Michael Perkins's Reviews > How We Die: Reflections on Life's Final Chapter

Lest there be any doubt, it was doctors who created the opioid epidemic. Big Pharma was there, ready to pounce, but it was foolish, god-like thinking that set it up....

https://www.vox.com/2017/6/5/15111936...

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My father practiced medicine for 40 years, retiring at the end of 1982. Subsequent generations of doctors now consider my dad's time the golden era of primary care. He was a master diagnostician (he loved to say that it was no accident that the author of the Sherlock Holmes stories and the real-life character Holmes was based on were both medical doctors). His era afforded him enough time with patients to really get to know them.

The author explains why this is important...

"Family history, dietary and smoking patterns, probability of compliance with medical advice, plans and hopes for the future, dependability of a support system of family and friends, personality type, and potential for modification if necessary—these are all factors that must be given proper weight in making decisions about treatment and long-term prognosis. It is his or her skill as a physician that enables them to befriend the patient and to know him—it is inherent in the art of medicine to appreciate that the testing and medications are of limited usefulness without the talking."

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The first time I read this book was when it came out in the mid-90's, not long after I lost my father. And, given my mother's health, I knew there wasn't much time left for her, either. (She was suffering from congestive heart failure, a product of decades of smoking, but she would not convey anything of what the doctor said to her to me. My sister, also a lifelong heavy smoker, was taking my mother to her appointments and was in denial about its effects on my mother. She's still in denial. My mother died of lung cancer).

This book is rather clinical. At the time, I found that helpful in better understanding the maladies that afflicted my parents.

But this time around, I better understand my daughter's critique of this author's writing. She earned a Masters of Science in Health Policy and Management at the Harvard School of Public Health. They did not read his books there, but when she gave them a shot, at my request, she was not impressed with them. She likened them to unedited grad theses, as opposed to fully formed and edited books. Indeed, she was right. For one thing he is verbose and highly repetitive, especially about pet concepts.

A much better alternative was penned by a member of the Harvard Public Health faculty, surgeon and contributor to The New Yorker, Atul Gawande, "Being Mortal."

https://www.goodreads.com/book/show/2...