BOOKS, JOURNALS, NEW MEDIA

Cancer Patient Wit: A Play, by Margaret Edson, paper, 84 pp, $12, IBSN 0571198775, New York, NY, Faber & Faber, 1999. Review based on performance directed by Derek Anson Jones, November 1999, Union Square Theater, New York, NY.

THE PLAY WIT IS AN ENGAGING AND ABsorbing drama about a cancer patient as she experiences established practices in medicine. The protagonist, Vivian Bearing, PhD (Judith Light), is a renowned professor of English. In her own assessment she has made major contributions to our understanding of the metaphysical poet John Donne and his Holy Sonnets. From such exalted heights she is thrust into an entirely new world of hospitals, physicians, and chemotherapy, when she is diagnosed with stage IV ovarian cancer. Initially, her approach to her illness is rational and probing, though mixed with cynical responses to the situation that she is pushed into by current medical practices. Without much choice, she is made the initial patient in an experimental chemotherapeutic protocol. The process by which she reassesses her life and work, and critiques medicine with profound insights and cynical good humor, transforms both the patient and audience. The playwright grips us intellectually and emotionally from the first few lines of dialogue: the typically perfunctory “Hi. How are you feeling today?” and the reflex response, whatever the patient’s answer or condition, “Great. That’s just great.” In the next two hours of uninterrupted drama, the patient at center stage freezes the action around her—the parade of doctors, nurses, technicians, and medical students—to comment on her life, its metaphors and conceits. Through the eight cycles of chemo that ultimately take her life, she realizes the irony that it’s not the disease that makes her sick but the treatment itself, to wit, when she is forced to return to the hospital with fever and neutropenia: “In my present condition every living thing is a health haz-

ard to me . . . particularly health-care professionals.” The play parodies our habit of breaking bad news impersonally, without even the offer of a chair to break the shock. Eloquent irony is introduced in the person of Jason Posner, MD (Grant Show), who, while a biochemistry major, had taken one of Professor Bearing’s required poetry courses. Physicians’ idiosyncrasies and the foibles of unsympathetic and mechanical technicians are woven into the play in wonderfully crafted sequences. A masterly scene parodies grand rounds, which are neither grand nor worthy of applause, but rather full of “subservience, hierarchy, gratuitous display, sublimated rivalries.” Bearing describes her role in the proceedings: “I just hold still and look cancerous. It requires less acting every time.” In this scene she sums up the crucial difference between her past and present life: “Once I did the teaching, now I am taught.” In another scene Professor Bearing helps Jason verbalize why he is so interested in oncology, exposing the limitations of his vocabulary despite his “well-rounded education.” Dr Posner is absorbed in his research, working to unravel the mysteries of cancer cells “and their endless powers of multiplication . . . immortality in culture.” For him, bedside manners and empathy are, as poetry had been, unwelcome chores. Although the dying Bearing is called “sweetheart” and “sweetie,” no one gives her a hand when she is vomiting or an empathetic touch when she is in dire pain. In my own medical training, I was encouraged to sit at a patient’s bedside during history taking and physical examination, and therefore found the sterility of the clinical scenes shocking. But to portray the play as simply an expose´ of the medical profession would be an injustice, as it is an equally searing critique of academia in general. Bearing and hermentor,E.M.Ashford,argueatlength

©2000 American Medical Association. All rights reserved.

abouttheappropriatenessofacommaversus a semicolon in a Donne poem. In another brilliant scene Bearing lashes out as she lectures on a poem of Donne’s, “If Pysonous Mineralls,” projected on a screen. Her powerful whacks with the pointer are metaphorical blows meted out to her students.DespiteherappreciationoffineEnglish poetry, her humanity is not moved by her students’ difficulties, and her demands on them are unceasingly exacting. A powerful prickly personality, Vivian Bearing is capable of dry asides even during gut-wrenching nausea or while discussingcodestatus.But,ashertimedraws to a close, a change occurs in the way she reflects on life, death, and Donne. The most awesome irony is that while Vivian Bearingissterile(emotionally,physiologically, and symbolically), she never had a loveaffair—hasnotgivenbirthoraccepted anyone into the essence of her body—she ultimately succumbs to ovarian cancer, a malignancy of a life-giving or renewing organ. The play, brutally human at one level, is layered: it disturbs, enlightens, and, strangely, comforts. The author won the 1999 Pulitzer Prize for distinguished drama by an American author, an award that is richly deserved. Margaret Edson is a kindergarten teacher in Atlanta, who while earning degrees in history and literature worked in the cancer and AIDS unit of a research hospital, and the events in the play unfold with authenticity. Several productions of Wit are planned. While the play’s ferocious intensity may intimidate, its transformative power should be provocative and enlightening for those of us who must make life-and-death decisions for our patients. Abraham Philip, MD Massachusetts General Hospital Boston Books, Journals, New Media Section Editor: Harriet S. Meyer, MD, Contributing Editor, JAMA; Jonathan D. Eldredge, MLS, PhD, University of New Mexico, Health Sciences Center Library, Journal Review Editor; adviser for new media, Robert Hogan, MD, San Diego.

