I first read of this book in the New York Times and knew I needed to read it. As a person with a chronic health condition (asthma and food allergies/intolerances) managing the chronic health condition of my child (asthma and food allergies), I was fascinated by first, the title, and second by the promise of exceptionally bold statements by a leader in the field of oncology, science and policy. Dr. Otis Brawley is the chief medical and scientific officer of the American Cancer Society and his book delivers powerful, if not at times outspoken opinions that are backed by not only his own observations, but also by science. This book has incredible timing as we move into what some are calling “Obama Care” and no one really knows what that is exactly, but some say that it may create out of control health insurance pricing in an already unbearable market.
I manage my disease and those of my family members by being an informed patient and advocate. By recognizing my triggers. By listening to my body. By working with my personal physicians to maintain optimum health. And by taking daily medication.
In HOW WE DO HARM, Dr. Brawley shows us every angle of the complicated triangle of the relationship between patients, doctors and disease. The Triumvirate becomes a Quartet if one adds insurance companies to the equation, since in every one of Doctor Brawley’s stories, insurance companies (or lack of insurance) figure predominantly. From the woman who carries her detatched breast into the ER, to the prostate cancer patient whose insurance is every bit a major character in his story. Neither the rich or the poor in Dr. Brawley’s book are getting close to what would be considered optimum care. While the rich suffer from overmedicating and unnecessary treatments, the poor suffer from inaccessibility to medical care. Low-income children who were born with a pre-existing condition are especially at risk for early morbidity.
A 2011 CDC report found that people who are 75 years of age or older, 24% percent reported some kind of cancer at some point in their lives. When Dr. Brawley writes of prostate cancer, he notes that there are risks in screening and as he tells us one story, a thriving seventy-year-old man died from complications caused by his treatment of a cancer that may or may not have eventually lead to his death. “We do not know that a man diagnosed and treated for prostate cancer benefits from the treatment.” He goes on to say “Men who understand the risks and the unknowns and who want to be screened anyway, should be screened and not criticized.”
What would Otis do? Otis has a saying that he has carried with him from his days in a Jesuit high school. “Say what you know, what you don’t know, and what you believe — and label it accordingly.” He also believes that everyone should be skeptical of their care, their doctors, their medications and their diagnoses.
In summary, HOW WE DO HARM describes how doctors and their patients do harm to themselves and to each other. How the system is broken. How patients are broken. How Doctors are broken. It explains why the system needs fixing. Not by Doctors or Pharmaceutical companies, but by the patients themselves. To do that, patients need to educate themselves. Educate themselves about their bodies, diseases and conditions, and also ask questions of their Doctors that will inspire, motivate and make demands that will create scientific based care. Thanks to Dr. Brawley for writing an awe-inspiring, eye-opening book on HOW WE DO HARM. This is a must-read for everyone who is human and infatuated with health and wellness.