You are old, ill, in pain, and your doctor asks you what you want to do about it. You may be uncertain but you're definitely not alone. By the year 2020, some 50 million Americans will be over sixty-five, and as the nation ages we must all ask what we ought to do about the health and medical care of our elderly. Our response will have profound consequences, not just for individuals and families, but for society as a whole. This book helps us start to form an answer.

To make decisions about medical care in old age, we need to know more about the reality of being elderly and sick, and Choosing Medical Care in Old Age gives us the opportunity. Muriel Gillick, a noted physician who specializes in the care of the elderly and in medical ethics, presents a panoply of stories drawn from her clinical experience. These encounters, with the robust and the frail, the demented and the dying, capture the texture of the experience of being old and faced with critical medical questions. From the stories of older people struggling to make choices in the face of acute illness, stories that are often poignant and sometimes tragic, Gillick develops broad guidelines for medical decision–making for the elderly. Within this framework, she confronts particular concerns and questions. When are certain procedures too burdensome to be justified? What are unacceptable risks? Should family members serve as exclusive spokespersons for relatives who can no longer speak for themselves? Gillick's bold and personal prescription for medical care for the elderly calls for a change in the way medicine is understood and practiced, as well as for changes in the institutions that serve the elderly, such as hospitals and nursing homes. An intelligent and deeply compassionate inquiry into the difficult issues and real–life dilemmas raised by current practices, her book offers a first step toward those changes.

Intuition is central to discussions about the nature of scientific and philosophical reasoning and what it means to be human. In this bold and timely book, Hillel D. Braude marshals his dual training as a physician and philosopher to examine the place of intuition in medicine.

In 1913, the Peter Bent Brigham Hospital in Boston admitted its first patient, Mary Agnes Turner, who suffered from varicose veins in her legs. The surgical treatment she received, under ether anesthesia, was the most advanced available at the time. At the same hospital fifty years later, Nicholas Tilney—then a second-year resident—assisted in the repair of a large aortic aneurysm. The cutting-edge diagnostic tools he used to evaluate the patient’s condition would soon be eclipsed by yet more sophisticated apparatus, including minimally invasive approaches and state-of-the-art imaging technology, which Tilney would draw on in pioneering organ transplant surgery and becoming one of its most distinguished practitioners.

In Invasion of the Body, Tilney tells the story of modern surgery and the revolutions that have transformed the field: anesthesia, prevention of infection, professional standards of competency, pharmaceutical advances, and the present turmoil in medical education and health care reform. Tilney uses as his stage the famous Boston teaching hospital where he completed his residency and went on to practice (now called Brigham and Women's). His cast of characters includes clinicians, support staff, trainees, patients, families, and various applied scientists who push the revolutions forward.

While lauding the innovations that have brought surgeons' capabilities to heights undreamed of even a few decades ago, Tilney also previews a challenging future, as new capacities to prolong life and restore health run headlong into unsustainable costs. The authoritative voice he brings to the ancient tradition of surgical invasion will be welcomed by patients, practitioners, and policymakers alike.

Any woman who has been examined by a gynecologist could tell Descartes a thing or two about the mind/body problem. Is her body an object? Is it the self? Is it both, and if so, how? Katharine Young takes up this problem in a book that looks at medicine's means of separating self and body--and at the body's ways of resisting.

Disembodiment--rendering the body an object and the self bodyless--is the foundational gesture of medicine. How, then, does medical practice acknowledge the presence of the person in the objectified body? Young considers in detail the "choreography" such a maneuver requires--and the different turns it takes during a routine exam, or surgery, or even an autopsy. Distinctions between public and private, inside and outside, assume new meanings as medical practice proceeds from one venue to the next--waiting room to examining table, anteroom to operating theater, from the body's exterior to its internal organs. Young inspects the management of these and other "boundaries"--as a physician adds layers of clothing and a patient removes layers, as the rules of objective and subjective discourse shift, as notions of intimacy determine the etiquette of exchanges between doctor and patient.

From embodied positions within the realm of medicine and disembodied positions outside it, Young richly conveys the complexity of presence in the flesh.

“A powerful and extraordinarily important book.”
—James P. Comer, MD

“A marvelous personal journey that illuminates what it means to care for people of all races, religions, and cultures. The story of this man becomes the aspiration of all those who seek to minister not only to the body but also to the soul.”
—Jerome Groopman, MD, author of How Doctors Think

Growing up in Jim Crow–era Tennessee and training and teaching in overwhelmingly white medical institutions, Gus White witnessed firsthand how prejudice works in the world of medicine. While race relations have changed dramatically since then, old ways of thinking die hard. In this blend of memoir and manifesto, Dr. White draws on his experience as a resident at Stanford Medical School, a combat surgeon in Vietnam, and head orthopedic surgeon at one of Harvard’s top teaching hospitals to make sense of the unconscious bias that riddles medical care, and to explore how we can do better in a diverse twenty-first-century America.

“Gus White is many things—trailblazing physician, gifted surgeon, and freedom fighter. Seeing Patients demonstrates to the world what many of us already knew—that he is also a compelling storyteller. This powerful memoir weaves personal experience and scientific research to reveal how the enduring legacy of social inequality shapes America’s medical field. For medical practitioners and patients alike, Dr. White offers both diagnosis and prescription.”
—Jonathan L. Walton, Plummer Professor of Christian Morals, Harvard University

“A tour de force—a compelling story about race, health, and conquering inequality in medical care…Dr. White has a uniquely perceptive lens with which to see and understand unconscious bias in health care…His journey is so absorbing that you will not be able to put this book down.”
—Charles J. Ogletree, Jr., author of All Deliberate Speed

If you’re going to have a heart attack, an organ transplant, or a joint replacement, here’s the key to getting the very best medical care: be a white, straight, middle-class male. This book by a pioneering black surgeon takes on one of the few critically important topics that haven’t figured in the heated debate over health care reform—the largely hidden yet massive injustice of bias in medical treatment.

Growing up in Jim Crow–era Tennessee and training and teaching in overwhelmingly white medical institutions, Gus White witnessed firsthand how prejudice works in the world of medicine. And while race relations have changed dramatically, old ways of thinking die hard. In Seeing Patients White draws upon his experience in startlingly different worlds to make sense of the unconscious bias that riddles medical treatment, and to explore what it means for health care in a diverse twenty-first-century America.

White and coauthor David Chanoff use extensive research and interviews with leading physicians to show how subconscious stereotyping influences doctor–patient interactions, diagnosis, and treatment. Their book brings together insights from the worlds of social psychology, neuroscience, and clinical practice to define the issues clearly and, most importantly, to outline a concrete approach to fixing this fundamental inequity in the delivery of health care.

Primary care has come into the limelight with the passage of the Patient Protection and Affordable Care Act, the unchecked and unsustainable rise in American health care expenditures, and the crest of Baby Boomers who are now Medicare-eligible and entering the most health care–intensive period of their lives. Yet how much is really known about primary care? What Matters in Medicine: Lessons from a Life in Primary Care is a look at the past, present, and future of general practice, which is not only the predecessor to the modern primary care movement, but its foundation. Through memoir and conversation, Dr. David Loxterkamp reflects on the heroes and role models who drew him to family medicine and on his many years in family practice in a rural Maine community, and provides a prescription for change in the way that doctors and patients approach their shared contract for good health and a happy life. This book will be useful to those on both sides of primary care, doctors and patients alike.