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BOOKS, JOURNALS, NEW MEDIA Addiction Treating Addiction as a Human Process, by Edward J. Khantzian (Library of Substance Abuse and Addiction Treatment), 687 pp, $70, ISBN 0-7657-0186-3, Northvale, NJ, Jason Aronson, 1999.

PSYCHODYNAMIC THERAPIES FACE TWO powerful foes to their development and survival. The first is an approach to medical and psychiatric care that insists on evidence-based theories and demonstration of positive outcomes for treatment based on those theories. Frequently, this approach is willing to suspend requirements for a theory if the outcome of a treatment is demonstrably positive. Psychodynamic therapies suffer because they reverse this hierarchy and give the majority of their energies to development of elaborate theories with little attention to the theory’s testability or enthusiasm for validating positive therapeutic outcomes. The second major threat to psychoanalytic therapies in today’s environment is managed care. Psychoanalytic treatment requires time—lots of time. Two to five days per week treatment extending for years is not an unusual requirement although not frequently practiced today. This intensity limits the number of patients who can be treated and is expensive per individual patient. Managed care does not gravitate to such treatments, especially in a climate of massive cuts to all forms of psychiatric care. Thus, this book, a thorough explanation of a particular psychodynamic perspective for treating substance abuse, is appearing at a difficult time. Written by a leader in the substance abuse field, it is divided into four sections and 39 chapters and represents a collection of Edward J. Khantzian’s writings on substance abuse over the past 20 years. Major focus is given to development of his hypotheses regarding the psychodynamic origins of addiction. These include his postulate that addiction is driven not by pleasure seeking but by the need of substance abusers to relieve their suffering caused by deficits in self esteem, relationships, selfcare, and regulation of affect, all of which predate the onset of addiction.

A second related major postulate is that the drug preferred by the abuser is one that specifically treats the disordered affect (eg, heroin for anger, cocaine for depression) and is used to selfregulate a disordered personality. Khantzian is well aware of the arguments against his hypotheses and addresses them in several ways. He gives evidence supporting his ideas but the studies supporting him best are not scientific (ie, have no controls or comparison groups, lack clear operational definition of terms, have multiple or likely alternative hypotheses, which are not noted). The most scientific studies that he does cite relate tangentially at best to his theories (eg, evidence that many substance abusers have concurrent psychiatric disorders to support the self-medication hypothesis). He also takes the tack that all concepts should be treated equally regardless of their truth: “[T]he challenge then is not to figure out whose concepts and related data are better or correct, but rather to consider how different concepts and their related findings complement rather than contradict each other.” Such a stance is perhaps worthy of a defense, but it is unlikely that a scientifically based medical audience will stay long enough to hear it. In this collection Khantzian does not address the challenges of managed care to the acceptance of his hypotheses and treatment approach. There is no mention, even in his later work, of the impact of such organizations on the practice of psychoanalytic therapies. He refers to his “work with such [substance abusing] patients, now spanning three decades and probably 250 patients (i.e., conservatively averaging 10 patients a year who were in treatment on average 1.5 years) . . .”. Today, many clinicians who treat substance abuse must care for several hundred such patients per year, and they need guidance. Khantzianisawonderfullylucidwriter who describes psychoanalytic concepts clearly, completely free of arcane jargon. He begins his book with an overview of its contents and introduces each of the

