Minggu, 26 Juni 2011

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  • Published on: 2008-06-15
  • Binding: Hardcover

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Sabtu, 25 Juni 2011

[K680.Ebook] Free Ebook Carole King - Piano Play-Along Volume 106 (Cd/Pkg), by Carole King

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  • Sales Rank: #3632014 in Books
  • Model: 15982331
  • Published on: 2011-02-01
  • Original language: English
  • Number of items: 1
  • Dimensions: 12.00" h x .17" w x 9.00" l, .40 pounds
  • Binding: Paperback
  • 40 pages

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Jumat, 24 Juni 2011

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Senin, 20 Juni 2011

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Adaptogens: Herbs for Strength, Stamina, and Stress Relief, by David Winston, Steven Maimes

The definitive guide to adaptogenic herbs, formerly known as “tonics,” that counter the effects of age and stress on the body

• Reveals how adaptogens increase the body’s resistance to adverse influences

• Provides a history of the use of these herbal remedies and the actions, properties, preparation, and dosage for each herb

We all deal with stress every day, and every day our bodies strive to adapt and stay balanced and healthy. In Adaptogens, authors David Winston and Steven Maimes provide a comprehensive look into adaptogens, non-toxic herbs such as ginseng, eleuthero, and licorice, that produce a defensive response to stress in our bodies. Formerly known as rejuvenating herbs or tonics, adaptogens help the body to “adapt” to the many influences it encounters. They increase stamina and counter the normal effects of aging and thus are becoming important tools in sports medicine and in the prevention and treatment of chronic fatigue and other stress-related disorders.

Winston and Maimes present the historical uses of these herbal remedies in India, Russia, China, and the Americas and explain how they work and why they are so effective at combating stress-induced illness. Monographs for each adaptogen also present the latest scientific research and include the origin, traditional use, actions, properties, preparation, and dosage for each herb.

  • Sales Rank: #27542 in Books
  • Brand: Winston, David/ Maimes, Steven
  • Published on: 2007-03-22
  • Released on: 2007-03-22
  • Original language: English
  • Number of items: 1
  • Dimensions: 9.00" h x .90" w x 6.00" l, 1.15 pounds
  • Binding: Paperback
  • 336 pages

Review
"Adaptogenic herbs can be most useful in the quest for health in our stressful society. David Winston and Steven Maimes explain and champion the use and benefits of these important herbs." (James A. Duke, author of The Green Pharmacy)

"This is a much needed book, an important update to the materia medica of North America, and constitutes important continuing education on a wide variety of new herbs entering into the North American herbal marketplace." (Paul Bergner, Medical Herbalism, Winter 2007)

"It's about time a book took on the subject of immune herbs, and this one does an excellent job of explaining why they are so effective at combating stress-induced illness. The text is very easy to read and understand, but still contains the latest scientific research, all well referenced." (American Herb Association, Vol. 23:1, April 08)

“Brilliant! Fully researched, full of information not readily available, as well as being practical and easy to digest. The authors have managed to blend the traditional and recent scientific information into a fully comprehensive and informative text. This will become a classic, a definitive work on this most important group of medicinal plants.” (Rosemary Gladstar, founder of United Plant Savers and author of Herbal Healing for Women)

“Essential reading for all involved with adaptogens, whether practitioners or consumers. This is the first comprehensive guide to adaptogens based on good herbalism, good science, and NO hype! A truly excellent book.” (David Hoffmann, BSc, FNIMH, author of Medical Herbalism and Herbal Prescriptions after 50)

“With Adaptogens, David Winston and Steven Maimes have finally made this important healing concept accessible to a wider audience. We need adaptogens--gentle remedies that, over time, have the powerful effect of restoring and protecting our health on many levels. David Winston’s vast clinical and practical knowledge of herbs adds tremendously to the value of the book.” (Christopher Hobbs, author of Handmade Herbal Medicines and Natural Therapy for Your Liver)

"There is so much valuable information packed into this volume that I am grateful to have my own copy and will keep it close by as a very handy reference" (Marjorie Tietjen, Price-Pottenger: Journal of Health and Healing, Volume 34 / Number 2, September 20)

From the Back Cover
HEALTH / NUTRITION

“We need adaptogens for their powerful effect of restoring and protecting our health. Finally, this important healing concept is made accessible to a wider audience.”
--CHRISTOPHER HOBBS, author of Handmade Herbal Medicines and Natural Therapy for Your Liver

“Adaptogens are destined to play an increasingly important role in the future of health care. This book provides an excellent introduction to and comprehensive overview of their traditional uses and of the science supporting their safety and therapeutic benefits.”
--MARK BLUMENTHAL, founder and executive director of the American Botanical Council

“Brilliant! . . . a definitive work on this most important group of medicinal plants.”
--ROSEMARY GLADSTAR, founder of United Plant Savers and author of Herbal Healing for Women

We all deal with stress every day, and every day our bodies strive to adapt and stay balanced and healthy. In Adaptogens, authors David Winston and Steven Maimes provide a comprehensive look into adaptogens, nontoxic herbs such as ginseng, eleuthero, and licorice, that produce a defensive response to stress in our bodies. These rejuvenating herbs and tonics help the body to “adapt” to the many influences it encounters. They increase stamina and counter the normal effects of aging and thus are becoming important tools in sports medicine and in the prevention and treatment of chronic fatigue and other stress-related disorders.

