This is a hard review: I'm goodreads friends with the author, so I'm hesitant about what I say here. But this book was...not good.
Let's start with thThis is a hard review: I'm goodreads friends with the author, so I'm hesitant about what I say here. But this book was...not good.
Let's start with the positive: this is a quick read. There are multiple narrators telling intertwining stories about the same period of time from their perspective, which is an interesting narrative device, filling in what seems like a subplot in the first narration. Each of the characters has different flaws, coloring their narrative slightly (although each seems to be a reliable narrator. I think unreliable narration would have added a lot here.)
And the negative: For me, the most difficult was how flimsy the characters were. Each was a very classic stereotype, most to the extent that I have never seen in relief, despite having gone to medical school, residency and fellowship myself and having a facebook feed that is literally full of doctors: one character is girly, obsessed with her long distance boyfriend and not very smart; another is ultra-feminist, but just needs to be laid by a good guy; another is an ultra-gunner who will go out of their way to set back others in the class, even going so far as to (view spoiler)[poison her boyfriend (hide spoiler)]. Another is an insanely rich child of doctors, looking to be a plastic surgeon. Another is A Nice Guy. I just...these aren't characters, they're archetypes. And the one we're supposed to feel the most sympathetic for is the ditzy dumb one, which didn't work out in my life.
The details are also lacking: The rich one? Has a doctor dad and a stay at home mom; the idea that someone could be so filthy rich from having one working parent who was a doctor is kind of hilarious.) The gunner? Wants to go into emergency medicine...at Yale...because (view spoiler)[her father's Parkinson's disease was late to diagnosis (hide spoiler)] you know, that ultra-competitive specialty where you get to focus on making hard diagnoses?
The next biggest problem is the pacing: just as I felt I was getting into each character's story, the narration would switch. And not in a way that built tension and was rising action, just in a way that was disruptive. Ultimately, the book led up to this huge climax, and then we had to hear about the climax from several characters points of view (although to be fair, some of them really helped flesh that part out) and a totally unnecessary epilogue
The pacing was a big deal from the mystery standpoint, too. (view spoiler)[The central mystery? That there was a suicide every year and that's why it was called suicide med and how was this happening? Med students get depressed. The end. Another one of the side mysteries: that bodies got turned upside down and no one knew why? The anatomy professor was running a public tutoring session during which they reviewed the back muscles. Mysterious.... (hide spoiler)]
Finally, a big grief that I have with the book is the sci-fi plotline. It's kind of out of place in what's supposed to be a realistic thriller. It doesn't really relate to anything else going on, and it makes every narrative event including that character seem jarringly out of place and unrelated to the central narration. (view spoiler)[and while a form fruste of conjoined twin manifesting as only a single eye with some attached brain matter seems plausible, the idea that the host twin would lose significant executive control when the conjoined twin was removed does not...the host twin had no apparent conjoining of his brain matter and his brain matter was unaltered. (hide spoiler)]
So overall, a fast light read, without much there there.["br"]>["br"]>["br"]>["br"]>["br"]>["br"]>["br"]>["br"]>["br"]>["br"]>["br"]>["br"]>["br"]>["br"]>["br"]>...more
It goes without saying that "popular statistics" book is mostly an oxymoron. On the one hand, statistics is largely a very dry field. On the other hanIt goes without saying that "popular statistics" book is mostly an oxymoron. On the one hand, statistics is largely a very dry field. On the other hand, those of us who do understand statistics (and even freaks, like my husband, who enjoy statistics), find any attempt at popular statistics largely too elementary to be interesting. Nate Silver doesn't just walk the fine line in the middle, he eliminates it and writes a completely novel statistic book that is appealing to both the mathematician and the math hater: this book fascinates.
