One-Minute Book Reviews

February 25, 2008

A Report From the Frontlines of the Cosmetic Surgery Boom Returns in Paperback

Filed under: Nonfiction,Paperbacks — 1minutebookreviewswordpresscom @ 1:38 am
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Heard about the Detroit radio station had a contest called “New Year, New Rear” and gave the winner $15,000 worth of liposuction? You would have if you’d read Beauty Junkies: In Search of the Thinnest Thighs, Perkiest Breasts, Smoothest Faces, Whitest Teeth, and Skinniest, Most Perfect Toes in America, (Broadway, 304 pp., $14.94, paperback), just out in paperback with a new subtitle (replacing Inside Our $15 Billion Obsession With Cosmetic Surgery). How did we get to the point that some people don’t blink when they hear about a “New Year, New Rear” promotion? What are the social, emotional and medical costs of the cosmetic surgery boom? New York Times reporter Alex Kuczynski www.alexkuczynski.com gives fearless answers in a skillful blend of reporting, social commentary and advice to people who may submit to the knife or needle.

© 2008 Janice Harayda. All rights reserved.
www.janiceharayda.com

February 12, 2008

Ishmael Beah Says He Was Shot ‘Three Times on My Left Foot’ But Suffered No Serious Damage — Can Any Soldiers, E.R. Doctors or Others Explain This?

Another scene I don’t understand from the memoir of the man who claims to have been a child soldier

On this site I try to keep reviews short enough that you can read them in a minute if you skip the supplemental material at the end, so I’ll often give one example instead of three or choose a brief quote from a book instead of a long one. But enough questions have been raised about the credibility of Ishmael Beah’s A Long Way Gone that I’d like to mention a scene from it that didn’t appear in my original review. In this scene Beah talks about continuing to fight after receiving “many bullet wounds” and about foot injuries don’t appear to have left him with a limp or a need to use a cane.

Beah’s account of his injuries seemed implausible, but I don’t have a medical or military background. Would anyone with expertise in such fields like to comment on the following?

Ishmael Beah says in A Long Way Gone that he received “many bullet wounds” in a firefight in Sierra Leone but kept attacking a village his squad was trying to take. He adds that after 24 hours, he and his fellow soldiers seemed to have achieved their aim.

Then they were attacked again, and he was hit three times in the left foot: “The first two bullets went in and out, and the last one stayed inside my foot.” The third bullet, he says, was later removed with “crooked-looking scissors” by a “sergeant doctor” in the Sierra Leone army at a base camp. After leaving the army, Beah entered a hospital and was told that medical tests showed that nothing was “seriously wrong” and he would just have to take medications until his next checkup.

Quotes from pages 156–158 and 163.

Links: The original review of A Long Way Gone appeared on this site on Feb. 27, 2007. www.oneminutebookreviews.wordpress.com/2007/02/27/. A reading group guide was posted on March 5, 2007 www.oneminutebookreviews.wordpress.com/2007/03/05/.

© 2008 Janice Harayda. All rights reserved.

January 28, 2008

Coming Tomorrow — John Gunther’s Classic Memoir of His Son’s Death From a Brain Tumor, ‘Death Be Not Pround’

Many school reading lists include John Gunther‘s classic memoir of his 17-year-old son’s fight to survive a deadly brain tumor, Death Be Not Proud. And perhaps for that reason, some people have come to see it as a book for teenagers. But the book was an adult bestseller in its day and popular among many ages. What does it offer to readers today? One-Minute Book Reviews will consider the reasons for the enduring appeal of the book tomorrow.

(c) 2008 Janice Harayda. All rights reserved.

January 8, 2008

Backscratching in Our Time — Gina Kolata and Jerome Groopman

The latest in a series of posts on authors who praise each other’s work in a way that may have financial benefits for both

 

