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The Pursuit of Perfection: The Promise and Perils of Medical Enhancement

David Rothman and Sheila Rothman
Pantheon Books/2003

Drs. David Rothman and Sheila Rothman take the reader behind the scenes and trace the history of medical enhancements: the researchers who design them, the physicians who prescribe them, the drug companies that promote them, and the individuals who pursue them.

The last century has shown much conflict between cure and enhancement. People are inundated with information about the latest medical treatments: A new pill to improve memory or a shot to maintain one's youthful appearance often inspires people to rush out and be one of the first to enjoy the results without fully assessing the potential hazards. "The Pursuit of Perfection" traces an arc from the early days of endocrinology (the belief that you are your hormones) to today's emphasis on genetic enhancements (the idea that you are your genes). It lays bare the always complicated and sometimes compromised positions of science, medicine, and commerce.

Dr. David Rothman is the Bernard Schoenberg Professor of Social Medicine and History and director of the Center for the Study of Society and Medicine at P&S; Dr. Sheila Rothman is professor of public health in the division of sociomedical sciences at the Mailman School of Public Health and deputy director of the Center for the Study of Society and Medicine.



Medicine Under Sail

Zachary Friedenberg
Naval Institute Press/2002

In the Age of Sail (15th to 18th centuries), sailors struggled to survive not only the hazards of battle but daunting health problems brought on by inadequate diets and long periods at sea in closely confined quarters. Ships that left port with banners flying all too often returned with remnants of a crew, haggard and sick and scarcely able to set a sail. "Medicine Under Sail" explores the work of maritime doctors of this time and how they dealt with shipboard illnesses such as scurvy, beriberi, typhus and tropical fevers, as well as death and disease in the slave trade.

Dr. Friedenberg, P&S'39, is an orthopedic surgeon and professor of orthopedic surgery at the University of Pennsylvania, where he has taught medicine since 1950. Dr. Friedenberg has long had an interest in the sea, as a scuba diver, underwater photographer and sailor.



I'm Not Slowing Down:
Winning My Battle with Osteoporosis

Ann Richards with Richard U. Levine
Dutton/2003

In 1996, after falling and fracturing her hand, former Texas governor Ann Richards went for a bone density test. She was diagnosed with osteopenia, an early stage of osteoporosis. Because the disease runs in her family, Ms. Richards was determined to try to overcome its incapacitating effects. She began a physician-approved regimen of medication and dramatically changed her lifestyle. In this book, Ms. Richards and Dr. Levine arm women with information they need to begin a bone-building program so that they may enter their later years with strength and agility.

Dr. Levine is clinical professor of obstetrics and gynecology at P&S and vice chairman of obstetrics and gynecology at NewYork-Presbyterian Hospital.



What Your Doctor May Not Tell You About Osteoporosis

Felicia Cosman
Warner Books/2003

Osteoporosis and low bone mass are estimated to be a major public health threat for almost 44 million U.S. women and men age 50 and over. A woman's risk of hip fracture is equal to her combined risk of breast, uterine, and ovarian cancer. This country spends about $14 billion per year on osteoporosis-related fractures and their consequences and this number is expected to more than double by the year 2020. In her book, Dr. Cosman describes the disease and its causes and offers steps a person can take toward prevention, including lifestyle changes, nutrition, and exercise. Dr. Cosman also describes ways to diagnose and test for osteoporosis and all the various medical and nonmedical treatments available.

Dr. Cosman, an osteoporosis specialist, is the medical director of the Clinical Research Center at Helen Hayes Hospital in West Haverstraw, N.Y., and associate professor of clinical medicine at P&S. She is also clinical director of the National Osteoporosis Foundation.



Handbook of Obesity Treatment

Edited by Thomas A. Wadden and Albert J. Stunkard,
The Guilford Press/2002

An estimated 61 percent of U.S. adults are either overweight or obese, a number that places the condition as one of the country's most pressing public health problems. Increasingly, this problem is shared with a growing number of developing nations, making obesity, according to the World Health Organization, a "global epidemic." "The Handbook of Obesity Treatment" brings together dozens of leading experts to discuss the causes and consequences of obesity and presents a comprehensive framework for planning and delivering clinical services. Topics include "Energy Metabolism and Obesity," "Genetics and Common Obesities," "Confronting the Toxic Environment," "Commercial and Self-Help Weight Loss Programs," and "Surgical Treatment of Obesity."

Dr. Albert Stunkard, P&S'45, is professor of psychiatry at the University of Pennsylvania School of Medicine, where he founded the Obesity Research Group in 1957.



