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The Rise and Fall of Modern Medicine
In the years following World War II, medicine won major battles against smallpox, diphtheria, and polio. In the same period it also produced treatments to control the progress of Parkinson's, rheumatoid arthritis, and schizophrenia. It made realities of open-heart surgery, organ transplants, test-tube babies. Unquestionably, the medical accomplishments of the postwar years stand at the forefront of human endeavor, yet progress in recent decades has slowed nearly to a halt. In this winner of the Los Angeles Times Book Prize, medical doctor and columnist James Le Fanu both surveys the glories of medicine in the postwar years and analyzes the factors that for the past twenty-five years have increasingly widened the gulf between achievement and advancement: the social theories of medicine, ethical issues, and political debates over health care that have hobbled the development of vaccines and discovery of new "miracle" cures. While fully demonstrating the extraordinary progress effected by medical research in the latter half of the twentieth century, Le Fanu also identifies the perils that confront medicine in the twenty-first. 16 pages of black-and-white photographs add to what the Los Angeles Times cited as "a sobering, contrarian challenge" to the "nostrum of medicine as a never-ending font of ‘miracle cures'." "[From] a respected science writer ... important information that ... has been overlooked or ignored by many physicians." —New Republic "Provocative and engrossing and informative." —Houston Chronicle "Marvelously written, meticulously researched ... one of the most thought-provoking and important works to appear in recent years." —Choice
448 pages, Paperback
First published January 1, 1999
About the author
James Le Fanu
20 books16 followersJames Le Fanu studied the Humanities at Ampleforth College before switching to medicine, graduating from Cambridge University and the Royal London Hospital. He subsequently worked in the Renal Transplant Unit and Cardiology Departments of the Royal Free and St Mary’s Hospital in London. For the past 20 he has combined working as a doctor in general practice with contributing a weekly column to the Sunday and Daily Telegraph. He has contributed articles and reviews to The New Statesman, Spectator, GQ, The British Medical Journal and Journal of the Royal Society of Medicine. He has written several books including The Rise and Fall of Modern Medicine that won the Los Angeles Prize Book Award in 2001.
He has made original contributions to current controversies over the value of experiments in human embryos, environmentalism, dietary causes of disease and the misdiagnosis of Non Accidental Injury in children. He lives in south London.
He has made original contributions to current controversies over the value of experiments in human embryos, environmentalism, dietary causes of disease and the misdiagnosis of Non Accidental Injury in children. He lives in south London.
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Displaying 1 - 30 of 38 reviews
December 9, 2014
This book was originally published in 1999 and I read the 2012 updated copy of the book.For a book that argued so much about the lack of integrity in medical science, I was sorely disappointed in the format that Le Fanu had updated his book. The updated copy wasn’t really an updated in as much as Le Fanu had written a few new chapters that were applicable to the 13 years since his original publishing but the original content of the book was completely unedited from its 1999 presentation. This was most notable in the references to costs of medical expenditure in the 1990’s that could have easily been updated with 2012 figures without needing to add on new redundant chapters to cover the last decade.
Another drawback to this book is that in being British and enjoying the benefit of a single-payer medical service, Le Fanu completely omitted any reference to the debilitating influence of American style medical insurers as a downfall to the medical system. Le Fanu did make reference to the overall expenditure of the US economy, but he seemed to completely ignore one of my most influential factors in the US system, that being that a myriad of insurance providers have an overly influential power with regard to dictating care administered because the insurance providers influence the cost of care received. Furthermore, in ignoring the influence of insurance providers Le Fanu takes no notice of the plight of the uninsured who do not receive the benefits of preventative medicine because they avoid the cost of seeing a medical provider. Shannon Brownlee’s OverTreated provides a much more thorough analysis of the labyrinthian influence of the American medical system and I would recommend that book over Le Fanu’s if you have interest in the cause for the high costs of medicine.
Another drawback to this book is that in being British and enjoying the benefit of a single-payer medical service, Le Fanu completely omitted any reference to the debilitating influence of American style medical insurers as a downfall to the medical system. Le Fanu did make reference to the overall expenditure of the US economy, but he seemed to completely ignore one of my most influential factors in the US system, that being that a myriad of insurance providers have an overly influential power with regard to dictating care administered because the insurance providers influence the cost of care received. Furthermore, in ignoring the influence of insurance providers Le Fanu takes no notice of the plight of the uninsured who do not receive the benefits of preventative medicine because they avoid the cost of seeing a medical provider. Shannon Brownlee’s OverTreated provides a much more thorough analysis of the labyrinthian influence of the American medical system and I would recommend that book over Le Fanu’s if you have interest in the cause for the high costs of medicine.
