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HOW WE DO HARM

A DOCTOR BREAKS RANKS ABOUT BEING SICK IN AMERICA

A powerful contribution to the ongoing discussion on health-care reform.

With the assistance of investigative journalist Goldberg (The Final Act: The Dramatic, Revealing Story of the Moscow Helsinki Watch Group, 1988, etc.), Brawley (Medicine/Emory Univ.), chief medical scientific officer of the American Cancer Society, delivers a scathing indictment of the American medical system.

The authors provide solid documentation in support of the case that the American health system is fundamentally flawed, drawing on illustrative examples taken from his own experience as an oncologist as well as his expertise in public health. Brawley presents a shocking conclusion: “The system is not failing. It's functioning exactly as designed,” with “the greedy serving the gluttonous.” While low-income Americans are denied adequate medical care, the wealthy are also poorly served, often paying for unneeded treatments that can have dangerous side effects. The authors describe the case of a man whose experience was not atypical. While receiving chemotherapy as a precaution against cancer following colon surgery, he became too debilitated to work. When he could no longer afford the co-pays, he landed at Atlanta's Grady Hospital, which accepts patients with financial problems. After evaluating the patient's case, Brawley concluded that he was fortunate that his high-priced previous oncologist would no longer treat him, since he had mishandled the chemotherapy. “A negative wallet biopsy may have saved his life,” he writes ironically. Less fortunate was the breast-cancer patient who received a fatal bone-marrow transplant intended to reduce the risk of recurrence— a procedure based on positive data later proved to be fraudulent. Brawley provides citations from a variety of cases—pharmaceuticals that have dangerous side effects, unnecessary treatments for prostate cancer, etc.—including those of misguided patients who demanded excessive treatment and threatened lawsuits if it was denied.

A powerful contribution to the ongoing discussion on health-care reform.

Pub Date: Feb. 1, 2012

ISBN: 978-0-312-67297-3

Page Count: 256

Publisher: St. Martin's

Review Posted Online: Nov. 27, 2011

Kirkus Reviews Issue: Dec. 15, 2011

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WHEN BREATH BECOMES AIR

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...

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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

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INTO THE WILD

A wonderful page-turner written with humility, immediacy, and great style. Nothing came cheap and easy to McCandless, nor...

The excruciating story of a young man on a quest for knowledge and experience, a search that eventually cooked his goose, told with the flair of a seasoned investigative reporter by Outside magazine contributing editor Krakauer (Eiger Dreams, 1990). 

Chris McCandless loved the road, the unadorned life, the Tolstoyan call to asceticism. After graduating college, he took off on another of his long destinationless journeys, this time cutting all contact with his family and changing his name to Alex Supertramp. He was a gent of strong opinions, and he shared them with those he met: "You must lose your inclination for monotonous security and adopt a helter-skelter style of life''; "be nomadic.'' Ultimately, in 1992, his terms got him into mortal trouble when he ran up against something—the Alaskan wild—that didn't give a hoot about Supertramp's worldview; his decomposed corpse was found 16 weeks after he entered the bush. Many people felt McCandless was just a hubris-laden jerk with a death wish (he had discarded his map before going into the wild and brought no food but a bag of rice). Krakauer thought not. Admitting an interest that bordered on obsession, he dug deep into McCandless's life. He found a willful, reckless, moody boyhood; an ugly little secret that sundered the relationship between father and son; a moral absolutism that agitated the young man's soul and drove him to extremes; but he was no more a nutcase than other pilgrims. Writing in supple, electric prose, Krakauer tries to make sense of McCandless (while scrupulously avoiding off-the-rack psychoanalysis): his risky behavior and the rites associated with it, his asceticism, his love of wide open spaces, the flights of his soul.

A wonderful page-turner written with humility, immediacy, and great style. Nothing came cheap and easy to McCandless, nor will it to readers of Krakauer's narrative. (4 maps) (First printing of 35,000; author tour)

Pub Date: Jan. 1, 1996

ISBN: 0-679-42850-X

Page Count: 320

Publisher: Villard

Review Posted Online: May 19, 2010

Kirkus Reviews Issue: Oct. 15, 1995

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