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The Laws of Medicine: Field Notes from an Uncertain Science (TED Books), by Siddhartha Mukherjee
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Essential, required reading for doctors and patients alike: A Pulitzer Prize-winning author and one of the world’s premiere cancer researchers reveals an urgent philosophy on the little-known principles that govern medicine—and how understanding these principles can empower us all.
Over a decade ago, when Siddhartha Mukherjee was a young, exhausted, and isolated medical resident, he discovered a book that would forever change the way he understood the medical profession. The book, The Youngest Science, forced Dr. Mukherjee to ask himself an urgent, fundamental question: Is medicine a “science”? Sciences must have laws—statements of truth based on repeated experiments that describe some universal attribute of nature. But does medicine have laws like other sciences?
Dr. Mukherjee has spent his career pondering this question—a question that would ultimately produce some of most serious thinking he would do around the tenets of his discipline—culminating in The Laws of Medicine. In this important treatise, he investigates the most perplexing and illuminating cases of his career that ultimately led him to identify the three key principles that govern medicine.
Brimming with fascinating historical details and modern medical wonders, this important book is a fascinating glimpse into the struggles and Eureka! moments that people outside of the medical profession rarely see. Written with Dr. Mukherjee’s signature eloquence and passionate prose, The Laws of Medicine is a critical read, not just for those in the medical profession, but for everyone who is moved to better understand how their health and well-being is being treated. Ultimately, this book lays the groundwork for a new way of understanding medicine, now and into the future.
- Sales Rank: #19648 in Books
- Published on: 2015-10-13
- Released on: 2015-10-13
- Original language: English
- Number of items: 1
- Dimensions: 7.00" h x .70" w x 5.00" l, .50 pounds
- Binding: Hardcover
- 96 pages
Review
"This mininarrative, packed with complex ideas translated into easily accessible language and an engaging style, leaves the readers time to ponder the author's ideas at greater length, and the result is a fascinating and illuminating trek through a beautiful mind. A splendid exploration of how medicine might be transformed." (Kirkus (starred))
"The prose is lovely, often witty, always clear.... a fast and informative read." (Booklist)
“What he writes is important, and he does so in an elegant,engaging fashion. This is a moving, deeply humane book.” – Los Angeles Review of Books
About the Author
Siddhartha Mukherjee is the author of The Emperor of All Maladies: A Biography of Cancer, winner of the 2011 Pulitzer Prize in general nonfiction, and The Laws of Medicine. He is the editor of Best Science Writing 2013. Mukherjee is an assistant professor of medicine at Columbia University and a cancer physician and researcher. A Rhodes scholar, he graduated from Stanford University, University of Oxford, and Harvard Medical School. He has published articles in Nature, The New England Journal of Medicine, The New York Times, and Cell. He lives in New York with his wife and daughters. Visit his website at: SiddharthaMukherjee.com
Most helpful customer reviews
19 of 19 people found the following review helpful.
"Medicine asks you to make perfect decisions with imperfect information."
By E. Bukowsky
Dr. Siddhartha Mukherjee is a brilliant oncologist whose book, "The Emperor of All Maladies: A Biography of Cancer," won the Pulitzer Prize for nonfiction. In this slim volume, the author discusses what he considers to be the essential principles of medicine: 1. A strong intuition is much more powerful than a weak test. 2. "Normals" teach us rules; "outliers" teach us laws. 3. "For every perfect medical experiment, there is a perfect human bias."
Dr. Mukherjee believes that having information at your fingertips is useless unless it is paired with "clinical wisdom." To help his students, he has developed "guiding rules that a young doctor might teach himself as he navigates a profession that seems, at first glance, overwhelming unnavigable." The author presents interesting anecdotes, not just from his practice but also from the history of astronomy, citing how scientific opinions about planetary motion evolved over time. In addition, he quotes the work of Lewis Thomas and explores the ideas of Thomas Bayes, an early eighteenth century clergyman and philosopher. Mukherjee, a cogent, persuasive, and thought-provoking writer, insists that modern medicine is not an exact science. A competent physician must pay close attention to a patient's appearance, speech, and of course, his family and medical history. In addition, a proficient doctor draws on extensive experience, the laws of probability, and his "gut instinct" to solve medical mysteries. When a patient is ill, but conventional testing does not reveal the cause, savvy practitioners will look for subtle clues to assist them in making the correct diagnosis.