March 1, 2020
It was an amazing experience. Medicine as a field of knowledge have made a major progress, but it still has a lot to do and deal with.
January 28, 2010
Read this a few years ago, so the details are fuzzy. I'd have given 5 stars for the first half - a rundown of twelve pivotal discoveries/inventions in medicine. Le Fanu brings these events, involving chance findings and big personalities, to life with skillful story-telling. The second half, about the 'fall' of modern medicine, includes some questionable analyses of the epidemilogical evidence regarding heart disease among other issues, which I would have liked to have seen better argued. Still, some interesting points made in the second half gets it 3 stars, so the book gets 4 overall.
May 17, 2021
Although informative, still out of date. Le Fanu paints a bleak and hopeless picture of the future of medicine and research that does not, in my opinion, accurately reflect the state of the field.
September 17, 2021
The first half is an engaging journey through the 12 major medical breakthroughs and innovations of the 20th century - an easy 5 stars.
The second half is a collection of weak arguments attempting to explain the faltering of medical advancement - 3 stars. I found the case studies littered throughout this section to be interesting, but the author's theses here are only really work a quick skim.
Overall 4 stars.
The second half is a collection of weak arguments attempting to explain the faltering of medical advancement - 3 stars. I found the case studies littered throughout this section to be interesting, but the author's theses here are only really work a quick skim.
Overall 4 stars.
March 10, 2014
Excellent read – part history book, part analysis and part critique Le Fanu traces out the rise and fall of modern medicine, starting with analysis of the factors that have contributed to the extra-ordinary success of medicine in the 30 years following 2nd world war and following through to the identifications of the factors that have contributed and are still contributing to subsequent stagnation.
The first half of the book is mostly uncontroversial – Le Fanu outlines a few now-famous examples of post-war medicine success stories including but not limited to discoveries of penicillin, cortisone, streptomycin, chlorpromazine and covering such breakthroughs as open heart surgery and kidney transplants. Two major themes recur in various forms throughout the success stories – serendipity and emphasis on practice over theory. Most of drug discoveries were indeed accidental and in fact the exact mechanism of their curing ability was not known at the time and for many is still not known today. But they do work. As such it is a classic example of bottom-up empirical approach where the main goal is to find something that works rather than attempt to explain why it does.
The second half of the book is more controversial – Le Fanu explains how the combination of our exhausting of chance discoveries and reframing of bottom-up medical practice into top-down medical theory have resulted in the stagnation of significant medical progress. Broadly the argument stipulates that once we’ve exhausted serendipitous “gifts of nature” (e.g. penicillin, cortisone etc) and have addressed single-cause diseases we’ve started running out of ammunition at which point top-down grand theories such as New Genetics and Social Theory of disease have swooped in. Here the specific analysis becomes more speculative and uneven – he does an excellent job of destroying the Social Theory via the examples of search of environmental causes of heart disease (brilliant expose on the subject btw) and cancer (remember Nixon’s war on cancer?) and a pretty good job of criticizing the shortcomings of genetic engineering, but some of his other critiques (e.g. gene therapy) are more questionable. Overall when it comes to technical details of evolution and molecular biology Le Fanu’s reasoning becomes less lucid. That said he nicely demonstrates the massive gap between the promises of New Genetics and its accomplishments and he also correctly calls Social Theory for what it is – yet another example of utopian social engineering. Finally, Le Fanu is certainly correct in lamenting the transition from practice-based approach aim at finding cures to theory-based approach aimed at finding explanations.
Frankly I was only marginally interested in the subject matter but once I picked up the book I couldn’t put it down – despite some of its flaws I can’t recommend it enough.
The first half of the book is mostly uncontroversial – Le Fanu outlines a few now-famous examples of post-war medicine success stories including but not limited to discoveries of penicillin, cortisone, streptomycin, chlorpromazine and covering such breakthroughs as open heart surgery and kidney transplants. Two major themes recur in various forms throughout the success stories – serendipity and emphasis on practice over theory. Most of drug discoveries were indeed accidental and in fact the exact mechanism of their curing ability was not known at the time and for many is still not known today. But they do work. As such it is a classic example of bottom-up empirical approach where the main goal is to find something that works rather than attempt to explain why it does.
