Episodit

  • Mental health care and its radical possibilities reimagined in the context of its global development under capitalism.
    The contemporary world is oversaturated with psychiatric programs, methods, and reforms promising to address any number of "crises" in mental health care. When these fail, alternatives to the alternatives simply pile up and seem to lead nowhere.
    In an original and compelling account of radical experimentation in psychiatry, Warren traces a double movement in the global development of mental health services throughout the 20th century: a radical current pushing totalizing and idealistic visions of care to their practical limits and a reactionary one content with managing or eliminating chronically idle surplus populations.
    Moral treatment is read in light of the utopian socialist movement; the theory of communication in the French Institutional Psychotherapy of Félix Guattari is put into conversation with the Brazilian art therapy of Nise da Silveira; the Mexican anti-psychiatry movement's reflections on violence are thought together with theories of violence developed in Argentinian psychoanalysis and Frantz Fanon's anticolonial therapeutic practice; the social form of the Italian Democratic Psychiatry and Brazilian anti-institutional movements are contrasted with the anti-psychiatry factions of the 1960s-70s North American counterculture.
    Storming Bedlam: Madness, Mental Health, and Revolt (Common Notions, 2024) subverts the divisions between social and biological approaches to mental health or between psychiatry and anti-psychiatry. By exploring the history of psychiatry in the context of revolution, war, and economic development, Warren outlines a minor history of approaches to mental health care grounded in common struggles against conditions of scarcity, poverty, isolation, and exploitation.
    Sasha Warren is a writer based in Minneapolis. His experiences within the psychiatric system and commitment to radical politics led him to cofound the group Hearing Voices Twin Cities, which provides an alternative social space for individuals to discuss often stigmatized extreme experiences and network with one-another. Following the George Floyd Uprising in 2020, he founded the project Of Unsound Mind to trace the histories of psychiatry, social work, and public health's connections to policing, prisons, and various disciplinary and managerial technologies.
    Resources:

    North American Networks of Alternatives to Psychiatry altpsy.net



    Of Unsound Mind Substack


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  • Based on over a decade of research, a powerful, moving work of narrative nonfiction that illuminates the little-known world of the anexos of Mexico City, the informal addiction treatment centers where mothers send their children to escape the violence of the drug war.
    The Way That Leads Among the Lost: Life, Death, and Hope in Mexico City's Anexos (FSG, 2024) reveals a hidden place where care and violence are impossible to separate: the anexos of Mexico City. The prizewinning anthropologist Angela Garcia takes us deep into the world of these small rooms, informal treatment centers for alcoholism, addiction, and mental illness, spread across Mexico City's tenements and reaching into the United States. Run and inhabited by Mexico's most marginalized populations, they are controversial for their illegality and their use of coercion. Yet for many Mexican families desperate to keep their loved ones safe, these rooms offer something of a refuge from what lies beyond them--the intensifying violence surrounding the drug war.
    This is the first book ever written on the anexos. Garcia, who spent a decade conducting anthropological fieldwork in Mexico City, draws readers into their many dimensions, casting light on the mothers and their children who are entangled in this hidden world. Following the stories of its denizens, she asks what these places are, why they exist, and what they reflect about Mexico and the wider world. With extraordinary empathy and a sharp eye for detail, Garcia attends to the lives that the anexos both sustain and erode, wrestling with the question of why mothers turn to them as a site of refuge even as they reproduce violence. Woven into these portraits is Garcia's own powerful story of family, childhood, homelessness, and drugs--a blend of ethnography and memoir converging on a set of fundamental questions about the many forms and meanings that violence, love, care, family, and hope may take.
    Infused with profound ethnographic richness and moral urgency, The Way That Leads Among the Lost is a stunning work of narrative nonfiction, a book that will leave a deep mark on readers.
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  • The beginning of the modern contraceptive era began in 1882, when Dr. Aletta Jacobs opened the first birth control clinic in Amsterdam. The founding of this facility, and the clinical provision of contraception that it enabled, marked the moment when physicians started to take the prevention of pregnancy seriously as a medical concern. In Contraception: A Concise History (The MIT Press, 2020), Donna Drucker traces the history of modern contraception, outlining the development, manufacturing, and use of contraceptive methods from the opening of Dr. Jacobs's clinic to the present. Drucker approaches the subject from the perspective of reproductive justice: the right to have a child, the right not to have a child, and the right to parent children safely and healthily.
    Drucker describes contraceptive methods available before the pill, including the diaphragm (dispensed at the Jacobs clinic) and condom, spermicidal jellies, and periodic abstinences. She looks at the development and dissemination of the pill and its chemical descendants; describes technological developments in such non-hormonal contraceptives as the cervical cap and timing methods (including the “rhythm method” favored by the Roman Catholic church); and explains the concept of reproductive justice. Finally, Drucker considers the future of contraception—the adaptations of existing methods, new forms of distribution, and ongoing efforts needed to support contraceptive access
    Dr. Donna Drucker leads the English as the Language for Instruction Project, which helps faculty, administrative staff, scientific staff, and students at the Technische Universität Darmstadt (Germany) improve their English abilities for teaching and learning.
    Chris Babits is an Andrew W. Mellon Engaged Scholar Initiative Postdoctoral Fellow at the University of Texas at Austin. He researches the intersecting histories of medicine, religion, and gender and sexuality and is currently working on his book about the history of conversion therapy in the United States.
     
