Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is -- complicated, perplexing, and profoundly human.
Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives.
At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor.
Complications is a 2002 National Book Award Finalist for Nonfiction.
The struggle to perform well is universal: each one of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable.
Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors' participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable.
At once unflinching and compassionate, Better is an exhilarating journey narrated by "arguably the best nonfiction doctor-writer around" (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.
Gaining admission to a top medical school requires more than "just" a stellar MCAT score and an excellent GPA. You'll also need to nail your personal statement. In this book, you’ll find the help you need to do just that:
• 45 real essays from future doctors, along with each applicant’s MCAT scores, GPA, and admissions profile
• An overview of med school admissions and financial aid, including a breakdown of the “anatomy” of the application
• Interviews with admissions officers who have read thousands of application essays
This fifth edition of Medical School Essays That Made a Difference includes application essays from students who enrolled at the following schools:
Cornell University, Joan and Sanford I. Weill Medical College
Georgetown University, School of Medicine
Johns Hopkins University, School of Medicine
New York University, NYU School of Medicine
Temple University, School of Medicine
Tulane University, School of Medicine
University of Virginia, School of Medicine
University of Wisconsin—Madison, School of Medicine and Public Health
Yale University, School of Medicine
From the Trade Paperback edition.
The bite attacks featured in this dramatic book take place in big cities, small towns, and remote villages around the world and throughout history. Some are as familiar and contemporary as encounters with mosquitoes in New York City and snakes in southern California's Hollywood Hills or as exotic and foreign as the tsetse in equatorial Africa, the camel in Riyadh, and the Komodo dragon in Indonesia. While others, such as people biting other people---well, these are in a category of their own.
Among the startling stories and fascinating facts in Bitten.
o A six-year-old girl descends into weeks of extreme lassitude until a surgeon plucks an engorged tick from her scalp.
o A diabetic living in the West Indies awakes one morning to a rat eating his left great and second toes.
o A twenty-eight-year-old man loses a third of his nose to a bite by his wife.
o In San Francisco, after a penile bite, a man develops "flesh-eating strep," which spreads to his lower abdomen.
o Severe bites by rabid animals to the face and digits, because of their rich nerve supply, are the most likely to lead to rabies and have the shortest incubation periods.
o Following the bite of a seal or contact with its tissues, sealers develop such agonizing pain and swelling in their bites that, far from medical care, they sometimes amputate their own fingers.
o Perhaps the most devastating human bite wound injuries are those involving the nose; doctors in Boroko near Papua, New Guinea, reported a series of ninety-five human bites treated in the Division of Surgery from 1986 to 1992---twelve were to the nose, nine in women, and three in men, and in most of the cases, the biter was an angry spouse.
With reports from medical journals, case histories, colleagues, and from her own twenty-eight-year career as a practicing physician and infectious diseases specialist, Pamela Nagami's Bitten offers readers intrigued by human infection and disease and mesmerized by creatures in p0the wild a compulsively readable narrative that is entertaining, sometimes disgusting, and always enjoyable.
For readers of Paul Kalanithi’s When Breath Becomes Air, a medical “page-turner” that traces one doctor’s “remarkable journey to the essence of medicine” (The San Francisco Chronicle).
San Francisco’s Laguna Honda Hospital is the last almshouse in the country, a descendant of the Hôtel-Dieu (God’s hotel) that cared for the sick in the Middle Ages. Ballet dancers and rock musicians, professors and thieves—“anyone who had fallen, or, often, leapt, onto hard times” and needed extended medical care—ended up here. So did Victoria Sweet, who came for two months and stayed for twenty years.
Laguna Honda, relatively low-tech but human-paced, gave Sweet the opportunity to practice a kind of attentive medicine that has almost vanished. Gradually, the place transformed the way she understood her work. Alongside the modern view of the body as a machine to be fixed, her extraordinary patients evoked an older idea, of the body as a garden to be tended. God’s Hotel tells their story and the story of the hospital itself, which, as efficiency experts, politicians, and architects descended, determined to turn it into a modern “health care facility,” revealed its own surprising truths about the essence, cost, and value of caring for the body and the soul.