Winston and Maimes present the historical uses of these herbal remedies in India, Russia, China, and the Americas and explain how they work and why they are so effective at combating stress-induced illness. Monographs for each adaptogen also present the latest scientific research and include the origin, traditional use, actions, properties, preparation, and dosage for each herb.

DAVID WINSTON, RH(AHG), is an herbalist and ethnobotanist who has practiced Cherokee, Chinese, and Western herbal medicine since 1969. He is a founding member of the American Herbalists Guild, an internationally known lecturer on the topic of herbal medicine, and the president of Herbalist and Alchemist, Inc., a company that manufactures over 300 herbal products. He is the author of Herbal Therapeutics and Saw Palmetto for Men & Women and coauthor of Herbal Therapy and Supplements, and he lives in Washington, New Jersey. STEVEN MAIMES, the former owner of an herbal products business in the San Francisco Bay Area, is a researcher, freelance writer, and principal of SALAM Research in Rochester, New Hampshire.

About the Author
David Winston, RH(AHG),is an herbalist and ethnobotanist who has practiced Cherokee, Chinese, and Western herbal medicine since 1969. He is a founding member of the American Herbalists Guild, an internationally known lecturer on the topic of herbal medicine, and the president of Herbalist and Alchemist, Inc., a company that manufactures over 300 herbal products. He is the author of Herbal Therapeutics and Saw Palmetto for Men & Women and coauthor of Herbal Therapy and Supplements, and he lives in Washington, New Jersey. Steven Maimes, the former owner of an herbal products business in the San Francisco Bay Area, is a researcher, freelance writer, and principal of SALAM Research in Rochester, New Hampshire.

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Cured Myself With This Book
By wildsun
I became extremely ill with an auto-immune disease and this book saved my life. Remember-treating yourself is safer with plants than pharmaceuticals because you would need to consume vast amounts to harm yourself. So, you can order the herbs, mix and match and see how you feel. You have time to experiment. I ordered the best quality organic bulk herbs and made strong tea. At first I hemmed and hawed about spending money on herbs, but since I could not walk and thought I would die, I decided this was not the time to be cheap! I made my tea with Ashwagandha and anti-inflammatory herbs, and another tea with medicinal mushrooms: Reishi, Shiitake, and Maitake. I was also seeing an MD. I was seeing an herbalist, and I double checked his work, and realized he made a mistake. I read this book and made my own cure. I tried one more herbalist who tried to scare me. She made it sound like making my own teas was insane. I am an intelligent person, and a good researcher, and when I called her to tell her I cured myself, she told me I was unrealistic. I could not believe it! I think she is jealous of David Winston. When I told my MD that I was using herbs, he laughed me out of his office. I thought I should give him my herbalists number, and they could commiserate! The pharmaceuticals helped me survive by masking the pain, but they made me so dizzy I was hanging on the walls! Not cute... When you are so sick like this, it is no joke, especially when you feel like you are fighting with your(paid)healers! Guess what? You still have to fight! I became full of faith in myself and trusted my intuition. I told myself I could do it. My symptoms are 95% gone. My MD explained it away by saying the pharmaceuticals had built up in my system and so that is why I felt good. He said if I did not take them, the pain would return. NOPE. I am drinking my two teas 3x's a day. The tree cannot be felled with one blow, so I will keep drinking them until I am 100%. I needed a cane during the worst part of it, and had a permanent handicapped parking tag! If you believe in yourself and can read, count drops from a tincture bottle, or can boil water for tea, you can heal yourself!!!! I must admit the day I stopped taking my pharmaceuticals, it was a leap of faith and I prayed, but then I was fine!!! Thank you David and Steven, because you saved my life! (Along with some Divinity!)P.S. There is also a pet section which I am using!

75 of 75 people found the following review helpful.
Highly Recommended
By Laura De Giorgio
I have a wide selection of books related to herbs, but this is the only one that I know of that deals specifically with adaptogens, and since everyone could benefit from boosting his immune system and helping the body to effectively deal with stress, this is one of those books that may help anyone to enjoy better health.

The main adaptogens covered in this book are American ginseng, amla, ashwagandha, asian ginseng, astragalus, cordyceps, dang shen, eleuthero, guduchi, he shou wu, holy basil, jiaogulan, licorice, lycium, prince seng, reishi, rhaponticum, rhodiola, shisandra, shatavari, shilajit - interestingly enough most of them seem to be either part of Ayurveda or Traditional Chinese Medicine, and there is not much mention of herbs that may be traditionally used in western herbalism.

With the herbs covered in this book, he author has listed the history of the herb, where the herb grows, modern uses of the herb, dosage and safety, and there is a mention of few related studies. Herbs are also grouped in relation to different health issues, so you'll find herbs that may help with stress, those that may be helpful for breathing problems, herbs that may be helpful with athletic performance, those that may be helpful when dealing with cardio-vascular problems, those that may be helpful with musculo-skeletal problems, and so on - though if you do have any such problems, you may benefit from also looking into other herbs that are not mentioned in this book.

The author has added a small section on additional herbs that are helpful as nerve tonics - like chamomile, passionflower, skullcap, lemon balm and few others; and a section on herbal nootropics like bacopa, gotu kola, bhringaraj (which is otherwise popular for boosting hair growth), and few others.

Included are some popular herbal formulations from Traditional Chinese Medicine (bu zong yi qi tang, sheng mai san, etc.), and from Ayurveda (chyavanprash, and triphala), as well as some recipes for incorporating adapogenic herbs into food or making teas with combination of different herbs.