I usually post these examples of backscratching without comment, but this one is bad on so many levels, I’d like explain why. A pillar of journalistic ethics says that reporters should avoid not just conflicts of interest but the appearance of conflicts. Gina Kolata is a science writer for the New York Times who has used Groopman, a professor at Harvard Medical School and a bestselling author, as a source. As the comments below make clear, she accepted a favor from Groopman — the blurb for Rethinking Thin — that could put money in her pocket if, say, you bought the book based on his recommendation or if a paperback or overseas publisher paid more for the reprint rights because of the quote (and quotes can affect the amount offered). Kolata has compounded the problem by selecting one of Groopman’s essays for Best American Science Writing 2007, a decision that has almost certainly put money in his pocket, given that contributors to anthologies typically receive an up-front fee or a percentage of the royalties or both. She also used on the cover of the paperback edition of her earlier Flu a quote from Groopman that appeared in the Boston Globe, which is owned by the New York Times. It gives me no pleasure to say any of this because I enjoy Kolata’s work for the Times and regard it as far superior to that of her colleague Jane Brody, who writes the Personal Health column. I also admired much about Flu, Rethinking Thin and Groopman’s How Doctors Think www.oneminutebookreivews.wordpress.com/2007/12/28/.

 

Jerome Groopman on Gina Kolata

“Kolata is a seasoned reporter, and knows how to craft a riveting tale … a masterly recounting of medical history.”

Groopman in a review of Kolata’s Flu: The Story of the Great Influenza Pandemic (Touchtone, $15, paperback) in the Boston Globe, Dec. 12. 1999. “A masterly recounting of medical history” appears on the cover of the paperback edition of Flu.

 

“An incisive, thought-provoking examination of a subject that concerns us all. This book will educate and illuminate those seeking solid information about the struggle to lose weight.”

Groopman in a blurb on the cover of Kolata’s new Rethinking Thin: The New Science of Weight Loss — and the Myths and Realities of Dieting (Farrar, Straus & Giroux, $24)

Gina Kolata on Jerome Groopman

“I also liked Jerome Groopman’s New Yorker article, ‘Being There.’ It raises an issue I had never considered, and in an unforgettable way …”

Gina Kolata on why she choose Groopman’s article as one of the best of the year, in her introduction to Best American Science Writing 2007 (HarperPerennial, $14.95, paperback), edited by Kolata and Jesse Cohen.

One-Minute Book Reviews welcomes suggestions about authors should be in “Backscratching in Our Time,” a series in inspired by “Logrolling in Our Time” in the old Spy magazine.

© 200X Janice Harayda. All rights reserved.

www.janiceharayda.com

December 29, 2007

If You’ve Made a New Year’s Resolution to Lose Weight, You May Want to Make Another Resolution to Read ‘Good Calories, Bad Calories’ Before You Start Your Diet

Good Calories, Bad CaloriesHave you made yet another New Year’s resolution to lose weight?  You may want to check out Gary Taubes’s Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease (Knopf,  601 pp., $29.95), which I wrote about in October  www.oneminutebookreviews.wordpress.com/2007/10/09/. This isn’t a diet book but one that investigates many of the claims that underlie other diet books.

Based on an exhaustive review of the scientific research, Taubes argues that obesity “experts” have demonized fat on the basis little or no evidence. Refined carbohydrates, he says, are a greater threat to health. And those fat-free brownies may hurt you more than foods that have more fat but fewer carbs. “Dietary fat, whether saturated or not,” he concludes, “is not a cause of obesity, heart disease, or any other chronic disease of civilization.”

(c) 2007 Janice Harayda. All rights reserved.

www.janiceharayda.com

December 28, 2007

Take One Misdiagnosis and Call Me in the Morning – Jerome Groopman’s ‘How Doctors Think’

A Harvard Medical School professor says that physicians’ faulty logic can kill

How Doctors Think. By Jerome Groopman, M.D. Houghton Mifflin, 291 pp., $26.

By Janice Harayda

It’s flu season, and that’s bad news for you if you have an obscure disease with flu-like symptoms. Your doctors’ diagnoses might reflect a confirmation bias (a tendency to find what they expect to find), an availability error (a decision based on how easily examples come to mind) or other cognitive flaws that Jerome Groopman describes in this engaging bestseller.

Groopman’s thesis is that a doctor’s state of mind strongly affects clinical decision-making. And many of his examples are eye-opening if paradoxically commonsensical. Do doctors’ friends get better care? Not necessarily, Groopman says. A doctor might hesitate to prescribe a necessary but painful test for a friend. Do doctors favor the sickest patients, who may need their care the most? Actually, they prefer healthy ones. One social psychologist found that “the sickest patients are the least liked by doctors, and that very sick people sense this disaffection,” Groopman writes. Apparently many doctors feel they have worked in vain when a disease resists treatment and stop trying to help. How Doctors Think

Much of this is so interesting that you wish this book didn’t reflect biases of its own. One is that it slights mistakes that result from factors other than cognitive flaws, such as fatigue, poor training and inadequate supervision.  “Experts studying misguided care have recently concluded that the majority of errors are due to flaws in physician thinking, not technical mistakes,” writes Groopman, a professor at Harvard Medical School and staff writer for The New Yorker.