The second half of the book is more controversial – Le Fanu explains how the combination of our exhausting of chance discoveries and reframing of bottom-up medical practice into top-down medical theory have resulted in the stagnation of significant medical progress. Broadly the argument stipulates that once we’ve exhausted serendipitous “gifts of nature” (e.g. penicillin, cortisone etc) and have addressed single-cause diseases we’ve started running out of ammunition at which point top-down grand theories such as New Genetics and Social Theory of disease have swooped in. Here the specific analysis becomes more speculative and uneven – he does an excellent job of destroying the Social Theory via the examples of search of environmental causes of heart disease (brilliant expose on the subject btw) and cancer (remember Nixon’s war on cancer?) and a pretty good job of criticizing the shortcomings of genetic engineering, but some of his other critiques (e.g. gene therapy) are more questionable. Overall when it comes to technical details of evolution and molecular biology Le Fanu’s reasoning becomes less lucid. That said he nicely demonstrates the massive gap between the promises of New Genetics and its accomplishments and he also correctly calls Social Theory for what it is – yet another example of utopian social engineering. Finally, Le Fanu is certainly correct in lamenting the transition from practice-based approach aim at finding cures to theory-based approach aimed at finding explanations.
Frankly I was only marginally interested in the subject matter but once I picked up the book I couldn’t put it down – despite some of its flaws I can’t recommend it enough.
October 5, 2020
This book was a disappointment. It wasn't a waste of time but it could have been so much better. Le Fanu mainly wants to make the point that lifestyle medicine is useless and that the genetics revolution hasn't delivered on its promises yet. He describes 12 milestones in medicine but fails to go any deeper than 'brave physician scientists paved the way' and instead goes on to hate on the whole of epidemiology.
It is thus clear that Le Fanu isn't ready to practice 21th century medicine in which we carefully balance clinical science with the personal needs of every patient. Rather, Le Fanu presents a false dichotomy - it's either cold science or a warm clinical gaze, devoid of 'modern technology'. He even goes as far as saying that doctors are suffering burnouts because they don't get enough hands on time with their patients. Maybe it has to do with overbooked schedules and way too many traumatic experiences?
Additionally, despite him touting patient wellbeing as an excuse to refrain from excessive diagnostics, he never describes patients as human beings who have agency to make decisions. He glosses over the terrible history of experimentation on non consenting patients, Tuskegee doesn't even get a mention and he mostly focuses on how awful it must have been for the doctors to lose patients, instead of how terrible it would be to lose your child to an experimental procedure (and the parents probably never knew it was experimental). Le Fanu even considers all the death as 'part of the learning curve'. So much for being patient centered...
This book wasn't a complete waste of time because it is always good to look back and see how far we've come and what price we (as a society) paid for that. But his view is very much centered on one type of white affluent male doctor. And he'd probably hate to see that the number 1 treatment option for diabetes type 2 is lifestyle modification!
The fun of being a doctor nowadays is to guide your patient through that maze of therapeutic and diagnostic options. Le Fanu obviously fell behind. I wouldn't want him as my doctor.
It is thus clear that Le Fanu isn't ready to practice 21th century medicine in which we carefully balance clinical science with the personal needs of every patient. Rather, Le Fanu presents a false dichotomy - it's either cold science or a warm clinical gaze, devoid of 'modern technology'. He even goes as far as saying that doctors are suffering burnouts because they don't get enough hands on time with their patients. Maybe it has to do with overbooked schedules and way too many traumatic experiences?
Additionally, despite him touting patient wellbeing as an excuse to refrain from excessive diagnostics, he never describes patients as human beings who have agency to make decisions. He glosses over the terrible history of experimentation on non consenting patients, Tuskegee doesn't even get a mention and he mostly focuses on how awful it must have been for the doctors to lose patients, instead of how terrible it would be to lose your child to an experimental procedure (and the parents probably never knew it was experimental). Le Fanu even considers all the death as 'part of the learning curve'. So much for being patient centered...
This book wasn't a complete waste of time because it is always good to look back and see how far we've come and what price we (as a society) paid for that. But his view is very much centered on one type of white affluent male doctor. And he'd probably hate to see that the number 1 treatment option for diabetes type 2 is lifestyle modification!