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  • Movements that take issue with conventional understandings of autism spectrum disorder, a developmental disability, have become increasingly visible. Drawing on more than three years of ethnographic fieldwork and interviews with participants, Dr. Catherine Tan investigates two autism-focused movements, shedding new light on how members contest expert authority. Examining their separate struggles to gain legitimacy and represent autistic people, she develops a new account of the importance of social movements as spaces for constructing knowledge that aims to challenge dominant frameworks.
    Spaces on the Spectrum: How Autism Movements Resist Experts and Create Knowledge (Columbia University Press, 2024) examines the autistic rights and alternative biomedical movements, which reimagine autism in different and conflicting ways: as a difference to be accepted or as a sickness to treat. Both, however, provide a window into how ideas that conflict with dominant beliefs develop, take hold, and persist. The autistic rights movement is composed primarily of autistic adults who contend that autism is a natural human variation, not a disorder, and advocate for social and cultural inclusion and policy changes. The alternative biomedical movement, in contrast, is dominated by parents and practitioners who believe in the disproven idea that vaccines trigger autism and seek to reverse it with scientifically unsupported treatments. Both movements position themselves in opposition to researchers, professionals, and parents outside their communities. Spaces on the Spectrum offers timely insights into the roles of shared identity and communal networks in movements that question scientific and medical authority.
    This interview was conducted by Dr. Miranda Melcher whose new book focuses on post-conflict military integration, understanding treaty negotiation and implementation in civil war contexts, with qualitative analysis of the Angolan and Mozambican civil wars.
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  • In Surgery & Salvation: The Roots of Reproductive Injustice in Mexico, 1770-1940 (University of North Carolina Press, 2023), Elizabeth O’Brien foregrounds the racial and religious meanings of surgery to draw important connections between historical and contemporary politics regarding fetal and maternal healthcare. She traces practices of caesarean section and coercive Christianization throughout Mexico’s colonial period; patriarchal pregnancy management during republican state formation; and tubal ligation and vaginal bifurcation in Mexico’s twentieth century Eugenics movement. Surgery and Salvation has received several awards including the Rocky Mountain Council for Latin American Studies’ Judy Ewell Award; the Latin American Studies Association 2024 Best Book Award for the Nineteenth-Century Section; and Honorable Mention for the 2024 Frances Richardson Keller-Sierra Prize (WAWH) as well as the Thomas McGann Prize (RMCLAS). O’Brien is an Assistant Professor of the History of Medicine and Latin American History at the University of California, Los Angeles. In this episode, O'Brien is interviewed by Leah Cargin (PhD candidate, University of Oklahoma).Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/medicine

