Review by Choice Review
Le Fanu's marvelously written, meticulously researched book is one of the most thought-provoking and important works to appear in recent years. His introduction includes the list "The Ten Definitive Moments of Modern Medicine"--only one, the discovery of "Helicobacter as the cause of peptic ulcer" dates later than the 1970s (1984). The 1940s-70s are clearly the years of "The Rise of Modern Medicine" and the great age of medical optimism. Penicillin, cortisone, streptomycin, chlorpromazine, e.g., are discoveries of that era. Viagra is the drug of the '90s; in drugs the shift has been from proven life savers to life style enhancers. "The Fall of Modern Medicine" reflects the frustration felt because medicine has not found many major cures since the 1970s. Improvements of therapies certainly, cures no. The emphasis in medicine, faced with a seeming brick wall, has shifted from biology to prevention. The twin agents of the fall, Le Fanu argues, are social theory and new genetics. The first centers around the concept that eating right can prevent at least 70 percent of diseases. Similarly, will "new genetics" cure or prevent diseases of aging? The answers may surprise readers. A must read for professionals, policy makers, and educated readers. All levels. I. Richman; Pennsylvania State University, Harrisburg
Copyright American Library Association, used with permission.
Review by Booklist Review
The post^-World War II rise of modern medicine is widely deemed a glory of our times. But Le Fanu, medical columnist and M.D., focuses instead on its fall--that is, he makes a cogent case that it has happened and continues. Modern medicine often benefited from fortuitous events and discoveries, and not solely from the much touted triumph of science and rationalism. Le Fanu demonstrates the substantial advances made during its rise and also the problems that brought about its ongoing fall. Those resulted in part from emphasizing and highly esteeming "clinical science" --the practice of looking at the patient as a case rather than as a person. More problems arose from promoting the social theory of medicine that most difficulties can be overcome by lifestyle changes--which leads to blaming the patient--and from the new genetics' search for simple answers and neglect of careful reasoning, especially in the application of statistics. Modern medicine faces a bleak, unimaginative future, Le Fanu portends in this tightly reasoned, well-documented wake-up call. --William Beatty
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
"Much current medical advice is quackery," cautions Le Fanu in this remarkably engrossing scholarly study of medical progressÄand the recent lack thereofÄin the 20th century. Le Fanu (a medical columnist for London's Daily and Sunday Telegraph) contemplates what he sees as the unhappy situation of contemporary health care. The decades from the 1940s to the 1980s saw some of the most critically important advances Western medicine has seen, from penicillin to the heart pump that made open-heart surgery possible. Yet doctors are disillusioned, and patients are turning in droves to alternative forms of medicine. How has this dilemma come about? Le Fanu first details the astonishing breakthroughs of the earlier part of the 20th century (he describes, for instance, the progress made by the first patient ever administered penicillin). But, more controversially, he argues that since the 1980s medical progress has been crippled by two developments, which he terms "Social Theory" and "New Genetics," respectively: according to the author, misguided epidemiologists promote a lifestyle changes (low-cholesterol diet, etc.) as a means of preventing heart disease; and geneticists have misled us into thinking that their research breakthroughs can eliminate genetic diseases. Both cases have been overstated, Le Fanu contends, drawing on a wealth of scientific data to attempt to show that dietary changes have done little to prevent heart disease and that genetic experiments, despite "millions of hours of research," have had "scarcely detectable" practical results. He concludes with a plea to return to the traditional in the practice of medicineÄthe relationship between doctor and patientÄand to a renewal of faith in the diagnostic skill and judgment of one's personal physician. B&w photos. Agent, Caroline Dawnay. (July) (c) Copyright PWxyz, LLC. All rights reserved
(c) Copyright PWxyz, LLC. All rights reserved
Review by Kirkus Book Review
English physician and Daily Telegraph columnist Le Fanu writes a thoughtful history of the only 20th-century revolution that turned out brilliantly. During the century before 1940, people grew healthier and lived longer through improved hygiene, housing, and nutrition. Once they got sick, however, doctors weren't that much help: except for a few treatments (such as thyroid hormone, insulin, and vitamins) a patient got better pretty much on his own--or he didn't. WWII marked the beginning of a torrent of miraculous advances. To label these "miracles" is no hype. Dreadfully sick people received penicillin, cortisone, or lithium--and suddenly they weren't sick. Every single child who contracted leukemia in 1950 died; today almost all live. Victims of congenital heart disease or kidney failure lived as pitiful invalids if they lived at all; now they live normally. This was a wonderful period full of heroes, and Le Fanu describes it superbly in the first half of his story. Then he grows sober, thoughtful, and pessimistic. Medicine's golden age peaked in the 1960s, he writes. Important discoveries trailed off after 1970, introduction of genuinely new drugs dropped sharply, and two disturbing trends appeared. He calls one the Social Theory. Misled by triumphs of the golden age (proof that smoking causes cancer and treating hypertension prevents strokes), doctors embraced a utopian theory of prevention with enthusiasm unaccompanied by proof. Readers will be jolted by the author's claim that diet, lifestyle, and pollution contribute only marginally to ill health. Obsessive efforts to fine-tune our diet and environment ("medical correctness") have, in Le Fanu's view, produced little beside anxiety. The author also takes a dim view of the New Genetics: science's fascination with DNA, genetic engineering, and genetic therapy. He points out that 20 years of expensive research, media obsession, and wildly optimistic claims have produced only minor benefits to patients. Le Fanu's doubts about prevention and genetic engineering place him in the minority among laymen as well as doctors, but he makes a convincing case in this readable and informative account. Copyright ©Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
Review by Choice Review
Review by Booklist Review
Review by Publisher's Weekly Review
Review by Kirkus Book Review
