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Broken Hearts: The Tangled History of Cardiac Care Hardcover – December 26, 2012

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Editorial Reviews

Review

Offers a historical perspective on medical decision making in the case of heart disease.

(The Chronicle Review)

For anyone who has had a heart attack or whose family member has had one, this book is definitely worth reading.

(Stephen Goddard History Wire - Where the Past Comes Alive)

Any health collection strong in cardiac care will find this a winning presentation perfect for general health or specialty collections alike.

(Midwest Book Review)

The light Jones shines on the interventional cardiovascular enterprise illuminates numerous, sometimes fatal and always costly flaws that every patient and society at large ignores at great peril.

(Nortin M. Hadler Scientists' Bookshelf)

A surprising and sobering book. David S. Jones combines rigorous research with a clear narrative style to produce a very persuasive historical analysis. I heartily recommend that physicians read Broken Hearts to benefit from a dose of detective work, a dose of insight, and a good dose of humility.

(Jack Coulehan, MD Pharos)

Jones does a very good job of outlining how difficult it is to understand all the workings of the human body, what is involved in medical research, and how that research is applied to human subjects through the lens of one medical specialty.

(Katherine Burger Johnson Watermark)

All in all, Jones presents a different and refreshing take on the challenges before us. He provides more questions than answers, but this is all to the good. Unless we pose the proper questions we cannot ever hope to obtain the right answers.

(Allen B. Weisse Bulletin of the History of Medicine)

Wide-ranging, full of interesting and telling historical details, steadily paced yet thorough in its making sense of complex medicine, Broken Hearts exposes cardiac care as neither mundane nor settled.

(Janet K. Shim Sociology of Health and Illness)

Jones asks us to embrace the complexity of medical decision-making, to recognize medical research gains and gaps, and to acknowledge the social values and priorities that shape our present scenario. Difficult decisions in medicine remain, but perhaps Jones’s book will contribute to more judicious ones.

(Shelley Mckellar Technology and Culture)

For the past half century, patients have been advised to undergo valve replacement, angioplasty, or coronary artery bypass graft procedures to prevent or ameliorate cardiac pathologies. But how good are these procedures? How certain are the surgeons or physicians who recommend them that they will work? How do they know? Giving some answers to these questions and showing how the criteria for making medical decisions change over time are the themes of Broken Hearts.

(Choice)

Jones’s larger point is a meditation on how we understand and misunderstand medical knowledge.

(Sarah Dine Health Affairs)

Very informative and containing important insights, Broken Hearts is thoroughly researched, well written, and the only work of its kind dealing with these treatments of heart disease.

(Christopher Lawrence, University College London)

This book will appeal to a wide audience interested in the history of coronary artery disease, its treatment options, and medical decision-making. For those wanting more, there is an extensive bibliography. In closing, Jones asks us to embrace the complexity of medical decision-making, to recognize medical research gains and gaps, and to acknowledge the social values and priorities that shape our present scenario. Difficult decisions in medicine remain, but perhaps Jones's book will contribute to more judicious ones.

(Shelley McKellar Technology and Culture)

A fascinating and insightful history of the interplay between research on the causes of coronary artery disease and the development and assessment of therapeutic―especially surgical―approaches to cardiac care... There is much to recommend in Broken Hearts. It is accessible, it will appeal to a wide range of readers, and it offers a useful overview of the complex issues surrounding cardiac care at a time with health-care policy, both in the United States and globally, is fiercely debated and rapidly changing.

(A.R. Ruis Journal of the History of Medicine and Allied Sciences)

An excellent resource... The information gleaned from the book will aid the patient in understanding his or her disease and will assist one in decision-making.

(Robin Wulffson Examiner.com)

Jones's book is a sophisticated history of heart attacks and some of the most spectacular medical interventions of the twentieth century. It is meticulously researched and thoughtful, and Jones pays equal attention to technical details, social contexts and economic implications. The book will be of interest to anyone interested in the uncertainties of modern medicine: uncertainties associated with understanding the cause of illness and, perhaps more importantly, the success of treatment.

(Carsten Timmermann Social History of Medicine)

From the Back Cover

Still the leading cause of death worldwide, heart disease challenges researchers, clinicians, and patients alike. Each day, thousands of patients and their doctors make decisions about coronary angioplasty and bypass surgery. David S. Jones sheds light on the nature and quality of those decisions. Why do doctors and patients overestimate the effectiveness and underestimate the dangers of medical interventions, especially when doing so may lead to the overuse of medical therapies? To answer this question, Jones explores the history of cardiology and cardiac surgery in the United States and probes the ambiguities and inconsistencies in medical decision making.

