Kidzdoc Looks Ahead to 2025 in 2024

These are books I've chosen to focus on between now and the end of the year:

Black Paper: Writing in a Dark Time by Teju Cole
Creating a New Racial Order: How Immigration, Genomics and the Young Can Remake Race in America by Jennifer Hochschild, Vesla Weaver, & Traci Burch
Legacy: A Black Physician Reckons with Racism in Medicine by Uché Blackstock, MD ✅️
The People’s Hospital: Hope and Peril in American Medicine by Ricardo Nuila ✅️
Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-science by Peter J. Hotez, MD, PhD
Self-Care for Black Men: 100 Ways to Heal and Liberate by Jor-El Caraballo

Currently reading:



The Covenant of Water by Abraham Verghese

January:
1. The House of Doors by Tan Twan Eng
2. The Upcycled Self: A Memoir on the Art of Becoming Who We Are by Tariq "Black Thought" Trotter
3. The Hundred Years' War on Palestine: A History of Settler Colonialism and Resistance, 1917-2017 by Rashid Khalidi

February:

March:
4. An Unquiet Mind: A Memoir of Moods and Madness by Kay Redfield Jamison

April:
5. Bipolar Disorder: A Guide for You & Your Loved Ones, 4th Edition by Francis Mark Mondimore, MD
6. The Details by Ia Genberg
7. What I'd Rather Not Think About by Jente Posthuma
8. Crooked Plow by Itamar Vieria Junior

May:
9. The Heart: Frida Kahlo in Paris by Marc Petitjean
10. Black AF History: The Un-whitewashed Story of America by Michael Harriott
11. Let Us Descend by Jesmyn Ward
12. Medgar & Myrlie: Medgar Evers and the Love Story That Awakened America by Joy-Ann Reid
13. Travelers to Unimaginable Lands: Stories of Dementia, the Caregiver, and the Human Brain by Dasha Kiper (DNF)
14. My Father's Brain: Life in the Shadow of Alzheimer's by Sandeep Jauhar

July:
15. Knife: Meditations After an Attempted Murder by Salman Rushdie
16. The Song of the Cell: An Exploration of Medicine and the New Human by Siddhartha Mukherjee
17. The Heaven & Earth Grocery Store by James McBride
18. Moral Man and Immoral Society by Reinhold Niebuhr

August:
19. James by Percival Everett
20. There There by Tommy Orange
21. Wandering Stars by Tommy Orange
22. Orbital by Samantha Harvey
23. My Friends by Hisham Matar
24. Desperately Seeking Basquiat by Ian Castello-Cortes

September:
25. What Kingdom by Fine Gråbøl
26. Orwell's Ghosts: Wisdom and Warnings for the Twenty-First Century by Laura Beers

October:
27. Held by Anne Michaels
28. Sister Deborah by Scholastique Mukasonga

November:
29. Stone Yard Devotional by Charlotte Wood
30. Our Malady: Lessons in Liberty from a Hospital Diary by Timothy Snyder
31. Legacy: A Black Physician Reckons with Racism in Medicine by Uché Blackstock, MD
32. The People's Hospital: Hope and Peril in American Medicine by Ricardo Nuila, MD

I also mentioned recently that I intended to have a more structured approach to my reading beginning next year, which would focus on books that I've owned for years but haven't gotten to, for some reason or another. I intend to read 20-30 books in that category, and roughly an equal number of new books that are especially appealing.

This is my first stab at a core list, subject to minor changes throughout the year:

The Arab of the Future by Riad Sattouf
The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, M.D.
Children of the Ghetto: My Name Is Adam by Elias Khoury
Children of the Ghetto: Star of the Sea by Elias Khoury
Collected Essays & Memoirs by Albert Murray
The Code Breaker: Jennifer Doudna, Gene Editing, and the Future of the Human Race by Walter Isaacson
James Baldwin: Collected Essays by James Baldwin
Flood of Fire by Amitav Ghosh
Haiti After the Earthquake by Paul Farmer
Latinx: The New Force in American Politics and Culture by Ed Morales
Life Embitters by Josep Pla
Memoirs of a Dutiful Daughter by Simone de Beauvoir
A Mind at Peace by Ahmet Hamdi Tanpinar
The Mirror & the Light by Hilary Mantel
More Than I Love My Life by David Grossman
My Struggle, Book 5 by Karl Ove Knausgaard
The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture by Gabor Maté
Nineteen Eighty Four by George Orwell
On Tyranny: Twenty Lessons from the Twentieth Century by Timothy Snyder
Pessoa: A Biography by Richard Zenith
Signs for Lost Children by Sarah Moss
Someone Like Us by Dinaw Mengestu
Stamped from the Beginning: The Definitive History of Racist Ideas in America by Ibram X. Kendi
Tremor by Teju Cole
W.E.B. Du Bois: Biography of a Race, 1868-1919 by David Levering Lewis
________________
Possible reads:
Bellevue by David Oshinsky
A Day in the Life of Abed Salama: Anatomy of a Jerusalem Tragedy by Nathan Thrall
Notes on Hospitals by Florence Nightingale
Rise of the Modern Hospital: An Architectural History of Health and Healing by Jeanne Kisacky
Rough Sleepers: Dr. Jim O'Connell's urgent mission to bring healing to homeless people by Tracy Kidder
We Have Only This Life to Live: The Selected Essays of Jean-Paul Sartre, 1939-1975

There will undoubtedly be a small number of additions, but probably few if any subtractions, so I'm happy with this list for now.

I had mentioned early this week that pediatricians view themselves as health advocates for children, as they cannot vote for themselves, and I fully expected a response from the American Academy of Pediatrics (AAP), the organization that board certified pediatricians such as myself belong to. Dr Ben Hoffman, the current AAP president, issued a statement in response to the announcement that Trump nominated Robert F. Kennedy, Jr to be his Secretary of Health and Human Services (HHS):



This is the full statement:

“The nomination of Robert F. Kennedy, Jr. to be Secretary of the U.S. Department of Health and Human Services (HHS) offers an important opportunity to share the settled science on vaccines with government leaders, policymakers and the American public. This is a conversation pediatricians have every day with families, and we welcome the chance to do the same with national leaders.

“Vaccines have been an invaluable part of the fabric of our society for decades and are one of the most significant medical innovations of our time. When everyone can access the recommended immunizations, we can stop preventable diseases from spreading in our communities. Vaccines are the safest and most cost-effective way to protect children, families and communities from disease, disability and death. Continuing national investment in vaccine access is absolutely essential to support healthy communities.

“Vaccinations prepare children’s immune systems to recognize and respond to serious diseases, helping them stay healthy so they can learn, grow and thrive. Immunization prepares children for long-term health, well-being and development into adulthood.

“HHS oversees programs and implements policies that are so important to infants, children and adolescents, from Medicaid to child welfare to immunizations. Nearly half of all children in the United States rely on Medicaid or the Children’s Health Insurance Program for their health care, making this process and the policies that flow from HHS leadership critical to children across the country.

“HHS’s motto is ‘Improving the health, safety, and well-being of America.’ This is a tall order, but a crucial and achievable one. As pediatricians, we firmly believe the most effective way for HHS to ensure the future health of our nation is to protect and support the health of our children: by ensuring that science continues to underpin all decision-making, policies and programs.”

###

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

Very interested in the books you have planned for 2025! I also wanted to say that I think that some of the years I've read fewer books have been the best reading years I've had, maybe because I was very selective about the books I chose to read. So even though you are reading less in quantity these days, I hope you find the same - that the quality of what you read makes your reading year extremely satisfying!

>3 kidzdoc: Hope that statement does some good.

Interested in all of your current reads. I was already aware of two, but not aware of Our Malady. Of your 2025 books, I have The Code Breaker but haven't yet read it.

Also: Doesn't the admin have power to change a thread title? I thought this feature was added fairly recently.

>4 japaul22: Thanks, Jennifer. I'm glad that you felt that way, as it only adds to my firm belief that I am finally on a track that will make my reading more enjoyable and satisfying.

>5 dukedom_enough: Same here, Michael. Despite the recent increase in vaccine skepticism and other anti-science beliefs studies have known that the vast majority of parents still trust their primary care pediatricians and the advice they get from them, which makes our input as "public health experts" that much more valuable.

>6 qebo: I think that heard from someone in Club Read about Our Malady, as I requested it from my local library afterward. I'll spend at least part of the day reading it.

ETA: Yes; Caroline_McElwee read Our Malady last month.

I knew that one's thread title could be changed in the first minutes or hours after it was created, but I wasn't sure about after that. I also didn't know if one could delete one's own thread. If anyone knows I would greatly appreciate it.

>6 qebo: >8 kidzdoc: Yes, I can change thread titles. Just let me know what you would like it changed to.

>9 labfs39: Fabulous! Thanks, Lisa. I'm fine with keeping this one as the thread going forward, and the other, controversial one switched to Kidzdoc Strives for Insanity in 2024 (5). I'll still let that thread die, due to the troll that posted on it.

>10 kidzdoc: Done! Plus I removed the problematic post.

>11 labfs39: Thanks, Lisa!

You might be interested in this - copied from a FB action group I follow.

Epidemiologist Gregg Gonsalves informs us that a group of epidemiologists, physicians, nurses, and other public health and clinical experts who assembled during COVID to fight back against bad policy and misinformation is coming back together to protect public health during the next Trump Administration - a task that seems somehow even tougher with the announcement of Robert F. Kennedy Jr’s nomination as Secretary of Health and Human Services. We can work together to push back against damaging executive actions, rules and legislation to keep our communities safe and healthy. When we sign up here (link below), we’ll be notified of a Zoom conversation to start things going in the coming weeks.

Link: https://docs.google.com/forms/d/e/1FAIpQLScyVGHzYqP2timk6mWO8TfcynEs2KqH2oRtucI4...

(I also posted this on the Science talk group on the Epidemiology/Infectious Diseases thread but don't know if you follow that one.)

>13 streamsong: Thanks, Janet! That is definitely of interest to me, so I signed up not long ago.

Where is the Epidemiology/Infectious Diseases thread?

This reminds me; I do owe Lisa a reply for her excellent question from the previous truncated thread. I'll do that now, using Google Docs, and return here when I'm finished.

I think this is such an important concept that is under siege across so many aspects of American life. I wish I better understood why so many people, across all demographics, are so skeptical of science, and how we can effectively dialogue with these people. I have had conversations with intelligent people who feel that since scientific knowledge grows and sometimes changes, that that means all science is a lie or at least open to belief. "After all," they say, "at one time Galileo was the outlier when everyone else believed in geocentrism. So who's to say that this lone conspiracist isn't the one who is right and all the so-called experts wrong?" How do you respond to that?

There are many factors that contribute to science denial, IMO. The first, IMO, is science illiteracy, which is intimately related to the decline in the American educational system and the underemphasis on critical thinking in schools. There is also less trust in “scientific experts” now in comparison to the first half of the 20th century, and with the rise of alternative news sources such as Fox News and a wider variety of them, as compared to the Big Three networks that many of us grew up watching (CBS, NBC, and ABC) there is even more room for “alternative facts,” as Kellyanne Conway famously said, to gain traction.

That is, of course, far too simplistic a view. Our government, our scientists and our health experts have lied to or deceived us for decades, with one example being the notorious Tuskegee Study of Untreated Syphilis in the Negro Male that ran from 1932-1972. Six hundred sharecroppers were enrolled in the study, nearly 400 of whom had syphilis, but none were offered treatment, and as a result 100 men died when they could have been easily cured by administration of penicillin. Even though that study ended over 50 years ago it has had long lasting implications, as many poor and uneducated African Americans sadly remain deeply distrustful of American medicine to this day, even when the benefit of beneficial treatment modalities such as the COVID-19 vaccines were offered to them. I don't have the exact data handy, but I recall that far fewer African Americans, especially in the Deep South, chose to receive the COVID-19 vaccine, and far more as a percentage of the American population died as a result.

