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As Leis da Medicina

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Repleto de detalhes históricos fascinantes e maravilhas médicas modernas, este importante livro é um envolvente vislumbre das lutas dos médicos e dos impasses que raramente vem à tona. Escrito com a prosa apaixonada e a linguagem envolvente características do Dr. Mukherjee, As leis da medicina é uma leitura crítica, para todos os interessados em entender melhor como sua sa Repleto de detalhes históricos fascinantes e maravilhas médicas modernas, este importante livro é um envolvente vislumbre das lutas dos médicos e dos impasses que raramente vem à tona. Escrito com a prosa apaixonada e a linguagem envolvente características do Dr. Mukherjee, As leis da medicina é uma leitura crítica, para todos os interessados em entender melhor como sua saúde e bem-estar estão sendo tratados. Este livro estabelece as bases para uma nova maneira de entender a medicina, agora e no futuro.


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Repleto de detalhes históricos fascinantes e maravilhas médicas modernas, este importante livro é um envolvente vislumbre das lutas dos médicos e dos impasses que raramente vem à tona. Escrito com a prosa apaixonada e a linguagem envolvente características do Dr. Mukherjee, As leis da medicina é uma leitura crítica, para todos os interessados em entender melhor como sua sa Repleto de detalhes históricos fascinantes e maravilhas médicas modernas, este importante livro é um envolvente vislumbre das lutas dos médicos e dos impasses que raramente vem à tona. Escrito com a prosa apaixonada e a linguagem envolvente características do Dr. Mukherjee, As leis da medicina é uma leitura crítica, para todos os interessados em entender melhor como sua saúde e bem-estar estão sendo tratados. Este livro estabelece as bases para uma nova maneira de entender a medicina, agora e no futuro.

30 review for As Leis da Medicina

  1. 4 out of 5

    Petra-X

    This is a very short book, but deep. It makes you reflect on the practice of medicine and how it might affect you if you had to make decisions for yourself or another. The first law of medicine, according to the author is “A strong intuition is much more powerful than a weak test.” Or, what you think you are seeing is more likely the case than what the computer spits out if you've been doing all the wrong tests or don't know the true circumstances. Mukherjee uses as an example a man, a conventio This is a very short book, but deep. It makes you reflect on the practice of medicine and how it might affect you if you had to make decisions for yourself or another. The first law of medicine, according to the author is “A strong intuition is much more powerful than a weak test.” Or, what you think you are seeing is more likely the case than what the computer spits out if you've been doing all the wrong tests or don't know the true circumstances. Mukherjee uses as an example a man, a conventional banker-type, whose sickness he cannot diagnose no matter what test he orders. Then he sees him not in a patient context but chatting to a known heroin addict, and thinks maybe he too is a heroin addict and tests for AIDS, which the man has. The second law is "Normals’ teach us rules; ‘outliers’ teach us laws.” That is, pay attention to the one person for who has a different story, a different treatment works for them, or they are the ones to beat the odds. It is their studying their differences that furthers medical knowledge. The third law, “For every medical experiment, there is a perfect human bias," is a warning that we see what we want to see. That no matter how well tests are designed, double blind for instance, there is always the possibility of confirmation bias in their interpretation. Which rather neatly brings it round to the first law and taking into consideration the second law: take a good history, get to know your patient well, and use your experience and intuition to interpret or even dismiss the results of tests when forming a diagnosis and treatment. This is a short book, or a long lecture. It's as if the brilliance of his The Emperor of All Maladies: A Biography of Cancer has been tempered with the practicality and brevity in writing of Atul Gawande (also a doctor) and produced a philosophical book that will have you thinking long after the few hours it took to read.

  2. 4 out of 5

    Diane S ☔

    How does the saying go? Sometimes big things come in little packages. Which certainly proved true with this book. A TED talk on medicine by the noted cancer physician. Unfortunately I have had more than my fair share of dealing with the medical profession, so I always have an interest in books such as this. Learned much about the tests that are ordered, how doctors make their decisions, drug trials and what they actually mean. Some interesting cases were presented in an easy to understand format How does the saying go? Sometimes big things come in little packages. Which certainly proved true with this book. A TED talk on medicine by the noted cancer physician. Unfortunately I have had more than my fair share of dealing with the medical profession, so I always have an interest in books such as this. Learned much about the tests that are ordered, how doctors make their decisions, drug trials and what they actually mean. Some interesting cases were presented in an easy to understand format. A very good if short read.