Each story vividly portrays a different dimension of teamwork, capturing the complexity—and sometimes messiness—of moving from theory to practice when it comes to creating genuine teams in health care. The stories help us understand what it means to be a team leader and an assertive team member. They vividly depict how patients are left out of or included on the team and what it means to bring teamwork training into a particular workplace. Exploring issues like psychological safety, patient advocacy, barriers to teamwork, and the kinds of institutional and organizational efforts that remove such barriers, the health care professionals who speak in this book ultimately have one consistent message: teamwork makes patient care safer and health care careers more satisfying. These stories are an invaluable tool for those moving toward genuine interprofessional and intraprofessional teamwork.
the course of illness
Since the time of the ancient Greeks, human beings have believed that hope is essential to life. Now, in this groundbreaking book, Harvard Medical School professor and New Yorker staff writer Jerome Groopman shows us why.
The search for hope is most urgent at the patient’s bedside. The Anatomy of Hope takes us there, bringing us into the lives of people at pivotal moments when they reach for and find hope--or when it eludes their grasp. Through these intimate portraits, we learn how to distinguish true hope from false, why some people feel they are undeserving of it, and whether we should ever abandon our search.
Can hope contribute to recovery by changing physical well-being? To answer this hotly debated question, Groopman embarked on an investigative journey to cutting-edge laboratories where researchers are unraveling an authentic biology of hope. There he finds a scientific basis for understanding the role of this vital emotion in the outcome of illness.
Here is a book that offers a new way of thinking about hope, with a message for all readers, not only patients and their families. "We are just beginning to appreciate hope’s reach," Groopman writes, "and have not defined its limits. I see hope as the very heart of healing."
From the Hardcover edition.
Four-fifths of American children with serious mental health problems receive no professional treatment whatsoever. They are the product of an overextended and often neglectful system that, as Lee Gutkind writes, has reached the level of insanity. Following the stories of three children—Daniel, Meggan, and Terri—Stuck in Time chronicles the tragedies and injustices wrought not only by the deficiencies of the mental healthcare system, but by government policymakers who have failed to address the problem. Through these children and their families, Gutkind explores mental illness as both a scientific and social issue, from the harsh economic realities of supporting a disabled child to the immense difficulty of finding a suitable counselor.
Written with passion and piercing detail, Stuck in Time is a poignant examination of three families fighting against impossible circumstances, and of a system too inflexible to accommodate the helpless victims it is meant to support.
Doctors have a sick sense of humor. This is the deep, dark, and hilarious secret of the medical profession revealed by the irreverent Dr. Douglas Farrago in his popular satirical magazine, Placebo Journal—affectionately known by its thousands of fanatic readers as “Mad magazine for doctors” and called, by U.S. News.com, “raunchy, adolescent, and very funny.” Now, in The Placebo Chronicles, Dr. Farrago has compiled the best of the most outrageous and uproarious true stories to come out of the ERs and examination rooms of doctors all over the country.
Submitted by actual physicians, these are the stories they tell each other at cocktail parties and in doctors’ lounges, trading sidesplitting and truly unusual tales of their most embarrassing medical moments, the grossest things they’ve ever seen in medicine, their favorite Munchausen patients, and much more, including “The X-Ray Files”—mind-boggling anecdotes and images of the oddest foreign objects doctors have removed from patients. Not for the faint of heart, the humor in The Placebo Chronicles is brutally funny—just what the doctor ordered to guard against the ill effects of an M.D.’s worst enemies: the Medical Axis of Evil, a.k.a. drug companies, HMOs, and malpractice insurers.
Fully illustrated with fake advertisements—for pseudopharmaceuticals like OxyCotton Candy and Indifferex (the mediocre antidepressant)—this refreshingly honest collection invites doctors and patients alike to share the laughter, a liberal dose of the very best medicine.
If Michelle could come back after three hours of being dead, what about twelve hours? Or twenty-four? What would it take to revive someone who had been frozen for one thousand years? And what does blurring the line between "life" and "death" mean for society?
In Shocked, Casarett chronicles his exploration of the cutting edge of resuscitation and reveals just how far science has come. He takes us to a conference of "cryonauts" who want to be frozen after they die, a dark room full of hibernating lemurs in North Carolina, and a laboratory that puts mice into a state of suspended animation. The result is a spectacular tour of the bizarre world of doctors, engineers, animal biologists, and cryogenics enthusiasts trying to bring the recently dead back to life.
Fascinating, thought-provoking, and funny, Shocked is perfect for those looking for a prequel—and a sequel—to Mary Roach’s Stiff, or for anyone who likes to ponder the ultimate questions of life and death.
From the Trade Paperback edition.
Puswhisperer is a collection of infectious disease anecdotes created from a year’s worth of clinical blog posts from the Medscape blog Rubor, Dolor, Calor, Tumor. Originally intended for residents and fellows, the posts have been compiled, edited, and revised for a non-specialist audience. The tales cover a wide range of diagnostic dilemmas and treatment quandaries. Which infection smells like buttered popcorn? Are some antibiotics “stronger” than others? Is it OK to eat the oysters?