Nate Silver focuses on the forecasting in areas that are difficult to predict: weather, climate, earthquakes, poker, politics, chess and sports. Each of these areas is individually interesting -- I had never spent much time considering online poker, for instance, and the chapter focusing on poker is not just mathematically-focused, but also an expose on the world of online poker and the life and times (or at least the two year subset thereof) of Silver's 6-figure gambling career. In addition, his overall thesis, which seems to be that we should use Bayesian analysis to think probabilistically about the world and continually evaluate our probabilities both builds naturally and has far-reaching applications.
I feel like I have spent years of my life trying to explain to medical students (and more advanced physicians who should really know better) why every time a paper is published with a p<0.05 we can't totally disregard all prior medical knowledge and dive after the new information. Silver's easy explanation of Bayes' theorem nicely summarizes why this is true - that alone should make this a must-read for anyone in an academic field....more
This is intended to be a complete overview of medical genetics and the current dilemmas at the forefront of the field. And, to be honest, as a medicalThis is intended to be a complete overview of medical genetics and the current dilemmas at the forefront of the field. And, to be honest, as a medical geneticist (trainee) myself, I felt a little bored at times. It hits all of the cliche notes: Dor Yeshorim, Jesse Gelsinger, Dolly the Sheep, Rosalind Franklin, the Ashkenazi Y chromosome, HeLa cells, Myriad's BRCA patents and sickle cell screening; basically, if you've read anything about genetics in the news in the last ten plus years, it's in this book.
The organization is also sloppy - chapters tend to be made up of semi-related topics trying desperately to coalesce into a theme. There's no segue or connection between chapters, to the point where if a concept explained in one chapter comes up in another, it is explained again (sometimes verbatim from the prior chapter.) I'm also not sure that there is consistency in the explanations of topics for a lay audience. Sometimes there would be an extensive explanation of a topic that seemed pretty self-explanatory and other times, I was left wondering if the average reader would come away with any understanding of what mass-spectroscopy is and why it's different than a Guthrie test. Each chapter ends anti-climatically with a sentence such as "we hope we have convinced you that [this chapter's issue] is worth thinking about"
That being said, it really is a thorough coverage of almost all recent issues in medical genetics and highlights of where the field is going, as seen by two big names in the field. And despite my high level of knowledge going into the book, I found a sizable handful of anecdotes that I had not previously known.
I will try to find the words to fully capture the love that I have for "Cutting for Stone." I have kept Verghese on my list of clinical superheroes evI will try to find the words to fully capture the love that I have for "Cutting for Stone." I have kept Verghese on my list of clinical superheroes ever since I read his memoir, "In My Own Country;" however, I had been hesitant to read "Cutting for Stone" because, in my experience, physician penned memoirs lead only to disappointment. Verghese; however, is as much a master writer as he is a master clinician. Although "Cutting for Stone" is a medical story (highlights include attribution to his characters the first living donor liver transplant, the discovery of caffeine for apnea of prematurity and others), it is not foremost a story about medicine. Instead it is an semi-coming of age epic about how people form connections to each other, push others away in the pursuit of perfection and ultimately about self-actualization through realization of human bond.
Despite such lofty ambitions, Verghese never lets idealism or heavy-handedness overpower the fact that "Cutting for Stone" is indeed a novel. His characters shine - each individuals, each with amazing strengths - the cunning Ghosh, the brilliant, fierce Hema, the sharp, quick-witted Genet and the genius but alien Shiva and the loyal, logical Marion - his language is evocative and beautiful and his settings are picture-perfectly described.
A review of "Cutting for Stone" would be incomplete without at least a glancing mention of it's treatment of medical education. What struck me the most was Verghese's characterization of the martyrdom that residency entails as being a defense mechanism. His depiction of the selflessness with which residents treat patients as being a form of indulgence was a little uncomfortably honest. That being said, what "Cutting for Stone" will be exalted for in years to come is the decency with which it treats international medicine graduates. The treatment of such graduates by American medical students is borderline racist, with training programs being judged harshly on the number of such trainees enrolled. It is common for IMGs to be treated with disdain, and Verghese's candor in describing the differences that they experience when they train compared to the training environment faced by American graduates will not soon be forgotten....more
Medical memoirs are my version of brain candy and being weeks away from earning my own M.D. from Dr. Firlik's alma mater, I thought this would be an aMedical memoirs are my version of brain candy and being weeks away from earning my own M.D. from Dr. Firlik's alma mater, I thought this would be an apropos read. Unfortunately, I don't think I'm part of Dr. Firlik's intended audience. Granted most medical memoirs are written for the layperson, but being some what of a connoisseur of the genre, I can tell you that some are more interesting to those of us who have done are own time in the neurosurgical OR and some of them are less so.