3262 JAMA, June 28, 2000—Vol 283, No. 24 (Reprinted)

five sections in the same manner. These overviews are succinct and informative and pull the concepts of the succeeding chapters into a coherent whole. Within each section chapters are organized by original year of publication, which leads to excessive repetition of concepts. Readers pressed for time could gain an understanding of the book’s basic concepts by reading the overviews at the beginning of the book and each section. Khantzian’s treatment of substance abuse patients is guided by his theories and also by his humanism. He refers to his patients’ strengths; the need to treat them as suffering, not evil, human beings; and the necessity for a therapist to be respectful, caring, and actively, not passively, involved with his or her patients’ treatment. His attitude that all substance abusing patients are deserving of the same compassionate, nonjudgmental care that other patients receive is a necessary and important message for all clinicians treating substance abuse patients, regardless of their scientific orientation or attitudes toward managed care. In summary, this book lucidly presents the case for a psychoanalytic humanistic approach to understanding and treating substance abuse patients. The psychoanalytic part of this approach is not likely to gain much traction in today’s medical world. The humanistic orientation, however, should be absorbed and practiced by all clinicians as they and their patients await more substantive advancements in the understanding and treatment of this widespread and often devastating illness. Barry I. Liskow, MD University of Kansas Medical Center Kansas City, Mo Minority Experience Forged by the Knife: The Experience of Surgical Residency from the Perspective of a Woman of Color, by Patricia L. Dawson, 176 pp, $24, ISBN 0-940880-63-6, Open Hand Publishing, 1999.

DO YOU RECALL THE CHILDREN’S RIDDLE: A young boy is hit by a car and taken to the hospital. As he is rolled, unconscious, through the emergency room

©2000 American Medical Association. All rights reserved.

BOOKS, JOURNALS, NEW MEDIA

doors, the trauma surgeon steps forward and gasps, “That’s my son!” The surgeon is not the boy’s father. Who is the surgeon? For most of us, myself included, the image of surgeon has been so stamped with the male countenance that to indicate otherwise we often say “woman surgeon.” As Joan Cassell writes in The Woman in the Surgeon’s Body1: When I began studying surgeons in 1983, I was struck by the martial, masculine ambiance of surgery. Several of the men I interviewed compared themselves to astronauts. . . . Male-identified occupations, such as surgeon, test pilot, soldier, fire fighter, and race car driver focus on one pole of a set of cultural oppositions: practitioners describe themselves and their comrades as active, strong, decisive, brave, aggressive. “Sometimes in error, never in doubt” is the motto a chief of surgery ascribed to surgeons. . . . In each of these vocations we find ritualized ordeals for initiates, active male bonding, and profound distrust and exclusion of females as participants.

As women have colonized the foreign lands of medical specialties, surgery has been one of the most difficult territories. Although many more women are in surgical residencies now, women surgeons remain absent in many communities. For example, in my own town of Santa Cruz, Calif, the Yellow Pages lists 12 general surgeons—none are women. And when the factor of race is added to gender, the foreign territory acquires even more challenging features. In Forged by the Knife, Patricia Dawson, MD, PhD, FACS, allows us to glimpse the experience of black women during and after their general surgical residencies. During her work as a general surgeon with a large Seattle health maintenance organization, Dr Dawson also was the Director of Medical Staff Diversity. She needed to understand “the significance of patient and physician diversity on health, wellness, and health care delivery.” During her work, both to contribute to feminist research and to review the personal impact of her own surgical training, she decided to study the experience of African American women in general surgery residencies. Forged by the Knife, a book derived from her PhD

thesis on this topic, is of strong interest to all physicians, especially surgeons, medical educators, and medical students. During her project she sent surveys to the 110 African American women general surgeons identified by several medical organizations. From the survey, she chose those surgeons who were five to 15 yearspostresidency.Ofthese,Dawsondid fivein-depthqualitativeinterviews.Forged by the Knife has extensive clips from her interviews and gives us a direct window onto the subjects’ experiences. African American women comprise only 0.005% of the general surgeons, yet their reflections give us a perspective on all surgical training. And although they were just as submerged in their training as any resident, each woman identified areas that were more difficult because of race or gender, eg, getting cases from attendings and having to worry about and race- and gender-related issues. As one woman said, “I remember one of the attendings. The reason why I always wore a T-shirt under my scrubs is because scrubs are not cut for women, and so when you leaned forward . . . men used to . . . you could tell they were looking down your shirt. It happened all the time. It was those sorts of inappropriate behavior that the male residents don’t have to deal with. You would wonder, am I wearing too big of a shirt? Do I need a safety pin, you can’t bend over and take care of the patient who is bleeding on the floor without worrying about somebody looking down your shirt. The male residents didn’t have to deal with that.”