  3. 5 out of 5

    India Marie Clamp

    The encomiums are copious concerning creations by Oncologist/Pulitzer Prize winner Siddhartha Mukherjee. Having read his “Emperor of All Maladies: A Biography of Cancer” to “The Laws of Medicine: Field Notes from an Uncertain Science.” Both teach us law one: “A strong intuition is much more powerful than a weak test.” Though not as involved or page heavy as previous works; this TED talks book helps us understand the reality that confronts all physicians having to make faultless decisions from im The encomiums are copious concerning creations by Oncologist/Pulitzer Prize winner Siddhartha Mukherjee. Having read his “Emperor of All Maladies: A Biography of Cancer” to “The Laws of Medicine: Field Notes from an Uncertain Science.” Both teach us law one: “A strong intuition is much more powerful than a weak test.” Though not as involved or page heavy as previous works; this TED talks book helps us understand the reality that confronts all physicians having to make faultless decisions from imperfect information. Mukherjee documents his time in medical school (1995) and his mentors (Astronomer Tycho Brahe, Physician Lewis Thomas) that guide him. “Law three for every perfect medical experiment, there is a perfect human bias. Why do some cancers carry similarities?...Humans are the final arbiters and interpreters of the medicine.” ---Siddhartha Mukherjee, MD The Laws of Medicine: Field Notes from an Uncertain Science is a depiction of the uncertainties in medicine. He lauds about how hope is both beautiful/dangerous (especially when traces of tumor are left behind). The three laws are discussed, and Ovid comes to mind with “dolor hic tibi proderit olim.” This book is “Mukherjee light.”

  4. 4 out of 5

    Cheryl

    Law One: A strong intuition is much more powerful than a weak test. Law Two: "Normals" teach us rules; "outliers" teach us laws. Law Three: For every perfect medical experiment, there is a perfect human bias. Well, interesting, sort of. I would have probably really liked this in the early days of medical school. Each 'law' is illustrated with a few examples that give the reader a peek into his medical world. You know, the sort of godly laying-of-the-hands-and-the-noble-art-of-medicine world. Not th Law One: A strong intuition is much more powerful than a weak test. Law Two: "Normals" teach us rules; "outliers" teach us laws. Law Three: For every perfect medical experiment, there is a perfect human bias. Well, interesting, sort of. I would have probably really liked this in the early days of medical school. Each 'law' is illustrated with a few examples that give the reader a peek into his medical world. You know, the sort of godly laying-of-the-hands-and-the-noble-art-of-medicine world. Not the mucky real world of indifference, greed,and incompetence all jostling and wrestling hard with the grunting idealists pulling out all the stops and trying their darndest to save this life, because dammit we all deserve that, don't we? Still, it is a lovely little book, physically. It would be a perfect gift for a new med student or newly minted doctor.

  5. 4 out of 5

    Steve

    This is a very short book and makes for a quick and easy read. It gives color and light to the concept of priors in Bayes theorem. And also reviews a bit more about Bayesian reasoning. The author points out why outliers are more important than inliers in current medicine and are the future of medical theories. So, we have two very important concepts being put forward in crystal clear language: Bayesian reasoning and "outliers" as the perfect ones to study when crafting a law of medicine. The ana This is a very short book and makes for a quick and easy read. It gives color and light to the concept of priors in Bayes theorem. And also reviews a bit more about Bayesian reasoning. The author points out why outliers are more important than inliers in current medicine and are the future of medical theories. So, we have two very important concepts being put forward in crystal clear language: Bayesian reasoning and "outliers" as the perfect ones to study when crafting a law of medicine. The analogies are very good and creatively used. The book may be used by students who are having trouble conceptualizing sensitivity and specificity and the concept of "prior". But that should actually be very few students. Statistics is now a required course. And it is included on the MCAT. And this book while clear and easy reading is not deep. There are no problems to work out and there are no numerical fleshed out examples. This will be most useful to the layperson looking for the future of medical thinking or an older physician who doesn't totally know what the term "prior" means. But for the physician to fully understand it, they will need to put in more time and listen to in depth lectures or take a new course in probability theory. To be current the physician will also need to go into more detail in probability theory and obtain a rudimentary understanding of Markov Decision Processes and similar concepts.

  6. 4 out of 5

    Charlene

    Please let Mukherjee develop this into a full size book! In this extremely short book, Mukherjee offered a much needed perspective in medicine. It seems to me that when considering this and other recent books from MDs (e.g. Lisa Sanders' Every Patient Tells a Story) who focus on the issue of the difficulty of properly diagnosing a patient, a pattern is forming. Doctors, at least the ones authoring the books I have been reading, are no longer as interested in seeming mysterious or godlike. I like Please let Mukherjee develop this into a full size book! In this extremely short book, Mukherjee offered a much needed perspective in medicine. It seems to me that when considering this and other recent books from MDs (e.g. Lisa Sanders' Every Patient Tells a Story) who focus on the issue of the difficulty of properly diagnosing a patient, a pattern is forming. Doctors, at least the ones authoring the books I have been reading, are no longer as interested in seeming mysterious or godlike. I like this trend (is it too early to call it a trend?) in which doctors write memoirs that highlight how much they don’t know, how unsure they are so much of the time, and describe their learning process that is not always smooth. It really engenders a feeling of teamwork between a doctor and patient who are trying their best to trudge through the mud of diagnosis together. Mukherjee​ laid out a simple argument for why and how essential changes need to be made to help doctors become more effective diagnosticians.: Time and financial resources are finite. Any doctor not using Bayesian methods to diagnose a patient is wasting everyone’s time playing a guessing game. Success rates of test results (false positive) vary for the same test​,​ depending upon whether doctors have successfully understood how to use probability to home in on the best candidates for each test. When probability based selection is practiced, test accuracy increases, sometimes making a useless test (50% success rate of correct diagnosis) into a useful test that can provide a reasonable diagnosis. ​Using Bayesian methods, doctors can and should get better at running the right tests, homing in on difficult to understand illness, and even know when to treat and when not to treat an illness. His point about treating of not treating was also covered quite brilliantly in his book Emperor of All Maladies. For example, need to give the right amount of radiation because more is not better. More might not be more effective at riding the body of cancer. Less might do as well and more might lead to cancer down the line. In Emperor of All Maladies, he also looked at breast cancer testing and efficacy. Eyeopening. I am pretty sure that is what he was referencing in this book.

