A book by an emergency room physician about the secrets doctors keep from patients and themselves, and how those secrets affect patient care. Here's one secret: what doctors do doesn't work. CPR, for instance, saves 1-5% of the people it is performed on. 95-99% of them die. Even if it is performed on people whom it is medically appropriate for (that is, the healthy dead), it only saves 30% of them.
Here's another secret: even when a treatment does something, it doesn't do what the patient thinks. For instance, patients go to the doctor with a sore throat, they get a strep test and are treated with antibiotics. The patient thinks the antibiotics will help their throat heal, but in fact antibiotics reduce a 7-day course of illness by just 16 hours. Doctors are actually giving antibiotics to prevent a rare complication of strep throat, rheumatic fever, and and an even rarer complication of that, heart damage. But we need to treat a million people with strep throat with antibiotics to prevent one case of heart damage, and of the million people we treat, 2,000 will have life-threatening reactions to the antibiotics, and 200 will die.
This book is well worth reading, but skip the last chapter. In it he tries to apply Heisenberg's uncertainty principle and Godel's incompleteness theorem to the practice of medicine. And they don't apply, and they don't make sense, and he just comes off as anti-science. Which is strange, given that in the rest of his book he is strongly in favor of science, of using scientific evidence, and of discussing it with patients. Actually, I fairly often find this with non-fiction books. Everything goes well till the last chapter, and then, in an attempt to sum up and place in a larger context, the author over-reaches and things go all fuzzy. But apart from the last chapter, I loved this book and thought it was really valuable to have read.
Hippocrates' Shadow: Secrets from the House of Medicine
David H. Newman
2008
Available from Amazon
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