"The Laws of Medicine" is an entertaining, enlightening, and provocative look at how imagination, creativity, and medicine converge. It is vital to realize that patients may lie or withhold key facts; that there is much to be gained from studying "outliers," (those who do not fit the norm); and that we have a tendency to allow preconceived notions to warp our judgment. A little humility goes a long way in health care as in life.
24 of 27 people found the following review helpful.
Short, pricey, stimulating
By Richard Scott
I bought this book immediately after the interview with Eric Topol. I had loved the Emperor of all Maladies and bought copies, hardcover, for friends and family. For a non oncologist physician and a lover of history, retired, the history of the war on cancer and the complex new genetics applications were wonderful. I had hoped this book would be the same. Isn't . I read House Of God, briefly mentioned in book and interview, when it was published. Had hoped the Laws would discuss those laws as well as ones newly formulated. I too read Lewis Thomas and Osler trying to understand medicine as a science and an art.
I join with the critic who noted cost is outlandish for a tiny book filled with blank pages. TED talks are regularly pleasing, but in their brevity leave the listener eager to read more or think harder. Perhaps the book can do same, but looking at the conclusions makes me wonder if a medical student can learn.
Bytes theorem is a magnificent application of an old theory, one where the mathematical statistics have been replaced by its function on common sense rules. Would that we could apply decision making to the complex formula or easily recognize when tests are not valuable, such as PSA or mammograms. Statistics in medicine are often bad statistics or unusable ones. Outcome studies require sufficient numbers to have power and so often there are more variables which may impact outcomes that are not able to be evaluated. Informed decision making is difficult.
So it is with insight. The cognitive scientists and psychologists as well as philosophers have rediscovered David Hume where his idea of reason being led by passion helps us understand why groups or tribes or clans defy pure reason and act poorly. In making medical diagnosis intuition is often experience, experience not formulated or conscious. One of my friends a long time ER doc could tell sick from non sick. Years of experience warned him.
Years ago I ran a clinic for the penurious and staffed orthopedic residents. A case referred to clinic by a family practitioner for severe back pain was seen by a host of residents and short white coats who by intuition realized the man was a drug user and he simply wanted medication. Writhing in pain, I said no he is infected. Judgment of the profile and social status of patients sometimes over rules attentiveness to quality of pain. In orthopedics spine surgery it is not unusual to have patients where infection is the diagnosis but because of other issues is missed.
None of us can write a flow chart or "scientific" method of figuring out whether one has disease or not. Perhaps Watson will. Students need to know there are outliers, and his rounds for outliers is significant to teach those learning that exam is more than a lab test or a scan. His recollection of the old skilled surgeon training residents in the o.r. brings back memories. So, the physician who had a list of seemingly unrelated questions which could help him sort out complex problems efficiently. Marvelous.
I cannot wait for his book on genetics. Any author who takes the time to go see where the monk, Mendel, worked has done his homework. And he writes with style and in prose easily understood.
This tiny book should stimulate readers to read more, such as the Stanford article on Bayes' theorem.
10 of 12 people found the following review helpful.
An introduction to probabilistic medicine
By Deniz Akyildiz
This is a very nice book: It is an application of probabilistic thinking to problems in medicine.
The author is familiar and into the most aspects of modern probabilistic thinking: In this very short book, he exemplifies many things ranging from cases where Bayes' rule can be applied to show that we are fooled to cognitive biases that prevent us from seeing the real laws behind mere observations (in medicine). I think people who like Nassim Taleb or Daniel Kahneman's works will find this book as a nice application of concepts developed for modern probabilistic thinking to medicine.
And this is an important thing because these things only matter if you can put them into practice, and show how you can make a difference with them. This book doesn't do it directly, but it is a very nice door to problems of decision making under uncertainty in medicine.
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