On a side note, there is a minimal mention on any herbs which have been traditionally used by western herbalists that will help you to boost your immune system, many of which you may find in your local grocery store, and add to food like turmeric, oregano, thyme and other spices, or make tea out of cinnamon, ginger and cloves - as will garlic and lemon, but they are beyond the scope of this book. Perhaps the greatest benefit of this book is that it covers herbs that many people in the west may be less familiar with.

69 of 73 people found the following review helpful.
A Love-Hate, well maybe Love-Dislike relationship
By Bookmaven
To be sure, the information found in this book is extremely informative and I am very glad I bought it. As many other reviewers have mentioned, there's not a lot of information on the subject compiled into a single work easily digested by layreaders like myself. If sourcing the herbs was easier, I'd give this book 5 stars.

WHAT THE BOOK IS -

- A very well organized body of work that focuses on concrete, consistent and reputable information on herbs used for millenia. I especially appreciate how the author is very clear and particularly mentions that he's referring to herb X from region Y, and constantly reminding the reader of his reference to that specific herb and X herb only from Y region. I conducted a quick search on a particular herb mentioned. I immediately noticed that there were numerous claims made by many vendors about that herb, except it was a cousin to the specific adaptogen to which the author was referring. I know that sort of thing happens all the time, however researching the herb during my reading proved a valuable academic exercise.

- One of the most interesting and enjoyable materia medica I've read in an herb book. I appreciate how the author weaves practice and perceptions of the herb from many diverse (vastly different herb use) cultures. The author also includes a very easy to understand compliment herbs section (most very easy to find).

- An interesting precursor to Traditional Chinese Medicine, Traditional Western Medicine, Native American Medicine, Tonic Herbs, Aromatherapy, Bach Flower Therapy/Vibration Healing, Cosmetic Formulations, Medicinal Mushrooms, Organ support, learning more about herbs or just about anything else.

WHAT THE BOOK ISN'T -

- A How-To book.

- A book on USA Adaptogens or easily found ones (though I was pleasantly surprised to calculate that I have a third of the primary herbs mentioned).

- A recipe compendium (though the author's website is very useful, though not necessarily for recipes)

- Where you'll find where to source raw materials mentioned in the book.

I'll definitely reread the book and update my review accordingly. And I know that regardless of what path one takes to wellness, it's important to understand herbs. As I've mostly already said, there are 3 primary issues I see with the book:

Herbs Identified: With the exception of American Ginseng, lavender (not one of the adaptogens) and a very few other ancillary herbs, many of the herbs are not easily accessible (though I found that at least 1/3 can be purchased online).

Sourcing. For a book that has so much interesting and useful information, I expected there to be more discussion on sourcing the raw materials needed. I was quite disappointed to discover that book seems to cover everything except that. All of the websites provided are, as the subheading states: Sources of Adaptogenic Products. Yes, perhaps the author only included, high-quality, reputable vedndors, but there are thousands of TCM, Ayurvedic, Homeo and Naturpathy shops all over the US. It doesn't take an expert to realize that many of them don't adhere to consistent standards and aren't a reliable source of information. And there is also the issue of many reputable suppliers exclusively sourcing practitioners and retailers. There were countless times during my reading where I was updating a shopping/wishlist, which by the end of my reading is where my list was left: as a wish list. The author does direct the reader to Herbal organization, and there one can comb through hundreds of links. All useful information overall, but not necessarily what one may be in search of at the time.

Practice. I also want to be clear in expressing my deep respect for experienced, knowledgeable practitioners creating formulations. Their work is NOT be taken lightly and good Herbalists rival any mastermind. So buying raw materials isn't a replacement for seeking the advice of a competent professional, it just ensures my likelihood of hiring COMPETENT ones. While there are some mouth-watering food recipes, most formulations in the book are tincture, capsule or tea form. And all of which, I think, anyone who's interested can, with practice, make themselves. In fact a reviewer of this book, wildsun, wrote: "If you believe in yourself and can read, count drops from a tincture bottle, or can boil water for tea, you can heal yourself!!!! "

Really, this book has solid information, so my mentioning the other books is simply as suggestions for a different perspective on sourcing. Unfortunately, concrete information I found for sourcing herbs ultimately came from where I pretty much always end up: Somewhere within the Hobbs/Gladstar/Hoffman resource realm. That realization brought me to the opinion that Hobb's Medicinal Mushrooms (also Teeguardan's Chinese Tonic Herbs and Gladstar's Medicinal Herbs & Herbal Recipes) is an ABSOLUTELY EXCELLENT compliment to this book. While they create commercial formulations, they ALWAYS gives the reader a DIY option and great raw material sourcing info.

Overall, the book left me of the opinion that no matter which route to wellness one takes, there are gatekeepers to ensure that what was meant to be enjoyed by all, quite inexpensively, will be aggressively withheld by capitalists of varying sorts. And that's not the author's fault. I get it. And scholars and practitioners should be compensated for their good work. However, man's inability to work collectively, putting aside his ego, pride and perhaps, a sense of world domination, is the only reason a more comprehensive version of this very book wasn't written two thousand years ago.

If you're looking to make things simpler (and cheaper) or relying on commercial formulations isn't what freedom (intellectual or health care) looks like to you, then you too may feel a sense of disappointment and frustration with the strange sense this book lends to a sort of field guide to commercial tonic formulations.