The women all note that during their residency it was difficult to ascertain if incidents were related to gender, race, both or neither. For example, “I did a case when I was an intern with a cardiothoracic surgeon . . . we were taking down some of the adhesions. He wanted me to Bovie on my finger. To put my finger under the blade. You can do that for a little while, and then it gets hot. When I told him that it was burning my finger, his response was, ‘Oh, c’mon, Janice, you can’t take it?’ and would he have said that if I was a guy? Well, I don’t know, but I took it and I had burns on my hands just because I thought I needed to show that I could do it. And that if I didn’t do it, it would be looked upon as though I was a woman and couldn’t do it, not because it was just a hot Bovie.”

©2000 American Medical Association. All rights reserved.

The experiences that these black women reveal and review are useful to all those who have undergone strenuous medical training, especially those who have wondered, despite all the benefits and necessary difficulties that prepare us for medical work, are we traumatized and perhaps permanently scarred by our medical education? And what are the costs of this training? (High rates of physician divorce, suicide, and substance abuse are a few.) Forged by the Knife gives us an opportunity to review those costs and traumas in microscopic detail. For those who are thoughtful about their own careers and about how to change medical training, Dr Dawson’s book contributes both to our specific knowledge about African American women general surgeons and to our understanding of all physicians and the ever more diverse medical students that we are now training. As in Dr Lori Alviso Alvord’s book, The Scalpel and the Silver Bear,1 Forged by the Knife gives a special perspective on the world of contemporary medicine. These two women surgeons of color are able to stand both at the frontier and the center of modern medicine, and their books allow us to stand with them and examine both the flaws and the glories of the culture of modern medicine. Charlea T. Massion, MD Santa Cruz, Calif 1. Cassell J. The Woman in the Surgeon’s Body. Cambridge, Mass: Harvard University Press; 1998:17-18. 2. Loewe R, reviewer. JAMA. 2000:283:405-406. Review of: Alvord LA, Van Pelt EC. The Scalpel and the Silver Bear: The First Navajo Woman Surgeon Combines Western Medicine and Traditional Healing. New York, NY: Random House;1999.

Amniocentesis Testing Women, Testing the Fetus: The Social Impact of Amniocentesis in America, by Rayna Rapp (The Anthropology of Everyday Life), 361 pp, $30, ISBN 0-415-91644-5, paper, $16.99, ISBN 0-415-91645-3, New York, NY, Routledge, 1999.

AFTER ENDING HER PREGNANCY IN 1983 following a positive diagnosis for Down syndrome, cultural anthropologist Rayna Rapp began to study the social impact and cultural meaning of amniocentesis. For the next 15 years she stud-

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BOOKS, JOURNALS, NEW MEDIA

ied seven constituencies intimately involved with this new reproductive technology: geneticists, genetic counselors, lab technicians, pregnant women and their supporters who used or refused the test, women who ended their pregnancies following a positive diagnosis, and parents of children with prenatally diagnosable disabilities. Rapp broke new methodological ground with this research and has served as a direction setter both in anthropology and in science and technology studies. Of the many facets of this remarkably rich study, her description of “counseling across cultural differences” may be most useful to medical care givers. Rapp interviewed genetic counselors from every medical center in New York City that offers prenatal diagnostics and observed more than 300 genetic counseling sessions in hospitals with very different client bases. She conducted follow-up interviews with more than 100 of these women and some of their partners. Rapp documents the code switching that takes place as counselors serve a population of diverse language, class, and ethnicity and shows how “even counseling materials developed for clients with low scientific literacy often miss their mark.” She demonstrates that “there is ample space for both improving the content of information and increasing awareness of the role which class structured etiquette plays” in shaping what is said and what is left unsaid in medical interviews. Rapp describes how prenatal diagnosis “forces each woman to act as a moral philosopher of the limits, adjudicating the standards guarding entry into the human community.” She illuminates the dense social and cultural context in which such decision making takes place—cultural ideas of maternal responsibility and which types of disability are acceptable, white middle class women’s concern about being “selfish,” Spanish-speaking women’s concern with fetal suffering, multiethnic working-class concerns with how a disabled child will affect other family members, and new immigrants’ fears about how such a child

