By Jerome Groopman and Pamela Hartzband
Book review by Richard L. Weaver II, Ph.D.
There are many people who can use, need, and will eventually treasure this book. It is not sophisticated nor analytical. It is just a simple, practical, easy-to-understand set of standards and principles that people need to understand when they are dealing with anyone in the medical community.
Having faced a couple of the problems Groopman and Hartzband discuss, such as high cholesterol and the death of a relative, I felt that their advice is accurate, specific, and to the point.
The book is easy to understand and speaks directly to readers. I loved their explanation of the difference between anecdotal evidence and statistics. Yes, anecdotes are delightful to read and incredibly convincing — even persuasive enough to change behavior — but the authors warn they are not statistics and should, instead, cause people to seek out more evidence. That is important information.
Having said that, readers should note that this book is full of anecdotal material. These medical doctors cite story after story of people involved in making medical decisions — and, it is important to note — the outcomes of those decisions. This makes a very enjoyable reading experience, and many readers who have some background with making medical decisions for themselves or for others, will identify with many of these stories.
How should patients weigh a doctor’s advice? How should patients treat advice when it is contradictory? How should patients weigh advice that goes against their basic values and beliefs? It what point should patients concede personal interests and desires to expert advice and counsel? I’ve never read such practical and specific advice.
If nothing else, Groopman and Hartzband will leave you with this idea that they use to begin their "Conclusion": "If medicine were an exact science, like mathematics, there would be one correct answer for each problem. Your preferences about treatment would be irrelevant to what is ‘right.’ But medicine is an uncertain science" (p. 211)> And that is precisely what these authors do so effectively: they lay out the various dilemmas that people face when having to make medical decisions. Medicine is about estimates, uncertainty, and choices: "Your preferences about treatment do matter. They provide a foundation so that you can choose the right treatment, the one that fits your values and way of living. Understanding your preferences begins with reflecting on your mind-set" (p. 212).
Their "Conclusion" to the book is fantastic for it helps people determine their own mind-set. It offers several specific continua on which readers can locate themselves. What is truly exceptional about the "Conclusion" is simply that it gives readers a better understanding of themselves and why they do (or might) make the decisions they do.