I was a first responder during the COVID-19 pandemic, being a pediatric hospitalist in a large children's hospital in Atlanta, and we were all deeply frightened on literally a daily basis, not knowing if a particular patient with a cough had COVID-19, and if we would soon contract it and become seriously ill—or worse. Fortunately the pandemic had a very minimal impact on children in the first half of 2020, but we didn't know that at the time. Many of us had taken care of patients with HIV/AIDS, but COVID-19 was an exponentially greater fear. We all read as much as we could, sat in on innumerable Zoom meetings from experts at the CDC and elsewhere, and tried to follow the ever shifting guidelines from the CDC, experts such as Dr Anthony Fauci of the White House COVID-19 Task Force and the Georgia Department of Health, and our in house Infectious Disease service. Unfortunately the recommendations and the advice we were given changed at least once a week, and we often felt that we were not provided the barrier protection needed to keep ourselves, and our families, safe. In addition, families of hospitalized children who were diagnosed with COVID-19 in the latter half of 2020 became extremely angry at the medical staff, would not uncommonly refuse to wear simple surgical masks or stay in their rooms, and would occasionally behave so irrationally that Security had to escort them from the hospital, as they were putting all of us at risk.

Up until the COVID-19 pandemic I loved my job and felt respected and appreciated by the vast majority of families. However, many physicians and other health professionals sustained serious cases of burnout, due to the way they were treated by patients and families, and thousands are no longer practicing at the bedside. My current situation means that I can't work as a hospitalist, but even though it's been nearly three years since I saw my last patient I sadly don't miss it one bit. Perhaps I would if I knew that I could deal with rational parents rather than have far too frequent arguments with those who have become science deniers or anti-vaxxers, and although I suspect the majority of parents and families haven't drunk the Kool-aid, enough have to make the practice of medicine far less appealing than it once was.

>15 kidzdoc: ever shifting guidelines

I experienced the edges of this, as it was summer/fall 2020 when both of my parents were hospitalized, and visitation rules kept changing. I can barely imagine being at the center of it. The rules kept changing because so little was known initially, and it takes time to study what does and does not work. Given this, how might've the CDC presented information and guidelines differently? To people such as doctors, who have sophisticated understanding of science, and to the general public which often needs repetitive clarity?

I will say, as a solid liberal who believes in science and has personally had great experiences with doctors and public health, that reading about the opioid epidemic shook a little bit of my faith in the government and its drug approval system, including the FDA. I've done a bit of reading about it, through nonfiction and long form articles, and I am more than dismayed by the lack of oversight and financial gain that members of the FDA got from allowing these drugs to go to market without the proper research and warnings.

I think this is one of many things that has chipped away at public confidence in the government and public health.

I think proponents of unsupported bad ideas aren’t in search of discussion or logic. They may want to be listened to. And sometimes listening goes a long way. But you can’t work with them in any logical way until unless and until they want to listen. Science is very much common sense in complicated action. It’s not mysterious. Science literacy isn’t going to change anyone’s mind who insists on thinking of science as a parallel to the logic of the medieval church.

Naomi Oreskes wrote about how doubt was instilled in the public in her book Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming published in 2011. This is not an easy book to read. It is very academic and the language it uses is academic. However, her point is that planting doubt about the science was the main hinge that the tobacco industry used to keep cigarettes circulating. She makes a direct line from the late 1940's campaign's to discredit medical researchers who were already pointing to smoking as the major cause of lung cancer to the science doubters of today.

As I said it was not an easy reading book, but it is an important book for many reasons.

You can look up Naomi Oreskes on YouTube. She is a more interesting speaker than she is a writer and there are numerous speeches on YouTube in which she makes her case for where science doubting started and who keeps those doubts on the forefront to the public. I was astonished at how often the same names kept appearing on peer reviewed articles on everything from medical articles touting the benefits of smoking to recent articles discrediting the science behind global warming.

I just realized the end of the last paragraph in >15 kidzdoc: was garbled and somewhat nonsensical, probably because I was watching football as I was typing it, so I've re-written it now; hopefully it makes sense!

I've started reading Our Malady, and I am absolutely outraged by the treatment that Timothy Snyder received at Yale-New Haven Hospital, which is supposedly one of the best in the country. I've been in the emergency departments of a non-academic hospital five times and hospitalized there three times, including once to get an appendectomy, but I was treated with the utmost care and respect. I could only read a few pages at a time before having to put it aside in anger.

I have a busy day ahead, and unfortunately
I'm still in a lot of pain, so I'll try to reply to messages posted here this afternoon or evening.

>20 kidzdoc: I’ve had to wait up to twelve hours on visits to ER in NYC teaching hospitals. I will say however, when it’s been a life-death situation I’ve been put in a triage room to wait. Other tines it’s been in a corridor for several hours. I’m never informed of wait times or what’s going on .

After a flight from Australia to NJ I was sent to a hospital and was put on a gurney in a corridor. After 90 minutes I left - I had not even had my name taken.

I just suffer now as ER is so frightening, especially when living alone and old. I’ve experienced health systems in England and Australia and am truly shocked at the American hospital system.

At one hospital, on a return visit at the hospital’s request - after a heart procedure- I was parked in front of reception for 8 hours with no examination. When I started crying in frustration (an orderly had started playing with the bed controls, laughing as my body was forced into different uncomfortable positions) , I was deemed senile and was given a coloring book .

I would now only go to ER if felt I was dying.
I am on Medicare but have to pay thousands in supplementary insurance in order to be able to see doctors of choice.

I have excellent doctors who are as frustrated at the system as I.

>16 qebo: I experienced the edges of this, as it was summer/fall 2020 when both of my parents were hospitalized, and visitation rules kept changing.

That was one of the greatest sources of stress amongst parents of hospitalized children with COVID-19. At first both parents were allowed to stay with their sick child, then suddenly only one parent could visit, and that person had to stay in the room and was not allowed to leave until the child was ready to be discharged. Many of the parents I cared for (yes, caring for a sick child involves caring for the parents as well!) were angry, not at me but at the faceless people who were involved in this change in policy, and many parents openly cried and begged me to do anything to allow them to go home, and switch out with the other parent or another trusted caregiver. It pained me to tell them that I was powerless to do that, as I would have been reported and possibly suspended if I did that. Some weeks to months later the policy was suddenly reversed so that both parents could stay in the room, and that led to a great deal of bad blood, which generally was not directed toward the medical staff but towards experts such as Dr Fauci and Dr Rochelle Walensky, the director of the CDC during the pandemic. That seemingly led to a groundswell of public opinion away from those experts, and towards people who offered alternative facts or quack cures (bleach or ivermectin, anyone?). It didn’t help that Trump openly criticized his own COVID-19 adviser, Tony Fauci, especially in a Deep South state such as Georgia where he was worshipped as the second coming of Christ (T-shirts or huge bumper stickers emblazoned with phrases such as “God Guns & Trump” are not uncommon there, especially once you leave metropolitan Atlanta). At least half a dozen parents asked me to prescribe ivermectin for their sick child, and when I told them that I was forbidden to do so by our Infectious Disease doctors or Pharmacy they became incensed with anger and either demanded for a new physician or left the hospital AMA {Against Medical Advice), especially when they realized that my partner that saw them next was not going to prescribe ivermectin either. I remember getting so fed up with an utterly irrational Caribbean mother that I wrote discharge orders for her daughter, as she should not have been admitted in the first place and was taking way too much of my time.

>17 japaul22: I will say, as a solid liberal who believes in science and has personally had great experiences with doctors and public health, that reading about the opioid epidemic shook a little bit of my faith in the government and its drug approval system, including the FDA.

I definitely want, and need, to read more about the opioid epidemic, and the FDA’s role in allowing that crisis to take place. I think I have a book or two in my library about it, so I’ll have to see if I can’t find out which one it is, and possibly read it next year.

I would suggest that the FDA’s greatest shining moment and most important person was Dr Frances Oldham Kelsey, the Canadian-American physician and FDA researcher who doggedly refused to permit thalidomide to be approved for use in pregnant women for morning sickness over fierce pressure from the manufacturer of the drug and the powers that be in FDA. By doing so Dr Kelsey prevented the births of untold thousands of babies with congenital malformations such as short limb syndrome in the United States, which affected at least 10,000 babies in Europe in the 1950s and early 1960s.

Oh, yeah… I’m pretty sure the book I own is Dopesick: Dealers, Doctors, and the Drug Company That Addicted America by Beth Macy. I’ll try to make room for it next year, as I definitely haven’t read it yet.

I am more than dismayed by the lack of oversight and financial gain that members of the FDA got from allowing these drugs to go to market without the proper research and warnings.

I think this is one of many things that has chipped away at public confidence in the government and public health.

I think you’re right. Jennifer. As well, profits and the ability to generate enormous profits from newly approved drugs such as the new GLP-1 receptor agonists (Ozempic, Wegovy, Zepbound and others) in the relatively short window before they can be sold as generic medications contributes to the obscenely high costs that all of us end up paying. I’m proud to say that I have achieved my weight loss “naturally,” without the use of medication; my weight loss doctor did give me a prescription for Zepbound in early January, but it made me sick and my insurance plan wasn’t covering its cost, so I only took it for three weeks. I found it rather disturbing that the manufacturers repeatedly said that anyone starting these medications would have to take them for life, to avoid regaining the weight they had lost. I wonder if they will have the same recommendations once those medications become generic.

>18 dchaikin: Interesting points, Dan.

>19 benitastrnad: Thanks, Benita. I’ll keep Naomi Oreskes’s name in mind, although I certainly won’t have time to read Merchants of Doubt next year. Too many books…

>21 kjuliff: That is horrifying, Kate. I haven’t heard anything good about the NYC hospitals, and my only experience was in the Emergency Department of NYU Medical Center in 1990, as I sustained a severe laceration of my right middle finger while I was at worked in a research lab on a non-clinical floor of the main hospital. I remember that the resident who saw me was probably the rudest physician I had ever interacted with, and despite my employee badge he treated me as if I was a nuisance and not worth his precious time. One or two of the research assistants in our departments were accepted into medical school there a year or two later, and I vividly remember seeing one of my former colleagues who was a first year student. She was normally a very friendly and outgoing person, but when I saw her she was very depressed, on the verge of tears when I asked her how it was going, and said “whatever you do, don’t come here.” As it turned out NYU didn’t even grant me an interview, and I don’t regret that one bit.

I was fortunate that Atlanta has a very good longstanding healthcare system. Piedmont Healthcare, including Piedmont Atlanta Hospital, and its affiliated hospitals and clinics, which date back to 1905. When I had the abdominal pain that was quickly diagnosed as appendicitis I could have gone to the Emergency Department at Emory University Hospital, especially since I was an intern in the Department of Pediatrics at Emory. However, I chose Piedmont Hospital because of the severity of the pain and because I did not want to see a battery of examiners (medical student, intern, resident and attending physician) who would all press on my very tender belly and ask in turn, “Does this hurt?” Fortunately by the time I got to the Piedmont ED it was in the early morning hours, and I only had to be examined by the ER physician. What was also odd was that I was asked when I checked in what my occupation was. When I told the intake person that I was a pediatric intern at Emory everyone from then on addressed me as “Dr M____,” which I found surprising and unnecessary, as I don’t like to be treated with any special consideration. Certainly Timothy Snyder’s almost infinitely more important position as Professor of History at Yale didn’t earn him any special care!

More importantly, everyone is due to a certain and equal degree of healthcare and respect as a patient, which sadly neither you nor Dr Snyder received, and that is a criminal indictment of our "healthcare system" IMO.

Okay, back to Our Malady...

>22 kidzdoc: Yes it’s truly horrible. I have an excellent pulmonologist who agrees with me. I intend to stay out of hospital and care homes.