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Minggu, 19 Juni 2011

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The Nelson Bunker Hunt Collection of Highly Important Greek Vases; The William Herbert Hunt Collection of Highly Important Greek, Roman, an

  • Sales Rank: #2639406 in Books
  • Published on: 1990
  • Binding: Hardcover

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Rabu, 15 Juni 2011

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  • Published on: 1600
  • Binding: Paperback

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Desire (#2): Desired by the Billionaire (Desire series), by Carrie Cox

Desire #2 - A steamy romance by Carrie Cox.
The second book in an addictive new series for fans of Fifty Shades of Grey.

Kate Taylor has never met a man like Benjamin Easton before. Everything about the enigmatic billionaire dazzles her, his immense wealth, his gorgeous body and his seductive touch.
After their last steamy encounter, Kate barely has time to catch her breath before Benjamin whisks her off to London where she has to deal with a difficult client and Benjamin’s no commitment rule. But worse than that, she’s developing stronger feelings for Benjamin.
Could her feelings of desire be turning into something more?

Desire part two is 14,000 words. Don’t miss the other instalments of this hot five-part serial novel.

  • Sales Rank: #172192 in eBooks
  • Published on: 2012-10-28
  • Released on: 2012-10-28
  • Format: Kindle eBook

From the Author
I love to write steamy romance and I have had a blast writing the DESIRE series. I want to thank each and every one of my readers. You guys are awesome - thank you!�I am currently working on a trilogy focusing on Kate's sister Tina. It should be on amazon soon. If you would like to get an email when the next books are released pleased sign up for my newsletter. You can sign up on my website.Carrie x

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2 of 2 people found the following review helpful.
Can't wait for Book 3
By RobinCB
I became a fan of Carrie Cox after reading Desire Part 1. And she does not disappoint with Book 2. There is mystery, intrigue, heartbreak and hot sex - who could ask for more! I can't wait for the next part of this series!

2 of 2 people found the following review helpful.
Desire
By Mattie
What will be the time line for the next three installments?
Just got 2. Will be reading it this afternoon. Loved 1. Can't wait to find out what the story is going to be about.

0 of 0 people found the following review helpful.
bravo carrie
By E. McDonough
You will not be disappointed in the second installment of Desire It follows along smoothly from no 1 I couldn't put it down and I can't wait for the next one

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RMS Titanic: A Modelmaker's Manual, by Peter Davies-Garner

RMS Titanic has had more written about her than any other ship but, surprisingly, there is a little information directed at the modelmaker. This new book contains all the information needed to build a highly accurate model down to the tiniest details of the hull's rivets. The book is based on the author's own remarkable 20ft model, specially commissioned for a traveling exhibition throughout North America. It contains a mass of practical information on how to construct every part of the great liner and is equally applicable to a small static bread-and-butter display model as to a large working version. It is highly illustrated with superb close-up photographs of the model, detailed drawings by the author and a large collection of photographs of the prototype herself, some of which have never been published before. In addition, the book contains a complete set of plans of the Titanic which are considered to be the most accurate yet drawn. With its mix of practical information, rare photographs and highly-detailed drawings this book will appeal to all Titanic enthusiasts as well as to ship modelers of every sort.

  • Sales Rank: #4512555 in Books
  • Published on: 2005
  • Original language: English
  • Number of items: 1
  • Dimensions: 10.00" h x .62" w x 7.50" l, 1.45 pounds
  • Binding: Hardcover
  • 150 pages

About the Author
Of Anglo-German descent, Peter Davies-Garner trained as an architect but is now a professional ship modeler. This is his first full length book.

Most helpful customer reviews

2 of 2 people found the following review helpful.
wonderful but
By ex-librarian
I agree that this is a WONDERFUL book. However, be aware that the "plans" on the inside cover are not enough and that on the 1:300 scale drawing, a large portion has been left out--the uniform area of the hull before the last funnel and to just before the foredeck. without a plan view, the body plan is of not so much use . There is a basic plan view on pg x that could be scaled up then you are home free.
The major pluses are the very many scale drawings or detail all to a standard based on 1:48--doubled, halved or whatever. The photos of the model are great because they provide clarity that shipboard photos do not generally.
That said, there are plans in John Bowen's book Miniature Merchant Ships and general arrangement plans in McCluskie's books (and they are also filled with great photos and clear details not to be missed. As noted, the drawings are generally of the "Olympic "class and only detail drawings are apparently available for the Titanic.
There are likely things here that are standard shipbuilding practise so the details in this book could likely be used on other H&W ships or other merchant ships of the period, especially where no detail drawings are available. For example, the stern on the Titanic is not much different from the stern and forefoot on the Bavarian of 1869--H&W yard No 68 (Titanic was Yard No 400). This suggests that where no plans exist, those of the T could likely be modified for other hulls of the same period.
This is a book not to be missed by any modeller and MR Davies-Garner has done a great service to all modellers by setting an example of the kind of work that should be standard.

3 of 3 people found the following review helpful.
A Very Detailed Book
By Transatlantique
This modestly sized handbook is a real boon for model builders or ship enthusiasts. There aren't many colour photos, but for a manual on model building the only colour photos needed for paint schemes are there. Additional photos of the finished model on display are also included. Detailed drawings of the deck spaces are shown with detailed written instructions, and rather smallish b/w photos as to how construction was pursued. I was hoping for a larger book with larger photos, but that's asking for a lot these days. One might even be able to transfer the same techniques for use in building other models, but one would have to have some detailed drawings/plans of those ships.