The fun of being a doctor nowadays is to guide your patient through that maze of therapeutic and diagnostic options. Le Fanu obviously fell behind. I wouldn't want him as my doctor.
Read
July 25, 2011An inspirational and eye opening piece of writing. The first part of the book, 'The Rise', documents 12 definitive moments in the 'golden age' of medicine from the end of the second world war to the mid 80s. These chapters are exciting and engaging accounts of such marvels as open-heart surgery, intensive care and the discovery of penicillin. It is often the case in these chapters that the discovery being chronicled was the offspring of tireless scientific effort and a healthy slice of good fortune. In fact this part was so awe inspiring that I couldn't bring myself to read the second part of the book: 'The Fall' for a year or so for fear that it would take the shine off what I had just experienced. However, the tale of the fall of modern medicine was equally exciting, if not sobering. The main point addressed here I believe, is the paradox that even as life expectancy and general good health continues to rise, there is more concern than ever about the health of the population. I particularly enjoyed the use of the word 'disease-mongering' to describe the sensationalist attitude taken by the media and big pharma in their efforts to convince us that, for example 'mobile phones cause brain cancer' or 'genetically engineered insulin is a new hope for diabetics'. Le Fanu goes on to lucidly explain that the amount of radiation emitted by mobiles is a fraction of what we are exposed to from that of the earth's static magnetic field, and also that pig and cow insulin is not only more effective than the GM counterpart, but also considerably cheaper! He goes on to debunk many more myths of good health (including the fabled 'low cholesterol diet'). This book is essential reading for any social scientist or medic and anyone who needs reminding that when it comes to science we should all have our feet planted firmly on the ground.
February 3, 2017
an analysis of medicine as it exists today, with a focus on 12 moments which the author considers to be "definitive" in the change of practical medicine through a therapeutic revolution. he then talks about the stalling and eventual decline of this progress, talking about a "dearth of new drugs" and the failure of social and genetic medicine. the epilogue provides an update 10 years on from first publication, talking about an increase in the scope of disease and age that has become treatable and recent tech advances such as keyhole surgery, before assessing the fortunes of "big pharma" and their (successful) efforts to subvert medical practice and guidelines towards their own interests. overall a well rounded and interesting book including the history and human spirit behind advances without going too detailed into the science behind them. it reads a bit biased at times but that is only to be expected since it is written by an individual who has been in the medical field for many years.
November 13, 2020
The first section is a truly thought provoking and eye-opening conspectus of some of the major milestones in modern medicine. The second section is, by comparison, a bit of a drag - the author's general takedown of the modern pharmaceutical industry and the widespread treatment of non-diseases. His dry, somewhat pedantic style gets the upper hand here, unfortunately.
January 7, 2020
The (extremely long) prologue of this book is amazing, the middle made me want to throw it at a wall, and then the epilogue to the second edition saved it. Lots of interesting anecdotes and facts about medical but the analysis and speculation didn't seem to say or prove a lot for me.
August 21, 2018
You should only invest within your own circle of competence – but you should also always try to increase that circle. Before Phoenix Asset Management ventured the fund’s money in health care stocks they ploughed through 30 books on the sector. According to portfolio manager Gary Channon, as stated at last years London Value Investor conference, two of these stood out. One was The Rise and Fall of Modern Medicine. The author is a practicing medical doctor and a journalist. The book is written with the explicit intent to question the present state of medicine and the health care sector.
The first two hundred pages reads like Bill Bryson’s A Short History of Nearly Everything, when Le Fanu tells the tale of the twelve definitive moments of medical development. This is the story of the medical triumphs such as the discovery of penicillin and cortisone, open heart surgery etc. that dwarves all that was accomplished prior to that through history. It’s an exposé of remarkable persons who push on endlessly pursuing their idea of how illnesses could be remedied. It’s also a journey in suffering and death. It is at times incomprehensible to me how those people could keep their trial and error processes going when “error” at times meant huge numbers of casualties.
The following 300 pages then convey what the author really wants to advance. The argument is that despite the hard work behind many of the discoveries, a large amount of them were also due to pure luck and during the 70s the medically important discoveries pretty much dried up. Deprived of discoveries that cured serious or common diseases and influenced by the social engineering of the times the focus of medical science shifted to what in the book is called the social theory, i.e. that it is by changing the diet of the population or by fighting environmental pollution that various unwanted conditions should be prevented. The problem is that much of the science in this case depended on a combination of bad or manipulative use of statistics and media hype. The beliefs around how cholesterol in the food of the Western World caused heart attacks; how various diets were important with regards to the risk of cancer; and how oestrogen from PCB in plastics could leak out into the ground water and cause male infertility are some of the many examples where the reality got seriously distorted.