  • Brynn Quick speaks with Dr. Ella van Hest (Ghent University, Belgium) about her ethnographic research related to language diversity at an abortion clinic in Belgium. The conversation focusses on a co-authored paper entitled Language policy at an abortion clinic published in Language Policy in 2023.
    For additional resources, show notes, and transcripts, go here.
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  • Throughout its history, the American West symbolized a place of hope and new beginnings, where anything was possible, especially for men. However, the history written until the 1970s and 1980s excluded women. 
    In 'Gold Fever' and Women: Transformations in Lives, Health Care and Medicine in the 19th Century American West (Transcript, 2023), Sigrid Schönfelder illustrates how the American West served as a catalytic gold mine for many transformations for women. It draws on the life narratives of three healthcare providers whose devotion within the social reform movements of the long nineteenth century contributed significantly to shaping healthcare policies. Their stories show how women contributed to place-making in the West and served as role models for other women to enter the field of medicine.
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  • In this Pandemic Perspectives Podcast, Ideas Roadshow founder and host Howard Burton talks to Michael Gordin, Rosengarten Professor of Modern and Contemporary History at Princeton University, about the differences between science and pseudoscience and how the COVID-19 Pandemic showed that most people don't realize that science is highly dynamic. Gordin is the author of (among other books) of On the Fringe: Where Science Meets Pseudoscience (Oxford UP, 2021).
    Ideas Roadshow's Pandemic Perspectives Project consists of three distinct, reinforcing elements: a documentary film (Pandemic Perspectives), book (Pandemic Perspectives: A filmmaker's journey in 10 essays) and a series of 24 detailed podcasts with many of the film's expert participants. Visit www.ideasroadshow.com for more details.
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  • Between the 1920s and 1980s, the choices that Ghanaian women made regarding their reproductive health were defined by development policy and practice. Spanning the colonial and immediate postcolonial periods, Holly Ashford's book Development and Women's Reproductive Health in Ghana, 1920-1982 (Routledge, 2022) demonstrates that whilst the substance of development discourse shifted over time, principles of development continued to be used to impact and legitimise reproductive health policy and practices well after independence. The book explores Ghana’s pluralist health system, the introduction of maternal and child welfare, the dominance of the Red Cross in Ghana’s maternal and child health landscape, nationalist pronatalism and global population activism. In order to understand how global iterations of development and health policy impacted ordinary lives in Ghana, the author uses evidence from multiple ‘levels,’ including private papers, national archives and records of international and transnational organisations. Providing balanced archival perspectives, the book includes extensive oral history interviews carried out with both rural Ghanaian women and traditional birth attendants, as well as with midwives, doctors and family planning fieldworkers.
    This book will have an important impact on a number of historical fields including Ghanaian history, global health history, global histories of population and family planning and histories of development. It will be of interest to researchers and students in the history of public health, development, Africa, Ghana and gender.
    Dr. Nicole Bourbonnais is an Associate Professor of International History and Politics and Co-Director of the Gender Centre at the Graduate Institute of International and Development Studies in Geneva, Switzerland. Her research explores reproductive politics and practice from a transnational historical perspective. More info here. Twitter: @iheid_history and @GC_IHEID
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  • Friars are often overlooked in the picture of health care in late mediaeval England. Physicians, surgeons, apothecaries, barbers, midwives - these are the people we think of immediately as agents of healing; whilst we identify university teachers as authorities on medical writings. Yet from their first appearance in England in the 1220s to the dispersal of the friaries in the 1530s, four orders of friars were active as healers of every type. Their care extended beyond the circle of their own brethren: patients included royalty, nobles and bishops, and they also provided charitable aid and relief to the poor. They wrote about medicine too. Bartholomew the Englishman and Roger Bacon were arguably the most influential authors, alongside the Dominican Henry Daniel. Nor should we forget the anonymous Franciscan compilers of the Tabula medicine, a handbook of cures, which, amongst other items, contains case histories of friars practising medicine. Even after the Reformation, these texts continued to circulate and find new readers amongst practitioners and householders.The Medicine of the Friars in Medieval England (Boydell & Brewer, 2024) by Peter Murray Jones restores friars to their rightful place in the history of English health care, exploring the complex, productive entanglement between care of the soul and healing of the body, in both theoretical and practical terms. Drawing upon the surprising wealth of evidence found in the surviving manuscripts, it brings to light individuals such as William Holme (c. 1400), and his patient the duke of York (d. 1402), who suffered from swollen legs. Holme also wrote about medicinal simples and gave instructions for dealing with eye and voice problems experienced by his brother Franciscans. Friars from the thirteenth century onwards wrote their medicine differently, reflecting their religious vocation as preachers and confessors.This interview was conducted by Dr. Miranda Melcher whose new book focuses on post-conflict military integration, understanding treaty negotiation and implementation in civil war contexts, with qualitative analysis of the Angolan and Mozambican civil wars.Learn more about your ad choices. Visit megaphone.fm/adchoicesSupport our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/medicine

