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Invasion of the Body: Revolutions in Surgery

Invasion of the Body: Revolutions in Surgery By Nicholas L. Tilney 360 pp, $29.95 Cambridge, MA, Harvard University Press, 2011 ISBN-13: 978-0-6740-6228-3 The 384-page Invasion of the Body: Revolutions in Surgery is scholarly, articulate, and even eloquent in spots, and, while formidable, also readable. As such, it is exceedingly uncommon to find in a single book a concisely told history of surgery and medicine as well as pertinent comments—pro and con—on US policy issues that will require attention and action in 2012. The book's patterns have been beautifully woven, both through its prose and through its organization. Focusing primarily on the United States, it mixes enjoyable vignettes of surgical care 90 years ago with contemporary options for treatment to compare the marked progress achieved in surgery over the last 125 years. The references are precise and relatively well chosen. However, this title is unfortunate for a really good book; indeed, one of the book's clearest themes is the progressively less invasive nature of 21st-century surgery. Perhaps the title and subtitle should have been reversed. Because Invasion of the Body is in places too detailed and too graphic, it may have little appeal to a lay readership. Certainly, the book should be required reading for all medical and nursing students moving toward their first clinical exposures. Its greatest value will be for students trying to decide whether to choose a career in any surgical discipline as opposed to other fields of medicine. The book will be an ideal gift for any physician or an ideal graduation gift for any of the 15 000 young women and men engaged in some form of surgical training. Among the greatest strengths of the book is its examination of many critical issues in play in 21st-century medicine in the United States. The author comes quite close to naming the villains (or villainous groups)—not only pharmaceutical and device manufacturers but also hospital and health plan executives. The author speaks to the educational indebtedness of American graduate surgeons as well as to “surgical tourism,” which likely will only become more prevalent with the increase of high-deductible health insurance among insured citizens. The author did not invent the considerable issues related to hospital accounting and its immediate role in obfuscating health care expenses and their rapid increases. The best segments are those that reflect the perspectives of the author's career in surgical research and education. His view of research is a precious one: the joys of intellectual challenge in new fields and the freedom from mental fatigue, as one addresses new science to be brought back to the bedside. Inevitably, some subjects are imperfectly addressed. He is historically most clear when covering the nuanced relationship between the work of Joseph Lister and that of Louis Pasteur as well as the former's long and, for his era, detailed basic research into prevention of infection. In the author's coverage of the current surgical era, the importance of general surgery1 is vastly downplayed by comments from a younger surgeon whose only frame of educational reference seems to have been in a highly specialized hospital devoid of general surgery role models. Invasion of the Body is a book to be savored and reread and then immediately passed on to the next generation of surgeons. Back to top Article Information Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. References 1. Fischer JE. The impending disappearance of the general surgeon. JAMA. 2007;298(18):2191-219318000204PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Invasion of the Body: Revolutions in Surgery

JAMA , Volume 307 (8) – Feb 22, 2012

Invasion of the Body: Revolutions in Surgery

Abstract

By Nicholas L. Tilney 360 pp, $29.95 Cambridge, MA, Harvard University Press, 2011 ISBN-13: 978-0-6740-6228-3 The 384-page Invasion of the Body: Revolutions in Surgery is scholarly, articulate, and even eloquent in spots, and, while formidable, also readable. As such, it is exceedingly uncommon to find in a single book a concisely told history of surgery and medicine as well as pertinent comments—pro and con—on US policy issues that will require attention and action in 2012. The...
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Publisher
American Medical Association
Copyright
Copyright © 2012 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2012.209
Publisher site
See Article on Publisher Site

Abstract

By Nicholas L. Tilney 360 pp, $29.95 Cambridge, MA, Harvard University Press, 2011 ISBN-13: 978-0-6740-6228-3 The 384-page Invasion of the Body: Revolutions in Surgery is scholarly, articulate, and even eloquent in spots, and, while formidable, also readable. As such, it is exceedingly uncommon to find in a single book a concisely told history of surgery and medicine as well as pertinent comments—pro and con—on US policy issues that will require attention and action in 2012. The book's patterns have been beautifully woven, both through its prose and through its organization. Focusing primarily on the United States, it mixes enjoyable vignettes of surgical care 90 years ago with contemporary options for treatment to compare the marked progress achieved in surgery over the last 125 years. The references are precise and relatively well chosen. However, this title is unfortunate for a really good book; indeed, one of the book's clearest themes is the progressively less invasive nature of 21st-century surgery. Perhaps the title and subtitle should have been reversed. Because Invasion of the Body is in places too detailed and too graphic, it may have little appeal to a lay readership. Certainly, the book should be required reading for all medical and nursing students moving toward their first clinical exposures. Its greatest value will be for students trying to decide whether to choose a career in any surgical discipline as opposed to other fields of medicine. The book will be an ideal gift for any physician or an ideal graduation gift for any of the 15 000 young women and men engaged in some form of surgical training. Among the greatest strengths of the book is its examination of many critical issues in play in 21st-century medicine in the United States. The author comes quite close to naming the villains (or villainous groups)—not only pharmaceutical and device manufacturers but also hospital and health plan executives. The author speaks to the educational indebtedness of American graduate surgeons as well as to “surgical tourism,” which likely will only become more prevalent with the increase of high-deductible health insurance among insured citizens. The author did not invent the considerable issues related to hospital accounting and its immediate role in obfuscating health care expenses and their rapid increases. The best segments are those that reflect the perspectives of the author's career in surgical research and education. His view of research is a precious one: the joys of intellectual challenge in new fields and the freedom from mental fatigue, as one addresses new science to be brought back to the bedside. Inevitably, some subjects are imperfectly addressed. He is historically most clear when covering the nuanced relationship between the work of Joseph Lister and that of Louis Pasteur as well as the former's long and, for his era, detailed basic research into prevention of infection. In the author's coverage of the current surgical era, the importance of general surgery1 is vastly downplayed by comments from a younger surgeon whose only frame of educational reference seems to have been in a highly specialized hospital devoid of general surgery role models. Invasion of the Body is a book to be savored and reread and then immediately passed on to the next generation of surgeons. Back to top Article Information Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. References 1. Fischer JE. The impending disappearance of the general surgeon. JAMA. 2007;298(18):2191-219318000204PubMedGoogle ScholarCrossref

Journal

JAMAAmerican Medical Association

Published: Feb 22, 2012

References