might jeopardize the family’s ability to assimilate. Rapp also conveys the importance of religion, in providing not only spiritual direction but also social and material resources that affect these decisions. She vividly conveys how for women living with the real risks of poverty—dangerous neighborhoods, unemployment, depression, substandard schools, family members involved with drugs—“the very idea that risks are measurable and individual may be overwhelmed by other assessments women make” about more diffuse, sociallybased risks to prenatal health. As she sketches this “practical epidemiology,” Rapp notes, “. . . ironically, the very populations most at risk—less privileged, ‘older,’ women having more pregnancies with more partners . . . may be the least likely to live by the numbers precisely because they understand their risks to be spread over a greater territory than chromosome analysis in pregnancy describes.” The final two chapters provide a “women-centered analysis” of what happens when a chromosomal anomaly is found. Rapp draws on interviews with 38 families of children with Down syndrome and participant observation with two parent support groups to describe the special pleasures and burdens of mothering these children. Here again we see how “the discursive and material resources available for families of disabled children vary greatly along the social fault lines.” Despite her support for “adequate, non-stigmatizing, integrative services” for children with disabilities, Rapp continues to “champion the reproductive rights of women to carry or refuse to carry to term a pregnancy that would result in a baby with a serious disability.” Interviews with 50 women enable Rapp to probe the special trials of a “chosen loss.” She describes these women’s assessments of the various medical procedures available and makes a case for dilatation and evacuation as the preferable mode for termination. She explains the “profound sense of social isolation” that the women she interviewed shared and makes clear that

3264 JAMA, June 28, 2000—Vol 283, No. 24 (Reprinted)

the social support offered in these circumstances is “insufficient.” The award of three coveted book prizes already attests to the importance of this book for the social sciences. Testing Women, Testing the Fetus is likely to prove equally valuable to health care providers concerned with offering the best possible care to patients from diverse social backgrounds. Linda Layne, PhD Rensselaer Polytechnic Institute Troy, NY

RECEIVED Alcohol and Drug Dependence Beyond the Influence: Understanding and Defeating Alcoholism, by Katherine Ketcham and William F. Asbury, 357 pp, paper, $13.95, ISBN 0-553-38014-1, New York, NY, Bantam Books, 2000. Resisting 12-Step Coercion: How to Fight Forced Participation in AA, NA, or 12-Step Treatment, by Stanton Peele and Charles Bufe with Archie Brodsky, 204 pp, paper, $14.95, ISBN 1-884365-17-5, Tucson, Ariz, See Sharp Press, 2000.

Cancer Cancer Chemotherapy and Biological Response Modifiers Annual 18, edited by H. M. Pinedo, D. L. Longo, and B. A. Chabner, 632 pp, $195, ISBN 0-444-50074-X, paper, ISSN 09214410, New York, NY, Elsevier, 1999. The Sentinel Node in Surgical Oncology, by Mohammed R. S. Keshtgar, Wendy A. Waddington, Sunil R. Lakhani, and Peter J. Ell, 193 pp, with illus, $119, ISBN 3-540-65176-4, New York, NY, Springer-Verlag, 1999.

Cardiology From Molecule to Men: Molecular Basis of Congenital Cardiovascular Disorders, edited by M. Zehender, G. Breithardt, and H. Just, 246 pp, $52, ISBN 3-7985-1168-3, New York, NY, Springer-Verlag, 2000. Handbook of Coronary Stents, edited by Patrick W. Serruys and Michael J. B. Kutryk, 3rd ed, 424 pp, with illus, $75, ISBN 1-85137-802-0, London, England, Martin Dunitz, Malden, Mass, Blackwell Science, 2000. Management of Acute Coronary Syndromes, edited by Peter M. Schofield, 244 pp, with illus, soft cover, $49.95, ISBN 1-85317719-9, London, England, Martin Dunitz, Malden, Mass, Blackwell Science, 2000.

©2000 American Medical Association. All rights reserved.

BOOKS, JOURNALS, NEW MEDIA Critical Care

Medicine

Pathology

Anaesthesia, Pain, Intensive Care and Emergency Medicine, edited by A. Gullo (Critical Care Medicine, vol 14, course, Trieste, Italy, November 1999), 585 pp, paper, $99, ISBN 88-4700095-5, New York, NY, Springer-Verlag, 2000.