I'm not sure if I could ever have the time or resources to undertake a larger model, but this will help anyone with a plastic model who wants an alternative detailed painting instruction other than those with the plastic model kit. At any rate, it's interesting to see how this was done.

10 of 10 people found the following review helpful.
Must have reference for building a Titanic Model
By Kurt A. Greiner
Like many ship modelers, I have always had a fascination with the three Olympic class liners, and particularly that most famous of the three, the Titanic. Of course, many are drawn to her story and tragically short life, but I have always been fascinated by her appearance - in my estimation, she was one of the most beautiful ocean liners ever built.

Over the years, I have made a couple of attempts at capturing her in miniature, but was not satisfied the results. One core problem has been the lack of reference material. The discovery of the ship and the subsequent James Cameron film has sparked massive amounts of interest in her, and a result has been the publication of many books, plans and websites on all things Titanic. The amount of research that has been done in the last decade has finally allowed highly accurate models of this ship to be built. This book documents a very impressive feat of the model shipwrights craft, a 1/48 scale Titanic that is some 18 feet in length.

Starting with a brief summary of the prototypes story, and quickly progressing into research and building, Peter Davies-Garner has written a no nonsense documentation of the model. The author touches on every area of the build, but some more thoroughly than others - a necessary compromise to control the size no doubt, but I was left wanting more. The many photographs are really the core of the book, and the model is covered thoroughly in black and white with a central color section. If you see a high resolution scan of the cover, this is a classic case of not judging the book by it's cover - for some reason, it is a poorly reproduced digital image, whereas the photographs in the body are higher quality.

This is an important work to scholars of the Titanic. What I particularly appreciated was the author's clear differentiation of which areas are factual and which are educated conjectures. As he states, there will never be a totally accurate model of the ship built, but his must surely be the closest to that goal yet made. I highly recommend the book, and, if you are visiting Orlando, seeing the model in person.

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Rabu, 01 Juni 2011

[T769.Ebook] Fee Download How We Do Harm: A Doctor Breaks Ranks About Being Sick in America, by Otis Webb, MD Brawley, Paul Goldberg

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How We Do Harm: A Doctor Breaks Ranks About Being Sick in America, by Otis Webb, MD Brawley, Paul Goldberg

How We Do Harm exposes the underbelly of healthcare today—the overtreatment of the rich, the under treatment of the poor, the financial conflicts of interest that determine the care that physicians' provide, insurance companies that don't demand the best (or even the least expensive) care, and pharmaceutical companies concerned with selling drugs, regardless of whether they improve health or do harm.

Dr. Otis Brawley is the chief medical and scientific officer of The American Cancer Society, an oncologist with a dazzling clinical, research, and policy career. How We Do Harm pulls back the curtain on how medicine is really practiced in America. Brawley tells of doctors who select treatment based on payment they will receive, rather than on demonstrated scientific results; hospitals and pharmaceutical companies that seek out patients to treat even if they are not actually ill (but as long as their insurance will pay); a public primed to swallow the latest pill, no matter the cost; and rising healthcare costs for unnecessary—and often unproven—treatments that we all pay for. Brawley calls for rational healthcare, healthcare drawn from results-based, scientifically justifiable treatments, and not just the peddling of hot new drugs.

Brawley's personal history – from a childhood in the gang-ridden streets of black Detroit, to the green hallways of Grady Memorial Hospital, the largest public hospital in the U.S., to the boardrooms of The American Cancer Society—results in a passionate view of medicine and the politics of illness in America - and a deep understanding of healthcare today. How We Do Harm is his well-reasoned manifesto for change.

  • Sales Rank: #181276 in eBooks
  • Published on: 2012-01-31
  • Released on: 2012-01-31
  • Format: Kindle eBook

Review

“My friend and colleague Otis Brawley has written a raw and honest portrayal of our health care system. There are certain to be special interest organizations and medical groups that take issue with Dr.Brawley's conclusions, but few can argue with the scientific rigor he has demonstrated in writing this book. Otis is the go- to oncologist I send so many patients to see, because he is not only a great doctor, but also a compassionate man. As we discuss the transformation of health care in this country, put Dr. Brawley's book at the top of your list.”-Sanjay Gupta, Associate Chief of Neurosurgery Grady Memorial Hospital, Chief Medical Correspondent, CNN

“Otis Brawley is one of America’s truly outstanding physician scientists.� In How We Do Harm, he challenges all of us-- physicians, patients, and communities-- to recommit ourselves to the pledge to 'do no harm.'”-David Satcher,Former Surgeon General of the United States, Director, Satcher Health Leadership Institute, Morehouse School of Medicine

“Sweeping, honest and brave . . . How We Do Harm dazzles with a wealth of� scientific insight, but its genius lies in the author’s recounting of individual patient stories that illuminate the dark underbelly of medicine’s missteps. Brawley does not shrink from revealing medicine’s warts, butthis book� offers much more. It is a� triumph of humanity and clarity in which oncology becomes a Rorschach for the practice of American medicine. You will finish this arresting book reluctantly, with a new appreciation of what American medicine could be.”-Harriet A .Washington, author of Deadly Monopolies: The Shocking Corporate Takeover of Life Itself and the Consequences for Your Health and Our Medical Future and Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present

“Dr. Brawley is a premier academic oncologist and a minority doctor in the nation's largest inner city hospital. How We Do Harm places in stark contrast the health care resources available to the rich and the poor, the insured and the uninsured, the white community and the community of color . He makes� the� cogent� point that more testing, screening, and interventions available to the rich does not always� mean better medical care .”-Bruce Chabner, MD, Director of Clinical Research, Massachusetts General Hospital Cancer Center