Further, partly due to the lack of innovation, the health care companies instead turned to the profitable so-called lifestyle drugs handling - for example depressions, obesity or erection problems. The hope was then spectacularly raised again with the triumphs of biotechnology and specifically with the mapping of the human genome. Sadly, Le Fanu comes to the conclusion that very little has actually come from all this. Partly this is because the complexities were larger than initially anticipated but more importantly it is due to the fact that few of the remaining frequent and serious diseases actually are genetic.
The author’s conclusion is that we are in an intellectual vacuum right now; doctors are unsatisfied despite being able to treat so very much more than a doctor could 100 years ago; the population is healthier than ever – yet they worry constantly and are obsessed over every media report that we should eat the exact opposite to what was recommended in the paper the last week; and alternative medicine is gaining popularity. We have seen the rise and fall of modern medicine.
Not being a MD or a health care analyst I find it hard to argue against Le Fanu’s convincing narrative. It is certainly an argument that rimes well with the well-discussed patent cliffs of the pharma companies. At the same time there seams to be a new wave of innovation in the biotech companies again so perhaps there is a light in the tunnel?
The first two hundred pages reads like Bill Bryson’s A Short History of Nearly Everything, when Le Fanu tells the tale of the twelve definitive moments of medical development. This is the story of the medical triumphs such as the discovery of penicillin and cortisone, open heart surgery etc. that dwarves all that was accomplished prior to that through history. It’s an exposé of remarkable persons who push on endlessly pursuing their idea of how illnesses could be remedied. It’s also a journey in suffering and death. It is at times incomprehensible to me how those people could keep their trial and error processes going when “error” at times meant huge numbers of casualties.
The following 300 pages then convey what the author really wants to advance. The argument is that despite the hard work behind many of the discoveries, a large amount of them were also due to pure luck and during the 70s the medically important discoveries pretty much dried up. Deprived of discoveries that cured serious or common diseases and influenced by the social engineering of the times the focus of medical science shifted to what in the book is called the social theory, i.e. that it is by changing the diet of the population or by fighting environmental pollution that various unwanted conditions should be prevented. The problem is that much of the science in this case depended on a combination of bad or manipulative use of statistics and media hype. The beliefs around how cholesterol in the food of the Western World caused heart attacks; how various diets were important with regards to the risk of cancer; and how oestrogen from PCB in plastics could leak out into the ground water and cause male infertility are some of the many examples where the reality got seriously distorted.
Further, partly due to the lack of innovation, the health care companies instead turned to the profitable so-called lifestyle drugs handling - for example depressions, obesity or erection problems. The hope was then spectacularly raised again with the triumphs of biotechnology and specifically with the mapping of the human genome. Sadly, Le Fanu comes to the conclusion that very little has actually come from all this. Partly this is because the complexities were larger than initially anticipated but more importantly it is due to the fact that few of the remaining frequent and serious diseases actually are genetic.
The author’s conclusion is that we are in an intellectual vacuum right now; doctors are unsatisfied despite being able to treat so very much more than a doctor could 100 years ago; the population is healthier than ever – yet they worry constantly and are obsessed over every media report that we should eat the exact opposite to what was recommended in the paper the last week; and alternative medicine is gaining popularity. We have seen the rise and fall of modern medicine.
Not being a MD or a health care analyst I find it hard to argue against Le Fanu’s convincing narrative. It is certainly an argument that rimes well with the well-discussed patent cliffs of the pharma companies. At the same time there seams to be a new wave of innovation in the biotech companies again so perhaps there is a light in the tunnel?
November 10, 2022
The first half of this book is fantastic. The second half - the downfall of medicine is unreadable. De Fanu cherry picks his research to completely disegard the role of nutrition and environmental factors in diseases such as cancer among others. Some of his points are interesting and may even be valid, but are not up to date. The cherry on the top of this publication is the glorification of psychiatric medication when compared to Freudian psychoanalysis. De Fanu makes it sounds as if ,for someone affected by mental health, there are only two options- cognitive therapy or medication. It cannot be denied that for disorders such as bipolar or schizophenia, medication plays an important role. However the notion that depression is caused by chemical imbalance, which can be treated by antidepressants has never had a scientific basis. In addition, while cognitive therapy, even more behavioural cognitive therapy is indeed a very target focused and overall, a succesfull form of treatment for a variety of conditions it is far from a mould that fits all. Other forms of therapeutic work were clearly not important enough to be mentioned. I feel that this book is outdated and contributes to the tunnel vision of medical approach to health, both physical and mental. approach, that has been long abandoned in favour of social and biomedical model of health or stress and vulnerability model of mental health.
