Saturday, February 12, 2011

Invasion of the Body: Revolutions in Surgery PDF

Rating: Author: Nicholas L. Tilney ISBN : Product Detai New from Format: PDF
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In 1913, the Peter Bent Brigham Hospital in Boston admitted its first patient, Mary Agnes Turner, who suffered from varicose veins in her legs. The surgical treatment she received, under ether anesthesia, was the most advanced available at the time. At the same hospital fifty years later, Nicholas Tilney—then a second-year resident—assisted in the repair of a large aortic aneurysm. The cutting-edge diagnostic tools he used to evaluate the patient’s condition would soon be eclipsed by yet more sophisticated apparatus, including minimally invasive approaches and state-of-the-art imaging technology, which Tilney would draw on in pioneering organ transplant surgery and becoming one of its most distinguished practitioners.

In Invasion of the Body, Tilney tells the story of modern surgery and the revolutions that have transformed the field: anesthesia, prevention of infection, professional standards of competency, pharmaceutical advances, and the present turmoil in medical education and health care reform. Tilney uses as his stage the famous Boston teaching hospital where he completed his residency and went on to practice (now called Brigham and Women's). His cast of characters includes clinicians, support staff, trainees, patients, families, and various applied scientists who push the revolutions forward.

While lauding the innovations that have brought surgeons' capabilities to heights undreamed of even a few decades ago, Tilney also previews a challenging future, as new capacities to prolong life and restore health run headlong into unsustainable costs. The authoritative voice he brings to the ancient tradition of surgical invasion will be welcomed by patients, practitioners, and policymakers alike.

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  • File Size: 4551 KB
  • Print Length: 384 pages
  • Publisher: Harvard University Press; 1 edition (September 26, 2011)
  • Sold by: Amazon Digital Services, Inc.
  • Language: English
  • ASIN: B006YPHEJU
  • Text-to-Speech: Enabled
  • X-Ray:
    Not Enabled
  • Lending: Not Enabled
  • Amazon Best Sellers Rank: #422,131 Paid in Kindle Store (See Top 100 Paid in Kindle Store)

Invasion of the Body: Revolutions in Surgery PDF

Nicholas Tilney's "Invasion of the Body" is a fascinating and accessible book about the history of surgery. On one level, it's amazing to think we voluntarily let other humans cut into us with sharp instruments. In the course of one's life, it is likely that we will undergo one or more such invasive procedures. Perhaps the book's title is a play on that well-known horror flick, "The Invasion of the Body Snatchers." Here, though, the setting is less diabolical and more geared toward healing.

Author Tilney knows of what he speaks. He is on the faculty of Harvard Medical School and is affiliated with the Brigham and Women's Hospital.

Of course, this trajectory has not been altogether smooth. Reading about early attempts at surgery, one can only imagine the pain and horror which patients endured. Tilney spotlights a number of breakthroughs, though. One was the development of anesthesia, both general and local. A second was sepsis control through hand-washing, hygiene and sterilization. A third was the development of a heart-lung bypass technology that enabled doctors to repair a heart without putting the patient at dire risk. On the horizon are innovations in micro-surgery, robotics and various drugs to augment surgical procedures.

This is a demanding book, in that you really have to concentrate. While Tilney has done it best to make the discipline accessible to a lay audience, the technical details of medicine and surgical procedure may still make the eyes of some readers glaze over.

Curiously, in his chapter about the Making of a Surgeon: Then and Now, Tilney seems to decry the current trend to limit the hours of surgeons in training. This has been a raging debate within medicine and in the training of residents.
I saw this book in Brigham gift shop while visiting a sick friend. Naturally, I bought it on Amazon for a fraction of the price. I have always been a fan of this genre of work, and you can see the major things that have changed surgery and medicine over time -- antisepsis, control of bleeding, control of infection, control of pain, improved educational standards, improved instruments and techniques and advanced pharmacology. This book goes over them and tries to tell the interesting stories behind them. Unfortunately, the author has spent too much time as a doctor to approach the subject in any but a clinical way. Instead of drama we get dry facts. You can almost read the outline. You can almost see the cases being presented as studies to med students. There are few definitions of terms for the non-doctors reading this book. What is a fistula? What is asepsis? There are soooo many of these terms not defined that you have glean from the surrounding text what they are in order to make sense of the paragraph. On the other hand, the effort taken to name the pioneers of these fields is laudable. I just wish more was done to inject the drama that would have made this book more compelling. The story of Semmelweis developing the first anti-septic techniques and how he was hounded into insanity is both exciting and heartbreaking. I suggest reading about in Wikipedia -- it's importance cannot be minimized and there's more drama. Here's he's given less than a paragraph and one sentence about his madness. And so on. And yet, I enjoyed the book very much. There is an attempt by the author to correlate expense, care, insurance and so on. I think he lets pharmaceutical companies and insurance companies off the hook too easily however.

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