After my last surgery I went to what is considered the best rehab in Manhattan. I had to go on a low fiber diet. So what they did was take the standard offering for the day, and remove any piece of food that had fiber in it. Leaving virtually nothing. When I left the place I weighed 78 pound.

I do know that NYC is particularly bad and not indicative of the rest of the country.

>23 kjuliff: I hope that you are able to avoid the NYC healthcare system as much as possible, Kate.

Unfortunately my intimate knowledge of adult healthcare here is quite limited. Piedmont Atlanta Hospital was very good, and I would have no hesitation returning there. I have some experience with the hospitals in Philadelphia, particularly the Hospital of the University of Pennsylvania and Thomas Jefferson University Hospital for my mother, and the care in the inpatient units for both were good. I went to the University of Pittsburgh, a highly regarded medical school, but my knowledge of its adult services is limited.

When I left the place I weighed 78 pound.

Yikes. That isn't a healthy weight for anyone!

I would recommend listening to Naomi Oreskes TED lecture in which she outlines exactly how Big Tobacco created the machine that discredited the science back in the late 1940's and until the Surgeon General finally made his recommendation. She then traces how the template for fighting the Tobacco War has been used successfully over and over again when dealing with disparate science issues. That lecture is about and hour and she is a very interesting speaker. That lecture is the short form of what is in the book. I know that you are a reader so my advice is to listen to the lecture and you will get the gest of what Oreskes is trying to say without having to plow through the tome. (and it is a tome.)

I recommend this because Oreskes message about how distrust and mistrust of science was created is so important to many of the events of the past months. It took Big Tobacco and a group of bought and paid for scientists 50 years to create the current anti-science environment and it behooves all of us to understand where, why, and how this was created.

>24 kidzdoc: I hovered around 78 pound for several years and was diagnosed as malnourished. I could not get in to see a nutritionist. Unfortunately I have late stage emphysema and several bowel and bone problems so can’t avoid the medical system here. I am too ill to leave or I’d be gone in a flash.

>17 japaul22: >22 kidzdoc: Another excellent book on the opioid crisis and the FDA, along with local officials turning a blind eye, is Death in Mud Lick. Kermit is a West Virginia town with a population of 382, where more than 12 million opioid pills were legally distributed in three years.

The author won a Pulitzer for his reporting. His book also highlight the importance of local news reporting, at a time when large chains are discarding local focus.

https://www.kirkusreviews.com/book-reviews/eric-eyre/death-in-mud-lick/

>17 japaul22: I think this is one of many things
I bet you're right.

>22 kidzdoc: had to stay in the room
Wow. That would take a toll.

>27 SassyLassy: Death in a Mud Lick
I wasn't aware of this one, thanks. The one I read was Empire of Pain, which is hefty but a page-turner.

>27 SassyLassy: >28 qebo: I also read Empire of Pain, but I'm interested in the other books mentioned as well.

>25 benitastrnad: Thanks, Benita.

>26 kjuliff: I'm very sorry for your health conditions, Kate.

>27 SassyLassy: Thanks for recommending Death in Mud Lick, Sassy.

>28 qebo: It was a toll indeed, Katherine.

>29 japaul22: I'll start with the book(s) I have first, as there are other public health books I own but hadn't mentioned. I probably won't get to all of the books that I identified as books I would like to read this year by the end of next month, so some of them will almost certainly need to be amongst my first reads of 2025.
__________________

Yesterday was a busy day, due to my responsibilities in caring for my mother and new problems with this house that had to be addressed, which I had to do despite my hip and thigh pain. I have an appointment with an orthopedic surgeon later this morning, and I hope to receive a diagnosis and, especially, a treatment plan that will allow me to function with less pain. I'll check back in here when I can.

Wow, your threads exploded while I retreated into my cave after the cataclysmic events of this month.

Your '25 reading list has titles I would like to explore. But it does look like an ambitious list.

Glad you are enjoying Covenant of Water. It's a great way to escape the day to day right now.

I hope you get relief from your pain.

Hi Darryl - here is the Epidemiology/Infectious Diseases thread. The thread was actually started in 2007 - so is **very** slow moving. - I wonder if it is the oldest thread here on LT. One person seems to be keeping the almost the entire Science talk group alive.

https://www.librarything.com/topic/6222#n8672946

Good luck with your orthopedic appointment.

BTW, my friend the PT said that the most effective way to use heat is to use it 20 minutes on and then 20 minutes off. It's something about moving the blood through the area as the veins expand with heat and then contract. I was doing it the way you describe - it felt so good just to keep heat on continuously. The heated seats in my car are the perfect angle and warmth. At one point I jokingly told her I was going to drive the five hours to Spokane and five hours back each day for a cup of coffee. That's when she enlightened me to the twenty minute rule.

I'm back from my appointment with the orthopedic surgeon, who agreed withe diagnosis of trochanteric (hip) bursitis the urgent care doctor gave me 1½ weeks ago. Other than a typical arthritis of the hip everything else looked fine. Dr Cha's treatment plan was in line with what I was expecting and hoping for: a cortisone injection into the inflamed bursa, followed by physical therapy once it has cooled down sufficiently. Unfortunately next week is a short one for non-urgent procedures, so my injection won't take place until the Monday after Thanksgiving, unless a cancellation opens up an earlier time slot.

I was concerned that I might need some sort of spinal surgery, given the radiation of pain and numbness down to my lower leg, so I'm relieved that I only seem to be a common, though very painful, case of bursitis. Unfortunately between now and the cortisone injection I'll have to manage the pain with naproxen, heat pads, and as much rest as I can get. It would be much more tolerable if I didn't have to care for Mom, but I'll just continue to grit and bear it. I won't make any attempt to cook all or most of Thanksgiving dinner, so that responsibility will fall to my younger brother, probably for the first time in his life.

Yes, the 2025 list is still a very ambitious one, but I feel that it is more doable than my "insane" ones of previous years.

Yes, The Covenant of Water is still a fabulous read, although I've lately spent more time with Our Malady, as I'll need to return it to my local library, and pick up the two books I requested, by Monday.

I'll have to restrict the time I spend on my own thread and on LT going forward, as I'm pretty sure than I spent more time there than in reading books!

>32 streamsong: Thanks for letting me know about the Epidemiology/Infectious Diseases thread, Janet; I was completely unaware of it. I'll submit a request to join it later today or tomorrow. I may try again to revive the Medicine group on LT, as well. There is only one other physician I know of who is a member of LibraryThing, kiwidoc from Vancouver; we are connected on LT and Facebook, but I haven't heard from her in many years. I've encouraged some of my physician friends to join LT, as many of them are avid readers, but no one has decided to do so.

Thanks for that piece of advice from your PT friend! My hip was barking at me after I returned from the Ortho appointment and had lunch, so I'm lying in bed and using that method, after I took 400 mg of Naproxen. I'm definitely feeling better, but I'll have to get up from here and pick up my mother from the adult day center in a little over an hour.

Catching up on your threads at last, after yet another period of falling far, far behind on everything. Best wishes for the bursitis improving for you ASAP. I've had a bit of bursitis in my elbow before, and I did not enjoy it, but your hip version sounds so much worse than what I experienced that I'm going to count myself lucky.

And words cannot express how distressed I am at the idea of an anti-vax nutcase like RFK Jr. being put in charge of public health. I feel like it's probably preaching to the choir a bit here, but just in case anyone wants or needs a good overview of vaccines and the history and dangers of the anti-vax movement, I can definitely recommend Deadly Choices by Paul Offit.

>34 bragan: Hi, Betty! I have nothing to compare this to, so I can't objectively determine if mine is a particularly bad case, or if I'm being a bit of a weenie about it.

Yes, many of us in the medical community are distressed and infuriated by the nomination of RFK, Jr at the Secretary of Health and Human Services, and that was one of the main reasons that we supported the Harris/Walz tickets. One of my pediatric colleagues posted an impassioned statement on her Facebook thread yesterday, which I plan to copy and post here later today; I have to bring my mother to a doctor's appointment shortly.

Thanks for recommending Deadly Choices. Even though my LT account denies that I own it I thought I had read it in the past. He is well known in the pediatric community, as he is a long time pediatrician and vaccine expert at the University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia. I've read two of his books that I can highly recommend, Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure, and The Cutter Incident: How America's First Polio Vaccine Led to the Growing Vaccine Crisis.

One of the books I'm reading now, Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-science by Peter J. Hotez, MD, PhD is a newer book in the same vein; it was published in 2021, whereas Deadly Choices came out in 2010, although it's still a very worthwhile read. Like Dr Offit, Dr Hotez is a highly respected pediatrician and vaccinologist, who teaches at the Baylor College of Medicine and Texas Children's Hospital, and also served in the second Obama administration. Another book of his which has gained attention is Vaccines Did Not Cause Rachel's Autism: My Journey As a Vaccine Scientist, Pediatrician, and Autism Dad, in which he refutes any and all suggestions that his daughter's case of autism was caused by vaccines.

>35 kidzdoc: Not a weenie, I'd say! My elbow pretty much only hurt if I touched it or leaned it against a desk or something. So it was more of an annoyance than anything, but even that made me pretty unhappy. Which probably makes me the weenie, really. :)

I fear the medicine-and-politics news is just getting worse, as I've just heard that that quack Dr. Oz is the pick to be in charge of Medicare. Ugh.

I'd thought maybe Autism's False Prophets was on my wishlist. I'd certainly heard of it. Apparently not, though, so on it goes, thanks! I'll be looking forward to seeing what you have to say about your current read when you finish it, too.

I'd love to see books with good information like this get a much wider audience. For many people, no doubt, resistance to vaccines comes out of emotion or ideology, whether it's "Western medicine=bad" on the left or "anything the government wants you to do=bad" on the right, and it is a truism that it's nearly impossible to logically argue people out of positions they didn't argue themselves into in the first place. But it seems to to be one area where more information sometimes really does help, because even people who genuinely want to make reasonable decisions can be so clueless about what is or isn't actually reasonable.

I remember having a discussion with a friend of mine once, an intelligent and supposedly well-educated guy. He said he wasn't anti-vax, but that he did think it made sense that using too many vaccines could be bad, because then your immune system might "rely on them too much" and "get lazy." And it was suddenly clear that he had absolutely no idea what a vaccine is or how it works, since that is the exact opposite of what they do! This is absolutely the sort of thing we should be teaching kids in schools, but it's not happening, and instead people are left with what they believe is basic common sense, but is really nothing but a series of dangerous assumptions made in ignorance. Assumptions that, of course, some people are all too keen to encourage.

This is the fiery and outstanding statement that one of my fellow pediatricians in Atlanta posted on her Facebook timeline earlier this week. I asked her yesterday if I could share it here, and last night Dr Contrucci enthusiastically replied "Yes!"

I refuse to stand by in silence. People have LOST THEIR MINDS. As a Pediatrician of nearly 30 years, I have seen babies and children DIE of vaccine preventable diseases for NO reason other than their parents choosing to be persuaded and lied to by anti-science people. Tik Tok and FB groups are not science and neither are people like RFK…say it louder for those in the back. These people simply put, ARE DEAD WRONG, and when children die as a result OF THEIR DISINFORMATION, I have no words for my outrage. Now, with RFK’s potential confirmation as head of HHS, we are at a very DANGEROUS place in our country. He is wrong WITH EVERY SENTENCE that comes out of his mouth about vaccines. Anecdotal stories and pseudoscience without real data is simply fiction, not fact.

There is NO GREY HERE. I trained in the era before we had the pneumococcal vaccine for instance, and cannot count how many babies whose spinal taps I did that had pneumococcal meningitis and/or sepsis and ended up with permanent impairments or death. Or the number of children I took care of who survived their H flu meningitis, always severely brain damaged. Or the number of kids I took care of with meningococcal meningitis or sepsis, in varying stages of dying or if they survived, having multiple amputations of their limbs from the disease.

Talk to my OBGYN colleagues about the horrible cervical cancers in women in their 20’s and 30’s which could have been prevented with the HPV vaccine.

