Description : In Being Mortal, bestselling author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its ending Medicine has triumphed in modern times, transforming birth, injury, and infectious disease from harrowing to manageable. But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering. Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified. Full of eye-opening research and riveting storytelling, Being Mortal asserts that medicine can comfort and enhance our experience even to the end, providing not only a good life but also a good end.
Description : The New York Times bestselling author of Complications examines, in riveting accounts of medical failure and triumph, how success is achieved in a complex and risk-filled profession The struggle to perform well is universal: each one of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable. Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors' participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable. At once unflinching and compassionate, Better is an exhilarating journey narrated by "arguably the best nonfiction doctor-writer around" (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.
Description : The international bestseller from the author of Being Mortal In these gripping accounts of true cases, bestselling author Atul Gawande performs exploratory surgery on medicine itself, laying bare a science not in its idealised form, but as it actually is - complicated, perplexing and profoundly human. This is a stunningly well-written account of the life of a surgeon: what it is like to cut into people's bodies and the terrifying - literally life and death - decisions that have to be made: operations that go wrong; of doctors who go to the bad; why autopsies are necessary; what it feels like to insert your knife into someone. 'Written as tautly as a thriller' Observer
Description : Today we find ourselves in possession of stupendous know-how, which we willingly place in the hands of the most highly skilled people. But avoidable failures are common, and the reason is simple: the volume and complexity of our knowledge has exceeded our ability to consistently deliver it - correctly, safely or efficiently. In this groundbreaking book, Atul Gawande makes a compelling argument for the checklist, which he believes to be the most promising method available in surmounting failure. Whether you're following a recipe, investing millions of dollars in a company or building a skyscraper, the checklist is an essential tool in virtually every area of our lives, and Gawande explains how breaking down complex, high pressure tasks into small steps can radically improve everything from airline safety to heart surgery survival rates. Fascinating and enlightening, The Checklist Manifesto shows how the simplest of ideas could transform how we operate in almost any field.
Description : A transitional book in the development of Royce's thought, originally published in 1908, The Philosophy of Loyalty is a key to understanding his influence on the development of pragmatism. Royce's basic argument is clear. Individual wills are a given, and social training is a natural aspect of community.
Description : How work gets done in complex health care systems is ethically important. When health care professionals and other staff are pressured to improvise, fix structural problems, or comply with competing policies, the uncertainty and distress they experience have potential consequences for patients, families, colleagues, and the system itself. This book presents a new theory of health care ethics that is grounded in the nature of health care work and how it is shaped by the ever-changing conditions of complex systems, in particular, problems of safety and harm. By exploring workarounds and other improvised practices in complex health care systems that are difficult for professionals to talk about openly, yet have unclear effects, including their value or risk to patients, this book offers a realistic look at our changing health care system and how we can improve the way we manage moral problems arising in the care of the sick. Berlinger argues that health care ethics in complex and changing health care systems should reflect the moral complexity of health care work, analyze common ethical challenges with reference to behaviors and pressures driven by the system itself, and support opportunities for health care professionals and staff at all levels to reflect on the problems they face and to take part in social change. The book's chapters include frameworks for looking at ethical challenges in health care as problems of safety and harm with consequences for patients. Are Workarounds Ethical? is designed to support clinician education in medicine, nursing, and interdisciplinary contexts and recommend methods for integrating ethics, safety, and justice in practice.
Description : A new edition of this practical guide for clinicians who are developing tools to measure subjective states, attitudes, or non-tangible outcomes in their patients, suitable for those who have no knowledge of statistics. - ;Clinicians and those in health sciences are frequently called upon to measure subjective states such as attitudes, feelings, quality of life, educational achievement and aptitude, and learning style in their patients. This fourth edition of Health Measurement Scales enables these groups, who often have limited knowledge of statistics, to both develop scales to measure non-tangible health outcomes, and better evaluate and differentiate between existing tools. It covers how the individual items are developed; various biases that can affect responses (eg social desirability, yea-saying, framing); various response options; how to select the best items in the set; how to combine them into a scale; and then how to determine the reliability and validity of the scale. It concludes with a discussion of ethical issues that may be encountered, and guidelines for reporting the results of the scale development process. Appendices include a comprehensive guide to finding existing scales, and a brief introduction to exploratory and confirmatory factor analysis. It synthesizes the theory of scale construction with practical advice, making it the ultimate guide to how to develop and validate measurement scales that are to be used in the health sciences. -
Description : Today’s economic growth challenges will become greater in the future because of the world’s aging population, fertility trends and current levels, and current entitlement policies. Those challenges could be overcome, however, with thoughtful public policies and a culture that fosters responsibility and appreciation. This book reconsiders what makes us “healthy, wealthy, and wise.” It focuses on how we might reimagine health care, retirement, and education policies to usher in a new ERA (from Entitlement to Responsibility with Appreciation) of sustainable long-term economic growth.