  • John T. Maier's The Disabled Will: A Theory of Addiction (Routledge Press, 2024) defends a comprehensive new vision of what addiction is and how people with addictions should be treated. The author argues that, in addition to physical and intellectual disabilities, there are volitional disabilities - disabilities of the will - and that addiction is best understood as a species of volitional disability. This theory serves to illuminate long-standing philosophical and psychological perplexities about addiction and addictive motivation. It articulates a normative framework within which to understand prohibition, harm reduction, and other strategies that aim to address addiction. The argument of this book is that these should ultimately be evaluated in terms of reasonable accommodations for addicted people and that the priority of addiction policy should be the provision of such accommodations. What makes this book distinctive is that it understands addiction as a fundamentally political problem, an understanding that is suggested by standard legal approaches to addiction, but which has not received a sustained defense in the previous philosophical or psychological literature. This text marks a significant advance in the theory of addiction, one which should reshape our understanding of addiction policy and its proper aims.
    Jeff Adler is an ex-linguist and occasional contributor to New Books Network!
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  • Compound Remedies: Galenic Pharmacy from the Ancient Mediterranean to New Spain (University of Pittsburgh Press, 2020) by Dr. Paula S. De Vos examines the equipment, books, and remedies of colonial Mexico City’s Herrera pharmacy—natural substances with known healing powers that formed part of the basis for modern-day healing traditions and home remedies in Mexico. Dr. De Vos traces the evolution of the Galenic pharmaceutical tradition from its foundations in ancient Greece to the physician-philosophers of mediaeval Islamic empires and the Latin West and eventually through the Spanish Empire to Mexico, offering a global history of the transmission of these materials, knowledges, and techniques.
    Her detailed inventory of the Herrera pharmacy reveals the many layers of this tradition and how it developed over centuries, providing new perspectives and insight into the development of Western science and medicine: its varied origins, its engagement with and inclusion of multiple knowledge traditions, the ways in which these traditions moved and circulated in relation to imperialism, and its long-term continuities and dramatic transformations. Dr. De Vos ultimately reveals the great significance of pharmacy, and of artisanal pursuits more generally, as a cornerstone of ancient, mediaeval, and early modern epistemologies and philosophies of nature.