  7. 5 out of 5

    Blair

    The Spaces Between the Facts Siddhartha Mukherjee is not only a prominent cancer specialist, he is also the author of the beautifully written (but long) The Emperor of All Maladies: A Biography of Cancer. In this very short book he tries to distill the essential features of medicine that make it a science. The result is about more than medicine, it is an insight into how all of science works, using medicine as a metaphor that is familiar to the reader. A doctor is expected to make perfect decisio The Spaces Between the Facts Siddhartha Mukherjee is not only a prominent cancer specialist, he is also the author of the beautifully written (but long) The Emperor of All Maladies: A Biography of Cancer. In this very short book he tries to distill the essential features of medicine that make it a science. The result is about more than medicine, it is an insight into how all of science works, using medicine as a metaphor that is familiar to the reader. A doctor is expected to make perfect decisions based on imperfect information. Medicine is distinctive in that we patients are not interested in averages, we want to know what is going to happen to us. Such certainty is impossible. The task of the doctor is to make the best use of the information available. We are gently led into an understanding of Bayesian probability. It seems obvious that if you might be sick we should run a bunch of tests and use the results. Ah, but he tells us that “a test can only be interpreted sanely in the context of prior probabilities,” meaning you need to have some idea of the answer before you can ask the question. The problem is that tests are never perfect - they can say patients have the condition when they do not, called a false positive. This can lead to unnecessary stressful and expensive treatment. We are taken through a scenario where an AIDS test on random patients results in 95% of the test results being wrong, even though the test is 99% accurate. When the same test is given to high risk patients, 95% of the results are correct. How can this be? Think of giving the test when no one has AIDS - all the positive results will be wrong, no matter how good the test. If there are more people who actually have the disease, there will be fewer false results. As he puts it, a test is “a machine that modifies probabilities.” If the probability starts very low, it will not change much, and little will be learned. The lesson is that there is no substitute for understanding the patient. Similarly, scientists need to understand what they are looking for; they don’t do a bunch of random experiments and hope new knowledge pops out. Tycho Brahe was an astronomer whose careful observations confirmed that the planets have circular orbits around the sun. Except for Mars. He handed that problem to his assistant, Johannes Kepler, who then discovered that the orbits are really elliptical. The point is that wisdom does not come from the “inliers”, those observations that fit the model, it comes from understanding what drives the outliers. The practice of medicine is full of outliers, which are traditionally ignored. Mukherjee gives us some examples of how we are starting to learn new things by paying attention to, and trying to explain, those outliers. Medicine tries to learn by observing patients, preferably in controlled clinical trials. Unfortunately simply being in a clinical trial changes the attitude of the patient, which can affect the outcome. [I forgive Mukherjee for incorrectly associating this with the Heisenberg Uncertainty Principle.] Asking patients to remember their behaviour or the progress of their condition is also problematic. He concludes “the greatest clinicians I know see to have a sixth sense for biases. They understand when bits of scattered knowledge apply, and more important, do not apply to their patients. What doctors really hunt is bias.” So there we have it. Tests are not enough, we have to understand what we are testing. Confirming rules is not enough, we need to understand why there are outliers. And good procedure is not enough, we are often misled by confirmation bias. In the end, facts are not enough. The truth is found in the spaces between the facts.

  8. 5 out of 5

    Romanas

    Siddhartha Mukherjee and me happen to have a common friend – Thomas Bayes, to whom the book is dedicated. Bringing Bayesian thinking in the world of medicine can make a huge difference there. The author starts with quite an astonishing eye-opening of how the present medicine operates and why there are still so many problems, despite the modern technology and deep theoretical basis. Part of the problem, as the author points out, lies in the fact that as the tools are getting better and better, th Siddhartha Mukherjee and me happen to have a common friend – Thomas Bayes, to whom the book is dedicated. Bringing Bayesian thinking in the world of medicine can make a huge difference there. The author starts with quite an astonishing eye-opening of how the present medicine operates and why there are still so many problems, despite the modern technology and deep theoretical basis. Part of the problem, as the author points out, lies in the fact that as the tools are getting better and better, the doctors are taking on more and more challenging deceases. So this race will probably continue forever. Despite that, no matter on what level the doctors are attempting to treat their patients, having a Bayesian approach in these matters would allow them to diagnose individual patients with a higher precision and increase the overall effectiveness of the medical management system and optimise the utilisation of the limited resources. These important points and perspectives are excellently presented in the book. I just wanted it to be much longer. Siddhartha Mukherjee appears to be not only a prominent cancer expert, but he also writes very good and interestingly. I am looking forward to get some time for his book on genes.