Description : Drawing upon the extraordinary skills of eight-times World Memory Champion Dominic O'Brien, Learn to Remember provides a unique illustrated repertoire of proven and effective ways to enhance your memory. In this book you learn how to extend your memory power, as well as to use a wealth of shortcuts and techniques applicable to a wide range of tasks, from memorizing a speech, a shopping list or a set of city street directions to remembering names and faces. Learn to recall details at work and never miss that anniversary. When Dominic first trained himself to remember longer and longer sequences of random units, he found himself recalling forgotten experiences from childhood as his brain's powers became strengthened and refined. We all have the potential to sharpen and extend our memories to a degree that might seem incredible to anyone who was never tried it. Improving our memory is the key to a more fulfilled life. If we can master the arts of storage, retention and recall, our knowledge of the world improves, we can derive more from our reading, we learn to be more effective at work, and even our relationships become richer and more harmonious. With a master memorizer as your guide, you can open up rewarding inner realms of possibility you never even knew existed. Join Dominic O'Brien on what may turn out to be the most memorable journey of your life.
Description : Black Skin, White Coats is a history of psychiatry in Nigeria from the 1950s to the 1980s. Working in the contexts of decolonization and anticolonial nationalism, Nigerian psychiatrists sought to replace racist colonial psychiatric theories about the psychological inferiority of Africans with a universal and egalitarian model focusing on broad psychological similarities across cultural and racial boundaries. Particular emphasis is placed on Dr. T. Adeoye Lambo, the first indigenous Nigerian to earn a specialty degree in psychiatry in the United Kingdom in 1954. Lambo returned to Nigeria to become the medical superintendent of the newly founded Aro Mental Hospital in Abeokuta, Nigeria’s first “modern” mental hospital. At Aro, Lambo began to revolutionize psychiatric research and clinical practice in Nigeria, working to integrate “modern” western medical theory and technologies with “traditional” cultural understandings of mental illness. Lambo’s research focused on deracializing psychiatric thinking and redefining mental illness in terms of a model of universal human similarities that crossed racial and cultural divides. Black Skin, White Coats is the first work to focus primarily on black Africans as producers of psychiatric knowledge and as definers of mental illness in their own right. By examining the ways that Nigerian psychiatrists worked to integrate their psychiatric training with their indigenous backgrounds and cultural and civic nationalisms, Black Skin, White Coats provides a foil to Frantz Fanon’s widely publicized reactionary articulations of the relationship between colonialism and psychiatry. Black Skin, White Coats is also on the cutting edge of histories of psychiatry that are increasingly drawing connections between local and national developments in late-colonial and postcolonial settings and international scientific networks. Heaton argues that Nigerian psychiatrists were intimately aware of the need to engage in international discourses as part and parcel of the transformation of psychiatry at home.
Description : THE NEW YORK TIMES NUMBER ONE BESTSELLER THE SUNDAY TIMES NUMBER ONE BESTSELLER 'Finishing this book and then forgetting about it is simply not an option...Unmissable' New York Times At the age of thirty-six, on the verge of completing a decade’s training as a neurosurgeon, Paul Kalanithi was diagnosed with inoperable lung cancer. One day he was a doctor treating the dying, the next he was a patient struggling to live. When Breath Becomes Air chronicles Kalanithi’s transformation from a medical student asking what makes a virtuous and meaningful life into a neurosurgeon working in the core of human identity – the brain – and finally into a patient and a new father. What makes life worth living in the face of death? What do you do when when life is catastrophically interrupted? What does it mean to have a child as your own life fades away? Paul Kalanithi died while working on this profoundly moving book, yet his words live on as a guide to us all. When Breath Becomes Air is a life-affirming reflection on facing our mortality and on the relationship between doctor and patient, from a gifted writer who became both.
