The drama of surgery conveyed by an eyewitness with the smarts of an American business watcher will appeal to the general...
The versatile Morris (The Tycoons: How Andrew Carnegie, John D. Rockefeller, Jay Gould, and J.P. Morgan Invented the American Supereconomy, 2005, etc.) brings his customary research and observational skills to probe the heart industry.
For it is an industry: fueled by discoveries, purveyed by artists and craftsmen supplied by medical schools, in demand by customers who shun the alternative. Heart disease is the number-one killer worldwide. In good hands, as the author graphically describes, even some of the worst cases—heart patients with multiple chronic ills and earlier surgery—survive to thrive. Morris spent a year at New York’s Columbia-Presbyterian Hospital watching coronary bypass surgeries, transplants, valve replacements and congenital-defect corrections, performed by some of the world’s best—the surgeons, anesthesiologists and nurses. No question, the doctors are dedicated (and well paid). Surprisingly, those at Columbia form a mutual-admiration society—no primal egos here. The author reiterates what the data show: If you’re a patient, you would be wise to go to a top-tier hospital whose ORs are busy 24/7 rather than one performing a few procedures a year. While Columbia treats some indigent patients, Morris leaves to the end the issue of haves and have-nots, seeing only incremental changes to expand insurance coverage and lamenting the emphasis on high-cost, high-tech therapies rather than prevention. The tech focus is largely driven by R and D, he observes. Science is moving toward less invasive procedures: stents to open blocked arteries and robotic instruments working through small incisions, rather than the breaking-the-chest-bone-and-entering styles of the past. Thus interventional cardiology, the medical specialty which allows placement of stents and angioplasties, is the hot new field, while heart surgery declines. The future may see a merger of the two specialties.
The drama of surgery conveyed by an eyewitness with the smarts of an American business watcher will appeal to the general public but be of particular pertinence to patients and policymakers.Pub Date: Oct. 1, 2007
ISBN: 978-0-393-06562-6
Page Count: 256
Publisher: Norton
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Aug. 15, 2007
Useful but disappointingly commonplace tips.
In a follow-up to The End of Illness (2012), which explored how technological advances will transform medicine, Agus (Medicine and Engineering/Univ. of Southern California) restates time-tested but too often overlooked principles for healthy living.
The author outlines simple measures that average citizens can take to live healthier lives and extend their life spans by taking advantage of modern technology to develop personalized records. These would include a list of medical tests and recommended treatments. Agus also suggests keeping track of indicators that can be observed at home on a regular basis—e.g., changes in energy, weight, appetite and blood pressure, blood sugar and general appearance. He advises that all of this information be made available online, and it is also helpful to investigate family history and consider DNA testing where indicated. Along with maintaining a healthy weight, Agus emphasizes the importance of eating a balanced diet, with plenty of fresh fruits and vegetables and a minimum of red meat. Avoid packaged vitamins and food supplements, and if possible, grow your own vegetables or buy frozen vegetables, which will generally be fresher than those on supermarket shelves. The author also warns against processed foods that make health claims but contain additives or excessive amounts of sugar or fat. Regular mealtimes and plenty of sleep, frequent hand-washing and oral hygiene are a must; smoking and excessive time in the sun should also be avoided. Agus recommends that adults should consider taking statins and baby aspirin as preventative measures. He concludes with a decade-by-decade checklist of annual medical examinations that should be routine—e.g. blood pressure, diabetes and cholesterol screenings, from one’s 20s on; colonoscopies, prostate exams and mammograms later—and a variety of top-10 lists (for example, “Top 10 Reasons to Take a Walk”).
Useful but disappointingly commonplace tips.Pub Date: Jan. 7, 2014
ISBN: 978-1-4767-3095-0
Page Count: 128
Publisher: Simon & Schuster
Review Posted Online: Sept. 30, 2013
Kirkus Reviews Issue: Oct. 15, 2013
BOOK REVIEW
BOOK REVIEW
Oncologist Agus (Medicine and Engineering/Univ. of Southern California) predicts that the application of advanced technology for modeling complex systems will transform 21st-century medicine.
The author writes that a remark Nobel Laureate Murray Gell-Mann made to him in 2009—“Look at cancer as a system"—transformed the way he views his own specialty and the entire field of preventative medicine. It made him realize that “[r]ather than honoring the body as the exceedingly complex system that it is, we keep looking for the individual gene that has gone awry, or for the one ‘secret’ that can improve our health.” Agus writes that although the ability to sequence the entire human genome is a great step forward, it is insufficient for achieving a significant breakthrough. Even though it may start with a mutation, cancer “is a dynamic process that's happening…far from the confines of a static piece of DNA”—it involves the body's immune system, its ability to regulate cell growth, metabolism and more. Agus directs his university’s Center for Applied Molecular Medicine and is the co-founder of two personalized medicine companies, Applied Proteomics and Navigenics. His hope is that their research will contribute to developing better analytical tools for preventative medicine and for the treatment of cancers. These will address the functioning of the body as a whole, applying digital technology already used by physicists to provide virtual models of cancers and model the action of proteins that regulate cell communication in the body. He also hopes to develop tools that will provide information on the concentration of different proteins in a drop of blood taken from a patient, which may reveal the onset of disease. The author also includes some guiding principles and warnings about certain healthy practices that may not be so healthy. A refreshing change of pace in the medical field, but by venturing beyond his field of expertise to pontificate on a wide range of subjects, Agus makes his otherwise intriguing narrative difficult to follow.
Pub Date: Jan. 1, 2012
ISBN: 978-1-4516-1017-8
Page Count: 288
Publisher: Free Press
Review Posted Online: Nov. 5, 2011
Kirkus Reviews Issue: Nov. 15, 2011
BOOK REVIEW
BOOK REVIEW
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