In the years following World War II, medicine won major battles against smallpox, diphtheria, and polio. In the same period it also produced treatments to control the progress of Parkinson's, rheumatoid arthritis, and schizophrenia. It made realities of open-heart surgery, organ transplants, test-tube babies. Unquestionably, the medical accomplishments of the postwar years stand at the forefront of human endeavor, yet progress in recent decades has slowed nearly to a halt. In this winner of the Los Angeles Times Book Prize, medical doctor and columnist James Le Fanu both surveys the glories of medicine in the postwar years and analyzes the factors that for the past twenty-five years have increasingly widened the gulf between achievement and advancement: the social theories of medicine, ethical issues, and political debates over health care that have hobbled the development of vaccines and discovery of new "miracle" cures. While fully demonstrating the extraordinary progress effected by medical research in the latter half of the twentieth century, Le Fanu also identifies the perils that confront medicine in the twenty-first. 16 pages of black-and-white photographs add to what the Los Angeles Times cited as "a sobering, contrarian challenge" to the "nostrum of medicine as a never-ending font of 'miracle cures'." "[From] a respected science writer ... important information that ... has been overlooked or ignored by many physicians." -New Republic "Provocative and engrossing and informative." -Houston Chronicle "Marvelously written, meticulously researched ... one of the most thought-provoking and important works to appear in recent years." -Choice
Take this book on holiday--it's a gripping story full of drama and suspense, heroes and villains and, despite charting dark periods when evil triumphed over virtue, has an optimistic message at the end. James Le Fanu has an enviable talent for making medical history fascinating and has produced a story about medicine's rise and fall since the Second World War that will surprise, intrigue and shock you. He claims that in a period of intense innovation between 1940 and 1970 medicine conquered all the major chronic diseases affecting the very young and the very old. With only the much rarer conditions that effect very small numbers of the population in middle life left to address, the revolution dramatically slowed down and innovation almost came to a halt.
Medicine looked subsequently for new frontiers but went up blind alleys, "The New Genetics" and "The Social Theory" of disease. Neither of these new "paradigms" have produced the same level of innovation and are responsible in part for bringing medicine into disrepute.
Despite enormous levels of funding, understanding the "code of life" has not produced any major therapeutic pay-offs, because genetically caused diseases--with only a few exceptions--are rare; genetic engineering and screening proved largely fruitless and genetic therapy made little impact. Theories that social behaviour causes disease, however, has not just been shown to be invalid but has also caused an epidemic itself of health hysteria amongst the well and resulted in blaming the sick for contracting their disease. He regards social theories such as the false idea that high- fat diets cause heart attacks as intellectual scandals that should be apologised for.
Perhaps his most controversial suggestion is that all university epidemiological departments should be closed down in order to prevent any further misinformation from being produced. But Fanu offers criticism of as well as praise for clinical practitioners, and scientists too. He suggests that doctors need to start listening to patients again and interpreting histories instead of ordering barrages of tests if they want medicine to regain respect. And clinical science needs to start trying to discover the biological transmissible agents of the diseases of middle-life if it is to awaken to a new dawn of innovation in the future. --Dorothy Porter