  9. 4 out of 5

    Raksha Bhat

    Some professions are passions, more than bread and butter. To cordon and define them by law or a set of rules is no easy task. Medicine is one among them and like Siddhartha Mukherjee says it is the most beautiful and fragile of all. Diagnostics and treatment rely greatly on accuracy and consistency but we always need to be intuitive because the outlier always gives us a chance for research, not to forget like any other people in this world we are prone to bias. These are some laws which he writ Some professions are passions, more than bread and butter. To cordon and define them by law or a set of rules is no easy task. Medicine is one among them and like Siddhartha Mukherjee says it is the most beautiful and fragile of all. Diagnostics and treatment rely greatly on accuracy and consistency but we always need to be intuitive because the outlier always gives us a chance for research, not to forget like any other people in this world we are prone to bias. These are some laws which he writes about giving us interesting anecdotes and trivia. As doctors we study a lot of textbooks of varied subjects and sizes, I must say that none of them have provided me the wisdom and perspective this seventy page book has in one morning.

  10. 5 out of 5

    Karishma

    Siddhartha Mukherjee is a wonderful teacher and a truly great science writer. I recently became a fan as I started to get halfway through his masterpiece book The Emperor of All Maladies. I'm still yet to finish that one and I've already bought Gene - An Intimate History and I've already flown through the significantly thinner The Laws of Medicine. A cancer physician and researcher, Dr. Mukherjee straddles academia, clinical work and research in a way only America makes possible for people and i Siddhartha Mukherjee is a wonderful teacher and a truly great science writer. I recently became a fan as I started to get halfway through his masterpiece book The Emperor of All Maladies. I'm still yet to finish that one and I've already bought Gene - An Intimate History and I've already flown through the significantly thinner The Laws of Medicine. A cancer physician and researcher, Dr. Mukherjee straddles academia, clinical work and research in a way only America makes possible for people and it's truly wonderful to read this and his other book where he simplifies and electrifies theories and tests that seemed unnaturally dense and dull when read from textbooks authored by preeminent experts in the field. I remember being particularly intimidated by biostatistics! In this book, Mukherjee teaches us about the likelihood ratio and positive predictive value of tests with such stunning ease that my jaw dropped while reading that page and the waitress in the coffee shop I was reading in came up to ask me if I was well! Dr. Mukherjee tells us about three laws of medicine here that anyone who's worked in the field for atleast a couple of years will agree with - intuition is a powerful tool, and biases are a powerful hindrance and that exceptions to the rule tell us ever so much about the rule itself! There's a book within this book called The Youngest Science written by a mid-twentieth century physician who truly lived in exciting times which was probably the only book the otherwise well-read Mukherjee read for one whole year as a trainee in medicine. I remember that being my situation also in my first year of MD when the only book I finished reading was The Making of a Psychiatrist! I am too fond of this author, his writing and its themes to be truly objective. But trust me, reading him is pretty damn mind-blowing! Try!

  11. 4 out of 5

    Brad Isaacs

    There is no doubt Mukherjee is an incredible writer. However, there were many times while reading this short book I wish it were a lot longer and more in depth. His description of Bayes' Theorem, and the entire book in general, was intended for the layperson. Overall, a good exposure to biases we all have while trying to make decisions in times of uncertainty, yet not enough to gain more than a superficial understanding.

  12. 5 out of 5

    Alfred Haplo

    The Laws of Medicine is a little book with a big impression. It highlights the conundrums of “laws” governing established medical science versus medical-science-in-progress. As a young intern, the author had grappled with bridging the tangible aspects of knowledge with intangible clinical wisdom. What is this X factor that would make him a better doctor? Those thoughts formulated and crystallized into the titular subject. The three laws outlined are not general laws of medicine, rather, they ar The Laws of Medicine is a little book with a big impression. It highlights the conundrums of “laws” governing established medical science versus medical-science-in-progress. As a young intern, the author had grappled with bridging the tangible aspects of knowledge with intangible clinical wisdom. What is this X factor that would make him a better doctor? Those thoughts formulated and crystallized into the titular subject. The three laws outlined are not general laws of medicine, rather, they are the personal tenets of the author, Siddhartha Murkherjee *, cancer physician, researcher, and awardee of the 2011 Pulitzer-winning Cancer: The Emperor of all Maladies. These self-guided principles have saved him from making egregious judgement errors in a field fraught with imperfections, and have guided him in diagnosing and treating complex cases. In essence, these are laws applicable to any disciplines where certainty is limited by current knowledge, which is in turn limited by uncertainty. In their entirety, Law One: A strong intuition is much more powerful than a weak test. Law Two: “Normals” teach us rules; “outliers” teach us laws. Law Three: For every perfect medical experiment, there is a perfect human bias. Filled with Murkherjee’s insightful and anecdotal observations, this book is imbued with the spirit of a lifelong learner. X = Y, until X does not equal Y, then what? Do we substitute X, or Y, or introduce a new variable Z? Or fractionalize X and invert Y? Think outside the box, implored Murkherjee. He often looked at history as a basis for learning what we did not know, and what we still need to know. Medical science may have progressed in leaps and bounds, but until doctors become perfectly unbiased, perfectly intuitive and perfectly comprehensive, signposts are needed - like these laws - to guide the way. Published in Oct 2015 following Murkherjee's presentation in Ted Talks, this is a nifty little book to keep handy in our bags, which is where my copy is. A quick, incisive, and thoughtful read, Murkerjee's three laws have held up well for him, and perhaps they might for us too. [* Murkerjee's bio]