I have seen a few babies die of Pertussis in the last 10’ish years…those numbers are increasing. Polio much? Seen in NY a few years ago with an outbreak. Measles anyone? Biggest number of cases overall in 2024 than the last 5 years combined.
There’s a specific reason why the vaccine schedule is the way it is. And it is not a simple “tik tok” 10 second explanation, but has a complex immunologic and physiologic basis. Essentially, babies cannot create long-term immunity. They are also at the greatest risk of death from many of these illnesses in the first year of life. Therefore: Vaccines are given every two months in order to provide infants with temporary immunity, to protect them from these diseases. This is why a delayed vaccine schedule is NOT helpful. Not to mention none of these “alternative” schedules have science to back them up. The baby then has gaps of time without protection without following the standard schedule. I don’t think people understand that. Their immune system is not yet capable of developing immunity for prolonged period of time. “Naturally acquiring” these diseases is like playing Russian roulette - why would anyone who knows the actual science do that??? THESE DISEASES ARE DEVASTATING AND DEADLY. Go to an old cemetery from the pre vaccine era and see how many babies and young children’s graves there are. Because they DIED of these infectious diseases! The same ones we have vaccines for now. And why we don’t see the same number of deaths. And also why we are seeing these diseases again…due to people not vaccinating. That part should not be complex to understand.

In addition, immunity is not lifelong and not everyone can receive vaccines. Which is why “herd immunity” is important - it protects older people in our community, or others who cannot be immunized or infants who are partially immunized due to age. And we are not at herd immunity levels in most of the country at this time.

RFK is dangerous, he is not an expert in anything medical AT ALL (unless we count pseudoscience and lies) and if his appointment is confirmed, it will not be a matter of if we start seeing even more of these PREVENTABLE diseases, but how big of a toll will they take on our society.

Please send a letter using the link below to your senators telling them RFK’s nomination MUST NOT be confirmed.

Science is real.
Vaccines cause adults.

Love,
your very weary friendly old Pediatrician

All of this is spot on. The vaccines against Streptococcus pneumoniae (pneumococcus) and Haemophilus influenzae type b (Hib) were created in the late 1980s and were routinely administered to children by the early to mid 1990s, just before I trained as a pediatric resident from 1997 to 2000. The residents that were only a couple of years older than I was marveled at the dramatic decrease in the number of cases of bacterial meningitis in infants and toddlers caused by those two organisms, which typically caused widespread blood borne infections that required amputation of some or all extremities (one of the first patients I saw on my first day as an intern was a young girl who had complete amputations of her arms and legs from bacterial sepsis), severe and permanent brain damage, or death. Residents who trained during or before the early to mid 1990s typically had to perform spinal taps multiple times a night on call for suspected bacterial meningitis, and the cerebrospinal fluid of those poor kids were so laden with bacteria that they resembled pus rather than clear fluid. By the time I trained bacterial meningitis was so rare that I cannot remember a single florid case of it, and essentially all the cases of meningitis I cared for were caused by viruses, and had far more favorable outcomes, with at least 95% returning to normal in days to weeks.

I suspect that one of the major drivers of vaccine hesitancy or denial is that there has been a roughly 30 year time span between the end of bacterial meningitis as a feared childhood infection in the Western world and the current day. Parents don't see children in their families, friends or neighbors who have suffered the sequelae of meningitis or died from it, so therefore it's a problem that no longer exists in their minds, and their fear from injury due to complications from a vaccine becomes more important, which isn't helped by statements made by people such as RFK, Jr and Dr Oz.

This is the link to the SAFE Communities Coalition website that Dr Contrucci referred to, which you can use to get more information and letters that can be electronically sent to your senators to express your disapproval of Trump's nomination of RFK, Jr as HHS secretary. I believe that a majority of Americans oppose this nomination, and it will be of the utmost importance to express that to members of Congress in a grassroots effort, in the hopes that enough non-MAGA Republican senators will oppose this nomination.

https://www.safecommunitiescoalition.org/rfk?fbclid=IwY2xjawGsBhpleHRuA2FlbQIxMQ...

>18 dchaikin: Sorry, coming in here late, but to add to Dan's comment just a bit, I think one very important root of vaccine denial, etc., is the now widespread antipathy to "experts" or "elites." Supposedly, everyone's opinion on any subject you care to name is now "valid," so anybody telling people that they actually know more than them on a particular topic is to be reviled. There's always been a strong strain of anti-intellectualism in the U.S., but now that's all been mainstreamed and, even more to the point, weaponized. I have read through all the posts here, but apologies if I missed the fact that someone else has made this point already.

On a happier note, Darryl, today is Stephanie's birthday! It's her Medicare entry year! One of the birthday cards I bought her was a Mickey Mouse-themed 1st birthday card. When you open the card is plays Happy Birthday to You in the Mickey Mouse march style. The final line says, "Happy First Birthday," and I wrote in below with an arrow so that it reads, "Happy First Medicare Birthday." Well, she laughed, anyway.

>37 kidzdoc: >38 rocketjk:

"Human history becomes more and more a race between education and catastrophe" - H. G. Wells 1920

>37 kidzdoc: Added my name to the safecommunities site, though my senators will reliably oppose Kennedy anyway. Thanks for that link.

Breaking news: The ultra sleazy US congressman Matt Gaetz has just withdrawn his name as nominee as Trump's attorney general, after two women announced that he paid them a total of $10,000 to have sex with him, the latest of the scandalous behaviors he has at least been accused of, including having sex with a minor.

>36 bragan: In my younger years my reputation was of being anything but a weenie. When I was in my twenties and working as a chemical engineering technician in a US Navy R&D center I badly sprained my ankle during a lunchtime pick up basketball game. My ankle swelled to at least the size of a grapefruit, but I managed to get an Ace bandage and crutches, possibly from the center's infirmary, and returned to work a couple of hours later. I was taking night classes at Rutgers at the time, and I remember walking to one of my classes after work (I think Physical Chemistry) with crutches, which was no fun but I didn't want to miss the class, as that was one of the most difficult I ever took and going to class made it much more understandable. I don't think I missed any work days, and it wasn't until many years later that an X-ray of the ankle revealed that I had actually broken it!

During my intern year I had a bout of appendicitis, underwent a laparoscopic (as opposed to an open) appendectomy on a Sunday afternoon, and was discharged home on midday the next day. The chief resident brought me home that day, and later that day a senior resident who has since become a close friend brought a shopping bag filled with a week's worth of ready to eat meals (soups, microwaveable dinners, oven pizzas, etc.), which I'm still grateful for. The program director called me either that day or the next to check on me. I told Dr Buchter that I felt well, as my pain was easily controllable with ibuprofen, and I offered to go back to service and take a 36 hour call later that week. The phone got very silent and she said, in a firm but motherly voice, "Darryl, you will stay home until Monday, as we have your shifts and calls covered. If anything changes let one of the chief residents know." That story was passed down for many years, as the responses from my fellow residents and the attending physicians ranged from admiration to incredulity.

Ugh, indeed. Your message was the first information I had received about Dr Oz's nomination to head the Centers for Medicare and Medicaid Services, which is utterly horrifying. Medicaid is the agency that provides health care for the poor, especially children, in the US, and Medicare is for people 65 years of older and younger people with disabilities. This is a kitchen table for millions of Americans (I will turn 65 in March 2026), and if Oz f*cks too much with Medicare even the most staunch MAGA Republicans will likely march to Washington en masse and look to put his head on a platter.

I'll try to do a much better job reviewing books promptly, especially ones in the health, medicine and health policy realm. The copies of The People’s Hospital: Hope and American Medicine by Ricardo Nuila and Legacy: A Black Physician Reckons with Racism in Medicine by Uche Blackstock, MD are waiting for me in my local library, so I need to finish Our Malady: Lessons in Liberty From a Hospital Diary by Timothy Snyder by Monday, as another library member is waiting for me to finish it.

In addition to being a horror story about his near fatal illness that was badly misdiagnosed by physicians in Germany, Florida, and the renowned Yale-New Haven Hospital (*rolls eyes*) he discusses why American medicine has failed so many people, particularly the working class who have lost good jobs and the ability to provide for themselves and their children, and he explains why so many of those who voted for Obama in 2012 chose Trump in 2016. I couldn’t help but marvel how applicable this remains the case in 2024 as it did in 2016, and I couldn’t undersand if any of the supposedly smart people in the DNC had read this or similar books that describe this very important segment of voters, Hillary Clinton’s “deplorables.”

The middle years of the 20th century were arguably the best ones for American medicine, as numerous discoveries allowed people to survive previously untreatable illnesses that claimed millions of lives or left many crippled. An overly proud shout out goes to two monumental researchers, one from Rutgers, my undergraduate alma mater, as the Nobel Prize winning microbiologist Selman Waksman discovered streptomycin, one of the first antibiotics that successfully treats tuberculosis, which remains in use today, and Jonas Salk of the University of Pittsburgh School of Medicine, the developer of the first successful polio vaccine that saved many thousands if not millions of children from developing paralytic polio and spending their lives in iron lungs. During those years these medical discoveries were widely heralded by the public and reported on the front pages of newspapers, particularly the Salk vaccine, and the respect that they had for physicians was arguably higher than it ever was.

The Cutter Incident was one of several missteps in which a drug company, namely Cutter Laboratories, was given a license to produce the Salk vaccine but distributed hundreds of thousands of doses of ones that had live poliovirus. As a result, 120,000 cases of vaccine related polio resulted, 40,000 developed symptomatic polio, and 56 developed paralytic poliomyelitis, including five deaths. It was a huge scandal in the mid 1950s, and Paul Offit’s book The Cutter Incident describes the effect it had on vaccine development in the United States, and the rise of vaccine skepticism that resulted.

>38 rocketjk: I think you're right, Jerry. I certainly ran across plenty of parents when vaccine skepticism began to rise in Atlanta in the mid 2010s and especially during the COVID-19 pandemic, who told me that "they had done their own research" and wanted me to read the information they had come across so that we could discuss it together. Essentially all of it was utter garbage, and I somehow had to tell them that I didn't agree with the points made in the information they provided me, and that we would have to agree to disagree and come to some mutually acceptable middle ground to treat their sick child, which wasn't always an easy proposition. One thing that was tremendously helpful to me is that I was conversant in Spanish (the medical translators said that I was fluent but the head of Translation Services department refused to allow people like me and even some Latino staff members to take a test to demonstrate our fluency), and since a sizable minority of our patients were suburban Latinos, with mothers who often spoke little or no English, I didn't have to deal with the often difficult vaccine hesitant upper middle class mostly White parents that my partners did. To be honest, I wouldn't mind working in a clinic or other setting where the families I see are solely Latino!

Ha! Wish Happy Birthday to Stephanie for me. Hopefully we can get together again before the year is out or sometime early next year.

>39 dukedom_enough: True, all too true.

>40 dukedom_enough: You're welcome, Michael. John Fetterman is now the senior senator from Pennsylvania, and as a good Democrat he will certainly oppose RFK, Jr's nomination. Barring any unforeseen vote change the Republican Dave McCormick won a very close race against incumbent senator Bob Casey, and it's too early to say what he thinks about RFK, Jr.

Here are the winners of this year's National Book Awards, which were awarded last night.

Shifa Saltagi Safadi won the award for Young People's Literature for her book Kareem Between, a coming-of-age novel about a Syrian refugee.

The prize for translated literature went to Yáng Shuāng-zǐ and her translator Lin King, for their book Taiwan Travelogue. The book is a novel about the relationship between a Japanese novelist and her Taiwanese interpreter. But it's also about the work of translation, as it presents itself as a translation of a rediscovered text by a Japanese writer.

Lena Khalaf Tuffaha, winner of the poetry award, also addressed politics — criticizing both major U.S. political parties. Her collection, Something About Living, is an expansive look at Palestinian history and the Palestinian diaspora. Tuffaha encouraged people to "demand that any administration — no matter what letter it has at the end of its name… should stop funding and arming a genocide in Gaza," she said.

