testing. The PKU Paradox is informed by interviews with scientists, clinicians, policymakers, and individuals who live with the disease. The questions it raises touch on ongoing controversies about newborn screening and what happens to blood samples collected at birth. -- M. Susan Lindee, University of Pennsylvania
Several themes explored in the book illustrate ways in which non-medical factors influence our views of a disease and our reaction to it. One of these themes is the tendency to focus blame for the spread of a disease on a particular group (e.g., women, blacks, sinners). The balance between protecting the rights of individuals and protecting the public health, in issues such as whether to quarantine the infected and whether to require mandatory testing for the disease, is another theme. A third theme is the persistent reluctance of many Americans to discuss venereal disease openly because it involves sex, a subject that we are often not comfortable talking about.
Treating these topics together takes advantage of all they have in common. The authors point out the many-shared elements in the methods they present for selecting, estimating, checking, and interpreting each of these models. They also show that these regression methods deal with confounding, mediation, and interaction of causal effects in essentially the same way.
The examples, analyzed using Stata, are drawn from the biomedical context but generalize to other areas of application. While a first course in statistics is assumed, a chapter reviewing basic statistical methods is included. Some advanced topics are covered but the presentation remains intuitive. A brief introduction to regression analysis of complex surveys and notes for further reading are provided. For many students and researchers learning to use these methods, this one book may be all they need to conduct and interpret multipredictor regression analyses.
The authors are on the faculty in the Division of Biostatistics, Department of Epidemiology and Biostatistics, University of California, San Francisco, and are authors or co-authors of more than 200 methodological as well as applied papers in the biological and biomedical sciences. The senior author, Charles E. McCulloch, is head of the Division and author of Generalized Linear Mixed Models (2003), Generalized, Linear, and Mixed Models (2000), and Variance Components (1992).
From the reviews:
"This book provides a unified introduction to the regression methods listed in the title...The methods are well illustrated by data drawn from medical studies...A real strength of this book is the careful discussion of issues common to all of the multipredictor methods covered." Journal of Biopharmaceutical Statistics, 2005
"This book is not just for biostatisticians. It is, in fact, a very good, and relatively nonmathematical, overview of multipredictor regression models. Although the examples are biologically oriented, they are generally easy to understand and follow...I heartily recommend the book" Technometrics, February 2006
"Overall, the text provides an overview of regression methods that is particularly strong in its breadth of coverage and emphasis on insight in place of mathematical detail. As intended, this well-unified approach should appeal to students who learn conceptually and verbally." Journal of the American Statistical Association, March 2006
In this highly original account, Stepan sheds new light on the role of science in reformulating issues of race, gender, reproduction, and public health in an era when the focus on national identity was particularly intense. Drawing upon a rich body of evidence concerning the technical publications and professional meetings of Latin American eugenicists, she examines how they adapted eugenic principles to local contexts between the world wars. Stepan shows that Latin American eugenicists diverged considerably from their counterparts in Europe and the United States in their ideological approach and their interpretations of key texts concerning heredity.
Christine Murphy has compiled a book that presents the vaccination dilemma from multiple perspectives. It clearly describes the immune system and its workings--and what science does and does not know about them. It offers suggestions and resources for parents whose children are sick, whether from a common childhood illness or from a vaccination reaction. And it makes a case for an alternate view of disease--as a teacher that allows us to develop physically and spiritually, and as a necessary test of strength that we have chosen out of our destiny.
This book will help educate parents about the vaccination dilemma and prepare them to make, in consultation with one or more health professionals, educated vaccination decisions for their children.
The real story of AIDS—how it originated with a virus in a chimpanzee, jumped to one human, and then infected more than 60 million people—is very different from what most of us think we know. Recent research has revealed dark surprises and yielded a radically new scenario of how AIDS began and spread. Excerpted and adapted from the book Spillover, with a new introduction by the author, Quammen's hair-raising investigation tracks the virus from chimp populations in the jungles of southeastern Cameroon to laboratories across the globe, as he unravels the mysteries of when, where, and under what circumstances such a consequential "spillover" can happen. An audacious search for answers amid more than a century of data, The Chimp and the River tells the haunting tale of one of the most devastating pandemics of our time.
In the summer of 1623, ten cardinals and hundreds of their attendants, engaged in electing a new Pope, died from the 'mal'aria' or 'bad air' of the Roman marshes. Their choice, Pope Urban VIII, determined that a cure should be found for the fever that was the scourge of the Mediterranean, northern Europe and America, and in 1631 a young Jesuit apothecarist in Peru sent to the Old World a cure that had been found in the New – where the disease was unknown.
The cure was quinine, an alkaloid made of the bitter red bark of the cinchona tree, which grows in the Andes. Both disease and cure have an extraordinary history. Malaria badly weakened the Roman Empire. It killed thousands of British troops fighting Napoleon during the Walcheren raid on Holland in 1809 and many soldiers on both sides of the American Civil War. It turned back many of the travellers who explored west Africa and brought the building of the Panama Canal to a standstill. When, after a thousand years, a cure was finally found, Europe's Protestants, among them Oliver Cromwell, who suffered badly from malaria, feared it was nothing more than a Popish poison. More than any previous medicine, though, quinine forced physicians to change their ideas about treating illness. Before long, it would change the face of Western medicine.