  13. 5 out of 5

    Nikki

    The description of this book weirdly states that one of the laws Mukherjee proposes is that “Rumours are more important than tests.” That’s not what he suggests: instead, he’s talking about intuition and putting two and two together so that you use the right tests in the right circumstances, reducing the number of needless false positives. He gives an example of realising that one of his patients who didn’t fit the profile was actually a drug addict, leading to being able to use a test for AIDs The description of this book weirdly states that one of the laws Mukherjee proposes is that “Rumours are more important than tests.” That’s not what he suggests: instead, he’s talking about intuition and putting two and two together so that you use the right tests in the right circumstances, reducing the number of needless false positives. He gives an example of realising that one of his patients who didn’t fit the profile was actually a drug addict, leading to being able to use a test for AIDs to figure out what was wrong with him. But doing the test for AIDs makes no sense when there are no risk factors: what really made things come together in this case was a little bit of intuition. I’m definitely a strong believer in the power of intuition as a diagnostic tool in general. You should always check when you can, of course! But from my vague medical knowledge as a doctor’s daughter and a reader, at seventeen years old, I once realised from something about the way his face looked that someone I knew a little had a serious heart problem. I described what I saw to my mother (the doctor!) and she agreed with my intuition. But when he went to the A&E, they didn’t admit him and didn’t operate. He had an aneurysm, and yes, he died. I wish I could give that moment of intuition and insight to the doctor who saw him in A&E; I’m pretty sure my mother will agree that that intuition, that ability to connect the faintest of dots, can turn an academically good doctor into a great one. (Yes, Mum, I know. I should be a doctor, but I’m a little old to go through medical school now and maybe my intuition will serve me well in a microbiology lab, too.) So that rule in particular struck a chord with me, and made reading this worth it just on its own. The other two laws Mukherjee mentions are interesting and important too, but that first one was what really got my interest. Reviewed for The Bibliophibian.

  14. 4 out of 5

    Joseph Sciuto

    "The Laws OF Medicine" by Siddhartha Mukherjee (acclaimed author of "The Emperor of all Maladeries" and "The Gene") is a short, engrossing, intellectually stimulating discussion that focuses on "medicine" as an uncertain science that despite all the technological advances still needs to rely on a one on one, doctor-patient, relationship to achieve a correct diagnosis and experimental certainty... There are simply too many variables in medicine to rely totally on technology to achieve accurate re "The Laws OF Medicine" by Siddhartha Mukherjee (acclaimed author of "The Emperor of all Maladeries" and "The Gene") is a short, engrossing, intellectually stimulating discussion that focuses on "medicine" as an uncertain science that despite all the technological advances still needs to rely on a one on one, doctor-patient, relationship to achieve a correct diagnosis and experimental certainty... There are simply too many variables in medicine to rely totally on technology to achieve accurate results. A patient's history, behavior, environment, and family history are just a few things that are important in treating a patient's illness and in running experimental trials that give you more perfect and correct result. Medicine, unlike physics, is an uncertain science and in order for it to continue to evolve it needs to look at all possible factors in treating patients and running important trials and not to rely solely on technology.

  15. 5 out of 5

    Akshay S Dinesh

    I pre-ordered the book because Siddhartha Mukherjee's Emperor of All Maladies is my all time favorite and the description of why there should be "laws" in medicine fascinated me. The only disappointment I had was that the book is just 70 pages and I finished it in one reading. I got at least one career idea and a lot of inspiring thoughts while going through them.

  16. 5 out of 5

    Rebecca

    Brilliant!!! Eloquent writing.. Will surely come back for a reread.

  17. 4 out of 5

    Annie

    I suspect that the vast majority of us know very little about how one becomes a doctor that hasn’t been informed by TV shows. We expect doctors to diagnose like Dr. House or care for us like Dr. Dorian or entertain us like Patch Adams. Anyone who’s gotten a whiff of medical school will be quick to correct our misperceptions, but there are only a few doctors who are bringing the mysterious inner workings of practicing medicine to light for the general public. Atul Gawande is one. The late Oliver I suspect that the vast majority of us know very little about how one becomes a doctor that hasn’t been informed by TV shows. We expect doctors to diagnose like Dr. House or care for us like Dr. Dorian or entertain us like Patch Adams. Anyone who’s gotten a whiff of medical school will be quick to correct our misperceptions, but there are only a few doctors who are bringing the mysterious inner workings of practicing medicine to light for the general public. Atul Gawande is one. The late Oliver Sacks was another. Siddhartha Mukherjee is a relative newcomer to this part of the literary world. His first book, The Emperor of All Maladies, won a Pulitzer in 2011. The Laws of Medicine is a less daunting book; Maladies clocks in at almost 600 pages. The Laws of Medicine runs to less than 100 pages, but it’s no less ambitious. I’d say that Mukherjee intends for his laws of medicine to become a quiet revolution in medicine. Read the rest of my review at A Bookish Type. I received a free copy of this book from Edelweiss, in exchange for an honest review.