Along with clinical insight, the book provides a good dose of humor and insightful, microbe-centered philosophy. The author speculates on what the Earth might look like in five billion years, when animals and plants are gone, but bacteria remain. He also draws attention to the staggering rate of evolution in bacteria, made possible by short generation times and passing of genetic material from one bug to another. Finding a 60-year-old Staph strain in an old wound, Crislip tells us, is like looking out your window and seeing a Neanderthal shuffle by.
Recommended for anyone interested in infectious disease and the microorganisms that run our planet.
A unusual spinal trauma that only affects first time surfers that can turn an active young person into a paraplegic in a matter of hours.
A disorder of the eardrum that turns a person's ability to hear inwards, so that the movement of eyeballs in their sockets sounds like a passing subway car.
An inherited disorder that gives the afflicted a fatal case of insomnia.
"Medical Mysteries" takes on these and many more unusual and rare medical ailments in this collection that is sure to mystify and inspire readers.
Rancour has an honest, humane, funny, and poetic style. She sweeps you along with her compassion, her wit, and her unerring ability to see into the truth of the matter. This book is for anyone who has an interest in what goes on in the patient rooms, hallways, stairwells, and elevators of a cancer hospital. You wont be able to put it down.
Contributors. Natalie Boero, Adele E. Clarke, Jennifer R. Fishman, Jennifer Ruth Fosket, Kelly Joyce, Jonathan Kahn, Laura Mamo, Jackie Orr, Elianne Riska, Janet K. Shim, Sara Shostak
With a foreword by physician and bestselling author Gabor Maté, MD, Hidden Lives gives readers a place to turn and communicates not despair but courage.
—Nicholas Shakespeare, author of Bruce Chatwin: A Biography
The continuing popularity of doctor shows on TV—from Scrubs, House, and Grey’s Anatomy to the television phenomenon ER—indicates a widespread fascination with all things medical. Direct Red, by practicing ear, nose, and throat surgical specialist Gabriel Weston, takes readers behind the scenes and into the operating room for a fascinating look at what really goes on on the other side of the hospital doors. “A Surgeon’s View of her Life-and-Death Profession,” Weston’s Direct Red is written not only with knowledge and insight, but with compassion, honesty, and literary flair.
With disarming candor and the audacity to admit that practicing medicine can be a crazy thing, Watts fills each page with riveting details, moving accounts, or belly-laughs. As the stories in this work unfold, we are witness to the moral dilemmas and personal rewards of ministering to the sick. Whether the subject is the potential benefits of therapeutic deception or telling a child about death, Watts’s ear for the right word, the right tone, and the right detail never fails him.
From The Orange Wire Problem and Other Tales from the Doctor’s Office:
We were lingering in the outer office. He mentioned again, no biopsy. I knew that. And I knew there would be no chemotherapy.
Maybe it's like that Orange Wire Problem, I said.
Yes exactly, he said, and four years from now when we're all sitting around the campfire we'll remember the Orange Wire Problem. . .
And I thought to myself, my brother did that. Spoke of the time ahead as he was dying of lung cancer. Six months from now he had said, we'll be glad we did all those drug therapies—as if to speak of the future laid claim to the future.
Using a variety of riveting stories from his own and others’ experiences, the author develops a series of metaphors to explore a doctor’s role in different healthcare reform scenarios: scientist, technician, author, gardener, teacher, servant, and witness. Each role influences what a physician sees when examining a person as a patient. Dr. Nussbaum cautions that true healthcare reform can happen only when those who practice medicine can see, and be seen by, their patients as fellow creatures. His memoir makes a hopeful appeal for change, and his insights reveal the direction that change must take.
–attributed to Hippocrates, c. 400 B.C.E.
The award-winning author of How We Die and The Art of Aging, venerated physician Sherwin B. Nuland has now written his most thoughtful and engaging book. The Uncertain Art is a superb collection of essays about the vital mix of expertise, intuition, sound judgment, and pure chance that plays a part in a doctor’s practice and life.
Drawing from history, the recent past, and his own life, Nuland weaves a tapestry of compelling stories in which doctors have had to make decisions in the face of uncertainty. Topics include the primitive (and sometimes illegal) procedures doctors once practiced with good intentions, such as grave robbing and prescribing cocaine as an anesthetic (which resulted in a physician becoming America’s first cocaine addict); the curious “cures” for irregularity touted by people from the ancient Egyptians to the cereal titan John Harvey Kellogg and bodybuilder Charles Atlas; and healers grappling with today’s complex moral and ethical quandaries, from cloning to gene therapy to the adoption of Eastern practices like acupuncture.