All of this is not to say that I didn't find Dr. Firlik's book entertaining. It certainly was, and in particular Dr. Firlik has inherited a gift of storytelling -- her patient encounters are touching, detailed and never judgmental. This is clearly the strong point of the book.
The weaker parts of the book are that, while she is clearly trying to be, Dr. Firlik herself admits that she is no Dr. Sacks. She alludes to him frequently, but just as frequently apologizes for the lack of deep thought on the brain/mind dichotomy that she is interested in, explaining that as a neurosurgeon, her first commitment is to the operating room. Her honesty is appreciated, and at points it seems that she is doing herself a disservice, for she is a very introspective person. But at the end of the day, she's correct -- she sees interesting questions that arise from her profession, but has not explored them in depth. At no point is this more clear than the very weak closing two chapters, particularly the last chapter regarding the future of neurosurgery.
This chapter is rushed and wandering. It contains too many ideas for one chapter, ranging from neuro-enhancements to minimally invasive surgeries to a discussion of turf-wars that may, in fact, be too entrenched in medical politics to be comprehensible to the lay audience. Dr. Firlik should play to her strengths -- the ability to recount the daily life of a neurosurgeon and leave further exploration of the questions she raises on consciousness, the mind and neurological enhancements to the reader....more
This memoir of one of the most famous medical examiners is a decent showing. It is immediately clear that Dr. Baden's strength is science, rather thanThis memoir of one of the most famous medical examiners is a decent showing. It is immediately clear that Dr. Baden's strength is science, rather than writing -- many of his cases lack a proper setup, climax and/or conclusion and he could stand to add some excitement to his descriptions of his findings.
The two major flaws of this book are length and audience. At approximately 250 pages for a narrative that covers Kennedy, Belushi, Marilyn Monroe, three serial killers, a prison riot, Baden's sundry employment history and several other chapters, each section can only be granted 2-3 pages, which really undermines the richness of the narrative. In terms of Dr. Baden's intended audience, it is simply unclear. He states in his conclusions that one of his intentions is to encourage more medical students to enter the field; however, as a senior medical student, I was untouched by his accounts. The clinical discussion did not occur at a high enough scientific level to intrigue me. At the other extreme, I am doubtful of how interesting this book would be to a purely lay audience -- there are several pages dedicated to the politics of the office of medical examiner, untold descriptions of hyoid bone fractures and petechiae and vitreous fluid, much of which with little explanation. A third drawback is that Unnatural Death is beginning to show its age -- Baden's discussion of the pathophysiology of cirrhosis is outdated and his account of how to prevent SIDS makes no mention of sleeping position, which is now the standard of care.
Nevertheless, Unnatural Death is a quick read and a rare first hand account of the myriad of roles taken on by a medical examiner, from autopsy to crime scene investigation to courtroom. If you can overcome the awkward pacing and uncanny valley between medical text and popular science book, it is certainly worth a read....more
A fascinating historical and medical perspective on fatal familial insomnia and prion disorders in general, highlighting historical and modern controvA fascinating historical and medical perspective on fatal familial insomnia and prion disorders in general, highlighting historical and modern controversies on these fascinating diseases. Max's strength lies in characterization and the placement of the events occurring in one family with FFI within a historical context. His prose is rich and readable. The subject matter is unspeakably sad, but Max handles a book about rapid neurodegeneration with ease, focusing on the excitement of discovery, the hopes of family and the scientific and medical curiosity evoked by the strange mysteries of prion disorders.