    This interview was conducted by Dr. Miranda Melcher whose new book focuses on post-conflict military integration, understanding treaty negotiation and implementation in civil war contexts, with qualitative analysis of the Angolan and Mozambican civil wars.
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  • In early modern Japan, upper status groups coveted pills and powders made of exotic foreign ingredients such as mummy and rhinoceros horn. By the early twentieth century, over-the-counter-patent medicines, and, more alarmingly, morphine, had become mass commodities, fueling debates over opiates in Japan's expanding imperial territories.
    The fall of the empire and the occupation of Japan by the United States created conditions favorable for heroin use, followed, in time, by glue sniffing and psychedelic mushroom ingestion.
    By illuminating the neglected history of drugs, Drugs and the Politics of Consumption in Japan (Brill, 2023) highlights both the transnational embeddedness and national peculiarities of the "politics of consumption" in Japan.
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  • Is involuntary psychiatric treatment the solution to the intertwined crises of untreated mental illness, homelessness, and addiction? In recent years, politicians and advocates have sought to expand the use of conservatorships, a legal tool used to force someone deemed “gravely disabled,” or unable to meet their needs for food, clothing, or shelter as a result of mental illness, to take medication and be placed in a locked facility. At the same time, civil liberties and disability rights groups have seized on cases like that of Britney Spears to argue that conservatorships are inherently abusive.
    Conservatorship: Inside California's System of Coercion and Care for Mental Illness (Columbia UP, 2023) is an incisive and compelling portrait of the functioning—and failings—of California’s conservatorship system. Drawing on hundreds of interviews with professionals, policy makers, families, and conservatees, Alex V. Barnard takes readers to the streets where police encounter homeless people in crisis, the locked wards where people receiving treatment are confined, and the courtrooms where judges decide on conservatorship petitions. As he shows, California’s state government has abdicated authority over this system, leaving the question of who receives compassionate care and who faces coercion dependent on the financial incentives of for-profit facilities, the constraints of underresourced clinicians, and the desperate struggles of families to obtain treatment for their loved ones.
    This book offers a timely warning: reforms to expand conservatorship will lead to more coercion but little transformative care until government assumes accountability for ensuring the health and dignity of its most vulnerable citizens.
    Michael O. Johnston, Ph.D. is a Assistant Professor of Sociology at William Penn University. He is the author of The Social Construction of a Cultural Spectacle: Floatzilla (Lexington Books, 2023) and Community Media Representations of Place and Identity at Tug Fest: Reconstructing the Mississippi River (Lexington Books, 2022). His general area of study is in the areas of social construction of experience, identity, and place. He is currently conducting research for his next project that looks at nightlife and the emotional labor that is performed by employees of bars and nightclubs. To learn more about Michael O. Johnston you can go to his website, Google Scholar, Twitter @ProfessorJohnst, or by email at [email protected].
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  • If you’ve ever worked with dementia patients before, you know how unique and bizarre the experience can be, and how little the stereotypes actually hold up to the experience. Even knowing about the diagnosis often does little to help us in caring for people, and many caregivers find themselves getting sucked into behavioral loops of their own. This is because your brain is not wired to deal with the altered form of reality that dementia patients inhabit. Evolution has not equipped us to deal with these dynamics.
    Unpacking all this is our guest today, Dasha Kiper in her book Travelers to Unimaginable Lands: Stories of Dementia, the Caregiver, and the Human Brain (Random House, 2023). Having both worked with dementia patients and run support groups for caregivers, she’s seen patterns play out over countless situations, and has mapped the cognitive landscape of people working to take care of those afflicted with the disease. In a series of engaging and provocative essays, she’s able to elucidate our limitations, the various neurological traps we are often tempted to fall into, hopefully offering caregivers some clarity on themselves and just how far from reality this work often takes them.
    Dasha Kiper is the consulting clinical director of support groups at an Alzheimer’s organization, and holds an MA in clinical psychology from Columbia University.