September 11: Trauma and Human Bonds

Edited by Susan W. Coates, Jane L. Rosenthal, and Daniel S. Schechter
The Analytic Press/2003

The perception of massive trauma has been indelibly shaped by the events of Sept. 11, 2001. This book, which contains contributions from leading scholars, researchers, and clinicians, focuses on the psychological consequences of the attack and deepens understanding of trauma in general. Drawing on research from a variety of domains — clinical studies of trauma, developmental psychopathology, interpersonal psychobiology, epidemiology, and social policy — the contributors address especially the fundamental relationship of human bonds and trauma. "September 11: Trauma and Human Bonds" underscores the way in which developments in all these fields are coming together in complementary ways that sustain a key finding: Trauma must be understood in its relational and attachment contexts. From their various disciplinary vantage points, the contributors show how human relationships can either provide an anodyne to trauma or serve as the vehicle of its transmission.

Dr. Coates is associate clinical professor of psychology in psychiatry at P&S; Dr. Jane Rosenthal is assistant clinical professor of psychiatry at P&S; and Dr. Schechter is assistant professor of clinical psychiatry (in pediatrics) at P&S.



Sexual Orientation and Psychoanalysis:
Sexual Science and Clinical Practice

Richard C. Friedman and Jennifer Downey
Columbia University Press/2002

In "Sexual Orientation and Psychoanalysis: Sexual Science and Clinical Practice," the authors, two leading psychoanalysts, tackle the problem of homophobia by identifying the developmental roots of sexual orientation and homophobia. Dr. Friedman and Dr. Downey show that homophobia tends to develop in mid (ages 5 to 7) and late (ages 8 to 12) childhood and has different manifestations in boys and girls. By identifying when homophobia begins and how peer cultures differ between boys and girls, the authors aim to help clinicians highlight those times of early life that are key in shaping masculine and feminine behavior. Though the book is geared to a professional audience, educators and parents may be able to use the information it provides to help children develop a healthy sense of their own sexuality and a positive, nonjudgmental view of the sexuality of others.

Dr. Downey is clinical professor of psychiatry at P&S; Dr. Friedman is clinical professor of psychiatry at Weill Medical College, Cornell University.



Fetal and Neonatal Physiology

Edited by Richard A. Polin, William W. Fox, and Steven H. Abman
Elsevier Press/2003

"Fetal and Neonatal Physiology" is a comprehensive, 33-chapter, two-volume text on the normal and abnormal physiology of the fetus and neonate. More than 270 international authorities detail the unique characteristics that distinguish fetal and neonatal physiology from the physiology of adults and, where appropriate, address the pathophysiology and clinical management of selected neonatal diseases. The volumes include new coverage of molecular genetics, extracellular matrix and embryogenesis, apoptosis, and angiogenesis.

Dr. Polin is professor of pediatrics at P&S and director of neonatology at the Children's Hospital of New York.



Alzheimer's Disease:
A Physician's Guide to Practical Management

Edited by Ralph Richter and Brigitte Zoeller Richter
Humana Press/2004

In "Alzheimer's Disease: A Physician's Guide to Practical Management," clinicians, scientists, and opinion leaders from all over the world provide a concise practical guide to the evaluation, assessment, and treatment of individuals with probable Alzheimer's disease. Because the early diagnosis of AD is now increasingly thought to be important, the authors include several chapters on early changes and preclinical conditions, such as mild cognitive impairment and predementia Alzheimer's disease. Basic scientists discuss their research about potential future options for prevention and treatment. As a result, the book provides readers with broad insight into such new therapeutic directions as stem cell therapy and other unique strategies. The book also offers guidance for caregivers and medical providers on how to overcome the breakdown in communication that the illness causes.

Dr. Richter, P&S'56, is clinical professor of neurology and psychiatry at the University of Oklahoma College of Medicine and director of the Alzheimer's Disease Research Unit at St. John Medical Center in Tulsa.



The Texture of Treatment On the Matter of Psychoanalytic Technique

Herbert Schlesinger
The Analytic Press/2003

Dr. Schlesinger's goal is to demystify psychoanalytic technique, to show that it derives from basic principles that are applicable both to psychoanalysis and to the psychotherapies that derive from it. He "reframes" such concepts as transference, resistance, interpretation, regression and empathy with the aim of helping the analytic therapist restore active control of his own life to the patient. For example, viewing neurosis as what the patient does rather that what he has, the analyst can see the "resisting" patient not as someone opposing treatment but rather doing what he feels he must do both to accommodate the demands of an unconscious fantasy and to adhere to his own sense of safety. The book is a presentation of principles Dr. Schlesinger has taught to generations of psychiatric residents, clinical psychology interns, clinical social work students, and psychoanalytic candidates.