“Otis Brawley shares in equal measure his compelling personal story, the development of modern medical oncology, and the wide range of his strong opinions.� Whether you agree with him or not, the reader is given access to Dr. Brawley’s unambiguous scientific and ethical framework.� He provides an anvil for shaping your own perspectives and biases.”-Michael A. Friedman, MD, President and Chief Executive Officer, Director Comprehensive Cancer Center, City of Hope

“A tough-minded, solidly argued indictment of health care. . . Brawley’s sense of outrage is palpable.” -The Boston Globe

"A powerful contribution to the ongoing discussion on health-care reform.”-Kirkus

This book is shockingly detailed and it should serve as a wake-up call to fix the dismal mess and rethink the politics of illness in America. Dr. Brawley provides a well-reasoned manifesto for change.”-Tucson Citizen


“Any who want to know how behind-the scenes healthcare works will find this a key title." –Midwest Book Review

About the Author

DR. OTIS BRAWLEY is the chief medical and scientific officer and executive vice president of the American Cancer Society. Dr. Brawley currently serves as professor of hematology, oncology, medicine and epidemiology at Emory University. He is also a CNN medical consultant. He is a graduate of the University of Chicago, Pritzker School of Medicine, and completed a residency in internal medicine at University Hospitals of Cleveland, Case-Western Reserve University, and a fellowship in medical oncology at the National Cancer Institute.

PAUL GOLDBERG is an award-winning investigative reporter who covers oncology for The Cancer Letter, a weekly publication focused on drug development and the politics of cancer. His articles have appeared in The New York Times, The Wall Street Journal, The Washington Post, The Washington Monthly and he has been featured on 60 Minutes, 20/20, CNN and NPR. Goldberg is also the author of two books on the Soviet human rights movement.