Nuland also recounts his most dramatic experiences in a forty-year medical career: the time he was called out of the audience of a Broadway play to help a man having a heart attack (when no other doctor there would respond), and how he formed a profound friendship with an unforgettable–and doomed–heart patient. Behind these inspiring accounts always lie the mysteries of the human body and human nature, the manner in which the ill can will themselves back to health and the odd and essential interactions between a body’s own healing mechanisms and a doctor’s prescriptions.
Riveting and wise, amusing and heartrending, The Uncertain Art is Sherwin Nuland’s best work, gems from a man who has spent his professional life acting in the face of ambiguity and sharing what he has learned.
From the Hardcover edition.
Written by editors of leading medical journals as well as publishing experts, this guide is relevant and easy to use for any novice writer wanting to publish in journals.
WITH HUMOR AND INSIGHT, Dr. Weisse explores the history and practice of the medical profession at large, incorporating anecdotes from his own career and in-depth examinations of medical controversies, education, research, and publication. As a clinician, teacher, researcher, historian, and keen observer of the medical scene for over forty years, Dr. Weisse has cast a wide net to capture both the triumphs and the foibles of his profession and the larger world in which it exists.
The book first ponders on quantitative and random variables, exploratory data analysis (EDA), probability, and probability distributions. Discussions focus on negative binomial distribution, non-random distributions, binomial distribution, fitting the binomial model to sample data, conditional probability and statistical independence, rules of probability, and Bayes' theorem. The text then examines inference, regression, and measurement and control. Topics cover analytical goals for assay precision, estimating the error variance components, indirect structural assays, functional assays, bivariate regression model, and least-squares estimates of the functional relation parameters.
The manuscript takes a look at assay method comparison studies, multivariate analysis, forecasting and control, and test interpretation. Concerns include time series structure and terminology, polynomial regression, assessing the performance of the classification rule, quantitative screening tests, sample correlation coefficient, and computer assisted diagnosis.
The book is a dependable reference for medical experts and statisticians interested in the employment of statistics in laboratory medicine.
I am a man of science, so before making the soft movement known, I wanted to verify that it was scientifically valid; the instruments that allowed me to prove the efficacy and the validity of my method were the computerized axial tomography, better known by its abbreviation CAT and magnetic resonance known as NMR. Subjecting patients to these tests before and after treatment, I have been able to prove that the manoeuvres of the soft movement created an opposing force that the one that had led to the expulsion of the disc. In this ebook, using a simple language everyone can understand, my aim has been to explain the components and the mechanisms regulating the spine and I have tried to illustrate how the soft movement works, with scientific demonstration and the statements by patients who have recovered.
Remediation in Medical Education: A Mid-Course Correction describes practical stepwise approaches to remediate struggling learners in fundamental medical competencies; discusses methods used to define competencies and the science underlying the fundamental shift in the delivery and assessment of medical education; explores themes that provide context for remediation, including professional identity formation and moral reasoning, verbal and nonverbal learning disabilities, attention deficit disorders in high-functioning individuals, diversity, and educational and psychiatric topics; and reviews system issues involved in remediation, including policy and leadership challenges and faculty development.
mHealth: Transforming Healthcare consists of nine chapters that addresses key content areas, including history (to the extent that dynamic technologies have a history), projection of immediate evolution, and consistent issues associated with health technology, such as security and information privacy, and government and industry regulation. A major point of discussion addressed is whether mHealth is a transient group of products and a passing patient encounter approach, or if it is the way much of our health care will be delivered in future years with incremental evolution to achieve sustainable innovation of health technologies.
In the 2nd edition of this popular and authoritative reference on Body Sensor Networks (BSN), major topics related to the latest technological developments and potential clinical applications are discussed, with contents covering.
Biosensor Design, Interfacing and Nanotechnology
Wireless Communication and Network Topologies
Communication Protocols and Standards
Energy Harvesting and Power Delivery
Ultra-low Power Bio-inspired Processing
Multi-sensor Fusion and Context Aware Sensing
Wearable, Ingestible Sensor Integration and Exemplar Applications
System Integration and Wireless Sensor Microsystems
The book also provides a comprehensive review of the current wireless sensor development platforms and a step-by-step guide to developing your own BSN applications through the use of the BSN development kit.