But when you go to the end notes of his book to look for the source of that hard-to-believe “majority,” you read: “Although the frequency of misdiagnosis has been studied, few researchers have focused on its relationship to physician cognition.” So who are those “experts” who found that most errors result from doctors’ thinking?  The notes name only one expert who found such a “majority,” a researcher who had studied “serious errors that led to malpractice claims.” But Groopman says that the majority of all errors result from physicians’ thinking, not the majority of errors that lead to malpractice suits. Either his end notes are incomplete or he misrepresents in the book some of the material he cites in the notes.

At the very least How Doctors Think leaves a different impression of the causes of mistakes than the chapters on medical errors and problem doctors in Atul Gawande’s Complications, a more cogently argued book by another physician who writes for The New Yorker.  Gawande quotes from a landmark series of papers in the New England Journal of Medicine that reported that one percent of all hospital admissions involved negligence that prolonged the stay or led to death or disability of the patient. A smaller study of the treatment of cardiac arrests found that “27 of 30 clinicians made an error in using the defibrillator – charging it incorrectly or losing too much time figuring out how to work a particular model.”

Groopman is a bit like a coach who blames the problems in baseball on the character flaws of individual players instead of the culture that produced them. He says that doctors “desperately” need patients to “help them think.” If that’s true, it reflects badly on the entire American system of medical education, training and certification, not just on individual physicians. Clearly many doctors need more than “help” thinking logically – they need to learn how to work the defibrillator.

Best line: “When a patient tells me, ‘I still don’t feel good. I’m still having symptoms,’ I have learned to refrain from replying, ‘Nothing is wrong with you.’ The statement ‘Nothing is wrong with you’ is dangerous on two accounts. First, it denies the fallibility of all physicians. Second, it splits the mind from the body. Because sometimes what is wrong is psychological, not physical. This conclusion, of course, should be reached only after a serious and prolonged search for a physical cause of the patient’s complaint.”

Worst line: Groopman says his book is for people who aren’t physicians “because doctors desperately need patients and their families and friends to help them think.”  Isn’t it bad enough that we have all those TV commercials telling us to ask our doctors if we need a certain drug because, basically, they’re too dumb to figure it out on their own? Do we need this kind of smarm from doctors, too? Groopman doesn’t mention that there are 285 doctors for every 100,000 people in the U.S. and, if he’d written his book for doctors, he might make a lot less money.

 

Recommendatiom? A good but one-sided book. If you’re interested in medical errors, consider reading the chapters called “When Doctors Make Mistakes” and “When Good Doctors Go Bad” in Atul Gawande’s Complications: A Surgeon’s Notes on an Imperfect Science (Holt/Metropolitan, 2002) www.gawande.com instead of or in addition to How Doctors Think

Editor: Eamon Dolan

Published: March 2007  www.jeromegroopman.com  and www.houghtonmifflinbooks.com

One-Minute Book Reviews is for people who like to read but dislike hype and review inflation. It is also for people who dislike long-winded weasel reviews that are full of facts and plot summaries but don’t tell you what the critic thought of the book.

© 2007 Janice Harayda. All rights reserved.

www.janiceharayda.com

November 13, 2007

The ‘Tyranny of Positive Thinking’ and Cancer Patients — A Physician-Author Says That It’s Not Always Best to Tell People to ‘Be Optimistic’

Can you give too much encouragement to people who are ill?

By Janice Harayda

Not long ago, I reviewed Betty Rollin’s Here’s the Bright Side and objected to its theme that all human suffering holds “a hidden prize waiting to be found.” I argued that some losses are so sad — the death of a child, say — that urging people to find their “bright side” is cruel.

Later I read some interesting, related comments by Jimmie Holland, chair of Department of Psychiatry and Behavioral Sciences at the Memorial Sloan-Kettering Cancer Center. They appeared in an article Leslie Brody wrote about caring for her husband, who has pancreatic cancer, for the New Jersey daily, The Record, on May 20, 2007.

