BITTER MEDICINE

GREED AND CHAOS IN AMERICAN HEALTH CARE

Its subtitle notwithstanding, this is not a polemic but a cool and balanced analysis of our ailing health care system. An internist and journalist, Kassler (Gay Men's Health, 1983) approaches the system as though it were a patient—taking its history, noting its chief complaints, examining it, and then coming up with a diagnosis and plan of treatment. The history shows that the system underwent enormous change when third-party payers severed the connection between receiving care and paying for it. After identifying the system's chief complaints as spiraling costs, access problems, insurance hassles, the vanishing family doctor, and loss of privacy, Kassler examines the system's many players. First to come under her critical eye are the multitude of new industries spawned by the availability of huge funds from Medicare and Medicaid. Then she deftly probes the pharmaceutical industry; the medical profession; the media, especially for its part in boosting public demand for high-tech medical services; society's changing values; the government's multiple and complex roles; and the effects of the legal system. Her assessment is that the health care system is becoming too expensive and exclusionary and that we must create something stable, fair, and flexible. To do so, she says, requires setting some general goals: stabilize costs, provide universal care, ensure medical advances, take the anxiety out of the system. She proposes some broadly defined steps toward reaching these goals: pool our risks, maximize choice, move to community-based primary care, demedicalize social problems, separate insurance from employment. Her approach is holistic—working on all parts of the system to ``nudge all players toward reform.'' In a brief epilogue, she takes issue with many of the Clinton plan's specifics. Highly recommended—convincing and comprehensive.

Pub Date: June 1, 1994

ISBN: 1-55972-223-1

Page Count: 288

Publisher: Birch Lane Press

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: April 15, 1994

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

THE IMMORTAL LIFE OF HENRIETTA LACKS

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

WHY WE SWIM

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. 5, 2020

Kirkus Reviews Issue: Feb. 1, 2020

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