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Medical Expose Calls for Change

By Sara Calabro

In the concluding chapter of Hippocrates’ Shadow, author David Newman says, “Secrets beget secrets.”

He’s referring to a vicious circle whereby physicians, overwhelmed by peer, time and system pressures, perpetuate medical practices that they know to be ineffective or even downright dangerous; their inaction breeds misinformation among patients and next-generation doctors, allowing the cycle to continue and worsen as false ideas and unrealistic expectations get lodged deeper and deeper in our collective psyche.

The book reads a bit like this phenomenon: Page by page, chapter by chapter, the sense that our medical system does more harm than good feels increasingly overwhelming. In parts—for example, when Newman digs into a statistical concept known as NNT, or Number Needed to Treat—it can feel like there’s no way out.

Yet on the whole, Hippocrates’ Shadow is actually an uplifting book, a well-written, fun-to-read exposé with optimism at its core.

Newman, an emergency medicine doctor, achieves this by inserting humor and first-hand anecdotes in apt places, and consistently bringing the discussion back to the book’s Hippocratic theme. Each chapter is dedicated to a different revelation about modern-day doctors—for example, they know less than everyone assumes, give treatments they know don’t work, and love tests and hate talking—and ends with an explanation of how these traits differ from those of their profession’s famous father, Hippocrates.

Newman mentions acupuncture a few times throughout the book, in the sections on placebo effect. (His discussion of placebo is one of the book’s high points.) But it’s his chapter-ending descriptions of Hippocrates that are likely to resonate most with acupuncturists and patients who have been treated by them.

“While today’s tests are done away from the patient, creating distance, a blood test in ancient Greece meant examining its color, viscosity, and taste,” writes Newman. “All excretions, all changes in facial expression, all dispositions and emotions, and all bodily evolutions were fanatically observed and described.”

This and other portrayals of Hippocrates-style medicine throughout the book are notably similar to the way acupuncturists are trained to assess and interact with patients.

The placebo chapter is topped only by the final, where Newman explains how modern medicine arrived at its current state, so drastically disconnected from its founding principles. The conclusion is revelatory, outlining how theories developed by mathematicians have been ignored in favor of blind faith in science and technology. This has led to missed opportunities—”When a drug or intervention is ‘equivalent to placebo’ no one asks how good the placebo was”—as well as job dissatisfaction among physicians and discontent with medical care among patients.

Ultimately, though, Newman’s conclusion is one of hope. He calls doctors back to their roots and patients to action. By laying bare the secrets of modern medicine, the author liberates his colleagues to engage in long-overdue discussions about the true meaning of medicine and empowers patients to demand openness from their healthcare providers. In an attempt to end the secrets-beget-secrets cycle, Newman uses honesty to beget change.

Photo by Sara Calabro

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Comments

Marjorie O'Connor
Reply

Brilliant Sara :D This book was voted in the top ten Wall Street Journal health books of 2009. This review makes me want to read it again because it is so full of important studies and conclusions concerning modern medical practices.

Editor
Reply

Thanks, Marjorie! And thanks for pointing out that it made WSJ’s top-books list. Well deserved. It’s definitely a keeper for the bookshelf, filled with important insights and refreshing honesty.

Chris Primavera
Reply

This sounds so interesting. We all have to take more control of our own health care. I’ll have to read this book.

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