A well-documented, unnerving, fascinating study for anyone adrift in the American health care system.
An ingenious exploration of “natural experiments” that influence medical care.
Physicians and researchers at Harvard, Jena and Worsham open with a teaser claiming that children born in summer suffer influenza more often than those born in autumn. Readers may be confused until they reveal the results of millions of insurance claims. Parents tend to follow pediatric guidelines for yearly checkups, and they recommend using a child’s birthday as a reminder. Flu shots become available in the fall, so some children are immunized during their yearly checkup. The vaccine isn’t available during the summer so those parents are told to make a fall appointment; many don’t follow up, so their children get sick. The text is full of such intriguing and surprising facts and trends. When cardiologists go on vacation, their patients’ death rates drop significantly, likely because the substitutes are less aggressive in treatments. Most doctors prefer action over inaction, and so do those they care for. Sick patients want their doctor to “do something.” Hearing that waiting is the best course is often greeted as bad news. In a parallel study, patients with metastatic lung cancer were either given standard cancer treatment or simple palliative care. The palliative care patients were more comfortable—and also lived longer. Few readers will ignore the long section on who makes the best doctor. Backed by millions of records, mostly of hospital discharges and deaths, the authors determine that graduating from the best medical school makes no difference. Experience matters for surgeons, who improve with age, but not for internists. Women doctors perform as well as men in most specialties and a little better as internists, and doctors trained internationally are just as effective. Pandemic politics provides a concluding shock. Republicans and Democrats died in equal numbers early in the pandemic, and with the vaccine came a highly politicized anti-vaccine movement, after which excess deaths among registered Republicans jumped to over 150% higher than those of Democrats.
A well-documented, unnerving, fascinating study for anyone adrift in the American health care system.Pub Date: July 11, 2023
ISBN: 9780385548816
Page Count: 320
Publisher: Doubleday
Review Posted Online: April 17, 2023
Kirkus Reviews Issue: May 15, 2023
PERSPECTIVES
A short, smart analysis of perhaps the most famous passage in American history reveals its potency and unfulfilled promise.
Words that made a nation.
Isaacson is known for expansive biographies of great thinkers (and Elon Musk), but here he pens a succinct, stimulating commentary on the Founding Fathers’ ode to “life, liberty, and the pursuit of happiness.” His close reading of the Declaration of Independence’s second sentence, published to mark the 250th anniversary of the document’s adoption, doesn’t downplay its “moral contradiction.” Thomas Jefferson enslaved hundreds of people yet called slavery “a cruel war against human nature” in his first draft of the Declaration. All but 15 of the document’s 56 signers owned enslaved people. While the sentence in question asserted “all men are created equal” and possess “unalienable rights,” the Founders “consciously and intentionally” excluded women, Native Americans, and enslaved people. And yet the sentence is powerful, Isaacson writes, because it names a young nation’s “aspirations.” He mounts a solid defense of what ought to be shared goals, among them economic fairness, “moral compassion,” and a willingness to compromise. “Democracy depends on this,” he writes. Isaacson is excellent when explaining how Enlightenment intellectuals abroad influenced the founders. Benjamin Franklin, one of the Declaration’s “five-person drafting committee,” stayed in David Hume’s home for a month in the early 1770s, “discussing ideas of natural rights” with the Scottish philosopher. Also strong is Isaacson’s discussion of the “edits and tweaks” made to Jefferson’s draft. As recommended by Franklin and others, the changes were substantial, leaving Jefferson “distraught.” Franklin, who emerges as the book’s hero, helped establish municipal services, founded a library, and encouraged religious diversity—the kind of civic-mindedness that we could use more of today, Isaacson reminds us.
A short, smart analysis of perhaps the most famous passage in American history reveals its potency and unfulfilled promise.Pub Date: Nov. 18, 2025
ISBN: 9781982181314
Page Count: 80
Publisher: Simon & Schuster
Review Posted Online: Aug. 29, 2025
Kirkus Reviews Issue: Oct. 1, 2025
BOOK REVIEW
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SEEN & HEARD
For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.
Pub Date: Jan. 1, 1979
ISBN: 0061965588
Page Count: 772
Publisher: Harper & Row
Review Posted Online: May 26, 2012
Kirkus Reviews Issue: Jan. 1, 1979
BOOK REVIEW
BOOK REVIEW
BOOK REVIEW
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