  18. 4 out of 5

    John of Canada

    Short but jam packed.Mukherjee is a wonderful writer.There's Bayes theorem,astronomy to explain medical mysteries,Heisenberg theories.Lots of stuff!Anyone who thinks that doctors will be replaced by technology can relax.The human touch is irreplaceable."The medical revolution will not be algorithmized." For the feminists he reports on bias."Women are notoriously underrepresented in randomized studies.In fact female mice are notoriously underrepresented in laboratory studies." Years ago I read abou Short but jam packed.Mukherjee is a wonderful writer.There's Bayes theorem,astronomy to explain medical mysteries,Heisenberg theories.Lots of stuff!Anyone who thinks that doctors will be replaced by technology can relax.The human touch is irreplaceable."The medical revolution will not be algorithmized." For the feminists he reports on bias."Women are notoriously underrepresented in randomized studies.In fact female mice are notoriously underrepresented in laboratory studies." Years ago I read about the Charles Manson 'family' and specifically about one member who would give his children LSD and leave them in the forest to enjoy their 'experience'.I was appalled.Now from Mukherjee "Children with autism were treated with electrical shocks,with attachment therapies,with hallucinogenic drugs to "warm"them to the world and more. When discussing the man called Carleton in Boston,it seems like an episode of 'House'.I learned so much from this slim book.I recommend it to the world.

  19. 4 out of 5

    Katie Bananas

    I have learned so much more information from this man in the past couple of hours than I've ever come close to learn anything so useful in classroom lectures. What an unbelievable experience this man emits to the future of medicine. I seriously wish he was my professor!! What an exemplary genius!!!! The study of medicine is grueling and challenging. It's an everyday discovery to come up with the laws explained in this little book!! This is a great reminder that everyone is different, just as in I have learned so much more information from this man in the past couple of hours than I've ever come close to learn anything so useful in classroom lectures. What an unbelievable experience this man emits to the future of medicine. I seriously wish he was my professor!! What an exemplary genius!!!! The study of medicine is grueling and challenging. It's an everyday discovery to come up with the laws explained in this little book!! This is a great reminder that everyone is different, just as in medicine, where treatment and diagnoses vary, but an error not promptly prevented can be of serious circumstances to the patient and spread out so much damage. This has been an excellent and highly recommended read.

  20. 5 out of 5

    Natalia

    Interesting to read this while also reading Thinking, Fast and Slow. He talks about doctors using intuition and that being better than some screening tests with less than perfect sensitivity and specificity. Intuition is the fast thinking built on subconsciously stored information and connections from previous experiences. It's both scary and interesting to think about how much of medicine is an art and still far from a hard and fast science.

  21. 4 out of 5

    Denise Alcaraz

    For a non-fiction piece of work, this guy can write and keep me interested almost like a fiction story. I've read The Emperor of All Maladies a few years ago and was fascinated. I am an Oncology Nurse, but they don't teach this stuff in Nursing School. I love how this man writes nonfiction. It is not a dry and boring affair. I have already pre-ordered his next book.

  22. 4 out of 5

    Surya

    This book is fun reading, even for a non-medico. It is interesting, hilarious and intriguing. It has interesting anecdotes not only from his life, but from Bayes, Tycho Brahe etc... which makes this book even more interesting and fun to read.

  23. 4 out of 5

    Lien To

    3.4 stars**** Loved the talk, wasn't too sure about the book though. I spent too much time looking up medical jargon and losing my rhythm with the book. Overall, a enriching read over a field I've admired afar. "It's easy to make perfect decisions with perfect information. Medicine asks you to make perfect decisions with imperfect information"

  24. 4 out of 5

    Zheen Khalil Kamala

    The laws state that a strong gut feeling and intuition is better than a mere test that has been standardized for the majority, normals don’t always have to be the normal, what is normal for the majority might be the opposite for an individual based on the factors associated with the disease or the patient, and lastly we tend to be biased in our opinions when it comes to unexplainable cases. What we need to do sometimes is to think out of the box, for each case sheet, each patient has their own st The laws state that a strong gut feeling and intuition is better than a mere test that has been standardized for the majority, normals don’t always have to be the normal, what is normal for the majority might be the opposite for an individual based on the factors associated with the disease or the patient, and lastly we tend to be biased in our opinions when it comes to unexplainable cases. What we need to do sometimes is to think out of the box, for each case sheet, each patient has their own story, their own factors contributing to their disease and their response to the medications and therapeutic measures.

