From Publishers Weekly
"Much current medical advice is quackery," cautions Le Fanu in this remarkably engrossing scholarly study of medical progressAand the recent lack thereofAin 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 medicineAthe relationship between doctor and patientAand to a renewal of faith in the diagnostic skill and judgment of one's personal physician. B&w photos. Agent, Caroline Dawnay. (July)
Copyright 2000 Reed Business Information, Inc.
From Kirkus Reviews
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 © 2000 Kirkus Associates, LP. All rights reserved.