I read Your Medical Mind in hard cover, the old-fashioned way.
This book, on how patients think, offers a penetrable, informed and anecdote-riddled discussion of how people make health-related decisions. It’s co-authored by a husband and wife, Drs. Jerome Groopman and Pamela Hartzband.
The two are experienced physicians: Groopman’s an oncologist and familiar author; Hartzband’s an endocrinologist. He says he’s a “believer” in modern medicine, although his faith’s been challenged since suffering untoward effects of back surgery. She’s a “doubter” and tends to wonder about other doctors’ directives. One thing I like about the book is its dual authorship; underlying its course lie communication, mutual respect and, in all likelihood, some compromises.
The book resembles a travel narrative of sorts, starting with an overview of the planned medical decisions “tour.” The pair sets out to interview “scores of patients of different ages, in different parts of the country, of different economic status, with different medical conditions, from various ethnic, racial and religious groups.” Appropriately, the journey begins at home; the authors tell where they’re coming from and reveal their general, distinct approaches to medical care. They move on to explore other patients’ stories, venturing from “easy” decisions like whether or not to take a cholesterol-lowering drug, to rougher territory where men choose among prostate cancer treatments, to brink-of-death places like ICUs with patients who change their minds. At the end, the couple reviews what they’ve learned along the way and, maybe, changed their way of thinking.
I like Your Medical Mind, largely because it doesn’t cave to pressures of oversimplification. Rather, the authors describe a “gray zone” of nuance and complexity in medical decisions.
They conclude:
If medicine were an exact science, like mathematics, there would be one correct answer for each problem. Your preferences about treatment would be irrelevant to what is “right.” But medicine is an uncertain science.
Even when the data are seemingly clear, or straightforward — such as the results of an individual woman’s BRCA genetic test result — statistics and algorithms may not be helpful, or even applicable, to an individual patient:
…Each of us is unique in the interplay of genetic makeup and environment. The path to maintaining or regaining health is not the same for everyone.
But, NTW, hope rules: You needn’t be paralyzed by too much information, or uncertainty, there’s a way to move forward:
…Your preferences about treatment do matter. They provide a foundation so that you can choose the right treatment, the one that fits your values and way of living. Understanding your preferences begins with reflecting on your mind-set.
At some level this is a book about self-discovery. The final word, as I read it, is to approach any medical decision with key med-ethics concepts, and a sense of your values, always in mind.
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