An engaging, provocative study of a much-hyped aspect of American health care.
A history and debunking of the health sciences’ embrace of precision medicine rooted in genetics.
Tabery, a professor of philosophy and health ethics, argues that the role of genetic research in a fundamental transformation of health care in America was not inevitable. In fact, he suggests, its promise of tailored medicine was not even all that revolutionary, and its current achievements are mostly exaggerated. To make his point, the author investigates the Human Genome Project and the scientists involved as they edged out the opposing environmental approach embodied in the National Children’s Study that fought—unsuccessfully—for more than a decade to offer an alternative data set. In an accessible narrative bolstered by prodigious research, Tabery reveals that victory for genomics was less about hard science and more about business interests, media fascination, and political leverage. The author admits his own belief in the superiority of the environmental approach, its attention to the social determinants of health, and its emphasis on prevention. However, Tabery does more to poke holes in the genetic approach than to validate the effectiveness of the environmental one, and comprehensive, detailed backstories are occasionally digressive and detract from the author’s primary argument. Still, even these details and the way they connect various scientific innovations serve to underscore concerns about how biological information is used, how quickly private industry and political interests can undermine the scientific community, and how cavalierly genetic medicine can play with patient expectations. Tabery succeeds in raising a compelling alarm about where things stand and making clear that the current situation could have been much different, all while laying the groundwork for an alternative future that better solves the disparities that personalized medicine has ignored—and, in some cases, exacerbated. The debates will continue, but the author provides a solid resource within that debate.
An engaging, provocative study of a much-hyped aspect of American health care.Pub Date: Aug. 15, 2023
ISBN: 9780525658207
Page Count: 336
Publisher: Knopf
Review Posted Online: May 27, 2023
Kirkus Reviews Issue: June 15, 2023
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
A philosophically rich critique of state violence and mass apathy.
An Egyptian Canadian journalist writes searchingly of this time of war.
“Rules, conventions, morals, reality itself: all exist so long as their existence is convenient to the preservation of power.” So writes El Akkad, who goes on to state that one of the demands of modern power is that those subject to it must imagine that some group of people somewhere are not fully human. El Akkad’s pointed example is Gaza, the current destruction of which, he writes, is causing millions of people around the world to examine the supposedly rules-governed, democratic West and declare, “I want nothing to do with this.” El Akkad, author of the novel American War (2017), discerns hypocrisy and racism in the West’s defense of Ukraine and what he views as indifference toward the Palestinian people. No stranger to war zones himself—El Akkad was a correspondent in Afghanistan and Iraq—he writes with grim matter-of-factness about murdered children, famine, and the deliberate targeting of civilians. With no love for Zionism lost, he offers an equally harsh critique of Hamas, yet another one of the “entities obsessed with violence as an ethos, brutal in their treatment of minority groups who in their view should not exist, and self-decreed to be the true protectors of an entire religion.” Taking a global view, El Akkad, who lives in the U.S., finds almost every government and society wanting, and not least those, he says, that turn away and pretend not to know, behavior that we’ve seen before and that, in the spirit of his title, will one day be explained away until, in the end, it comes down to “a quiet unheard reckoning in the winter of life between the one who said nothing, did nothing, and their own soul.”
A philosophically rich critique of state violence and mass apathy.Pub Date: Feb. 25, 2025
ISBN: 9780593804148
Page Count: 224
Publisher: Knopf
Review Posted Online: Dec. 14, 2024
Kirkus Reviews Issue: Jan. 15, 2025
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