The major flaw is that by attempting to focus on prion disorders in general, what Max covers in breadth often lacks in depth. The discussion of kuru seems to focus on one of the main researcher's pedophilia to a large extent, which seems to occur in place of a real examination of the husband and wife team that did the anthropological work to discover the true origins of the disease. It would be both more salient and more interesting to focus instead on the controversies of cannibalism and how that discovery was made. In addition, Max remarks several times on the similarity between scrapie and FFI to the already discovered hereditary prion disorders CJD and GSS, without ever really discussing the discovery of those conditions. Since one of the stated goals of the book is to bring about public awareness and support for research to inherited prion disorders, more exploration of these two diseases would have added a lot, in addition to enriching the history of the field. ...more
Dr. Zuk is first and foremost a terrific parasitologist. The portions of the book that Zuk spends discussing her own Ph.D. thesis and her own researchDr. Zuk is first and foremost a terrific parasitologist. The portions of the book that Zuk spends discussing her own Ph.D. thesis and her own research, especially regarding sexual selection. The central portion of the book from about page 80 to page 180 is fascinating & probably should have been released as a stand-alone book -- it is focused, it flows and the topic is fascinating (these are the chapters on sexual selection, infection differences between the sexes and sexually transmitted diseases.)
The first 80 pages drag, and are covered both more interestingly and in more detail in hundreds of other popular science books. Also, the topics in these chapters (heterozygote advantage, hygeine hypothesis) have little to do with Zuk's central themes. Theis portion of the book also is infested with what Zuk seems to think are wry little asides, which grate terribly. The concluding paragraphs are interesting, but lack the compulsive readable of the earlier chapters....more
Shilts' contemporary account of the advent of what is now HIV/AIDS is truly a classic. Shilts takes an unbiased, journalistic approach to the scienceShilts' contemporary account of the advent of what is now HIV/AIDS is truly a classic. Shilts takes an unbiased, journalistic approach to the science surrounding the discovery of the "GRID" complex, the underlying virus, the epidemiology required to figure out how the disease was spread as well as the international politics limiting the closing of the bathhouses, treatment, testing of the blood supply and delaying the correct taxonomy of HIV.
Interspersed with this, Shilts shows the ready a very personal view of the stories of individuals affected by HIV/AIDS and their personal struggles both as patients and as advocates. These interspersed narratives are touching and strong, and completely unfictionalized.
Although it would be easy for these one of the many different components of the narrative to become overwhelmed by the vastness and intricacy of the story that Shilts is telling, he handles each of these components deftly, making the 600 page book a manageable and entertaining read.
Although And the Band Played On is now over 20 years old, it was the first comprehensive account of the advent of HIV/AIDS, it was an instant classic in its time and its contemporary nature lends an honesty to the homophobia, politicking and counter-productive maneuvering on all sides that would likely be glossed over in a modern telling....more
Half how-to, half actual textbook, this is an easy to use and fairly thorough overview of computational techniques for answering bioinformatic questioHalf how-to, half actual textbook, this is an easy to use and fairly thorough overview of computational techniques for answering bioinformatic questions. The writing is very approachable, the text light and compact -- overall a good first source....more
The closest thing that clinical genetics has to a pocket reference -- this text is invaluable for the general pediatrician, pediatric neurologist or mThe closest thing that clinical genetics has to a pocket reference -- this text is invaluable for the general pediatrician, pediatric neurologist or medical geneticist in training. Unlike many other dysmorphology texts, The Bedside Dysmorphologist categorizes traits by body part, helping to shape the approach to diagnosis....more
While widely considered the ur-textbook for genetic syndromes presenting with dysmorphology, Smith is invaluable as a reference, but limited as a textWhile widely considered the ur-textbook for genetic syndromes presenting with dysmorphology, Smith is invaluable as a reference, but limited as a textbook....more