The non-fiction award went to Jason De León, who's book Soldiers and Kings: Survival and Hope in the World of Human Smuggling is an anthropological look at the people who bring migrants over the southern border. In his speech, he addressed the recent presidential election, saying "I will not accept the dystopian American future of unchecked corruption, border walls, misogyny, mass deportations, transphobia, climate change denial and all this other garbage that this incoming administration wants to propagate and profit from."

And, as many of you probably know by now, Percival Everett finally received his first major literary award, winning the fiction award for James, which retells the story of Huckleberry Finn but from the perspective of Jim — the escaped slave Huck becomes friends with. At his acceptance speech Everett let his work speak for itself and stuck to thanking family, friends and colleagues. But he did open with a jab at artificial intelligence, saying it's "no replacement for the real thing."

I managed to catch the entire award segment of last night's broadcast on YouTube, starting just after 9 pm. All of the acceptance speeches were good, but the ones by Shifa Saltagi Safadi and Lena Khalaf Tuffaha were especially moving. Something About Living deserves a place in my personal library, so I'll buy it from one of my favorite local bookshops and read it early next year.

>37 kidzdoc: Thank you for sharing the information and the link to Safe Communities. I sent off my letters, fortunately they were overcome by events.

>37 kidzdoc: Kudos to her for such a pull-no-punches response!

>42 kidzdoc: OK, I was wincing just reading your walking-on-a-broken-ankle story!

And sorry to be the bearer of bad news, re: Dr. Oz. My mother has Medicare, so of course this worries me along with all the other millions of things that are currently worrying me.

Our Malady sounds like one I might want to read, too.

>45 labfs39: You're welcome, Lisa. I didn't quite understand what you meant by your letters being overcome by events.

>46 bragan: Yes! Dr Contrucci is passionate, fiery and has always spoken her mind clearly for as long as I've known her, which I greatly admire.

I also can't believe I walked on a broken ankle! Granted it was a small fracture, as only a fragment of either the fibula or the tibia was pulled off of the other bones of the ankle, but it was still very obvious on X-rays taken 20+ years later. I probably would have only needed splinting then, and there certainly wasn't anything to do for it once it was discovered.

I'll be curious to see what the fallout is from Mehmet Oz's nomination as Secretary of the Centers for Medicaid and Medicare. I saw or heard somewhere that Trump wants to make significant cuts to Medicaid, which could cause great harm to many thousands of poor children. I also saw that RFK, Jr wants to make substantial changes to the way that physicians are reimbursed here, with a greater emphasis on primary care and preventive medicine and less on far more expensive specialty care. Some of those ideas are quite sound and would be welcomed by organizations such as the American Academy of Pediatrics (AAP), although the highly powerful and influential American Medical Association (AMA) would almost certainly balk at having some of its power and ability to craft medical codes and enrich the wealthiest of doctors taken away from it. BTW I'm a member of the AAP but not the AMA, as it has far less interest in physicians at the lower end of the financial totem pole.

I finished Our Malady: Lessons in Liberty from a Hospital Diary not long ago, and I wanted to applaud Timothy Snyder once I was finished, as he absolutely nailed the problems with the American healthcare system, including reminding me of what it was like to practice as a hospitalist (inpatient pediatrician) during the COVID-19 pandemic. It easily gets 5 stars from me, and I'll write a review of it tomorrow.

Just catching up on your thread and you have such interesting reading planned for 2025. There's quite a lot of overlap on my tentative list and yours, so I'm looking forward to seeing your thoughts on these books. I hope the hip is better soon. Also, I appreciate all the advocacy you and your colleagues are doing for children, in these grim times.

I used your safecommunities link in >37 kidzdoc: to contact my senators. My only gripe is that I was not given an option to contact my newly minted magat senator who will actually be doing the confirmation voting, instead of our wonderful Democrat senator who was ousted. I did find an email address online for the new guy and sent him a copy of the letter, too. I couldn't find a contact in safecommunities to make the suggestion that they add the recently elected.

I used to watch Mehmet Oz's TV show occasionally but quit when he became more and more enamored of snake oil and alternative "medicines". Another scary cabinet pick.

Book #30: Our Malady: Lessons in Liberty from a Hospital Diary by Timothy Snyder



My rating:

This impassioned, accurate and timely critique of the American healthcare system by the famed Yale historian originated from a diary he wrote while hospitalized from December 2019 to March 2020 after a series of medical misdiagnoses nearly claimed his life.

On December 3, 2019, Dr Snyder gave a lecture in Munich, but later that evening he fell ill, so he sought medical attention. The German doctors could not find anything wrong with him, and he was cleared to return home to the United States. Shortly after his return he fell ill again, and while at Yale-New Haven Hospital in mid December he was diagnosed with and treated for a burst appendix. (My best guess is that the German doctors missed the burst appendix because the ruptured organ caused relief of the typical reproducible pain expected in a classic case of acute appendicitis, and Dr Snyder flew back to the US before the symptoms of a burst appendix, including peritonitis, began.) Unfortunately the surgeon(s) failed to recognize that he also had a large abscess in his liver, which was followed by a case of near fatal bacterial sepsis that was nearly missed by nurses and physicians working in the Yale-New Haven Hospital Emergency Department on a very busy Saturday night in late December (note: a blood pressure of 70/30 is not normal for anyone!!). Eventually after multiple surgeries and procedures, along with a huge hospital bill, he was sent home in March, shortly after COVID-19 was declared as a pandemic.

Dr Snyder documented his experiences during those three months as a patient and his thoughts about why the healthcare system fails so many people, both patients and healthcare providers, due to the takeover of the system by corporate medicine and other monied interests, which stand to gain when people are sick and need expensive medications and procedures, rather than providing them with preventive care that keeps them healthy. He mentions that the Declaration of Independence lists as three unalienable rights “life, liberty and the pursuit of happiness,” yet chronic illness and pain prevent many Americans from being happy, or truly free.

The first lesson of “Our Malady” is ‘Health Care is a Human Right,’ and in it he mentions that this right, which was declared by the United States after World War II and adopted by numerous countries, including Germany and Japan, was not fully embraced here, and that far too many Americans suffer in a system that costs all of us more but provide us with less care, save for the widespread distribution of opioid pills that enrich companies such as Purdue Pharma but only shorten and decrease the quality of life for many rural and working class Americans.

In lesson 2, ‘Renewal begins with children,’ Dr Snyder notes the stark differences in the medical care he and his wife received when their daughter was born in Vienna with the experience with their son in the United States, and how American parents leave the hospital far less equipped to care for a young newborn. He argues that an excellent early start in life provides young children and their parents with a greater chance of success and normalcy, which we in the United States are often not providing to families.

‘The truth will set us free’ is a sharp rebuke of the deplorable management of the COVID-19 pandemic by the Trump administration, which was worse than in any other countries, as over one million Americans died. Reading this lesson brought back memories of the fear and difficulties first responders such as myself faced, as Trump sent millions of precious and lifesaving N95 masks to China and those of us caring for patients hospitalized with COVID-19 often had to use the same mask and protective gown for a week at a time, labeled with our names. Any complaints about not having sufficient protection, even by my partners with families, was quickly squashed by hospital administrators (none of whom, of course, were involved in direct patient care) until we were finally provided with enough masks, gowns and other personal protective equipment (PPE) months after the pandemic was declared in March 2020.

The final lesson, ‘Doctors should be in charge,’ successfully argues that doctors have very little ability to adequately care for patients in corporate medicine settings where even non-profit hospitals focus on the bottom line and money generating activities such as robotic surgeries as opposed to mental health care that would benefit many more children, or clinics in low income or underserved communities. Insurance companies, drug companies and specialists all benefit from the status quo, and primary care physicians and, more importantly, the patients they serve suffer as a result.

I can identify with Our Malady on many levels: first as a patient who sought emergency care for severe abdominal pain, was quickly and accurately diagnosed with acute appendicitis, was operated on within 24 hours, and was discharged home appropriately the following day; as a patient who was hospitalized in the same facility twice for an abnormal heart rhythm, and treated with respect and attention by the nurses and physicians who cared for me; as a physician first responder during the COVID-19 pandemic, who witnessed the often inadequate and misleading information that came from the federal government, particularly the Trump administration; and as a physician who is well aware of the deep seated problems in the American healthcare system and agrees with Dr Snyder's criticisms of it and his suggestions to make it better for everyone, both patients and healthcare providers. This is a fantastic book that I can't recommend more highly.

If you got a quick and accurate diagnosis and treatment the first time, you're doing much better in the medical system than my mother has, or my sister, or me, or so many other people I know. Your reading looks interesting and this medical system is so screwed.

>48 rv1988: Thanks, Rasdhar! I also look forward to your reading plans for 2025.

My hip is marginally better, but it certainly isn't worse. The good news is that if I lie down it's far easier to attain a position of comfort. I do have to continue to care for my mother, though, so I do have to get up at least three times a day to tend to her, by changing her disposable underwear and pants, making her meals, etc. Fortunately she does not ask for much, and she is being a Good Mom by expressing concern for me, apologizing that she cannot help me (I have to constantly assure her that this problem isn't her fault and that it should get better once I get a steroid injection in my hip bursa on the Monday after next), and not asking for much. She definitely appreciates me taking care of her after her husband, my father, died, and we have a great relationship.

Yes, the American Academy of Pediatrics will certainly ramp up its advocacy efforts in the coming weeks and months, and do whatever it can to fight for the rights and care for all children, especially the most vulnerable of them. Even the staunchest of MAGA voters have kids, some of whom rely on public programs such as Medicaid and the Children's Health Insurance Program to cover the costs for their care, and we'll undoubtedly reach out to them and urge them to contact their MAGA senators and congressman to protect their children.

>49 streamsong: Thanks, Janet. I actually haven't registered with that SAFE Communities link yet, so I need to get on it. Our incumbent senator Bob Casey only conceded to his MAGA opponent a day or two ago, so given what you said I'm sure that Casey's name will be on there.

I haven't watched any of Dr Oz's television programs, and I was unaware that he had migrated to the dark side until he was announced as the Republican candidate for the open Senate seat here in Pennsylvania.

>51 reconditereader: I'm sorry to hear that about you and your mother. My case of acute appendicitis was a textbook one, and when the ER physician pressed right at the anatomic location of the appendix I nearly passed out from the pain and vomited bile. Appendicitis can be anything but straightforward in children, who often require radioimaging (ultrasound or CT scan) to reveal the inflamed appendix, and I'll have to plead ignorance on whether my case was truly common. The cases of atrial fibrillation I had showed up very easily on an EKG, and even though I wasn't sure what was happening I could feel the abnormal rhythm by checking my pulse and using my stethoscope to listen to my chest.

Your point is well taken, though; the American healthcare system definitely fails far too many people.

Possibly women present less "textbook" symptoms of various maladies, possibly because the textbooks were written by, for, and about men. Just a hypothesis I have. Also nobody studies women's health. It's a crime and a shame what we don't know about menopause, or endometriosis, or autoimmune disorders, or all sorts of things that mainly affect women.

(I'll get off the soapbox, really!)

>50 kidzdoc: Excellent review and a book that I'll look for. I was born in that hospital when its name was Grace-New Haven, and I would've expected better.

My only experience with hospitalization was over 20 years ago at the University of Pennsylvania hospital, and I was positively impressed throughout. When I arrived at the emergency unit with abdominal pain I was taken seriously and seen to promptly, tests confirmed a gallbladder attack (no prior hint and I had no idea this was a thing) serious enough to require surgery, a cast of medical personnel explained what was happening and confirmed that I understood, and (as described to me in detail after the fact by an enthusiastic resident) the surgeon was determined to complete laparoscopic surgery despite difficulties, instead of conceding defeat and resorting to standard incisions; probably a matter of pride on his part but I am grateful. My only gripe was that a doctor with an entourage of students of appeared at the crack of dawn the next day, asked a series of questions, and complained that I wasn't answering coherently.