“Think twice before telling the patient to ‘be positive,’” Brody wrote. She added:

“Dr. Jimmie C. Holland, author of The Human Side of Cancer and a pioneer in the psychological aspects of the illness, has written about the ‘tyranny of positive thinking.’ When people insist patients should ‘be optimistic,’ they imply that those who get sicker may be to blame for not trying hard enough to stay upbeat and conquer the disease.

“Holland says a patient’s mind-set might help him stick to a grueling chemo regimen, but it’s less clear whether attitudes and emotions in themselves can affect tumor growth or the body’s response. Patients — and their families — should feel free to vent depressing and anxious thoughts without being judged.

“Instead of saying ‘Chin up,’ or, ‘You’ll be fine,’ it’s better to say, ‘Hang in there,’ or ‘We’re thinking of you,’ or ‘We’re hoping for the best.’”

Links: To read the original review of Here’s the Bright Side, click here www.oneminutebookreviews.wordpress.com/2007/08/21/. To read about The Human Side of Cancer, click here www.humansideofcancer.com.

© 2007 Janice Harayda. All rights reserved.

www.janiceharayda.com

August 6, 2007

Emily Rapp Writes in ‘Poster Child’ About Life After Her Foot Was Amputated

A former poster child for a March of Dimes chapter in Wyoming had a meltdown after years of trying to persuade herself that her disability made her no different from others

Poster Child: The Story of a Broken Girlhood. By Emily Rapp. Bloomsbury, 240 pp., $23.95.

By Janice Harayda

Emily Rapp was born with a birth defect that required the amputation of her left foot just before her fourth birthday. She adapted so well – in her own eyes and others’ – that at the age of six she was a poster child for her March of Dimes chapter in Wyoming.

But her view of her condition began to change in college, where she read a book of essays by women with disabilities. One contributor wrote that others tended to view people with disabilities “either as helpless things to be pitied or as Super Crips, gallantly fighting to overcome insurmountable odds.”

A great virtue of Poster Child is that it avoids those extremes. In this lucid memoir, Rapp gives a much more complex view of what it meant to walk first with braces, then with a wooden leg and finally with a Flex-Foot, “a prosthetic limb that featured a suction socket and a hydraulic knee unit.”

Poster Child is not a perfect book, partly because Rapp’s effort to understand her disability seems to be a work-in-progress. After years of pretending to be just like anybody else, Rapp developed undiagnosed anorexia in high school. But she did not seek counseling until she had a meltdown, including severe panic attacks, as a Fulbright Scholar in Korea. And in her final pages she at times sounds as though she has traded her earlier beliefs for the new jargon she absorbed in therapy. In the next-to-last chapter, she writes:

“I realized that if I did not break free of my faulty logic, I might spin forever in a destructive trap of my own making, and then I would never be whole.”

That is pretty much the party line for cognitive behavioral therapy, the standard treatment for panic attacks: If you’re having attacks, it’s because you need to fix your “incorrect” thinking. But much of the evidence in this book suggests that Rapp’s problems were caused not by her “faulty logic” but by others’ cruelty and insensitivity. Rapp also doesn’t make clear whether she overcame her anorexia, which once caused her to stop menstruating and carry only 98 pounds on her 5’6″ frame. This is the equivalent of an unresolved subplot in a novel, and the lapse isn’t irrelevant to the story. Anorexia is generally regarded as a condition that involves a desire for control, and some research suggests that it commonly reflects anger with the opposite-sex parent. Rapp says little enough about her father, a Lutheran minister, that you wonder if he had more to do with this story than she lets on.

Such inconsistencies in the last 50 or so pages rob Poster Child of the unity of such as memoirs as Autobiography of Face. But it is still a very good book, maybe the best we have about growing up as an amputee. It also has a powerful message for parents, teachers, health-care workers and others who repeatedly tell children with disabilities, as Rapp’s mother did, “You are just like everybody else.” The question that lingers is: If you tell children with disabilities that they’re exactly the same as others, what happens when they figure out that they’re not?

