The Laws of Medicine: Field Notes from an Uncertain Science

by Siddhartha Mukherjee Narrated by Santino Fontana

Overview

Essential, required reading for doctors and patients alike: A Pulitzer Prize-winning author and one of the world's premiere cancer researchers reveals an urgent philosophy on the little-known principles that govern medicine-and how understanding these principles can empower us all.

Over a decade ago, when Siddhartha Mukherjee was a young, exhausted, and isolated medical resident, he discovered a book that would forever change the way he understood the medical profession. The book, The Youngest Science, forced Dr. Mukherjee to ask himself an urgent, fundamental question: Is medicine a “science”? Sciences must have laws-statements of truth based on repeated experiments that describe some universal attribute of nature. But does medicine have laws like other sciences?

Dr. Mukherjee has spent his career pondering this question-a question that would ultimately produce some of most serious thinking he would do around the tenets of his discipline-culminating in The Laws of Medicine. In this important treatise, he investigates the most perplexing and illuminating cases of his career that ultimately led him to identify the three key principles that govern medicine.

Brimming with fascinating historical details and modern medical wonders, this important book is a fascinating glimpse into the struggles and Eureka! moments that people outside of the medical profession rarely see. Written with Dr. Mukherjee's signature eloquence and passionate prose, The Laws of Medicine is a critical read, not just for those in the medical profession, but for everyone who is moved to better understand how their health and well-being is being treated. Ultimately, this book lays the groundwork for a new way of understanding medicine, now and into the future.

Editorial Reviews

Publishers Weekly

★ 01/04/2016
Mukherjee, an oncologist and Pulitzer Prize winner for The Emperor of All Maladies, brilliantly observes the practice of medicine from a wide angle, offering his perspective on three crucial elements: intuition, statistical outliers, and human bias. He recounts his medical education, both formally and informally, as he delves into the practical lessons he has learned. For example, now that it's possible to cheaply collect reams of genetic data on every patient, understanding those patients who lie outside the parameters of "normalcy" becomes essential. Previously, the one patient responding to an otherwise failed drug was dismissed as an "exceptional responder" and the drug shelved. But now that patient's genes can be sequenced to see mutations for possible drug targeting. Mukherjee advises viewing medicines and surgical procedures "not as therapeutic interventions but as investigational probes." Still, as successes multiply, so do biases. One hospital's new doctors were stunned by a drug's anecdotally high response rate, only to discover that the real rate was only 15%. Hospital staff had given new doctors good responders, afraid they couldn't handle poor ones. The lesson is repeated throughout: bias is fought with solid data and the instincts that grow with experience. Mukherjee has established himself as new medicine's philosopher/poet and has produced a brief, accessible book for patients and practitioners alike. (Apr.)

Booklist

"The prose is lovely, often witty, always clear.... a fast and informative read."

From the Publisher

What he writes is important, and he does so in an elegant,engaging fashion. This is a moving, deeply humane book.” – Los Angeles Review of Books

Booklist

"The prose is lovely, often witty, always clear.... a fast and informative read."

JANUARY 2016 - AudioFile

In this elaboration of a TED Talk, Mukherjee (THE EMPEROR OF ALL MALADIES) explains that physicians are asked to “make perfect decisions with imperfect information” because medicine is still a young science. Mukherjee reads his introduction, and then Santino Fontana takes over in a resonant, clear voice. His timing is perfect, and he expresses all the gravitas, fascination, and occasional disbelief found in this work. Mukherjee explains why a physician needs acute intuition, knowledge of human foibles, and a deep understanding of statistics. We learn why a battery of tests is not useful without understanding the individual patient, how a single anecdotal outlier in research can lead to further knowledge, and why human bias cannot be eliminated but must be acknowledged. Mukherjee’s book is a precise and empathetic gem, and Fontana narrates it perfectly. A.B. © AudioFile 2016, Portland, Maine

Kirkus Reviews

★ 2015-08-06
Oncologist and Pulitzer Prize winner Mukherjee (Medicine/Columbia Univ.; The Emperor of All Maladies: A Biography of Cancer, 2010) skillfully dives into the hidden side of medicine in this elaboration of the author's 18-minute TED talk. Easily consumed in a single sitting, this brief book concisely explains the author's reasoning of why and how medicine asks its practitioners "to make perfect decisions with imperfect information." The author builds a solid foundation demonstrating the genesis of his concept of establishing laws for the practice of medicine. Cogently moving through books that influenced his thinking and the effects of his medical training and numerous practical experiences with patients, Mukherjee guides readers through his thought process on establishing the laws. The author admits beginning slowly but then spending much of his time during medical school with his "odd preoccupation" researching laws governing his chosen profession. Mukherjee stumbled upon the first law, dealing with intuition, by chance. Another law, regarding issues of medical testing, was refined by his analysis of how data, which doesn't fit accepted models of disease, such as "single patient anecdotes," can point to new methods for interpreting test results. The author deftly examines the diverse personalities and subjects that have influenced his thinking (e.g., 16th-century Danish astronomer Tycho Brahe and early-20th-century physician and scientist Lewis Thomas, author of The Youngest Science); the positive effect of the 20th-century philosophy on therapeutic nihilism; and the utility of the magical laws embraced by the novice witch Hermione Granger of Harry Potter fame. This mininarrative, packed with complex ideas translated into easily accessible language and an engaging style, leaves the readers time to ponder the author's ideas at greater length, and the result is a fascinating and illuminating trek through a beautiful mind. A splendid exploration of how medicine might be transformed.

Product Details

BN ID:	2940170567614
Publisher:	Simon & Schuster
Publication date:	10/13/2015
Edition description:	Unabridged

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