A lucid, persuasive case for overhauling diagnosis regimes to catch cancer early rather than late.
Ratner and Bonislawski argue that the American way of cancer detection is all wrong.
Ratner, a board member for Weill Cornell Medical Center and the Memorial Sloan Kettering Cancer Center, is perfectly placed to advocate for a variety of reforms. “Early detection, a critical solution to the cancer epidemic, is hiding in plain sight,” he writes in this co-authored book. Rather than await the diagnosis of an illness when it is well developed and thus often expensive to treat—to say nothing of the treatment often being only a strategy to buy time—it would be better to “shift the emphasis to early detection of cancerous growths, until now the poor stepchild of the whole process.” This will require the redirection of research funding, only a small fraction of which goes to early detection. As the authors note, it will also require a persuasion campaign to get Americans to the doctor for those early tests; an early-warning lung cancer screening now in place is little used, in part, perhaps, because medical staff aren’t pushing it. Where tests have become standardized, they have shown remarkable success: The authors write that the Pap smear, for instance, “has arguably done more than any other single intervention to cut cancer deaths,” but it’s sobering to consider how long it took for it to be used widely—even more sobering to note how the medical and insurance establishments relegated interpreting the test to poorly paid, overworked women staffers. Other forms of cancer can be just as effectively treated if caught early, and the authors identify many unaddressed pieces of the puzzle, not least that “doctors must be highly proficient in cancer screening literacy” so that patients understand what’s happening—a matter for which they offer additional advocacy.
A lucid, persuasive case for overhauling diagnosis regimes to catch cancer early rather than late.Pub Date: June 11, 2024
ISBN: 9781682193518
Page Count: 256
Publisher: OR Books
Review Posted Online: May 15, 2024
Kirkus Reviews Issue: June 15, 2024
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
PERSPECTIVES
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
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