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OVERDIAGNOSED

MAKING PEOPLE SICK IN THE PURSUIT OF HEALTH

An antidote to alarmist thinking about the prevalence of disease.

Three medical practitioners concerned about the impact of increased use of diagnostic screening tools address the underlying causes and present their prescription.

Welch, Schwartz and Woloshin—professors at the Dartmouth Institute for Health Policy and Clinical Practice—assert that too many Americans are receiving unnecessary treatment for so-called abnormalities that are prevalent in the population but cause no symptoms, and thus no harm. Due to the increased use of high-tech diagnostic tools and a corresponding lowering of diagnostic thresholds, more of us are being told we meet the criteria for conditions and diseases that warrant intervention. The authors recognize that they are presenting a tough platform—isn’t it better, conventional wisdom states, to find and prevent high blood pressure or prostate cancer before actual onset of symptoms?—but their point is that it can be costly and even harmful. Potential problems become magnified, increasing numbers of people are labeled as patients and the side effects of many medications may generate more problems then they alleviate. Overdiagnosis leads to overtreatment, write the authors, who ask readers to look closely at claims that testing will save lives—e.g., “most women will not benefit from mammography—for example, about two thousand forty-year-old women need to be screened over ten years for one woman to benefit.” The authors do a fine job incorporating relevant medical terminology to bolster their argument. However, because citing randomized trials and rational risk estimates doesn’t hold great emotional weight, they also share their own common-sense observations as well as a body of research culled from many sources. The tone is sensible and serious but reassuring, and the authors make a strong case for moderation.

An antidote to alarmist thinking about the prevalence of disease.

Pub Date: Jan. 18, 2011

ISBN: 978-0-8070-2200-9

Page Count: 256

Publisher: Beacon Press

Review Posted Online: Sept. 27, 2010

Kirkus Reviews Issue: Oct. 15, 2010

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WHY WE SWIM

An absorbing, wide-ranging story of humans’ relationship with the water.

A study of swimming as sport, survival method, basis for community, and route to physical and mental well-being.

For Bay Area writer Tsui (American Chinatown: A People's History of Five Neighborhoods, 2009), swimming is in her blood. As she recounts, her parents met in a Hong Kong swimming pool, and she often visited the beach as a child and competed on a swim team in high school. Midway through the engaging narrative, the author explains how she rejoined the team at age 40, just as her 6-year-old was signing up for the first time. Chronicling her interviews with scientists and swimmers alike, Tsui notes the many health benefits of swimming, some of which are mental. Swimmers often achieve the “flow” state and get their best ideas while in the water. Her travels took her from the California coast, where she dove for abalone and swam from Alcatraz back to San Francisco, to Tokyo, where she heard about the “samurai swimming” martial arts tradition. In Iceland, she met Guðlaugur Friðþórsson, a local celebrity who, in 1984, survived six hours in a winter sea after his fishing vessel capsized, earning him the nickname “the human seal.” Although humans are generally adapted to life on land, the author discovered that some have extra advantages in the water. The Bajau people of Indonesia, for instance, can do 10-minute free dives while hunting because their spleens are 50% larger than average. For most, though, it’s simply a matter of practice. Tsui discussed swimming with Dara Torres, who became the oldest Olympic swimmer at age 41, and swam with Kim Chambers, one of the few people to complete the daunting Oceans Seven marathon swim challenge. Drawing on personal experience, history, biology, and social science, the author conveys the appeal of “an unflinching giving-over to an element” and makes a convincing case for broader access to swimming education (372,000 people still drown annually).

An absorbing, wide-ranging story of humans’ relationship with the water.

Pub Date: April 14, 2020

ISBN: 978-1-61620-786-1

Page Count: 288

Publisher: Algonquin

Review Posted Online: Jan. 4, 2020

Kirkus Reviews Issue: Feb. 1, 2020

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THE IMMORTAL LIFE OF HENRIETTA LACKS

Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and...

A dense, absorbing investigation into the medical community's exploitation of a dying woman and her family's struggle to salvage truth and dignity decades later.

In a well-paced, vibrant narrative, Popular Science contributor and Culture Dish blogger Skloot (Creative Writing/Univ. of Memphis) demonstrates that for every human cell put under a microscope, a complex life story is inexorably attached, to which doctors, researchers and laboratories have often been woefully insensitive and unaccountable. In 1951, Henrietta Lacks, an African-American mother of five, was diagnosed with what proved to be a fatal form of cervical cancer. At Johns Hopkins, the doctors harvested cells from her cervix without her permission and distributed them to labs around the globe, where they were multiplied and used for a diverse array of treatments. Known as HeLa cells, they became one of the world's most ubiquitous sources for medical research of everything from hormones, steroids and vitamins to gene mapping, in vitro fertilization, even the polio vaccine—all without the knowledge, must less consent, of the Lacks family. Skloot spent a decade interviewing every relative of Lacks she could find, excavating difficult memories and long-simmering outrage that had lay dormant since their loved one's sorrowful demise. Equal parts intimate biography and brutal clinical reportage, Skloot's graceful narrative adeptly navigates the wrenching Lack family recollections and the sobering, overarching realities of poverty and pre–civil-rights racism. The author's style is matched by a methodical scientific rigor and manifest expertise in the field.

Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and Petri dish politics.

Pub Date: Feb. 9, 2010

ISBN: 978-1-4000-5217-2

Page Count: 320

Publisher: Crown

Review Posted Online: Dec. 22, 2010

Kirkus Reviews Issue: Jan. 1, 2010

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