Customer Reviews

Unnatural History: Breast Cancer and American Society (Cambridge Studies in the History of Medicine)

5 star:		(1)
4 star:		(0)
3 star:		(0)
2 star:		(0)
1 star:		(0)

 

 

This is a moving and thoughtful book that packs a lot into relatively few pages. It has haunted me for months since I read it. It is a nuanced, non-polemical account of the hidden dialectic (hidden, at least, to us laymen) between surgeons and internists, family physicians and researchers, counselors and advocates, about what cancer means and how to respond to it. Aronowitz moves skillfully back and forth between broad-stroke history of medical technology and the famous researchers of the past 200 years, and the intimate details of individual patients and their physicians and loved ones, gleaned from journals, correspondence, and medical records. It's not for the faint of heart: Some of the basic themes of the book are profoundly depressing. Aronowitz shows that there was essentially no change in age-adjusted breast cancer mortality in the 200 years between 1800 and 2000, and that most of the apparent improvements in outcomes related to defining more conditions as "cancer" that were less likely to result in death, and treating them aggressively. He also carefully disects the ways in which physicians treating breast cancer cope with the essential hopelessness of much of what they do, including lots of subtle, well-meaning, and even unintended deception of their patients, and finding myriad ways to define "success" that do not depend on prolonging a patient's life or improving its quality. He carefully attends to the interplay of hope, pain, and spiritual fulfillment in the face of death. And he casts a cold light of analysis on many popular ideas about detection and treatment. But he is sympathetic and compassionate towards all, doctors and patients. Most of all, patients.