  25. 5 out of 5

    Rajmr64 Rajeev

    The author calls it the Uncertain Science-yes, you heard it right, Siddhartha Mukherjee, who himself is at the pinnacle of clinical medicine (he is an oncologist), considers Medicine to be an uncertain science. I do endorse his view, being from the medical fraternity. But, alas a layman isn’t aware of all the uncertainties that is associated with the enigmatic science that is Medicine. There is an urgent need for people to know of the pitfalls that are prevalent in Medicine, where two plus two i The author calls it the Uncertain Science-yes, you heard it right, Siddhartha Mukherjee, who himself is at the pinnacle of clinical medicine (he is an oncologist), considers Medicine to be an uncertain science. I do endorse his view, being from the medical fraternity. But, alas a layman isn’t aware of all the uncertainties that is associated with the enigmatic science that is Medicine. There is an urgent need for people to know of the pitfalls that are prevalent in Medicine, where two plus two isn’t always four, and where all disease manifestations cannot be explained in the ambit of straightforward biological, physical or chemical laws. Once the layman gets to understand this, there will be an appreciable abatement to the discordant notes that exist between the patient and the physician in today’s world. The facts that are recorded by the author in this short treatise has to be read in conjunction with the TED talk delivered by him where he addresses the use of cell biology and genetic engineering in the management of illnesses in the future. He rightly points out that one of the reasons for the rapid gains of Medicine in the preceding century was on account of the phenomenal effect of antibiotics on microbes. But we have reached a saturation point as far as antibiotics are concerned. The time-tested model of treating ailments by using chemical agents to act against the disease processes has started to fail. That is where the role of genetic engineering and gene manipulation has shown promise, especially in the management of lifestyle and chronic infirmities. Stem cell therapy is another promising field that is bound to revolutionize the ways in which we will be tackling diseases in the future. Mukherjee says that intuition is something that a good physician cannot do without. I have also experienced that in my practice. The way the patient walks into the surgery, the way in which he talks, the nuances in his or her body language, all lead to forming an opinion about the patient and consequently his illness. All this happens even without your conscious realizing it. Here in lies the importance of elicitation of history of the illness, talking to the patient and of a thorough physical examination. Sadly, this is one thing that is lacking in the practice of Medicine today, wherein undue importance is given to tests and investigations. Hence the first law- “A strong intuition is much more powerful than a weak test”. The second law has to do more with research in Medicine than the actual clinical practice. Mukherjee cites the example of clinical trials of chemotherapeutic drugs in oncology. Logically, researchers tend to gravitate towards those drugs that are predominantly successful or predominantly fail in the treatment of a particular type of cancer. The author argues that if a drug is predominantly a failure but is seen to work on a single patient, then one needs to assess the causes as to why that drug has worked on that patient. Maybe, that would lead to more valuable observations which in turn would lead to potential breakthroughs in the treatment of that condition. Hence the second law- “Normals teach us rules; Outliers teach us laws” The author then talks about the statistical analyses that are undertaken in Medicine and the major pitfalls that can happen in the interpretation of results, since the chances of a bias are so very real. Herein, he states the third law- “For every perfect medical experiment, there is a perfect human bias”. The Laws of Medicine, is as much for the sensitization of the physician as it is for the enlightenment of the layman. This is a short concise work, with its limited expanse being worth its weight in gold. A must read for all- for the healer and the infirm, in equal measure.

  26. 4 out of 5

    Philipp

    Small book based on a TED-talk, but luckily without the annoying language of a TED-talk. It serves as a very brief introduction to Bayesian thinking or Bayesian inference, with a short intro to a world where everything has a false and a negative positive rate - here it is applied to the world of medicine, but you could (should?) also use it in politics, research, sports, economics, the way you run your company etc. I'd love to live in a world where a politician "flip-flopping" isn't a bad thing, Small book based on a TED-talk, but luckily without the annoying language of a TED-talk. It serves as a very brief introduction to Bayesian thinking or Bayesian inference, with a short intro to a world where everything has a false and a negative positive rate - here it is applied to the world of medicine, but you could (should?) also use it in politics, research, sports, economics, the way you run your company etc. I'd love to live in a world where a politician "flip-flopping" isn't a bad thing, but something to be lauded when it's a careful decision based on new information (this is a problem in scientific research, too - scientists themselves rarely "flip-flop", they just die. The younger generation then picks up the novel outlook from the start - "science advances one funeral at a time", as it is ascribed to Planck). The short length of the talk/book makes criticisms of this style of thinking impossible; for example, you have to be extremely careful when choosing your data, and (un)conscious bias may make you dismiss evidence that you should have included, there can be a lot of (bad) subjectivity involved. The other two laws are less applicable to a non-researching world - 1) outliers are the source of novel laws (as the "weird" motion of Mars while all other planets moved "nicely" was the source of Kepler's laws). 2) Human bias influences everything, even the mere act of a patient enrolling in a study introduces bias - this is a bigger problem in medicine since you have two groups who are influenced by bias (the researchers and the patients). Bonus quote: The advent of new medical technologies will not diminish bias. They will amplify it. More human arbitration and interpretation will be needed to make sense of studies - and thus more biases will be introduced. Big data is not the solution to the bias problem; it is merely a source of more subtle (or even bigger) biases. (I see that in bioinformatics often - there are many sources of false positive noise, which people usually discard (unmapped reads, repetitive regions etc.), the more noise, the more is discarded. We always throw away important information - in plants, resistance genes often carry many repeats, so I've had a few cases where we had to go "dig in the garbage" for our expected resistance genes)

