Hippocrates' Shadow: Secrets from the House of Medicine

Everyone knows of the Hippocratic Oath, the famous invocation sworn by all neophyte physicians. But most don't realize that the father of modern medicine was an avid listener and a constant bedside presence. Hippocrates believed in the doctor-patient connection and gained worldwide renown for championing science over mysticism while respecting and advocating the potency of human healing. Today, argues Dr. David H. Newman, medicine focuses narrowly on the rewards of technology and science, exaggerating their benefits and ignoring or minimizing their perils. Dr. Newman sees a disconnect between doctor and patient, a disregard for the healing power of the bond, and, ultimately, a disconnect between doctors and their Oath.

The root of this divergence, writes Dr. Newman, lies in the patterns of secrecy and habit that characterize the "House of Medicine," modern medicine's entrenched and carefully protected subculture. In reflexive, often unconscious defense of this subculture, doctors and patients guard medical authority, cling to tradition, and yield to demands that they do something or prescribe something. The result is a biomedical culture that routinely engages in unnecessary and inefficient practices, and leaves both patient and doctor dissatisfied. While demonstrating an abiding respect for, and a deep understanding of, the import of modern science, Dr. Newman reviews research that refutes common and accepted medical wisdom. He cites studies that show how mammograms may cause more harm than good; why antibiotics for sore throats are virtually always unnecessary and therefore dangerous; how cough syrup is rarely more effective than a sugar pill; the power and paradox of the placebo effect; how statistics and studies themselves are frequently deceptive; and why CPR is violent, invasive — and almost always futile.

Through an engaging, deeply researched, and eloquent narrative laced with rich and riveting case studies, Newman cuts to the heart of what really works — and doesn't — in medicine and rebuilds the bridge between physicians and their patients.

David H. Newman, M.D., runs a clinical research program and teaches at Columbia University and in the Department of Emergency Medicine at St. Luke's-Roosevelt Hospital Center. He has also been widely published in biomedical journals. In 2005, as a major in the army reserve, he was deployed to Iraq, where he received an Army Commendation Medal. He lives in New York City

Foreword: Dr. Hippocrates

SECRETS FROM THE HOUSE OF MEDICINE

1. We Don't Know

2. It Doesn't Work

3. We Don't Agree

4. We Don't Talk

5. We Prefer Tests

6. We Won't Unlearn (The Pseudoaxioms)

7. We're Missing the Meaning (The Placebo Paradox)

8. You're a Number (The "NNT")

9. A New Old Paradigm

Acknowledgments

Notes

Index