The Human Effect in Medicine: Theory, Research and Practice, by Michael Dixon and Kieran Sweeney, 157 pp, £17.95, paper, ISBN 1-85775-369-0, Abingdon, Oxon, England, Radcliffe Medical Press, 2000 (http://www .radcliffe-oxford.com).

Review of Pathology, by Ivan Damjanov and Emanuel Rubin, 2nd ed, 250 pp, with illus, paper, $27.95, ISBN 0-397-58408-3, New York, NY, Lippincott Williams & Wilkins, 2000.

Dermatology

Mayo Internal Medicine Board Review 200001, by Udaya B. S. Prakash and Thomas M. Habermann, 987 pp, with illus, soft cover, $89.95, ISBN 0-7817-2393-0, Philadelphia, Pa, Lippincott Williams & Williams, 2000.

An Atlas of Microbiology of the Skin: An Illustrated Textbook and Reference for Clinicians, by Jack L. Lesher, Jr, 134 pp, with illus, $89, ISBN 1-85070-904-1, New York, NY, Parthenon Publishing Group, 1999.

Health Systems Communicate and Negotiate: Professional, Business, Personal, Family, by Rick E. Schroeder and Eileen E. Morrison, 118 pp with 102 pp exercise guide, $83, ISBN $55 members, spiral-bound, $65 affilliates, ISBN 1-56829125-6, Englewood, Colo, Medical Group Management Association, 2000. Error Reduction in Health Care: A Systems Approach to Improving Patient Safety, edited by Patrice L. Spath, 284 pp, $55, ISBN 1-55648-271-X, San Francisco, Calif, JosseyBass Publishers, Chicago, Ill, Health Forum, 2000.

Miscellaneous Preventing Falls: A Defensive Approach, by J. Thomas Hutton, 115 pp, with illus, $18.95, ISBN 1-57392-761-9, video, $21.95, ISBN 1-57392762-7, paper, $34.95, ISBN 1-57392-763-5 book and video, Amherst, NY, Prometheus Books, 2000.

Neurology Atlas of Electromyography, by A. Arturo Leis and Vicente C. Trapani, 199 pp, with illus, $65, ISBN 0-19-511250-4, New York, NY, Oxford University Press, 2000.

Public Health Community Health, by Richard H. Grimm, Jr (Rypins’ Intensive Reviews), 148 pp, paper, $20, ISBN 0-397-51558-8, Philadelphia, Pa, Lippincott Williams & Wilkins, 2000. Dying for Growth: Global Inequality and the Health of the Poor, edited by Jim Yong Kim, Joyce V. Millen, Alec Irwin, and John Gershman, 584 pp, with illus, $49.95, ISBN 1-56751161-9, paper, $29.95, ISBN 1-56751-160-0, Monroe, Me, Common Courage Press, 2000. Health and Human Rights: A Reader, edited by Jonathan M. Mann, Sofia Gruskin, Michael A. Grodin, and George J. Annas, 505 pp, paper, $28, ISBN 0-415-92102-3, New York, NY, Routledge, 1999.

Reference EndNote v.4: The All-In-One Solution, by ISI ResearchSoft, one CD-ROM, for Windows, 445 pp, with illus, $269.95, Berkeley, Calif, ISI ResearchSoft, http://www.endnote.com, 2000.

Health Care Policy and Politics A to Z, by Julie Rovner (Congressional Quarterly), 244 pp, with illus, $55, ISBN 1-56802-437-1, Washington, DC, CQ Press, 2000.

Hormone Therapy and the Brain: A Clinical Perspective on the Role of Estrogen, by Victor W. Henderson, 112 pp, with illus, $58, ISBN 1-85070-078-8, New York, NY, Parthenon Publishing Group, 2000.

Healthcare Development Strategies in the Kingdom of Saudi Arabia, by Mohammed Hassan S. Mufti, 136 pp, with illus, ISBN 0-30646314-8, New York, NY, Kluwer Academic/ Plenum Publishers, 2000.

Nervous Control of the Eye, edited by Geoffrey Burnstock and Adam M. Sillito (The Autonomic Nervous System), 302 pp, with illus, $120, ISBN 90-5823-018-X, Newark, NJ, Harwood Academic Publishers, 2000.