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  • The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No (Norton, 2024) is an intellectual inquiry into the moral struggle that whistleblowers face, and why it is not the kind of struggle that most people imagine.
    Carl Elliott is a bioethicist at the University of Minnesota who was trained in medicine as well as philosophy. For many years he fought for an external inquiry into a psychiatric research study at his own university in which an especially vulnerable patient lost his life. Elliott’s efforts alienated friends and colleagues. The university stonewalled him and denied wrongdoing until a state investigation finally vindicated his claims.
    His experience frames the six stories in this book of medical research in which patients were deceived into participating in experimental programs they did not understand, many of which had astonishing and well-concealed mortality rates. Beginning with the public health worker who exposed the Tuskegee Syphilis Study and ending with the four physicians who in 2016 blew the whistle on lethal synthetic trachea transplants at the Karolinska Institute, Elliott tells the extraordinary stories of insiders who spoke out against such abuses, and often paid a terrible price for doing the right thing.
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  • Each year in India more than two million people fall sick with tuberculosis (TB), an infectious, airborne, and potentially deadly lung disease. The country accounts for almost 30 percent of all TB cases worldwide and well above a third of global deaths from it. Because TB’s prevalence also indicates unfulfilled development promises, its control is an important issue of national concern, wrapped up in questions of postcolonial governance. Drawing on long-term ethnographic engagement with a village in North India and its TB epidemic, anthropologist Andrew McDowell tells the stories of socially marginalized Dalit (“ex-untouchable”) farming families afflicted by TB, and the nurses, doctors, quacks, mediums, and mystics who care for them. Each of the book’s chapters centers on a material or metaphorical substance - such as dust, clouds, and ghosts - to understand how breath and airborne illness entangle biological and social life in everyday acts of care for the self, for others, and for the environment.
    From this raft of stories about the ways people make sense of and struggle with troubled breath, McDowell develops a philosophy and phenomenology of breathing that attends to medical systems, patient care, and health justice. He theorizes that breath - as an intersection between person and world - provides a unique perspective on public health and inequality. Breath is deeply intimate and personal, but also shared and distributed. Through it all, Breathless: Tuberculosis, Inequality, and Care in Rural India (Stanford UP, 2024) traces the multivalent relations that breath engenders between people, environments, social worlds, and microbes.
    Andrew McDowell is Assistant Professor of Anthropology at Tulane University. He has a Ph.D. in socio-cultural anthropology from Harvard University. His research interests focus on care, contagion, pharmaceuticals, diagnosis, and inequality in North and Western Indian social worlds entangled with tuberculosis. His work has appeared in Medical Anthropology Quarterly, Ethos, and The Lancet among other venues.
    Yadong Li is a PhD student in anthropology at Tulane University. His research interests lie at the intersection of the anthropology of state, the anthropology of time, hope studies, and post-structuralist philosophy. More details about his scholarship and research interests can be found here.
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  • Policing the Womb: Invisible Women and the Criminalization of Motherhood (Cambridge University Press, 2020) a brilliant but shocking account of the criminalization of all aspects of reproduction, pregnancy, abortion, birth, and motherhood in the United States. In her extensively researched monograph, Michele Goodwin recounts the horrific contemporary situation, which includes, for example, mothers giving birth shackled in leg irons, in solitary confinement, even in prison toilets, and in some states, women being coerced by the State into sterilization, in exchange for reduced sentences. She contextualises the modern day situation in America’s history of slavery and oppression, and also in relation to its place in the world. Goodwin shows how prosecutors abuse laws, and medical professionals are complicit in a system that disproportionally impacts the poor and women of color. However, Goodwin warns that these women are just the canaries in the coalmine. Not only is the United States the deadliest country in the developed world for pregnant women, but the severe lack of protections for reproductive rights and motherhood is compounding racial and indigent disparities.
    Jane Richards is a doctoral candidate in Human Rights Law at the University of Hong Kong. Her research interests include disability, equality, criminal law and civil disobedience. You can find her on twitter @JaneRichardsHK where she avidly follows the Hong Kong’s protests and its politics.