November 3, 2022
I love this book second favourite book I like the way I feel reading with someone who has truly mastered their craft and is truly impartial regardless of their old beliefs and allegiances for a person is remade every ninety days down to every single cell the brain resets with every cycle of sleep every person you meet has a different perception of you and each of every one of those perceptions differ based on a deontological like list of fake constructs which mean truly nothing in reality none of those perceptions are even .1% similar to those of yourself and those truly close to you. The mastery in piecing together pharma history with nuggets of information which I know tk be tru is remarkable. With this book your perception might change but it won’t you won’t let it
January 3, 2021
Pretty sure there was a reason I got this in goodwill. This is one of those strange books that doesn’t really have any clear purpose. Maybe I’ve been reading too many books like this lately, but it doesn’t really bring anything new to the table until the last couple chapters. Honestly, skip the first three quarters of the book to get to the actual meat of the content — opposition to the idea that medicine will progress forever and everything can be cured and our world is killing us with carcinogens. SKIP.
July 6, 2021
Wasn't terrible but wasn't great. As with all science books, they are out of date as soon as they are published, but reading this nearly 10 years after it was republished made it even more so.
It took me a while to get into, and the first half of the book was interesting to read. However the second half of the book was slow, and outdated.
I agree with another reviewer, that the revisions for the second edition should have been incorporated throughout the original book; instead they were an additional afterthought pasted on at the end.
It took me a while to get into, and the first half of the book was interesting to read. However the second half of the book was slow, and outdated.
I agree with another reviewer, that the revisions for the second edition should have been incorporated throughout the original book; instead they were an additional afterthought pasted on at the end.
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December 13, 2023If you took Western civilization in college and were assigned “The Rise and Fall of the Roman Empire,” you might be tempted to pass on this one, but that would be a shame because there are many interwoven parallels. Modern Medicine is a veritable world of kingdoms more complex than even George R. R. Martin could fathom.
Read our entire review and see more book club selections on The DO!
Read our entire review and see more book club selections on The DO!
This entire review has been hidden because of spoilers.
April 27, 2020
Read this in 2019, long after its release.
I liked the history part of the book.
The current and future things were off, now that I'm living it.
Things of value tend to persist, until something better comes along.
The predicted downfall hasn't happened because despite the flaws, the replacement hasn't arrived.
I liked the history part of the book.
The current and future things were off, now that I'm living it.
Things of value tend to persist, until something better comes along.
The predicted downfall hasn't happened because despite the flaws, the replacement hasn't arrived.
Want to read
June 5, 2021Good
Currently reading
October 19, 2014If you think that the discovery of penicillin was a lucky, unplanned discovery, you must read this book! A fascinating page turner! Compared to some of the talks given by some Nobel Prize winners at Imperial College, the stories depicted here are very much for the 'lay' reader. Only when one of these uniquely gifted people will take the scientific audience through the details of 'what and how', it is only then one can truly realise how much knowledge, thought, brilliance, determination, curiosity, inventivity, courage, vision, humility, uniqueness and trust in something no one else believed in, takes to discover and translate such discoveries. Somehow selective, the book makes (however) some injustice to some other amazing discoveries that are equally laudable and beyond imagination (for example the successful separation of twins joined by one brain). Perhaps just another indication of the fact that such things are indeed beyond what can be glimpsed at in between two book covers! And to wrap it up, my favourite picture, is the one with Sir Bradford Hill enjoying a walk with his wife in the Highlands, gazing lovely and joyfully into each other's eyes. The measure of a fulfilled life indeed!!!