ACSM’s Guidelines for Exercise Testing and Prescription, by American College of Sports Medicine, 6th ed, 368 pp, spiral-bound, $29.95, ISBN 0-683-30355-4, Philadelphia, Pa, Lippincott Williams & Wilkins, 2000.

New Media

Statistics

History

e-Healthcare: Harness the Power of Internet e-Commerce & e-Care, by Douglas E. Goldstein, 491 pp, CD-ROM, $79, ISBN 0-83421365-6, Frederick, Md, Aspen Publishers, 2000.

Adorn the Halls: History of the Art Collection at Thomas Jefferson University, by Julie S. Berkowitz, 725 pp, with illus, $79, ISBN 0-9674384-1-1, Philadelphia, Pa, Thomas Jefferson University, 1999.

Fuzzy Systems in Medicine, edited by Piotr S. Szczepaniak, Paulo J. G. Lisboa, and Janusz Kacprzyk (Studies in Fuzziness and Soft Computing), 698 pp, $151, ISBN 3-7908-1263-3, New York, NY, Springer-Verlag, 2000.

Statistics Applied to Clinical Trials, by Ton J. Cleophas, Aeilko H. Zwinderman, and Toine F. Cleophas, 97 pp, paper, $35, ISBN 0-79236184-9, Boston, Mass, Kluwer Academic Publishers, 2000.

Safety in Medicine, edited by Charles Vincent and Bas De Mol (NeTWork workshop, 1998), 268 pp, $99, ISBN 0-08-043656-0, New York, NY, Pergamon, 2000.

Bodies of Evidence: Medicine and the Politics of the English Inquest 1830-1926, by Ida A. Burney, 245 pp, $39.95, ISBN 0-80186240-X, Baltimore, Md, Johns Hopkins University Press, 2000. Gout: The Patrician Malady, by Roy Porter and G. S. Rousseau, 393 pp, with illus, paper, $16.95, ISBN 0-300-08274-6, New Haven, Conn, Yale University Press, 1998 (hardcover edition reviewed August 11, 1999).

Nutrition Nutrients in Food, by Elizabeth S. Hands, 315 pp, includes CD-ROM, spiral-bound, $48, ISBN 0-683-30705-3, Philadelphia, Pa, Lippincott Williams & Wilkins, 2000.

Obstetrics-Gynecology

Law

Obstetrics and Gynecology, by Elmar P. Sakala (Board Review Series), 2nd ed, 443 pp, soft cover, $26.95, ISBN 0-683-30743-6, Philadelphia, Pa, Lippincott Williams & Wilkins, 2000.

The Health Care Provider’s Guide to Facing the Malpractice Deposition, by Constance G. Uribe, 139 pp, paper, $39.95, ISBN 0-84932059-3, Boca Raton, Fla, CRC Press, 2000.

Obstetrics and Gynecology, by Marilynn C. Frederiksen (Rypins’ Intensive Reviews), 302 pp, paper, $21.95, ISBN 0-397-51557-X, Philadelphia, Pa, Lippincott Williams & Wilkins, 2000.

©2000 American Medical Association. All rights reserved.

Sports-Exercise

Surgery Current Perspectives of the Extracorporeal Circulation, edited by D. Baykut and A. Krian, 135 pp, with illus, paper, $49, ISBN 3-79851214-0, New York, NY, Springer-Verlag, 2000. Manual of Common Bedside Surgical Procedures, by the Halsted Residents of the Johns Hopkins Hospital, edited by Herbert Chen and Christopher J. Sonnenday, 2nd ed, 371 pp, with illus, spiral-bound, $25.95, ISBN 0-68330792-4, Philadelphia, Pa, Lippincott Williams & Wilkins, 2000.

Women’s Health Tobacco and Women’s Health, by Hannu Vierola, 324 pp, with illus, paper, 20.20 EUR, ISBN 951-884-236-1, Helsinki, Finland, Art House, [email protected], http://www.arthouse.fi, orders: http://www.a-kirjat.com, 1998.

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books, journals, new media

Books, Journals, New Media Section Editor: Harriet S. Meyer, MD ..... Cam- bridge, Mass: Harvard University Press; 1998:17-18. 2. Loewe R, reviewer. JAMA.

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