Excerpt. � Reprinted by permission. All rights reserved.
Chapter 1

Chief Complaint


SHE WALKS THROUGH the emergency-room doors sometime in the early morning. In a plastic bag, she carries an object wrapped in a moist towel.
She is not bleeding. She is not in shock. Her vital signs are okay. There is no reason to think that she will collapse on the spot. Since she is not truly an emergency patient, she is triaged to the back of the line, and other folks, those in immediate distress, get in for treatment ahead of her. She waits on a gurney in a cavernous, green hallway.
The “chief complaint” on her chart at Grady Memorial Hospital, in downtown Atlanta, might have set off a wave of nausea at a hospital in a white suburb or almost any place in the civilized world. It reads, “My breast has fallen off. Can you reattach it?”
She waits for at least four hours—likely, five or six. The triage nurse doesn’t seek to determine the whereabouts of the breast.
Obviously, the breast is in the bag.
*���*���*
I am making rounds on the tenth floor when I get a page from Tammie Quest in the Emergency Department.
At Grady, we take care of patients who can’t pay, patients no one wants. They come to us with their bleeding wounds, their run-amok diabetes, their end-stage tumors, their drama. You deal with this wreckage for a while and you develop a coping mechanism. You detach. That’s why many doctors, nurses, and social workers here come off as if they have departed for a less turbulent planet.
Tammie is not like that. She emotes, and I like having her as the queen of ER—an experienced black woman who gives a shit. When Dr. Quest pages me, I know it isn’t because she needs a social interaction. It has to be something serious.
“We are wanted in the ER,” I tell my team.
The cancer team today consists of a fellow, a resident, two medical students, and yours truly, in a flowing white coat, as the attending physician. I lead the way down the hall. Having grown up Catholic, I can’t help thinking of the med students and young doctors as altar boys following a priest.
I am a medical oncologist, the kind of doctor who gives chemotherapy. My other interests are epidemiology and biostatistics. I am someone you might ask whether a drug works, whether you should get a cancer screening test, and whether a white man’s cancer differs from a black man’s cancer. You can also ask me if we are winning the “war” on the cluster of diseases we call cancer. As chief medical officer of the American Cancer Society—a position I have held since 2007—I often end up quoted in the newspapers, and I am on television a lot. In addition to my academic, journalistic, and public-policy roles, I have been taking care of cancer patients at Grady for nearly a decade, first as the founding director of the cancer center, and now as chief doctor at the ACS.
My retinue behind me, I keep up a fast pace, this side of a jog. Bill Bernstein, the fellow, is the most senior of the group. Bill is a Newton, Massachusetts, suburbanite, still boyish. He is having trouble adjusting to the South, to Atlanta, to its inner city. He is trying, but it’s hard to miss that black people and poor people perplex him. Contact with so much despair makes him awkward. But he has a good heart, a surfeit of common sense—and he is smart. Whatever we teach him at Grady will make him a better doctor wherever he ends up.
Grady suffers from what the administration here calls a “vertical transportation problem.” Our elevators are slow at best, broken at worst. We head for the stairs, rushing down to the first floor, then through long, green hallways into the ER.
Grady is a monument to racism. Racism is built into it, as is poverty, as is despair. Shaped like a capital letter H, Grady is essentially two hospitals with a hallway—a crossover—in the middle to keep things separate but equal for sixteen stories.
In the 1950s and ’60s, white patients were wheeled into the front section, which faces the city. Blacks went to the back of the H. This structure—built in 1953—was actually an improvement over the previous incarnation. The Big H—the current Grady—replaced two separate buildings—the whites got a brick building, the blacks a run-down wood-frame structure. Older Atlantans continue to refer to the place in a chilling plural, the Gradys.
You end up at Grady for four main reasons. It could happen because you have no insurance and are denied care at a private hospital, or because you are unconscious when you arrive by ambulance. When your lights are out, you are in no position to ask to be taken to a cleaner, better-lit, suburban palace of medicine. A third, small contingent are older black folks with insurance, who could go anywhere but have retained a dim memory of Grady as the only Atlanta hospital that accepted us. The fourth category, injured cops and firemen, know that we see a lot of shock and trauma and are good at it. We are their ER of choice.
Today, our 950-bed behemoth stands for another form of segregation: poor versus rich, separate but with no pretense of equality. Grady is Atlanta’s safety-net hospital. It is also the largest hospital in the United States.
The ER, arguably the principal entry point to Grady, was built in the center of the hospital, filling in some of the H on the first floor. To build it, Grady administrators got some federal funds in time for the 1996 Summer Olympics. This fueled financial machinations, which led to criminal charges, which led to prison terms. (In retrospect, the bulk of the money was put to good use. Many of the victims of the Olympic Park bombing came through our ER.)
The hallways here are incredibly crowded, even by the standards of inner-city hospitals. Patients are triaged into three color-coded lines—surgery, internal medicine, obstetrics—and placed on gurneys two-deep, leaving almost no room for staff to squeeze through.
You might see a homeless woman drifting in and out of consciousness next to a Georgia Tech student bloodied from being pistol-whipped in an armed robbery, next to a fifty-seven-year-old suburban secretary terrified by a sudden loss of vision, next to a twenty-eight-year-old hooker writhing in pain that shoots up from her lower abdomen, next to a conventioneer who blacked out briefly in a cylindrical tower of a downtown hotel, next to a fourteen-year-old slum dweller who struggles for breath as his asthma attack subsides.
When I first arrived in Atlanta and all of this was new to me, I took my wife, Yolanda, through the Grady ER on a Friday night.
“Oh, the humanity,” she said.
Yolanda, a lawyer with the U.S. Securities and Exchange Commission, feels happier above the Mason-Dixon Line.
*���*���*
TAMMIE Quest—I use her real name—is cute, has a broad, infectious smile, and comes from privilege. She grew up in Southern California and frequently refers to herself as a “black Valley girl.”
Though she identifies with the West Coast, a lot of Atlanta has rubbed off on her in the Grady ER.
No two ERs are alike. Ours tells the story of Atlanta more clearly, more poignantly than its skyline. Patients everywhere are scared of their wounds or diseases that rage inside them. Here, in the middle of this big, hot, loud, violent city, they have an added fear: they are terrified of each other, often with good cause.
Elsewhere, patients might trust us doctors, admire us, even bow to our robes, our honorifics, and the all-caps abbreviations that follow our names. Here, not so much.
A place called Tuskegee is about two hours away from here. It’s where government doctors staged a medical experiment in the thirties: they watched black men die of syphilis, withholding treatment even after effective drugs were invented.
Tuskegee is not an abstraction in these parts. It’s a physical place, as palpable as a big, deep wound, and eighty-plus years don’t mean a thing. Tuskegee is a huge, flashing CAUTION sign in the consciousness of Southern black folks. It explains why they don’t trust doctors much and why good docs such as Tammie have to fight so hard to earn their elementary trust.
Like me, Tammie is a member of the medical-school faculty at Emory University, and, like me, she has several academic interests. One of these interests is end-of-life care for cancer patients: controlling the symptoms when someone with advanced cancer shows up in your ER.
Seeing us approach, she walks toward us and hands me a wooden clipboard with the Grady forms. I look at her face, gauging the mixture of sadness, moral outrage, and fatigue.
She says something like “This patient needs someone who cares,” and disappears.
I glance at the chief complaint.
“Holy shit,” I say to Bill Bernstein and, more so, to myself.
I introduce myself to a trim, middle-aged, black woman, not unattractive, wearing a blue examination gown conspicuously stamped GRADY. (At Grady, things such as gowns, infusion pumps, and money tend to vanish.)
From the moment Tammie paged me, I knew that the situation had to be more than a run-of-the-mill emergency. This patient clearly is not about to die on the examination table. She doesn’t need emergency treatment. Before anything, she needs somebody to talk to. She needs attention, both medical and human.
The patient, Edna Riggs, is fifty-three. She works for the phone company and lives on the southeast side of Atlanta.
Sitting on an exam table, she looks placid. When she extends her hand, it feels limp. She makes fleeting eye contact. This is depression, maybe. Shame does the same thing, as does a sense of doom. Fatalism is the word doctors have repurposed to describe this last form of alienation.
In medicine, we speak a language of our own, and Edna’s physical problem has a name in doctorese: automastectomy. It’s a fan...

Most helpful customer reviews

164 of 172 people found the following review helpful.
The Unfortunate Reality of American Medicine
By Loyd Eskildson
First, a few words on Dr. Otis Brawley and my bias - he's the Chief Medical Officer for the American Cancer Society, Professor of Medicine at Emory University, and a CNN medical consultant. As for my bias, after reading his book and bio, I would trust him to give me the best medical recommendations. I wish I lived closer so he could be my physician - I'm really impressed!

'First, do no harm' is the first precept of medical ethics taught in medical school 'How We Do Harm' is Dr. Brawley's description of the real world, of how medical practice deviates from that basic ethic. The bulk of the book consists of anecdotal examples that he has become aware of.