Best line: Born with one leg shorter than the other, Rapp attracted stares long before her amputation. She says the questions began soon after she took her first steps: “Whenever she was asked, ‘What happened to your baby?’ Mom replied, ‘Oh, she is okay. She just has one leg shorter than the other, and the brace helps her walk.’ She became comfortable with this standard response. It didn’t bother her when children asked her what was wrong with me; she felt that their curiosity was innocent and natural. She got annoyed only when adults asked or, worse, expressed condolences (‘I’m so sorry; it must be so hard’) or dispensed useless medical advice like ‘There are medical advances every single day’ or ‘God works in mysterious ways; at least she looks happy.’ And according to my mother, I was.”

Worst line: Rapp writes that on “a pleasant summer afternoon” in Colorado, “The smell of dry sagebrush and lilacs hung in the air.” A post by the Colorado State University Extension Service says that in Colorado lilacs bloom, as elsewhere in the U.S., in the spring – specifically, in May.

Editor: Annik La Farge

Published: January 2007

Recommendation? An excellent book for reading groups, not just because it’s so well-written but because it has implications for how Americans respond to many kinds disabilities, not just to amputees. Poster Child may especially interest reading groups at houses of worship that have ministries to or programs for people with disabilities.

Caveat lector: This review was based on an advance reading copy. Some material in the finished book may differ.

Links: www.emilyrapp.com and www.bloomsburyusa.com

(c) 2007 Janice Harayda. All rights reserved.

www.janiceharayda.com

July 18, 2007

Atul Gawande Tells What You Can REALLY Expect When You’re Expecting

A surgeon looks at the pros and cons of forceps, Cesarean sections, epidural anesthesia, fetal heart monitors and other fixtures of modern delivery rooms

Better: A Surgeon’s Notes on Performance. By Atul Gawande. Holt/Metropolitan, 273 pp., $24.95.

By Janice Harayda

Last year the New York Times published an article on a remarkable medical study that found that – contrary to a near-universal belief – pushing during labor helps neither the mother nor the baby. The study also found that women who were told to push may have more urinary problems after the delivery. One of the doctors who did the survey, published in the American Journal of Obstetrics and Gynecology, said that the research did not mean that women should never push. Instead, he said, they should do “what feels natural to do – and for some women that would be no pushing.”

I had two reactions to this news. First, if I were pregnant, I would ask my obstetrician if he or she planned to tell me to push and, if so, why, given there seems to be no benefit to doing this during every birth. Second, why didn’t we know this news sooner? Why have doctors for so long inflicted the needless agony of pushing on women? I had no idea what the answer to the second question might be until I came across a striking fact in the chapter on childbirth in Atul Gawande’s Better: Most doctors pay lip service to the idea that nothing should be used in medicine unless it has been properly tested and shown to be effective by a respected research center, preferably through a double-blind, randomized trial.

“But in a 1978 ranking of medical specialties according to their use of hard evidence from clinical trials, obstetrics came in last,” Gawande writes. “Obstetricians did few randomized trials, and when they did they largely ignored the results.”

That observation helps to explain why Gawande, a surgeon and writer for The New Yorker, may be our most important medical writer. Unlike many others working in the field, he doesn’t write mainly about the latest developments in medicine. He digs deeper, looking for the “why” behind the “what,” while taking on extraordinarily complex topics. But his writing is rarely harder to understand than in his lines about the 1978 survey of medical specialties. He seems to make a grail not just of accuracy but of clarity.

The chapter on childbirth in Better shows his work at its finest. It deals largely with why so many women have Cesarean deliveries, which account for about 30 percent of American births. Many people explain the statistic by saying that Cesareans are more convenient and lucrative for doctors than vaginal births. Gawande argues persuasively that there is a larger reason for the pattern. And part of it has to do with the virtual disappearance of forceps from delivery rooms.

In the 1960s fewer than 5 percent of deliveries were Cesareans and more than 40 percent involved forceps. And those numbers are related. Gawande makes a strong case that in the hands of experts, forceps are safe (according to some research, safer for mothers than Cesareans). But forceps are hard to learn to use properly – a process that can take two years. And if forceps are used by inexpert doctors, the results can be disastrous. Cesareans are easier to master. And this has led hospitals to phase out forceps and, in many cases, do C-sections instead. To discourage the inexpert from using forceps, Gawande says, “obstetrics had to discourage everyone from using them.” This change has come at a cost. Gawande notes that, as straightforward as Cesarean deliveries can be, they can go wrong. The baby can be lacerated. If the head doesn’t come free quickly, the child can asphyxiate. The mother also faces risks:

“As a surgeon, I have been called in to help repair bowel that was torn and wounds that split open. Bleeding can be severe. Wound infections are common. There are increased risks of blood clots and pneumonia. Even without any complication, the recovery is weeks longer and more painful than with vaginal delivery.”