Using fresh research from the Vatican and the Indian Archives in Seville, as well as hitherto undiscovered documents in Peru, Fiammetta Rocco describes the ravages of the disease, the quest of the three Englishmen who smuggled cinchona seeds out of South America, the way quinine opened the door to Western imperial adventure in Asia, Africa and beyond, and why, even today, quinine grown in the eastern Congo still saves so many people suffering from malaria.
Note that it has not been possible to include the same picture content that appeared in the original print version.
Pioneer Doctor: The Story of a Woman's Work is the true story of Dr. Mary (Mollie) Babcock Atwater, a medicine woman who found freedom and opportunity in the wide-open spaces of America's frontier west. This remarkable tale has been creatively retold here by her granddaughter, award-winning author Mari Grana. Blending information from historical records as well as interviews with family and friends, the author has reconstructed Mollie's steps into a dramatic narrative that brings to life the doctor's struggles, her accomplishments, and the times in which she lived.
Beautifully written and thoroughly researched, this is not just the biography of a fascinating woman. It is also the story of an era when daring women ventured forth and changed history for the rest of us.
This book cuts through Money’s talent for polemic and self-promotion by digging into the substance of Money’s theories and achievements. It offers, for the first time, a balanced and probing textual analysis of this pioneering scholar’s writing to assess Money’s profound impact on the debates and research on sexuality and gender that dominated the last half of the twentieth century. Through his analysis, Goldie recovers Money’s brilliance and insight from simplistic dismissals of his work due to his involvement in the tragic David Reimer case, while never losing sight of his flaws.
“This book will serve to greatly complement the growing number of texts dealing with mixed models, and I highly recommend including it in one’s personal library.”
—Journal of the American Statistical Association
Mixed modeling is a crucial area of statistics, enabling the analysis of clustered and longitudinal data. Mixed Models: Theory and Applications with R, Second Edition fills a gap in existing literature between mathematical and applied statistical books by presenting a powerful examination of mixed model theory and application with special attention given to the implementation in R.
The new edition provides in-depth mathematical coverage of mixed models’ statistical properties and numerical algorithms, as well as nontraditional applications, such as regrowth curves, shapes, and images. The book features the latest topics in statistics including modeling of complex clustered or longitudinal data, modeling data with multiple sources of variation, modeling biological variety and heterogeneity, Healthy Akaike Information Criterion (HAIC), parameter multidimensionality, and statistics of image processing.
Mixed Models: Theory and Applications with R, Second Edition features unique applications of mixed model methodology, as well as:Comprehensive theoretical discussions illustrated by examples and figures Over 300 exercises, end-of-section problems, updated data sets, and R subroutines Problems and extended projects requiring simulations in R intended to reinforce material Summaries of major results and general points of discussion at the end of each chapter Open problems in mixed modeling methodology, which can be used as the basis for research or PhD dissertations
Ideal for graduate-level courses in mixed statistical modeling, the book is also an excellent reference for professionals in a range of fields, including cancer research, computer science, and engineering.
Visualize the most recent topics in cutaneous pathology such as sporothrix and cutaneous t-cell lymphoma as well as classic problems like alopecia and neurofibromatosis, informed by the latest developments in molecular biology and histologic imaging.
See current dermatologic concepts captured in the visually rich Netter artistic tradition via major new contributions from Netter disciple Carlos Machado, MD - making complex concepts easy to understand and remember through the precision, clarity, detail, and realism for which Netter’s work has always been known.
Get complete, integrated visual guidance on the skin, hair, and nails in a single source, from basic sciences and normal anatomy and function through pathologic conditions.
Adeptly navigate current controversies and timely topics in clinical medicine with guidance from the Editor and informed by an experienced international advisory board.
"Military Medicine" surveys the development of military medicine from its prehistoric origins through modern threats and practice. That coverage is followed by over 200 of alphabetically organized entries with special emphasis placed on those areas with the most dramatic applications to civilian medicine, including triage and trauma management, treatment for infections, emergency surgical procedures, and more.
This volume provides formulas and procedures for determination of sample size required not only for testing equality, but also for testing non-inferiority/superiority, and equivalence (similarity) based on both untransformed (raw) data and log-transformed data under a parallel-group design or a crossover design with equal or unequal ratio of treatment allocations. It contains a comprehensive and unified presentation of statistical procedures for sample size calculation that are commonly employed at various phases of clinical development. Each chapter includes, whenever possible, real examples of clinical studies from therapeutic areas such as cardiovascular, central nervous system, anti-infective, oncology, and women's health to demonstrate the clinical and statistical concepts, interpretations, and their relationships and interactions.
The book highlights statistical procedures for sample size calculation and justification that are commonly employed in clinical research and development. It provides clear, illustrated explanations of how the derived formulas and/or statistical procedures can be used.
Black Skin, White Coats is the first work to focus primarily on black Africans as producers of psychiatric knowledge and as definers of mental illness in their own right. By examining the ways that Nigerian psychiatrists worked to integrate their psychiatric training with their indigenous backgrounds and cultural and civic nationalisms, Black Skin, White Coats provides a foil to Frantz Fanon’s widely publicized reactionary articulations of the relationship between colonialism and psychiatry. Black Skin, White Coats is also on the cutting edge of histories of psychiatry that are increasingly drawing connections between local and national developments in late-colonial and postcolonial settings and international scientific networks. Heaton argues that Nigerian psychiatrists were intimately aware of the need to engage in international discourses as part and parcel of the transformation of psychiatry at home.