"Wide-ranging, full of interesting and telling historical details, steadily paced yet thorough in its making sense of complex medicine, Broken Hearts exposes cardiac care as neither mundane nor settled."― Sociology of Health and Illness

"A surprising and sobering book. David Jones combines rigorous research with a clear narrative style to produce a very persuasive historical analysis. I heartily recommend that physicians read Broken Hearts to benefit from a dose of detective work, a dose of insight, and a good dose of humility."― The Pharos

"Jones presents a different and refreshing take on the challenges before us. He provides more questions than answers, but this is all to the good. Unless we pose the proper questions we cannot ever hope to obtain the right answers."― Bulletin of the History of Medicine

"Jones asks us to embrace the complexity of medical decision making, to recognize medical research gains and gaps, and to acknowledge the social values and priorities that shape our present scenario. Difficult decisions in medicine remain, but perhaps Jones’s book will contribute to more judicious ones."― Technology and Culture

"Jones’s larger point is a meditation on how we understand and misunderstand medical knowledge."― Health Affairs

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Product Details

  • Hardcover: 336 pages
  • Publisher: Johns Hopkins University Press; 1 edition (December 26, 2012)
  • Language: English
  • ISBN-10: 1421408015
  • ISBN-13: 978-1421408019
  • Product Dimensions: 6 x 1.1 x 9 inches
  • Shipping Weight: 1.3 pounds (View shipping rates and policies)
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (4 customer reviews)
  • Amazon Best Sellers Rank: #1,243,666 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

31 of 31 people found the following review helpful By Kenneth E. MacWilliams on February 27, 2013
Format: Hardcover
WHAT IS MY CONNECTION TO THIS BOOK -- "BROKEN HEARTS: The Tangled History of Cardiac Care" by David S. Jones, MD, PhD, the A. Bernard Ackerman Professor of the Culture of Medicine at Harvard Medical School? Especially given the title I have selected for this review, I should make clear that I have not been asked by anyone to write this review. Neither have I communicated with anyone about it, nor do I know the author or anyone who knows him. I write this review solely because I hope to persuade as many people as possible to read this exceptionally well researched, beautifully written, and ever so timely and important book.

And so that you might have some perspective regarding my own professional background to enable you to evaluate better my remarks herein, my own personal perspective is as follows. I am not a medical doctor. My professional career has been in finance on Wall Street, which I left after 30 years to establish my own financial organization in Russia. Throughout my life I have had a keen interest in medicine in general and in medical history in particular. Truth be known, although Wall Street was a great ride, I probably would have even more enjoyed becoming a physician or surgeon. Nevertheless, I have for many years been involved in different ways in national medical policy issues, and I have served for long periods on the clinical trial review boards of four of the largest and best academic medical centers in the country, during which years I developed personal relationships with some of the best medical scientists in the world. I hope you will therefore conclude that my remarks are independent and objective, and hopefully that they come from a background that provides me with a wee bit of familiarity about the subject of this book.
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1 of 1 people found the following review helpful By Rainsayre on August 19, 2014
Format: Hardcover
An invaluable contribution to healthcare in American. David Jones shares information that illustrate aggressive cardiology interventions such as angiograms, angioplasties, and coronary by-pass surgery are overdone and frequently harmful. He takes a historical approach in an attempt to understand this ugly chapter in American medicine. His writing is interesting and illuminating, if a bit long winded. In trying to understand why these procedures are practiced in light of evidence to the contrary, he probes the human psyche and presents several insights. His topic is of critical importance but rarely discussed. The juggernaut of the health care industry rolls along, crushing any opposition in its path. Perhaps that is why he is so diplomatic in his treatise. Dr. Nortin Hadler, a brilliant, profound patient centered physician has written about this cardiology debacle for decades, and is not so timid in reprimanding the physician involvement that drives this sad practice. A must read!
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Format: Paperback
I frankly don't know how exactly to describe this book, except to say it is a very precise, methodical look at innovation in heart operations, bypass and angioplasty.
This is not an author who gets on his high horse. Rather, he is mystified about how doctors embrace several life-saving operations, or purported life-saving.
When I read it, I felt like I was watching a chess game. After returning it to the library, I find I would like to read it again. I think I will.
This was very absorbing.
Several points from the book:
Drugs took off in conjunction with the germ theory of disease when antibiotics appeared. Thus, medical innovation depends on doctors' having something to do, along with a scientific theory.
The Rand Corporation had a project to establish consensus among cardiologists about when a bypass is needed - the docs only agreed with each other 50% of the time.
Evidence Based Medicine usually focuses on the efficacy of a treatment, not so much on the side effects.

I highly recommend this book for its thoroughness and factual information about what goes on behind the scenes. There are few like it. This is a book about medical innovation in the case of bypass and angioplasty. The discussion of neurological side effects from bypass is an eye opener.
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1 of 3 people found the following review helpful By Eric Wolff on August 27, 2013
Format: Kindle Edition Verified Purchase
I purchased this book when I heard that my dad was going to have angioplasty and then he wound up having bypass. I found the history of the procedures very interesting, and I thought the book had some good critiques of the culture surrounding the procedures, both on the medical side and on the patient side. But ultimately the book trails off on social science tangents and vague assertions of discrimination and whatnot that were far afield from assessing whether angioplasty and bypass are a bright idea for anyone. Also, I was disappointed that there wasn't more discussion of the changes in conventional wisdom about why people have heart disease. In particular, some discussion of how America went overboard on low-fat diets and narrow fixation on LDL cholesterol. Given the discussion of statins in the book, I thought there might be a critical appraisal of those issues, but there was not.

Could have been an awesome book on an important topic. It isn't. It is a good book on the history of angioplasty and bypass that will help some folks think critically about the procedures.
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