With all of this, Gawande isn’t trying to frighten women away from having Cesareans or bring forceps back to every community hospital. He is instead trying to show the trade-offs that medicine involves. And this is only a small part of what he says in his chapter on childbirth, “The Score,” which also covers such delivery-room fixtures as fetal heart monitors, epidural anesthesia and the labor-inducing drug Pitocin. It is an even smaller part of what he has to say in the 11 chapters of Better that deal with subjects other than childbirth, including advances in military medicine and the need for doctors to wash their hands more often.

Women who are pregnant may reach for books like What to Expect When You’re Expecting and The Girlfriends’ Guide to Pregnancy. And patients who are facing surgery may turn to guides to their illnesses. But both groups could benefit from also reading this fine collection of essays. For some of them, Better may just be better.

Best line: Gawande writes about the Apgar score, which rates a newborn’s health: “In a sense, there is a tyranny to the score. While we rate the newborn child’s health, the mother’s pain and blood loss and length of recovery seem to count for little. We have no score for how the mother does, beyond asking whether she lived or not – no measure to prod us to improve results for her, too. Yet this imbalance, at least, can surely be righted. If the child’s well-being can be measured, why not the mother’s, too?”

Worst line: None.

Editor: Sara Bershtel

Published: April 2007

Furthermore: The New York Times article on pushing during labor, “Rethinking the Big Push During Contractions, appeared on Jan. 3, 2006, page F8. I can’t link directly to it, but here’s a link to a similar reprint in its sister publication, The International Herald Tribune. When you click on the following link, you will reach a page that says “Multiple Choices” and see another link that looks just like it (below the phrase “Available Documents”). You have to click on that one, too, to read the story (which appears below an article on “lazy eye”): www.iht.com/articles/2006/01/04/healthscience/snvital/php/php.

Links: Gawande has posted many of his articles on medicine at www.gawande.com.

© 2007 Janice Harayda. All rights reserved.

www.janiceharayda.com

May 30, 2007

Atul Gawande Takes the Pulse of the Medical Profession

Filed under: Essays and Reviews,Nonfiction — 1minutebookreviewswordpresscom @ 1:18 pm
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True or false: More people go crazy when the moon is full.

If you said “true,” you probably haven’t read Atul Gawande’s Complications: A Surgeon’s Notes on an Imperfect Science (Picador, $14, paperback), a stylish collection of essays by a Boston surgeon and contributor to The New Yorker. Gawande reviewed more than a hundred studies of how lunar phases affect human behavior after his fellow doctors warned him to expect more hospital admissions when the moon was full. He found that researchers had pored over all kinds of evidence – police logs, homicide statistics, emergency room visits and consultations with psychiatrists. The result? There’s no relation at all between craziness and the full moon. Some studies have suggested the opposite – that full moon has a beneficial effect on human behavior.

This is the kind of fascinating material regularly dispensed by Gawande, who also wrote the new Better: A Surgeon’s Notes on Performance (Metropolitan, $24). The essays in Complications deal with subjects from doctors’ mistakes to patients with terrifying diseases like necrotizing fasciitis (known, somewhat misleadingly, “flesh-eating bacteria”). Gawande often takes controversial positions. He challenges the idea – cherished by many doctors – that surgeons need “good hands,” saying the continual practice of surgery matters more. (Doesn’t the quality of the practice matter? What about education? Can practice make you a great surgeon if you went to a medical school or work at a hospital that’s a step away from losing its accreditation?) But part of the appeal of Complications is that Gawande www.gawande.com has the courage to risk saying things other doctors won’t and the rhetorical skill to give his views force. He never hides behind a cardboard shield of medical omniscience. And he deals with a wider and more offbeat range of medical topics than physician-authors like Oliver Sacks and Sherwin Nuland. So you may enjoy Complications even if you couldn’t get through The Man Who Mistook His Wife for a Hat or How We Die.

© 2007 Janice Harayda. All rights reserved.

www.janiceharayda.com

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