An outstanding primer that readers should put into the hands of their doctors.
A professor of medicine at the University of Pennsylvania delivers a lucid, opinionated history of the science, politics, and care involved in the fight against this century’s most problematic disease.
The first symptom of Alzheimer’s is usually difficulty with memory, often recognized by a spouse, friend, or caregiver. Over years, memory deteriorates, and victims can no longer perform simple tasks such as paying bills or taking medicine. As the disease worsens, they become apathetic or delusional; lose the ability to dress, feed, and clean themselves; become bedridden and depressed; and often die from complications. Caring for an affected spouse or parent is a crushing experience, often bankrupting all but the wealthy because medical insurance and Medicare pay for medicine and doctor visits but not “custodial care,” which is estimated at as many as 170 hours per month. As Karlawish shows, Alzheimer’s usually causes more suffering for the caregiver than the patient. Until the 1970s, most doctors explained that this was “senility,” a consequence of aging beyond the scope of medical science. Eventually, researchers realized they were dealing with an epidemic of brain disease. At the same time, patient advocacy groups formed to lobby Congress, which was amenable to providing funding. Formerly, doctors diagnosed Alzheimer’s by examining the brain after death. Observing and testing living patients was a major advance. In 2012, the FDA approved an ingenious brain scan that illuminates the areas damaged by Alzheimer’s. Sadly, Medicare won’t pay for the $3,000 test, which doesn’t directly help patients because no good treatment exists (several drugs purport to slow its progress, but many experts believe they’re worthless). A medical expert with a page-turning style, Karlawish is mostly successful in conveying optimism. Hopeful drugs are in the research pipeline, but even better news is that physicians, institutions, and advocacy organizations are adopting more imaginative and humane programs to care for victims both before and after their disease becomes crippling.
An outstanding primer that readers should put into the hands of their doctors.Pub Date: Feb. 23, 2021
ISBN: 978-1-250-21873-5
Page Count: 336
Publisher: St. Martin's
Review Posted Online: Nov. 4, 2020
Kirkus Reviews Issue: Dec. 1, 2020
Cogent, well-timed ideas for meeting today’s biggest challenges.
Helping liberals get out of their own way.
Klein, a New York Times columnist, and Thompson, an Atlantic staffer, lean to the left, but they aren’t interrogating the usual suspects. Aware that many conservatives have no interest in their opinions, the authors target their own side’s “pathologies.” Why do red states greenlight the kind of renewable energy projects that often languish in blue states? Why does liberal California have the nation’s most severe homelessness and housing affordability crises? One big reason: Liberal leadership has ensnared itself in a web of well-intentioned yet often onerous “goals, standards, and rules.” This “procedural kludge,” partially shaped by lawyers who pioneered a “democracy by lawsuit” strategy in the 1960s, threatens to stymie key breakthroughs. Consider the anti-pollution laws passed after World War II. In the decades since, homeowners’ groups in liberal locales have cited such statutes in lawsuits meant to stop new affordable housing. Today, these laws “block the clean energy projects” required to tackle climate change. Nuclear energy is “inarguably safer” than the fossil fuel variety, but because Washington doesn’t always “properly weigh risk,” it almost never builds new reactors. Meanwhile, technologies that may cure disease or slash the carbon footprint of cement production benefit from government support, but too often the grant process “rewards caution and punishes outsider thinking.” The authors call this style of governing “everything-bagel liberalism,” so named because of its many government mandates. Instead, they envision “a politics of abundance” that would remake travel, work, and health. This won’t happen without “changing the processes that make building and inventing so hard.” It’s time, then, to scrutinize everything from municipal zoning regulations to the paperwork requirements for scientists getting federal funding. The authors’ debut as a duo is very smart and eminently useful.
Cogent, well-timed ideas for meeting today’s biggest challenges.Pub Date: March 18, 2025
ISBN: 9781668023488
Page Count: 320
Publisher: Avid Reader Press
Review Posted Online: Jan. 16, 2025
Kirkus Reviews Issue: Feb. 15, 2025
BOOK REVIEW
For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.
Pub Date: Jan. 1, 1979
ISBN: 0061965588
Page Count: 772
Publisher: Harper & Row
Review Posted Online: May 26, 2012
Kirkus Reviews Issue: Jan. 1, 1979
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