>53 reconditereader: Certainly men dominated the study of medicine from antiquity until well into the 20th century, as Elizabeth Blackwell was the first women to earn a medical degree in the United States in 1849, and women's health only began as an area of study in the 1960s, during the women's rights movement. Medicine is still a stodgy profession, and one of my longtime partners, who isn't that much older than me, related stories about being a medical student in, I think, the early 1980s and experiencing a great deal of sexism from professors, who thought she should go into nursing rather than medicine, and her classmates, many of whom viewed her presence as taking away a spot from one of their more deserving buddies 🙄. I would venture to say that women were not viewed as subjects worthy of intensive medical study until the 1980s, at the very earliest, or at least until women started to become OB/GYN professors in significant numbers and OB/GYN residents had a majority of female students. However, I wouldn't claim to have any knowledge about women's health, especially being a pediatrician for nearly a quarter century, and I would defer to any and all of my female colleagues in that regard.

My only quibble is that I don't believe it's fair to say that “nobody studies women's health,“ especially to the physicians and researchers who are actively engaged in this effort.

>54 qebo: Thanks, Katherine. The care that Timothy Snyder received at Yale-New Haven Hospital was infuriating, as he sat in the Emergency Department with litte attention from nurses or physicians until it finally became obvious that he was septic and needed to undergo emergency surgery. A BP of 70/30 is indicative of sepsis, and that alone should have merited more attention, whether there were 10 patients in the ED or 100. Snyder recounts that a family friend, who I believe is a physician at Yale Medical School, brought him to the Emergency Department and expressed her concerns about him to several nurses. However, because she was Black the nurses laughed about her after she left and questioned if she was a doctor. As a result, Dr Snyder experienced substandard care due to racism against his friend. The arrogance of the nurses and resident physicians was unbelievable, and I can only hope that several heads were chopped off and placed on platters once Dr Snyder made this story public.

I'm glad that you had a good experience at the Hospital of the University of Pennsylvania. My mother was hospitalized there in 2016 for removal of one of her adrenal glands, which contained a benign tumor that was emitting a hormone which caused her to have severe (malignant) hypertension until a sharp nephrologist finally figured out what was going on. The hospital is very old, as you know, but the care she received there was excellent, including that from Mom's endocrinologic surgeon. Other than having a gaggle of trainees your experience at HUP mimicked mine at Piedmont Atlanta Hospital. I specifically avoided going to Emory University Hospital when I had the abdominal pain that was diagnosed as appendicitis because I anticipated that I would be examined by a series of trainees, all of whom would likely wish to examine my exquisitely tender abdomen to learn about acute appendicitis, even though I was a trainee (intern) myself ("does that hurt?").

Hi Darryl, just stopping in to say hi as I try to get caught up on some threads after an absence. I'm sorry to hear about your hip and hope that the shot and PT will give you long-lasting relief.

>57 Jim53: Thanks for visiting, Jim. I'm optimistic that the steroid injection and physiotherapy will work, and that I'll be back to normal in two weeks or less.

>50 kidzdoc: This one has definitely gone onto the wishlist, thanks!

>59 bragan: You're welcome, Betty! Our Malady is a short and easily digestible read, which adds to its appeal.

Based on this book I'll plan to read On Tyranny next year.

>50 kidzdoc: I had both my kids in Germany and lesson two is very true. There is the right to Wochenbett, where the person giving birth has a week in the hospital, to heal and to work through all the issues that come from caring for a newborn, and a midwife visits daily, then weekly once mother and baby are out of the hospital. For my first child, given that we were far from home, that midwife was invaluable. For my second, she helped me pragmatically work through some nursing issues in a way that removed all judgement from the decision. And all prescriptions for children are provided free of charge and there is a small monthly stipend directly deposited in the bank account that we used for things like diapers and clothes.

>61 RidgewayGirl: Timothy Snyder and his wife experienced a similar level of care in Vienna as you did in Germany, Kay. He mentioned that expectant mothers were encouraged to present to L&D when their contractions were 20 minutes apart, whereas in the United States they were told to wait until they were three to four minutes apart, and because of that more American babies are born before they can get to the hospital or suffer significant postnatal complications, including death. He blames that on the lack of adequate hospital beds for mothers and babies, and the overall profit margins under which so many hospitals in this country operate; an empty bed does not generate any income.

It was not uncommon for us to admit babies less than a week old to our hospital who probably would not have required readmission if they weren't discharged so quickly after birth, most commonly for jaundice or poor feeding. That of course drives up hospital costs, and although we could "benefit" financially from caring for those kids it would not have happened in hospitals in Austria or Germany.

I did return the copy of Our Malady I had borrowed from my local library yesterday, the day it was due, and I picked up the two books I had requested, Legacy: A Black Physician Reckons with Racism in Medicine by Uché Blackstock, MD, and The People's Hospital: Hope and Peril in American Medicine by Ricardo Nuila, MD. Dr Blackstock's book has been high on my radar screen since January, when it was first published to rave reviews, and I started reading it last night. So far it lives up to the hype, as her story is compelling and the book is a fabulous read. She and her twin sister Oni both graduated from Harvard University and Harvard Medical School, and the women were the first Black mother and daughters to graduate from Harvard Medical School. Dr Blackstock describes the barriers to equal lives that Blacks have experienced in this country for centuries, including unequal health care, lack of access to quality and environmentally safe neighborhoods, good schools, local supermarkets that offer fresh and reasonably priced produce, and other factors that cause Black men to die at far younger ages, Black women of childbearing age to die from pregnancy related complications far more often, and the infant mortality rate of Black babies to be more than twice that of White babies. I'll put the other books I'm reading aside for the time being, and devour this book over the next couple of days.

I finished Legacy: A Black Physician Reckons with Racism in Medicine yesterday, which was a well written and compelling memoir, combined with detailed information about the ways in which the American health care system and systemic racism combine to adversely impact health outcomes amongst Blacks in the United States, and a call to action to a variety of sectors to do more to correct these problems. Kay, one of the eye opening sections to me concerned a program in an inner city neighborhood of Minneapolis that provided expectant mothers with doulas and midwives that assisted with out of hospital deliveries, and an analysis which demonstrated that babies and mothers who utilized that and similar programs had far better outcomes than in hospital births and postnatal care. We were taught in medical school that the latter was the standard care of treatment, and that doulas and midwives were associated with inferior outcomes, when the reverse seems to be the case. That was one of several myths and mistruths that Dr Blackstock punctured in her superb book. Review coming soon...

I'm giving serious thought to creating a new group on LibraryThing in the next month or two, which I'll probably title Medicine, Public Health, and Health Policy, which will be designed for people to discuss fiction and non-fiction books about medicine, books and articles about public health, including topics such as vaccine hesitancy and global health initiatives, and books and articles about the potential changes in health policy under an incoming Trump administration. The current Medicine group has been dead in the water for years, and because of that LibraryThing will allow me to create a new group with these themes.

I would appreciate input from members of Club Read about my idea, especially if you think this is a bad or snooze worthy idea, or if you have suggestions that would make this prospective group more appealing to a wide audience.

>65 kidzdoc: I think this is a great idea. I would be happy to join and follow along, although I'm not sure I would be able to contribute a lot.

>66 labfs39: Thanks, Lisa. I'll have to give this some thought, as I want to make this prospective group as inclusive and possible and not overly academic, especially since there are only a few health care professionals, epidemiologists and other professionals in similar fields. I think that input from as many people as possible, especially but not solely this group, will be helpful in helping me create an interesting site. Given that there may be changes to the American healthcare system under a new Trump administration I think there will be broad interest in what RFK, Jr and Mehmet Oz, if they are nominated, try to implement, especially in regard to private and public insurance programs that we all have.

>67 kidzdoc: And the group will be all geared up when the next pandemic hits!

Best wishes for hip recovery, Darryl. I don't envy you (well, or anyone, but it's extra galling given the profession...) having to put up with the scary clown car set to run your health and research institutions for the foreseeable future.

I don't read much that relates directly to public health, but one recent book I liked a lot was Dr. Gabor Maté's
The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture.

You've heard this song before from me: it's way past time for the Americans (and I include Canadians) to change the systemic structures that create, abet, and contribute to society's maladies.

>68 dukedom_enough: That's sad but very true, Michael. Given how badly Trump mishandled the COVID-19 pandemic I can only pray that the next one occurs after he is out of office.

>69 LolaWalser: Thanks, Lola. I'm hopeful that Monday's steroid injection will provide a great deal of relief of this pain, and I'll need physiotherapy once the inflammation in the bursa has cooled down sufficiently. One of my nurse friends recommended pelvic floor exercises, which she has found to be helpful for her patients that have hip bursitis, so I'll ask about that during my first physiotherapy session.

Clown car, indeed. I shudder to think of people such as RFK, Jr and Mehmet Oz being appointed to such important positions, and I only hope that enough Republican senators will oppose their nominations. Unfortunately the Republicans picked up two seats after this month's elections, so they have a 53-47 advantage, and four of them would need to vote against any nominations to overcome a tie breaking vote by (shudder) Vice-President Vance.

I hadn't heard of The Myth of Normal before, so thanks for mentioning it. My local library has a copy of it so I'll either read it next month or in early 2025.

Hi Darryl--Hopelessly behind, but I skimmed. Rough year for me with both parents passing, heart surgery for my daughter and Covid at the start. Can not wait for 2025! Hope your bursitis is better soon (ouch!) and that you manage to find/make time to take care of yourself. I totally understand wanting less politics on your thread -- it is so draining right now. I just saw Verghese here at Literary Arts and got a copy of The Covenant of Water and it is on the top of my TBR list. Hang in there and best wishes. : )

>71 Berly: Good to see you here, Kim; I shall have to reciprocate in kind soon. You have had a difficult year, and I'm very sorry about that. I pray that your daughter has a complete recovery from her heart surgery.

I'm glad that you were able to see Abraham Verghese in person. I've put aside The Covenant of Water temporarily in favor of three excellent library books about medicine I've recently read, but I'll bring it with me to my local dealership later this morning to get a new tire, as I have plenty of time to read The People's Hospital before I have to return it in 2½ weeks.

I'm pretty much in the same boat as Lisa (>66 labfs39:), Darryl. I think the group is a great idea but will likely do a lot more following along than contributing.

We definitely need to get profit out of our health care system.

>65 kidzdoc: I went looking for the old group and found https://www.librarything.com/ngroups/278/Medicine, dormant for nearly a decade. Seems it may have had the problem of >67 kidzdoc:, gives an impression that it's confined to professionals. Whereas public health affects us all. I'd definitely be interested in following a public health group and in reading books on occasion. I'd think a difficulty in keeping such a group active would be a need for professional expertise to weigh in on conversations, which puts some demand on your time. OTOH, an alternative might be a dedicated thread in this group, which has the advantages of a built-in membership and experimenting with the idea, but the disadvantage of seeming closed to non-CR members.

My niece and her husband are both microbiologists who work for the federal government, so this was a topic of conversation at the family Thanksgiving gathering yesterday.

With one daughter a developmental pediatrician at Texas Children’s and another daughter a PhD. in genetics doing cancer research at a biotech startup, I read a fair amount of books focused on medical, health, science issues in order to be able to intelligently (sometimes) converse with them, though most of what I read is not aimed at the professional in these fields. I would definitely follow along on a thread for these topics, but as you might have noticed I have a very poor track record on following through with my intents regarding LT participation.

Thanks for your good ideas, everyone. I had no idea that it had been over 10 years since I (or anyone else) posted to the Medicine group! I'm now thinking it would be a better idea, based on your input, to create Medicine (for fiction and non-fiction books), Public Health and Health Policy threads in Club Read, rather than creating an entirely new group.