  27. 4 out of 5

    Kazen

    I've been meaning to read Mukherjee for a while now, especially considering how highly regarded Emperor of all Maladies is. That tome is 571 pages, though, so I thought The Laws of Medicine would be a better introduction. And straight off I can tell you that I like his writing and his style. He neither dumbs down examples nor overexplains details. I want to read more... especially because this book is so short. Clocking in at under 100 pages, it introduces the three laws of medicine Mukherjee devi I've been meaning to read Mukherjee for a while now, especially considering how highly regarded Emperor of all Maladies is. That tome is 571 pages, though, so I thought The Laws of Medicine would be a better introduction. And straight off I can tell you that I like his writing and his style. He neither dumbs down examples nor overexplains details. I want to read more... especially because this book is so short. Clocking in at under 100 pages, it introduces the three laws of medicine Mukherjee devised. One is more aimed at research than clinical practice, and one is dead obvious to anyone who has studied medicine (even this lowly interpreter) but they're still good points and worthy of the attention. What hurts the most for me is that book could have been longer. The idea of laws could be better explored, corollaries proposed and debated, and exceptions that prove the rule gone over. As it stands the information is sufficient but not satisfying. I listened to the audiobook and like the reader and the way it is produced. Having the author read the introduction is always a nice touch. While I liked The Laws of Medicine it didn't affect me as much as What Doctors Feel: How Emotions Affect the Practice of Medicine and other medical non-fiction does. But that's okay - I'm viewing it as a tantalizing preview of Mukherjee's longer, more in-depth work. Onward!

  28. 4 out of 5

    Alexandra

    I am sorry to give such a low review for the author I like. But GoodReads should have some kind of a warning like "It's a teeny-tiny book and if you like to read something 500+ pages long, you'll be disappointed". That's exactly what happened to me. I read The Emperor of All Maladies and loved it. So I ordered this one just because of the author and hoped for the same deep and interesting info just outside of cancer research and more on general medicine. And what I got is a TED talk in a book forma I am sorry to give such a low review for the author I like. But GoodReads should have some kind of a warning like "It's a teeny-tiny book and if you like to read something 500+ pages long, you'll be disappointed". That's exactly what happened to me. I read The Emperor of All Maladies and loved it. So I ordered this one just because of the author and hoped for the same deep and interesting info just outside of cancer research and more on general medicine. And what I got is a TED talk in a book format. Which is all fine and good, but why would you publish it as a separate book?! A collection of TED talks - may be. A collection of talks by one speaker - OK. But this? Its pages are about 1/3 of a normal book and there are only 70 of those (including pictures and the whole page large font quotations). It took me a lunch break and a ride on a bus to finish the book in one day. My 8 year old son laughed at me when he saw me unpacking this book (I ordered online and it never gave any indication of the size of the book). Again, my point is that the book format is simply wrong for TED talks. Ordering online and waiting for a book that can be read in less than 2 hours feels kind of stupid.

  29. 5 out of 5

    Jessica

    This is a short, introductory book about how "decisions" are made in modern medical practices and how insufficient they can be. Not satisfied with the current, statistically based medicine, Dr. Siddhartha Mukherjee urges his peers to practice from a more humane and intuitive angle. He has devices three laws as his own guiding principles. With each principle, Mukherjee includes few examples and explains what has driven him to draw such a conclusion. Law #1 - A strong intuition is much stronger tha This is a short, introductory book about how "decisions" are made in modern medical practices and how insufficient they can be. Not satisfied with the current, statistically based medicine, Dr. Siddhartha Mukherjee urges his peers to practice from a more humane and intuitive angle. He has devices three laws as his own guiding principles. With each principle, Mukherjee includes few examples and explains what has driven him to draw such a conclusion. Law #1 - A strong intuition is much stronger than a weak test. Law #2 - Normal teaches us rules; outliers teach us laws. Law #3 - For every perfect medical experiment, there is a perfect human bias. I think his principles serve as nice reminders during the decision-making process, even for patients themselves. I believe what Mukherjee writes about in this book can also be applied to other fields of work. It certainly is an interesting read, one that rouses a different way of thinking. The book gets solid 3 stars from me.

  30. 4 out of 5

    Isil Arican

    Great and a short book about the unwritten laws of medicine. Mukherjee summarizes the three rules of medicine that all medical professionals and anyone else interested in medicine should be aware of. We all see common mistakes of false interpretation of tests, unnecessary orders and incorrect treatments. His quick and short summary of three rules shed a light of how many of these errors occur and what is a better way to practice medicine - which is not a pure science but a mixture of a science an Great and a short book about the unwritten laws of medicine. Mukherjee summarizes the three rules of medicine that all medical professionals and anyone else interested in medicine should be aware of. We all see common mistakes of false interpretation of tests, unnecessary orders and incorrect treatments. His quick and short summary of three rules shed a light of how many of these errors occur and what is a better way to practice medicine - which is not a pure science but a mixture of a science and art. I only wish that this book was deeper and longer with more details.

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