Description : On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong -- with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can -- with our help -- avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track. Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems. How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.
Description : Homeward Bound shows that as family structure becomes more complex, so too does elder care, and existing institutions and legal approaches are not prepared to handle those complexities. As 79 million American Baby Boomers approach old age, their diverse family structures mean the burden of care will fall on a different cast of family members than in the past. Our current approaches are based on an outdated caregiving model that presumes life-long connection between the parents and offspring, with the existence of high internal norm cohesion among family members providing a valuable safety net for caregiving. Single parent and remarried parent-led families are far more complicated, fragile, and point to the need for increased formal support from the religious, medical, legal, and public policy communities. We base our analysis on in-depth, qualitative interviews with surviving grown children and stepchildren whose mother, father, stepparent, or ex-stepparent died. Their stories illustrate the profound ways that the caregiving, mourning, and inheritance process has changed in ways not adequately reflected in formal legal, medical, and religious tools. The solutions center on awareness and preparation: providing more support for individual planning for incapacity and death and, even more importantly, creating legal, political, and social planning for the "graying of America" at a time of increasingly complex familial ties.
Description : This book predicts the decline of today's professions and introduces the people and systems that will replace them. In an internet-enhanced society, according to Richard Susskind and Daniel Susskind, we will neither need nor want doctors, teachers, accountants, architects, the clergy, consultants, lawyers, and many others, to work as they did in the 20th century. The Future of the Professions explains how increasingly capable technologies - from telepresence to artificial intelligence - will place the 'practical expertise' of the finest specialists at the fingertips of everyone, often at no or low cost and without face-to-face interaction. The authors challenge the 'grand bargain' - the arrangement that grants various monopolies to today's professionals. They argue that our current professions are antiquated, opaque and no longer affordable, and that the expertise of their best is enjoyed only by a few. In their place, they propose five new models for producing and distributing expertise in society. The book raises profound policy issues, not least about employment (they envisage a new generation of 'open-collared workers') and about control over online expertise (they warn of new 'gatekeepers') - in an era when machines become more capable than human beings at most tasks. Based on the authors' in-depth research of more than a dozen professions, and illustrated by numerous examples from each, this is the first book to assess and question the future of the professions in the 21st century.
Description : The author of the highly acclaimed Overdiagnosed describes seven widespread assumptions that encourage excessive, often ineffective, and sometimes harmful medical care. You might think the biggest problem in medical care is that it costs too much. Or that health insurance is too expensive, too uneven, too complicated—and gives you too many forms to fill out. But the central problem is that too much medical care has too little value. Dr. H. Gilbert Welch is worried about too much medical care. It’s not to deny that some people get too little medical care, rather that the conventional concern about “too little” needs to be balanced with a concern about “too much”: too many people being made to worry about diseases they don’t have—and are at only average risk to get; too many people being tested and exposed to the harmful effects of the testing process; too many people being subjected to treatments they don’t need—or can’t benefit from. The American public has been sold the idea that seeking medical care is one of the most important steps to maintain wellness. Surprisingly, medical care is not, in fact, well correlated with good health. So more medicine does not equal more health; in reality the opposite may be true. The general public harbors assumptions about medical care that encourage overuse, assumptions like it’s always better to fix the problem, sooner (or newer) is always better, or it never hurts to get more information. Less Medicine, More Health pushes against established wisdom and suggests that medical care can be too aggressive. Drawing on his twenty-five years of medical practice and research, Dr. Welch notes that while economics and lawyers contribute to the excesses of American medicine, the problem is essentially created when the general public clings to these powerful assumptions about the value of tests and treatments—a number of which are just plain wrong. By telling fascinating (and occasionally amusing) stories backed by reliable data, Dr. Welch challenges patients and the health-care establishment to rethink some very fundamental practices. His provocative prescriptions hold the potential to save money and, more important, improve health outcomes for us all.