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IF I BETRAY THESE WORDS

MORAL INJURY IN MEDICINE AND WHY IT'S SO HARD FOR CLINICIANS TO PUT PATIENTS FIRST

An expert bottoms-up examination of our diseased health care system.

A fierce denunciation of American medicine in which physicians are the heroes—mostly.

Doctors Dean and Talbot, founders of a nonprofit called The Moral Injury of Healthcare, explain that “moral injury” occurs when we experience something that transgresses our beliefs. For doctors, that means the oath to put patients’ needs first. It’s no secret that doctors must now comply with powerful stakeholders in the system, including insurers, hospital administrators, and oppressive regulators, as well as lugubrious electronic medical records. Stories of health care workers suffering “burnout” fill the media, but most blame overwork aggravated by the pandemic. Not so, maintain the authors. The culprit is moral injury, the result of applying aggressive, modern business methods to medical practice. In the introduction, the authors describe a dynamic entrepreneur whose massive hospital earned huge profits by minimizing staff and maximizing testing and services whether necessary or not, and perhaps breaking the law. Finally sent away with a golden parachute, he was replaced by another entrepreneur who promised “significant value for our shareholders.” As the authors demonstrate consistently, hospital executives see themselves as responsible to stockholders, not to physicians or patients. This includes many nonprofits, whose administrators give profits priority and benefit from them. Dean and Talbot profile the work of physicians forced to endure moral injury who then try, sometimes successfully, to find a practice more to their liking. In the final chapter, they deliver a passionate plea for more sensible and better enforced government regulation and more generous reimbursement from public and private insurance. Neither seems on the horizon. Sadly, heartless, assembly-line health care is more profitable than the good kind and, despite lurid stories, only slightly less effective. Doctors and patients hate it, but in a nation that worships the free market, profit is evidence of a well-run institution. Pair this powerful book with an equally painful yet important view from the top: Brian Alexander’s The Hospital.

An expert bottoms-up examination of our diseased health care system.

Pub Date: April 4, 2023

ISBN: 9781586423544

Page Count: 306

Publisher: Steerforth

Review Posted Online: Jan. 11, 2023

Kirkus Reviews Issue: Feb. 1, 2023

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WHAT THIS COMEDIAN SAID WILL SHOCK YOU

Maher calls out idiocy wherever he sees it, with a comedic delivery that veers between a stiletto and a sledgehammer.

The comedian argues that the arts of moderation and common sense must be reinvigorated.

Some people are born snarky, some become snarky, and some have snarkiness thrust upon them. Judging from this book, Maher—host of HBO’s Real Time program and author of The New New Rules and When You Ride Alone, You Ride With bin Laden—is all three. As a comedian, he has a great deal of leeway to make fun of people in politics, and he often delivers hilarious swipes with a deadpan face. The author describes himself as a traditional liberal, with a disdain for Republicans (especially the MAGA variety) and a belief in free speech and personal freedom. He claims that he has stayed much the same for more than 20 years, while the left, he argues, has marched toward intolerance. He sees an addiction to extremism on both sides of the aisle, which fosters the belief that anyone who disagrees with you must be an enemy to be destroyed. However, Maher has always displayed his own streaks of extremism, and his scorched-earth takedowns eventually become problematic. The author has something nasty to say about everyone, it seems, and the sarcastic tone starts after more than 300 pages. As has been the case throughout his career, Maher is best taken in small doses. The book is worth reading for the author’s often spot-on skewering of inept politicians and celebrities, but it might be advisable to occasionally dip into it rather than read the whole thing in one sitting. Some parts of the text are hilarious, but others are merely insulting. Maher is undeniably talented, but some restraint would have produced a better book.

Maher calls out idiocy wherever he sees it, with a comedic delivery that veers between a stiletto and a sledgehammer.

Pub Date: May 21, 2024

ISBN: 9781668051351

Page Count: 384

Publisher: Simon & Schuster

Review Posted Online: March 5, 2024

Kirkus Reviews Issue: April 1, 2024

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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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