>76 kidzdoc:
I moderate two different threads here on LT and I can tell you from experience that just creating a separate thread in the Group to which you belong works quite well. It will mean that most of the members who post to the thread will be from the same group, but I find that it also tends to eliminate dissension and derision. People seem to be more respectful of others opinions when they see their posts often.

>74 qebo: I would probably read a dedicated thread within this group. But I, personally, wouldn't join a new group for such a narrow topic.

>77 benitastrnad:, >78 WelshBookworm: Thanks, Benita and Laurel. Based on your input and everyone else's I'll create threads within Club Read, rather than outside of it.

>79 kidzdoc: Sounds like a good plan! I may or may not have much to contribute to such a thread, but I will definitely be interested in following it.

>80 bragan: Great, Betty. I hope to make these thread(s) as open and non-technical as possible, to encourage discussion and sharing of books, articles, and other stories related to those topics.

Speaking of which, I imagine that most people have heard about the assassination of the CEO of UnitedHealthcare in NYC yesterday morning, and the messages spelled out on several of the bulletin casings that indicated that it was a targeted attack and a protest against the company's frequent denial of services to its members. There may well be repercussions against highly paid executives of these obscenely profitable organizations, and it will be interesting to see what the fallout will be.

>81 kidzdoc:

It's obscene that healthcare is treated like a for-profit business at all. Stockholders are literally making money off other people's misery and deaths. Everyone involved in this criminal enterprise should feel fear. Billionaire capitalist Warren Buffet said ages ago (I paraphrase) that the class war is indeed been waged--by the rich on the poor. The rich and comfy didn't bother listening. Maybe they'll listen to bullets.

it will be interesting to see what the fallout will be.

I read that another company backpedalled its decision to limit the length of anaesthesia they cover.

And then of course there's all the removing of staff pages from online resources. :)

Absolutely, Lola. American physicians are also to blame for creating the fee for service plan that originated in the 1930s, and for shooting down President Truman's dream of creating a single payer government run health plan in 1946 that would have provided affordable health care to all Americans, thanks to an intense lobbying effort by the powerful American Medical Association (AMA), as I may have mentioned previously. That opened the door for physicians and insurance companies to start charging ever higher costs to hospitals, which were ultimately passed down to people covered under these plans. The AMA continues to put physicians and profits over patients, whereas the organization I belong to, the American Academy of Pediatrics, focuses mainly on the health and well-being of children.

Yes, it was Anthem Blue Cross Blue Shield that made that highly reviled announcement that it would no longer cover anesthesia services for surgeries that exceeded specified time limits. Fortunately the public outcry was so swift and harsh that it walked back that despicable decision.

I'm sure that health care executives will be lying low in the coming months. They certainly earn enough to afford security details.

>83 kidzdoc: I still after 25 years in America, cannot believe how bad the American health system is. I’ve experienced the health systems in England and the UK. Though in the UK I was young and healthy, I did not fear hospitals. I didn’t fear hospitals in Australia either.

In Australia we have universal healthcare for all. Doctors are employed by clinics, hospitals or are self-employed. You don’t have to find an employer to cover you. Healthcare is considered a birthright.

Although I have some good doctors here in NYC I was surprised at first when they could not recommend a good hospital. Right now I’m sick as a dog and the specialist I have for a chronic condition is trying to treat me at home. The thought of being parked on an uncomfortable gurney for 18 hours is more than I can bear.

After my first hospital visit I asked my then PCP what was a god rehab place. His answer, “There aren’t any”

And what’s even worse, he was right.

>83 kidzdoc:

True, security firms look to make a (haha) killing.

>84 kjuliff:

Sorry to hear that.

>85 LolaWalser: the insurance fees will go up further with the added security they will be obliged to pay. And what’s with this limited time under general anesthetic? Do they just bring you out of it when time’s up.

I just don’t get it. In my time in my first job here a co-worker was denied coverage on a late-term miscarriage, her first pregnancy. The reason given was that it was a pre-existing illness.

My hope is that current events will at least shine a light on what is happening with health care/insurance companies. My sisters and I have already been through the wringer last summer when my mom was denied compensation for rehab after having her toes amputated. She wasn't regaining her strength and ability to get herself from sitting to standing fast enough. We appealed three times, jumping through their hoops, and finally won although we still haven't seen the money reimbursed yet. I was just there visiting her this week, because unfortunately she had a fall last month and had to have her hip replaced. Keep in mind she is 94. I arrived on Tuesday, and on Wednesday we were informed that insurance was only going to cover her through Friday. I went with her to her PT sessions, where she is having to relearn how to walk with a new hip. This is complicated by the fact that she is now terrified of falling again, so when the therapist tries to get her from sitting to standing, she has her legs and feet too far forward, and then tends to either lean back too far so that she can't stand at all, or we get her standing and then she is hunched over the walker with all of her weight on her wrists and hands. It is going to take some time - certainly another 3-4 weeks. My sister sent in an appeal after having me detail what she could and couldn't do and it was granted - this time. But they almost certainly will deny again after another week. If insurance won't continue to pay for her rehab, then we can't afford to continue to pay for her apartment, which we hope she will go back to. This is the kind of thing that is enacted out over and over and over again thousands of times a day across the country. She may be old, but we are not about to give up on her and just put her in a nursing home.

To keep this at least sort of on topic, I do admire your desire to read and be informed on medical issues.

Yes, the American healthcare "system" is uneven and has badly failed millions of citizens. A reform from the ground up is desperately needed, but I have little hope that it will take place during a second Trump administration.

I'm sorry for what you and your mother are going through, Kate and Laurel.

To celebrate the fall of the murderous Bashar al-Assad regime I will resume trying recipes in Soup for Syria: Recipes to Celebrate Our Shared Humanity, a cookbook which consists of 30-40+ recipes donated by well known chefs and cookbook authors and is dedicated to the millions of Syrians in refugee camps; the proceeds from the cookbook go to food relief efforts in these camps. Now that the Syrian Civil War has apparently come to an end hopefully these refugees can be repatriated soon.

In addition to these recipes Soup for Syria is filled with several dozen touching photos of Syrian children, and this would be a wonderful Christmas gift.

>89 kidzdoc:

The Syria of my childhood was a beautiful, diverse, secular country that despite being a military dictatorship thrived and had a future.

I won't pretend to believe that what replaces Assad is going to be better. Europeans, Americans and their ally Israel have done as much and worse to poison the Middle East as any secular Arab dictator ever did.

That said, hope is cheap, so of course I hope to be proved wrong.

>90 LolaWalser: I know essentially nothing about Syria, save for the gassing, torture and disappearance of thousands of Syrians and the displacement of millions more under the Bashar al-Assad regime. I can only hope that some degree of peace can be achieved there.

>91 kidzdoc:

To be sure; few of us can do more than hope. Btw, I'll comment some more on Syria in my thread, in case you're interested, as soon as I gather myself a bit.

>92 LolaWalser: What’s the name of your thread Lola? I can’t find it.

>92 LolaWalser: I would absolutely be interested, Lola.

>93 kjuliff: Here's a link to Lola's thread: https://www.librarything.com/topic/356587

Unfortunately my reading has slowed down significantly, due to Real Life tasks, including accruing year end continuing medical education (CME) credits and completing maintenance of certification (MOC) activities so that my status as a board certified pediatrician remains intact. I'll focus on finishing The People's Hospital and The Covenant of Water by the end of the year, and moving the books I had hoped to get to this month to 2025.

Congratulations to the Mauritian author Ananda Devi, who was selected as the winner of the 2024 Neustadt International Prize for Literature, also known as the "American Nobel." The January/February issue of World Literature Today includes several articles about Devi, including one she wrote herself. I've heard of her, but I'm completely unfamiliar with her work. If anyone has read anything by her I would be interested in getting your opinion of her.

This issue of WLT has several reviews of enticing books that will be published in 2025, especially those by Han Kang, Olga Tokarczuk, Jon Fosse, Chigozie Obioma, Edwidge Danticat, Karl Ove Knausgaard and Jean Echenoz; several of these books will almost certainly be ones I'll want to read next year.

Hello!
It has been a long time since I posted to your thread. My move is completed - as in, all my furniture and household belongings are here, but I am not completely moved in. The furniture fit into the house where I had planned but my household things and clothing are in boxes in the carport. I am slowly moving a box at a time and it is going well. The bedrooms end of the house looks good. I have not been able to find all of my blankets yet, so I am sleeping in what will be the guest room - but that is OK as I will not be having Christmas guests this year. My main concern is the kitchen as I am trying to do some holiday baking and the kitchen is a real mess. I have managed to bake my traditional gingerbread cakes and I feel like that is a real accomplishment. I will be baking all of next week and I am excited by that prospect, even with all of the mess.

It has been a December more typical of the 1980's as far as weather is concerned. It has been cold here. Last week the lowest nighttime temp was 11 degrees Fahrenheit and the daytimes didn't get much above freezing. Today is misty and gloomy with visibility poor. The wind is not blowing so it is nice and cozy in the house. She lives across the road and I find it nice that I can see the lights at her house at night.

It has taken me a bit of getting accustomed to it getting dark here about 5:30 PM. Living further south spoiled me with an extra half hour of light in the dead of winter. I have Sirius radio subscription and I have been playing Christmas music nonstop, so I am in the mood for Christmas. I requested that my sisters not give me any gifts this year because I would not be able to use them until I get moved into the house. Instead I asked them to donate to NPR because I am afraid of what will happen with that "mainstream media" outlet and want to do whatever I can to keep it around and functioning.

I have been surprised that I am not getting as much reading done as I have wanted, but I have been reading big books - things over 450 pages, so that makes a difference in how much time it takes to read them. I requested and got a book through ILL from the local public library. It took about 2 weeks to get, so now I know that the type of nonfiction book I like to read might take longer to arrive than it did in Tuscaloosa. That's OK, I can plan for that.

I have been surprised at how much work it is moving here. I had moved three times in 30 years in Tuscaloosa, but I stayed in the same town. Now I am having to get new insurance, license tags, identity cards such as driver's licenses, etc. and it is taking more time than I like, and I feel like I am getting nickel and dimed because there is at least a $45.00 fee for changing everything.

Along those lines, I was incensed when I went to cancel my automatic payment for my dental and vision insurance. (the University dropped its coverage of retirees for those two insurance plans.) The University Credit Union charges $29.99 to stop payment on automatic payments. What?! I was angered for the following reasons: 1) Automatic payments were required by both of the insurance companies, 2) When the automatic withdrawal payments were set up NO mention was made by the Credit Union that it would cost $30.00 to stop the automatic withdrawal payments. I was not very nice on the phone and told the Credit Union employee that I should have been told that it would cost to stop the payments. Furthermore, I have free checking with my Credit Union so since I have only been retired for 18 months it would have been cheaper for me to write a check, put a stamp on an envelope and mail the check to the insurance company. I suggested that the Credit Union should charge people the $30.00 to start the automatic payments instead of sneaking that payment in at the back end. The Credit Union employee said to me "oh no - if we did that people wouldn't use this service." I almost wanted to laugh because clearly this person did not think about what they were saying, and didn't understand that I felt I was trapped into paying the fee. I did go on to say that this is exactly the kind of predatory fees that are so angering to customers of banks all across the U.S. It made be glad that I had voted the way I did because at least President Biden and Senator Elizabeth Warren tried to bring this kind of banking practice to the attention of the public. It is clear that heads of big corporations, whether they are health insurance companies or banks, don't understand how frustrated their customers are with their rapacious practices. The Credit Union at UA just built a huge new building so it is clear that they are making plenty of money and the head of that institution proudly told the shareholders at the grand opening of that building, that the company is very profitable. Perhaps these heads of companies shouldn't brag so much about how much money they are making.

>97 benitastrnad: Wow, you've had quite a time of it, Benita! Hopefully Real Life will settle down soon, and you'll be able to have a more relaxing year by the spring of 2025, if not earlier.

I wish you and your loved ones a happy and blessed festive season.

