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A Year-Long Night
A doctor recounts his year of medical internship and reveals the codes and rituals required for handling procedures and crises, and well as the devastating effects of encountering constant human suffering
Am I My Genes?
In the fifty years since DNA was discovered, we have seen extraordinary advances. For example, genetic testing has rapidly improved the diagnosis and treatment of diseases such as Huntington's, cystic fibrosis, breast cancer, and Alzheimer's. But with this new knowledge comes difficult decisions for countless people, who wrestle with fear about whether to get tested, and if so, what to do with the results. Am I My Genes? shows how real individuals have confronted these issues in their daily lives. Robert L. Klitzman interviewed 64 people who faced Huntington's Disease, breast and ovarian cancer, or Alpha-1 antitrypsin deficiency. The book describes--often in the person's own words--how each ...
When Doctors Become Patients
For many doctors, their role as powerful healer precludes thoughts of ever getting sick themselves. When they do, it initiates a profound shift of awareness-- not only in their sense of their selves, which is invariably bound up with the "invincible doctor" role, but in the way that they view their patients and the doctor-patient relationship. While some books have been written from first-person perspectives on doctors who get sick-- by Oliver Sacks among them-- and TV shows like "House" touch on the topic, never has there been a "systematic, integrated look" at what the experience is like for doctors who get sick, and what it can teach us about our current health care system and more broadl...
Mortal Secrets
In the era of the Internet and Oprah, in which formerly taboo information is readily available or freely confided, secrecy and privacy have in many ways given way to an onslaught of confession. Yet for those who are HIV positive, decisions about disclosure of their diagnosis force them to confront intimate, fundamental, and rarely discussed questions about truth, lies, sex, and trust. Drawing from interviews with over seventy gay men and women, intravenous drug users, sex workers, bisexual men, and heterosexual men and women, the authors provide a detailed portrait of moral, social, and psychological decision making. The interviews convey the complex emotions of love, lust, longing, hope, de...
The Ethics Police?
All studies on people involving diseases, from cancer to autism, and behavior. Yet ethical violations persist. At the same time, critics have increasingly attacked these committees for delaying or blocking important studies. Partly, science is changing, and the current system has not kept up. Since the regulations were first conceived 40 years ago, research has burgeoned 30-fold. Studies often now include not a single university, but multiple institutions, and 40 separate IRBs thus need to approve a single project. One committee might approve a study quickly, while others require major changes, altering the scientific design, and making the comparison of data between sites difficult. Crucial dilemmas thus emerge of whether the current system should be changed, and if so, how. Yet we must first understand the status quo to know how to improve it. Unfortunately, these committees operate behind closed doors, and have received relatively little in-depth investigation.
Designing Babies
Since the first "test tube baby" was born over 40 years ago, In Vitro Fertilization and other Assisted Reproductive Technologies (ARTs) have advanced in extraordinary ways, producing millions of babies. An estimated 20% of American couples use infertility services to help them conceive, and that number is growing. Such technologies permit thousands of people, including gay and lesbian couples and single parents, to have offspring. Couples can now transmit or avoid passing on certain genes to their children, including those for chronic disease and, probably sometime soon, height and eye color as well. Prospective parents routinely choose even the sex of their future child and whether or not t...
In a House of Dreams and Glass
A psychiatric resident's firsthand account reveals his struggles with the homeless, suicidal, and paranoid, and his frustrations with hospital politics and the limitations of an inexact science. Fresh from medical school, Robert Klitzman began his residency in psychiatry with excitement and a sense of mission. But he was not prepared for what he found inside the city psychiatric center where he was to spend three grueling years. In truth, as Dr. Klitzman's absorbing account of his apprenticeship reveals, he never ceased to be surprised—by his patients, by the senior psychiatrists' conflicting advice on how to help them, and by the unpredictable results of the therapies, both psychoanalytic and biologic, that he and his fellow residents practiced. Nights in the emergency room, professional controversy, the minefield of hospital politics, the stress of his own therapy--everything is here, in a passionate and illuminating analysis of a doctor's struggle against tremendous odds to banish his patients' demons.
The Trembling Mountain
Kuru, like Mad Cow disease, is caused by a rare, infectious crystal protein that invades and colonizes human cells, destroying the nervous system of its victims. There is no known cure. It flourished in one of the remotest places on earth, Papua New Guinea, among the Fore, a people living in the Stone Age, who until recently practiced ritual cannibalism, consuming the brains of their forebears during funerary feasts. Robert Klitzman helped establish the links between these rituals and kuru. What he discovered has provided keys to understanding the mysterious Mad Cow Disease, which may become the world's next major epidemic. Robert Klitzman was 21 years old when he was invited by the Nobel prize-winning scientist Dr. Carleton Gajdusek, then at the National Institutes of Health, to conduct original research on kuru. Seizing the chance to travel to the other end of the world, Klitzman embarked on an adventure that would change his life.
Designing Babies
Since the first "test tube baby" was born over 40 years ago, In Vitro Fertilization and other Assisted Reproductive Technologies (ARTs) have advanced in extraordinary ways, producing millions of babies. An estimated 20% of American couples use infertility services to help them conceive, and that number is growing. Such technologies permit thousands of people, including gay and lesbian couples and single parents, to have offspring. Couples can now transmit or avoid passing on certain genes to their children, including those for chronic disease and, probably sometime soon, height and eye color as well. Prospective parents routinely choose even the sex of their future child and whether or not t...
Between Doctors and Patients
Although there are many books on the mechanics of doctor-patient interaction, none has previously confronted the philosophical and psychological issues of power and trust that bind these figures. One consequence of their changed relationship, Furst asserts, has been the decrease of interest in patients as individuals. In this time of impersonal HMOs and spiraling health-care costs, she hopes that doctors and patients can learn from the past and eventually find a mutually beneficial balance of power that will see medicine as both a science and an art and will recognize human understanding as an integral element of healing.