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  • Students in twelfth-century Paris held slanging matches, branding the English drunkards, the Germans madmen and the French as arrogant. On Crusade, army recruits from different ethnic backgrounds taunted each other’s military skills. Men producing ethnography in monasteries and at court drafted derogatory descriptions of peoples dwelling in territories under colonization, questioning their work ethic, social organization, religious devotion and humanness. Monks listed and ruminated on the alleged traits of Jews, Saracens, Greeks, Saxons and Britons and their acceptance or rejection of Christianity.
    Ethnicity in Medieval Europe 950-1250, Medicine, Power and Religion (Boydell and Brewer, 2021), provides a radical new approach to representations of nationhood in medieval western Europe, the author argues that ethnic stereotypes were constructed and wielded rhetorically to justify property claims, flaunt military strength, and assert moral and cultural ascendance over others. The gendered images of ethnicity in circulation reflect a negotiation over self-representations of discipline, rationality and strength, juxtaposed with the alleged chaos and weakness of racialized others. Interpreting nationhood through a religious lens, monks and schoolmen explained it as scientifically informed by environmental medicine, and ancient theory that held that location and climate influenced the physical and mental traits of peoples. Drawing on lists of ethnic character traits, school textbooks, medical treatises, proverbs, poetry and chronicles, this book shows that ethnic stereotypes served as rhetorical tools of power, crafting relationships within communities and towards others.
    Claire Weeda is a cultural historian at the Institute for History at Leiden University, Netherlands. Her main fields of interest include ethnic stereotyping, the history of the body, Greco-Arabic medicine, and organic politics in Europe, 1100-1500.
    Evan Zarkadas is a graduate student of European history at the University of Maine focusing on Medieval Europe, the Eastern Mediterranean, medieval identity, and ethnicity during the late Middle Ages.
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  • Dialysis is a medical miracle, a treatment that allows people with kidney failure to live when otherwise they would die. It also provides a captive customer for the dialysis industry, which values the steady revenues that come from critically required long-term care that is guaranteed by the government. 
    Tom Mueller's six year deep dive into the dialysis industry has yielded his latest book, How to Make a Killing: Blood, Death, and Dollars in American Medicine (W. W. Norton, 2023). It's both an historical account of this lifesaving treatment and an indictment of the industry that is dominated by two for-profit companies that control ~80% of the market.  
    There is a precarious balance between ethical care for patients and the prioritization of profits for the providers, a tension that has led to ethical, political, and legal debates about the rationing and exploitation of life-saving care and quality of life. 
    Dialysis services are desperately needed by patients who require the dangerous, uncomfortable, and exhausting treatments multiple times per week, and pay for it through complex insurance procedures.
    Tom Mueller’s book includes a vivid account of CEOs who lead their companies with messianic zeal to drive revenues continually up while simultaneously reducing the cost of care. He introduces us to the doctors charged with reducing those costs even at the expense of high-quality care and negative health outcomes. And we meet the patients themselves, who have little choice but to put their lives and well-being at the mercy of this system.
    How did a lifesaving medical breakthrough become a for-profit enterprise that threatens many of the people it’s meant to save? And who are the brave people -patients, doctors, and employees of the system who are willing to tell their stories despite tremendous pressure to remain silent? And why do we as Americans accept worse outcomes at higher costs than the rest of the world?
    Tom Mueller's highly readable yet devastating book illustrates the dialysis industry as a microcosm of American medicine. 
    Mueller challenges us to find a solution for dialysis, an approach that could also provide the opportunity to begin fixing our country’s dysfunctional healthcare system and a fighting chance at restoring human health outcomes, rather than the extraction of profits, as its true purpose.
    To contact Tom Mueller, visit www.tommueller.co
    Suggested reading: 


    The Body's Keepers by Paul L. Kimmel, M.D.


    The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No by Carl Elliott

    Also mentioned: 


    How to Get Away with Merger by Thomas G. Wollman (NBER working paper, 2020)


    "How Acquisitions Affect Firm Behavior and Performance" by Eliason, Heebsh et al. (The Quarterly Journal of Economics, 2020)


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