>99 Ameise1: Thanks, Barbara! May you and your family have a Blessed and Happy Christmas and New Year.

Nadolig Llawen, Happy Christmas and Happy Holidays!

>101 SandDune: Happy Christmas and New Year to you, Alan and Jacob (and Daisy), Rhian!

Book #31: Legacy: A Black Physician Reckons with Racism in Medicine by Uché Blackstock, MD



My rating:

This remarkable book about racism in American medicine was written by an even more remarkable physician, who graduated from Harvard Medical School along with her twin sister and, before them, their mother, making them the first Black mother and daughters to accomplish that feat. She grew up in Brooklyn and she and her sister were inspired by their hard working and dedicated mother, who served her poor and working class community as an attending physician at Kings County Hospital Center until leukemia prematurely claimed her life while her daughters were undergraduate students at Harvard. After they graduated from Harvard Medical School both Uché and her sister Oni returned to New York City for residency, and Uché chose to work as an emergency medicine physician, initially at Kings County Hospital serving a diverse population, and later at NYU Langone Medical Center, until the blatant and hidden racism from staff and well to do patients there led her to resign and found the organization Advancing Health Equity, which “is dedicated to partnering with organizations on their journey to eliminate bias and discrimination in healthcare, cultivate an equitable organizational structure, and improve health outcomes” for all patients.

In addition to her own journey, Dr Blackstock discusses institutional barriers that keep Black patients and physicians from receiving adequate care and being treated as equals, and differences between Black patients and those of other races that lead to adverse outcomes. For example, I was unaware that pulse oximeters, the ubiquitous devices used to measure blood oxygen levels in patients, do not give accurate readings in those with dark skin color, and that pulmonary function tests, which are used by allergists/immunologists and pulmonologists to measure lung function in patients with asthma, chronic obstructive pulmonary disease (COPD) and other respiratory conditions, use data based on White patients that are not accurate when applied to Black patients. Another eye opening story was the success of a clinic in an inner city neighborhood in Minneapolis, in which midwives and doulas provide out of hospital care, including home births to the women and newborns they serve, where outcomes are far superior to similar care they receive in the hospital setting. As a medical student I was taught that hospital births by OB/GYNs were the standard of care, and that midwives and doulas were both undesirable and unsafe in many cases, even though the Black maternal and neonatal mortality rate are two to three times higher than for White patients.

Legacy was a superb read that lived up to the high praise heaped upon it after its release earlier this year, and this may be the best book I’ve read in 2024.

Book #32: The People's Hospital: Hope and Peril in American Medicine by Ricardo Nuila, MD



My rating:

Dr Nuila is an adult hospitalist at Harris Health Ben Taub Hospital, a safety net hospital serving the residents of Houston and the county in which it resides who would otherwise far in the cracks of the fractured American healthcare “system.” Ben Taub provides comprehensive care to Houstonians who don’t have private insurance, aren’t covered under Medicaid or Medicare, the country’s public insurance programs, don’t have adequate insurance to meet their needs, especially if they are chronically ill and are in need of expensive care such as hemodialysis or metastatic cancer, or are in the country illegally, as Houston is close to the USA-Mexico border. These patients are turned away from the for profit hospitals in the nearby Texas Medical Center, which has world class physicians and staff, but only stabilize patients like these in their Emergency Departments before discharging them home or transferring them to Ben Taub.

In The People’s Hospital Dr Nuila introduces us to five patients that he has gotten to know well over the years, each with a remarkable story of life threatening illness whose lives were saved thanks to the care they received at Ben Taub. He also shows that, despite the financial limitations that come with working in a public hospital with limited resources, the hospital provides excellent and cost effective care as compared to nearly all for profit hospitals, including those in the Texas Medical Center. We are also introduced to Dr Nuila’s colleagues, who dedicate their lives to the care of these patients, along with his very conservative father, a OB/GYN in private practice in Houston, who does not agree with his son and believes that Ben Taub is taking money away from his hospital and out of his own pockets.

Dr Nuila also discusses the problems inherent in “Medicine, Inc.,” the corporatized system that prioritizes profit for physicians, hospitals, insurance companies and drug manufacturers but leads to the excessive costs of private insurance and substandard care and health outcomes of Americans as compared to citizens of similar First World countries.

The People’s Hospital was another excellent book about the broken American healthcare “system,” and similar to Our Malady by Timothy Snyder it is a call to improve healthcare here by creating a equal system that serves patients first.

I think these two reviews will be the last ones I write in 2024. As usual I didn't do a great job in reviewing books this year, but I vow to do better next year. I seriously doubt that I'll finish The Covenant of Water by next Tuesday, as I have just over 300 pages to go and I don't want to rush through this immensely enjoyable novel, but if I do I'll review it either here or in my first thread of 2025.

Great reviews, Darryl! Both sound wonderful.

I'm behind about ten reviews for the year and hope to finish four more books to make it to a hundred.

I'm currently reading On Call by Anthony Fauci. I had bought it when it first came out a few months ago, but am just reading it now. I think you would enjoy it for its public health/epidemiology aspects. As someone who was way way way down the food chain from Fauci (technician vs head of one of the largest research divisions and advisor to multiple presidents), I never met him, but did hear him talk several times as he would visit the RML division at least once a year. Still, there is so much to his career that I wasn't aware of. I knew the bookends of his career - AIDS and Covid-19. But his accomplishments in the years between those two saved millions of lives in Africa and around the world. It's a real crime that he has been so vilified by the far right.

At 450 pages, it's another chunkster, but not sure what, if anything, should have been left out.

I hope your Christmas is warm and rewarding. Best wishes to you and your mom!

>105 kidzdoc: I'm glad you're enjoying The Covenant of Water so much. My nephew (who is currently in medical school) lectured me severely on not having read Verghese's first book, Cutting for Stone, and I plan to remedy that next year.

It is one of those misty grey days here in Kansas but it is so peaceful outside. I plan on attending our local church's Christmas Eve service and participate in Christmas caroling afterwards, but won't do anything tomorrow.

I have unpacked a few boxes of books, but Christmas seasonal baking has occupied most of my time this last week, so unpacking has been relegated to a low spot on the list of things to do. I am stymied by the fact that I can't find the shelves for my bookcases. I know they are in a box somewhere - but where? After New Years I plan on getting back into it.

>106 streamsong: Thanks, Janet. On Call will definitely be one of the books I intend to read in 2025.

I hope that you also have a Merry and Blessed Christmas! You saw the African sweet potato, bean and peanut soup that I posted on my Facebook timeline not long ago; I'll post it to La Cucina 2025 shortly. I'll make my father's macaroni & cheese and collard greens tomorrow, and we'll have all of that with a precooked spiral ham, cornbread muffin and cinnamon walnut coffee cake that my brother bought yesterday (he doesn't cook) for Christmas dinner tomorrow.

>107 RidgewayGirl: Thanks, Kay. I would also highly recommend Cutting for Stone, along with his equally superb memoir My Own Country: A Doctor's Story, in which he recounts his time as a newly minted infectious disease specialist in an underserved area of rural east Tennessee in the 1980s, when HIV/AIDS first affected the region. I still need to read his other non-fiction book The Tennis Partner, which is about a fellow physician who struggles with substance abuse, IIRC.

>108 benitastrnad: Your Christmas Eve plans sound great, Benita. We had roughly an inch of snow this morning, but the high temperature rose to the upper 30s to low 40s so everything melted by the middle of the afternoon.

I hope that your baking goes well. In addition to the Christmas dinner I mentioned above I'll continue the usual New Year Deep South tradition of cooking Hoppin' John, although I may not make collard greens if we have sufficient leftovers from tomorrow and make cornbread instead. I'll have to find out from one or more of my Southern friends if collard greens have to be freshly made to ensure wealth in the New Year.

>103 kidzdoc:, >104 kidzdoc: Excellent reviews, and although I doubt I'll read the books, I'm glad to become aware of the people. Also the information that if you didn't know, you can imagine the rest of us.
>109 kidzdoc: African sweet potato, bean and peanut soup
I saw your post, and foodwise it's tempting, but only if someone else does the cooking. :-)

Merry Christmas!

Thanks for the reviews of Legacy and The People's Hospital. I'll put them on my list for '25.

Happy Holidays!

>103 kidzdoc: >104 kidzdoc: Both of these books look fabulous. I already had Legacy on my radar, but The People's Hospital is new to me.

>110 qebo: I'm glad that you liked my reviews of Legacy and The People's Hospital, Katherine.

I saw your post, and foodwise it's tempting, but only if someone else does the cooking. :-)

😂 Is that because the long list of ingredients made your eyes cross? It isn't as bad as it looks, as you only have to dice the sweet potato, yellow bell pepper, jalapeño pepper and red onion and combine the other ingredients; granted, it would be helpful, though not necessary IMO, to have an assistant. Recipes like these with lots of ingredients (18 in this case) used to intimidate me when I began cooking in earnest about 15 years ago, but I'm much more comfortable making them now.

How much snow did you get in Lancaster? We received a good inch here in Lower Bucks County yesterday morning, but that had completely melted by late afternoon.

Merry Christmas to you, too!

>111 tangledthread:. You're welcome, tangledthread. I look forward to your comments about those books.

>112 labfs39: Thanks, Lisa. As you said, Legacy was on my radar from the beginning of the year, and Deborah (arubabookwoman) let me know about The People's Hospital.

>104 kidzdoc: safety net hospital - what a Dickensian sound - I certainly hope things are not going back in time.

Lots to think about there and have added it to my list

Very interesting about Ben Taub hospital. It has a long dark history here of public funding neglect.

>96 kidzdoc: i had never heard of the Neustadt International Prize for Literature. I’m intrigued.

That's some good-looking and thoughtful reading, Darryl. A lot of what you're reading about issues in medical care are of interest to me because my son is in the profession, and I'm guessing his med school reading was not big on medical narratives, ethics, etc. He's a reader himself, but I also doubt—as a third-year resident with a new baby due to arrive next month—he has much time to sit down and read something cover to cover. But I'm taking note, and might dive into a few myself, based on your reviews.

Merry Christmas and happy holidays to you, and here's to a smoother year in 2025 (saying this for you and for me both, and probably for a lot of us here).

>114 SassyLassy: Fortunately Ben Taub Hospital and similar hospitals, such as Grady Memorial Hospital in Atlanta and Bellevue Hospital in Manhattan are "catching" a good number of people who would not receive care in other hospitals.

>115 dchaikin::Dr Nuila does give a history of Ben Taub Hospital, and suggests that, although it struggles with funding, as do all public hospitals, it does a superb job with the resources it has.

The Neustadt International Prize for Literature has been awarded by the University of Oklahoma, which publishes the bimonthly journal World Literature Today, a great resource for international literature published in the United States; I've subscribed to it for several years, but I need to read it more closely.

>116 lisapeet: Thanks, Lisa. I may have read a book or two for pleasure during my first two years of medical school, but it wasn't until my last few months of residency that I had time to read anything else.

Merry Christmas to you and your family! I also pray that 2025 is a better year for all of us.

>113 kidzdoc: long list of ingredients
Yup, although they all seem standard enough to find at a regular grocery store. Plus the time; my patience for cooking wears thin at about 10-15 minutes.

Weather-wise, about the same, a nuisance snow gone by afternoon yesterday, chilly but not frozen and gray but no precipitation today.

>118 qebo: Plus the time; my patience for cooking wears thin at about 10-15 minutes.

A few people I know, including my brother, would agree with you. I enjoy cooking, and I don't mind spending several hours in the kitchen, as I did this morning to cook collard greens and macaroni & cheese, both of which are going now and will be ready just in time for a 4 pm Christmas dinner. Off to check...

Just stopping in to wish you happy new year, and looking forward to our conversations in 2025.

Happy New Year to you too, Rasdhar! I'm glad that you'll be joining us again in 2025, and I look forward to your literary journeys.