March 26, 2016
I was enamoured of the first few chapters, where the author elegantly presents several anecdotes of medical history in a fascinating, very readable way, but by the middle of the book I was just wishing for it to be over with. James Le Fanu is a meticulous researcher and lucidly extracts the lessons we all can take from individual historical discoveries in medicines, but unfortunately he has a tendency towards dry, self-indulgent and impenetrable prose that reaches its nadir in the second half of the book. This book could be much shorter than its 500+ pages and it would be all the stronger for it. (I must admit I'm holding a minor grudge towards it, as I'm way behind on my 2016 reading challenge and I wholly blame this never-ending doorstopper.)
December 30, 2015
I recommend this book to anyone interested in medicine, and to anyone who is afraid that they might get cancer from pesticides or that they might get a heart attack from eating bacon and eggs.
Le Fanu gives a moderately detailed history of the major medical advances of the last 60 years. His thesis is that the Golden Age of medical advances is over.
He does not think that we will plunge into a medical dark age as you might suspect from the word "Fall" in the title. Rather, Le Fanu argues convincingly that the medical community has run out of good ideas and for the last 40 years have been chasing the false theories of diseases caused by environment and diet.
Le Fanu gives a moderately detailed history of the major medical advances of the last 60 years. His thesis is that the Golden Age of medical advances is over.
He does not think that we will plunge into a medical dark age as you might suspect from the word "Fall" in the title. Rather, Le Fanu argues convincingly that the medical community has run out of good ideas and for the last 40 years have been chasing the false theories of diseases caused by environment and diet.
January 21, 2012
This concerns the 2011 edition, which doesn't appear to be on goodreads.
I'd actually give this 3.5 stars, and half way through I was sure it would be 4. The history of the authors 12 major advances in medicine is fascinating and superbly written, however after that appears to be somewhat outdated. As mentioned this is the 2011 edition, which appears to consist of 30 or so pages of new writing at the end of the original edition.
If you want a brief history of some of the major events in post war medicine, then this is it. Anything else then go for something more recent.
I'd actually give this 3.5 stars, and half way through I was sure it would be 4. The history of the authors 12 major advances in medicine is fascinating and superbly written, however after that appears to be somewhat outdated. As mentioned this is the 2011 edition, which appears to consist of 30 or so pages of new writing at the end of the original edition.
If you want a brief history of some of the major events in post war medicine, then this is it. Anything else then go for something more recent.
July 30, 2014
This book does a great job at questioning the status quo of current medicine. It takes a hard look at the history of sentinel events that made the medical field what it is today. The author does a good job at acknowledging what we have done right, and what has been "given" to us from Providence. This is a good read for anyone who wants to go into the medical field (in any capacity), or who will be participating in medical treatment, with a non-naive mindset. Medicine is great for those who need it, but we don't always have to eat what we are fed.
February 4, 2015
This was a provocative read and I liked the fact that the author was taking such a fresh perspective on our whole medical research enterprise. From the emphasis in the pharmaceutical industry on developing "lifestyle drugs" or slightly tweaked variations of existing treatments, to the lack of funding for basic science there's a lot of unorthodox thinking to absorb. I was interested to read LeFanu's call for a return to "first principles" which I hear echoed sometimes at this research institution where I work.
September 22, 2015
For a book that is over 500 pages long and with an already predetermined conclusion to make (glaringly obvious from the pretentious title) - this book is really unnecessarily long. I could very well imagine it to be 300 pages tops. I remember getting at the page 485 or something and I literally cried out, "when will this book ever end!" - which is really a sad affair since I belive as a rule, a good book should leave the readers not wanting it to be.
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June 2, 2010I liked this book very much, although at 3/4 of the book it looses momentum. What I learned was especially how much serendipity AND stamina was involved in medical research, as well as a different view on epidemiology. This last point refers to "cheese is bad for you", although you have to eat a lot of cheese to disturb the equilibrium.
July 28, 2012
This is a well written and an enlightening book.However a tad overlong, and scary in parts. The chapter on the "new genetics" was really interesting and the explanation on how the DNA is replicated to aid gene therapy is the most clear and concise that you will ever find. If you are a regular user of the NHS as I am, you will find this disturbing reading.
October 3, 2015
An excellent book for those interested in the golden era of medicine, the discovery of antibiotics and of modern surgical techniques. It is an impressive achievement for le Fanu to be able to succinctly say this story to lay audience. The second half of the book is his personal opinion on the future of medicine - a bit gleam in my opinion but interesting nonetheless.
September 13, 2012
This book started out pretty well, with lots of interesting medical history. Le Fanu's description of "The Fall" was incredibly disappointing though, as he took some good points and ran off a cliff with them.
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