In a well-documented, panoramic narrative, an insider demystifies what makes many doctors tick.



The former CEO of the Permanente Medical Group takes readers into the world that shapes the medical practitioner’s mindset and lays out necessary changes for a broken system.

By the early 2000s, the U.S. health care system, once a global leader, had become the most expensive and least effective in the developed world. Of course, Covid-19 has only exacerbated the situation. Among the number of factors that have led to our current state of affairs—a situation that implicates everyone from hospital administrators to insurers, regulators, and pharmaceutical giants—Pearl singles out for examination the flawed culture that guides doctors in their practice. Physician culture, writes the author, “elevates intervention over prevention,” resulting in a lack of effective treatment for chronic killers such as diabetes, obesity, hypertension, and heart disease. In a brightly delineated—and highly disturbing—dissection, Pearl lays out the rituals, rules, and beliefs that often isolate physicians from their colleagues and their patients. The foundation of the culture may rest on concepts of healing, resilience, and artistry, but it also breeds a hierarchical sense of individual exceptionalism, heroism, and invincibility. This entitlement and autonomy often clash with the implementation of advanced diagnostic technology, undercutting the doctor’s sense of status and control. In this new environment, characterized by long hours, lowered pay, diminished decision-making, and erasure of prestige, more and more physicians are experiencing burnout. Pearl sensibly advocates a coevolution of these two streams, taking advantage of a doctor’s experience and independent judgement while tapping into the structural and scientific changes in medical practice. Incorporating peer-reviewed research, personal experience, and anecdotal evidence, the author excoriates overtesting and overprescribing as well as institutionalized racism within the medical community, and he advocates for “broadly available, prepaid, integrated, high-quality healthcare,” a system that is open to change, collaboration, and “safe, effective, patient-centered, timely, efficient, and equitable” care.

In a well-documented, panoramic narrative, an insider demystifies what makes many doctors tick.

Pub Date: May 18, 2021

ISBN: 978-1-5417-5827-8

Page Count: 400

Publisher: PublicAffairs

Review Posted Online: March 13, 2021

Kirkus Reviews Issue: April 1, 2021

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Fans will find comfort in Lawson’s dependably winning mix of shameless irreverence, wicked humor, and vulnerability.

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The Bloggess is back to survey the hazards and hilarity of imperfection.

Lawson is a wanderer. Whether on her award-winning blog or in the pages of her bestselling books, she reliably takes readers to places they weren’t even aware they wanted to go—e.g., shopping for dog condoms or witnessing what appears to be a satanic ritual. Longtime fans of the author’s prose know that the destinations really aren’t the point; it’s the laugh-out-loud, tears-streaming-down-your-face journeys that make her writing so irresistible. This book is another solid collection of humorous musings on everyday life, or at least the life of a self-described “super introvert” who has a fantastic imagination and dozens of chosen spirit animals. While Furiously Happy centered on the idea of making good mental health days exceptionally good, her latest celebrates the notion that being broken is beautiful—or at least nothing to be ashamed of. “I have managed to fuck shit up in shockingly impressive ways and still be considered a fairly acceptable person,” writes Lawson, who has made something of an art form out of awkward confessionals. For example, she chronicles a mix-up at the post office that left her with a “big ol’ sack filled with a dozen small squishy penises [with] smiley faces painted on them.” It’s not all laughs, though, as the author addresses her ongoing battle with both physical and mental illness, including a trial of transcranial magnetic stimulation, a relatively new therapy for people who suffer from treatment-resistant depression. The author’s colloquial narrative style may not suit the linear-narrative crowd, but this isn’t for them. “What we really want,” she writes, “is to know we’re not alone in our terribleness….Human foibles are what make us us, and the art of mortification is what brings us all together.” The material is fresh, but the scaffolding is the same.

Fans will find comfort in Lawson’s dependably winning mix of shameless irreverence, wicked humor, and vulnerability.

Pub Date: April 6, 2021

ISBN: 978-1-250-07703-5

Page Count: 288

Publisher: Henry Holt

Review Posted Online: Jan. 27, 2021

Kirkus Reviews Issue: Feb. 15, 2021

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Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our...


A psychologist and Nobel Prize winner summarizes and synthesizes the recent decades of research on intuition and systematic thinking.

The author of several scholarly texts, Kahneman (Emeritus Psychology and Public Affairs/Princeton Univ.) now offers general readers not just the findings of psychological research but also a better understanding of how research questions arise and how scholars systematically frame and answer them. He begins with the distinction between System 1 and System 2 mental operations, the former referring to quick, automatic thought, the latter to more effortful, overt thinking. We rely heavily, writes, on System 1, resorting to the higher-energy System 2 only when we need or want to. Kahneman continually refers to System 2 as “lazy”: We don’t want to think rigorously about something. The author then explores the nuances of our two-system minds, showing how they perform in various situations. Psychological experiments have repeatedly revealed that our intuitions are generally wrong, that our assessments are based on biases and that our System 1 hates doubt and despises ambiguity. Kahneman largely avoids jargon; when he does use some (“heuristics,” for example), he argues that such terms really ought to join our everyday vocabulary. He reviews many fundamental concepts in psychology and statistics (regression to the mean, the narrative fallacy, the optimistic bias), showing how they relate to his overall concerns about how we think and why we make the decisions that we do. Some of the later chapters (dealing with risk-taking and statistics and probabilities) are denser than others (some readers may resent such demands on System 2!), but the passages that deal with the economic and political implications of the research are gripping.

Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our minds.

Pub Date: Nov. 1, 2011

ISBN: 978-0-374-27563-1

Page Count: 512

Publisher: Farrar, Straus and Giroux

Review Posted Online: Sept. 4, 2011

Kirkus Reviews Issue: Sept. 15, 2011

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