Dr. Schlesinger is clinical professor of psychology in psychiatry at P&S and supervising analyst at CUMC's Center for Psychoanalytic Training and Research.

A Proud Heritage:
An Informal History of Surgery at Columbia

Edited by Frederic P. Herter, Alfred Jaretzki III, and Kenneth A. Forde
The John Jones Surgical Society/2003

Once the domain of barbers, surgery is now a medical wonderland of robotics, imaging and minimal-access procedures. As part of the first chartered medical school in the nation, the Columbia University Medical Center Department of Surgery has borne witness to surgery's remarkable transformations for more than two centuries. "A Proud Heritage: An Informal History of Surgery at Columbia" looks at the heroes and characters who have embodied these transformations at one of the nation's top surgical institutions. The editors, alumni of Columbia's Department of Surgery, offer insightful and often funny accounts of generations of surgeons-in-chief who have tried to balance surgical innovation with excellence in teaching.

Dr. Herter is the Auchincloss Professor of Emergency Surgery at P&S; Dr. Jaretzki is associate professor of clinical medicine; and Dr. Forde is the Jose M. Ferrer Professor of Clinical Medicine.



Reckoning With Homelessness

Kim Hopper
Cornell University Press/2003

Kim Hopper has dedicated his career to trying to correct the problem of homelessness in the United States. In "Reckoning With Homelessness," he draws upon his dual strengths as anthropologist and advocate to provide a deeper understanding of the roots of homelessness. Beginning with his own introduction to the problem in New York, Dr. Hopper uses ethnography, literature, history, and activism to place homelessness into historical context and to trace the process by which homelessness came to be recognized as an issue. He tells the largely neglected story of homelessness among African-Americans and vividly portrays various sites of public homelessness, such as airports.

Dr. Hopper is research scientist at the Nathan S. Kline Institute for Psychiatric Research and lecturer at the Mailman School of Public Health and the Columbia School of Law. He is a cofounder of both the New York and the National Coalition for the Homeless.



How to Survive Your Doctor's Care: Get the Right Diagnosis, the Right Treatment, and the Right Experts for You

Pamela Gallin
Lifeline Press/2003

When Dr. Gallin, a physician with access to the best health care in the country, experienced medical errors that led to nearly permanent nerve damage to her hand, the close call with medical disaster opened her eyes to the perils all patients potentially face. This book offers extensive advice on how to navigate today's complex health care system. Readers will come away with information as varied as "How a Magic Marker might be your final defense against a ghastly surgical mishap" to "Crucial questions to ask any prospective physician."

Dr. Gallin is director and associate professor of pediatric ophthalmology at the Edward S. Harkness Eye Institute and associate professor of pediatrics at Children's Hospital of New York. Dr. Gallin has served on the White House Health Care Task Force and is the author of the highly acclaimed book, "The Savvy Mom's Guide to Health Care." She has been listed in Best Doctors in America since 2001.

Excerpt from "How to Survive Your Doctor's Care"

Finding Your Doctor

A lawyer friend came to me with this question:

"My beloved internist of many years just retired. He suggested a younger internist. I went to the guy and I liked him. He recommended that I have a colonoscopy. How do I know that I really need this and that he has no financial relationship with the doctor he was suggesting would do the procedure — you know, some kind of financial incentive?"

First I asked him which hospital the new internist was affiliated with and determined that the doctors there were all good. After that, I told him that as a patient, you're stuck with honor and trust. There's no way around this. You can't possibly know every conceivable motivation for your doctor's recommendation, and you'll drive yourself crazy if you question everything he says. You need to trust your own instincts and decide: Is this doctor going to give me good care and good advice? A doctor you can trust is worth his weight in gold. But it's also up to you to give him that trust.

Then I turned the question around to him: If I came to him for legal advice and he suggested I see a more specialized lawyer, could I trust that his referral didn't involve some kind of payback? Frankly, he was insulted. I told him it was the exact same thing in medicine: There's a core of honor and expertise in the profession.

Since trust is a pretty big word, you want to take time to make your choice. As it is, many people spend less time picking their doctors than they would a pair of shoes. People select doctors for reasons like location, convenience, or "she seemed nice." People can tell you why they bought their car more easily than they can tell you why they chose their doctor. In my experience, people all too often don't take enough time to determine whom they go to, and then get angry at the results.


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