Dr. Brawley begins by comparing how much America spends on health care vs. other nations. We're now at 18% of GDP, and Switzerland is #2 - at 12%, obviously much lower. We spend 3.5X as much on health care as on food. Canadians spend half what we do, and are ranked #7 in life expectancy. We're #50. More is not better - in fact, American health care is making our nation sick, in an economic sense.

Many health care providers allege that they're financially short-changed by Medicare and Medicaid; others contend that the relatively low reimbursement rates of those programs is a form of 'cost-shifting' that raises rates for others. Dr. Brawley, however, states that providers can still make money at those reduced rates treating complex cases involving uncontrolled diabetes, kidney failure, heart disease, and late-stage cancer.

As for Tea Party allegations of ObamaCare medical rationing, per 'Death Panels', Dr. Brawley says this is already happening - via insurance companies. Yet, irrational spending is still rampant. We need to return to a focus on not doing harm, peddling snake-oil and false hope - that will lower costs and improve quality. The current financial incentives driving medical practice have a bad impact on patient health and costs. Doctors who own labs order more tests than those who don't. Some community oncology practices hold regular meetings to inform physicians about treatment techniques that maximize billing. 'Disease Mongering' is overly prevalent - the proactive marketing of disease with free initial tests followed by lots of expensive for-pay follow-up. Another example - 'Zero,' an advocacy group that sponsors prostate screening vans, receives funding from the makers of Depend diapers. (Prostate removal, usually not required or recommended, subsequent to these screenings creates incontinence.)

Professional medical societies have chosen collegiality over patient well-being. Professional doctor societies issue 'evidence-based' guidelines for performing expensive procedures that are anything but evidence-based. Many patient advocacy groups act as unquestioning advocates for drug companies and medical specialists, not realizing that the interests they advocate run counter to their own. Debates between Tea Partiers and fictional characters created by PR firms further mislead.

Pseudoscience, greed, myths, lies, fraud, and looking the other way have far too often taken the place of science in directing health care. Good health care will have to be won in a public struggle, just as civil rights were. We need more stress on prevention, starting with health education.

Bottom-Line: Dr. Brawley is to be commended for shattering the 'good-old boy' image of medicine. Reality is that, like Wall Street, the profession is driven by outrageous greed. Days of family practitioners making house calls, accepting payment in eggs and chickens (if paid at all), are long gone. My most recent health care experiences (dental and medical) both follow Dr. Brawley's observations. Also amazing is the disparity between providers' 'list prices' and the prices paid by insurance firms - if list prices matched even the highest insurance payment, far fewer uninsured patients would be bankrupted by health care, and expenditures wasted on health care overheads (advertising, patient 'selection,'care review) would drop.

"How We Do Harm" is an invaluable contribution to those wanting to improve health care.

86 of 88 people found the following review helpful.
Horror stories about health care, Breast Cancer, PSA Test
By jwt99
I could not put this book down. I would say this is a must read for anyone that might get or who has cancer. Also anyone who has a chronic health problem should put this book in their library.

I think Dr. Brawley gives compelling examples that illustrate how our health care systen is broken.

Read this book!

This is an excellent book unless you are a quack, a greed driven doctor or drug rep. Dr.Brawley points out that we should not waste valiable tax money or even insurance money on unproven cures or on drugs that cost 10-20 times as much as a proven drug. All medical care should be research based, rational and above all "do no harm".

I hate to tell you this, but we as a country cannot afford to waste massive amounts of money anymore. If we don't get serious about health care it will break the country. We cannot afford to transfer wealth to quack doctors or for procedures that don't work. A spinal fusion costs about $80,000 yet 80% of the research says it does no good and it does a lot of harm. Is this any way to run a health care system?

If you don't believe Dr. Brawley read the research for yourself.

Use a little of your time to dig and see if he is telling the truth.

A lot of the raw research is locked up tight and hard to access and not easy for a lay person to understand. We must rely on honest doctors like Dr. Brawley to tell us the truth about our healthcare system

The chapters on the "PSA" test for prostate cancer were shocking to say the least.

All the examples about the breast cancer problems are on point. My wife went through this several years ago and thank goodness we had a doctor whose first words were us was " I don't give any treatment that has not been through a double blind study."

We feel like my wife received excellent treatment without receiving too much treatment. Too much can be as bad as too litttle as Dr. Brawley states.

Dr. Brawley points out through his examples that "raw greed" on the part of hospitals, doctors and drug companies has layed waste to our health care system.

The economic incentives are all on the side of more care not appropriate care. There is a vast difference between the two.

Thank you Dr. Brawley.

72 of 74 people found the following review helpful.
Terrible and true
By Kara Smigel
Dr. Brawley (excuse me, Otis) has written a book about the kind of things doctors say to each other, but not out loud and certainly not for publication. The contrast of healthcare for the overprivileged to the lack of care for the underserved (and the sea of confusion for those in-between) should not exist in the United States, and yet it does. That so much of this happens in the care of people with cancer is really unforgivable. Many will be unhappy with the author, but many more will have to agree that he is indeed telling the truth -- and doing so in a way that is compulsively readable. Otis knows how to get your attention and weave a tale that points out the things you should be seeing. He does not claim to have the answers and is free with admitting his own missteps along the way. I already sent a copy to my niece who is a 2nd year resident at an inner-city hospital and told her to be sure to pass it around once she has read it.

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