Slow Medicine

"Wonderful... Physicans would do well to learn this most important lesson about caring for patients." —The New York Times Book Review Over the years that Victoria Sweet has been a physician, “healthcare” has replaced medicine, “providers” look at their laptops more than at their patients, and costs keep soaring, all in the ruthless pursuit of efficiency. Yet the remedy that economists and policy makers continue to miss is also miraculously simple. Good medicine takes more than amazing technology; it takes time—time to respond to bodies as well as data, time to arrive at the right diagnosis and the right treatment. Sweet knows this because she has learned and lived it over the course of her remarkable career. Here she relates unforgettable stories of the teachers, doctors, nurses, and patients through whom she discovered the practice of Slow Medicine, in which she has been both pioneer and inspiration. Medicine, she helps us to see, is a craft and an art as well as a science. It is relational, personal, even spiritual. To do it well requires a hard-won wisdom that no algorithm can replace—that brings together “fast” and “slow” in a truly effective, efficient, sustainable, and humane way of healing.

Victoria Sweet's new book, SLOW MEDICINE, is on sale now! For readers of Paul Kalanithi’s When Breath Becomes Air, a medical “page-turner” that traces one doctor’s “remarkable journey to the essence of medicine” (The San Francisco Chronicle). San Francisco’s Laguna Honda Hospital is the last almshouse in the country, a descendant of the Hôtel-Dieu (God’s hotel) that cared for the sick in the Middle Ages. Ballet dancers and rock musicians, professors and thieves—“anyone who had fallen, or, often, leapt, onto hard times” and needed extended medical care—ended up here. So did Victoria Sweet, who came for two months and stayed for twenty years. Laguna Honda, relatively low-tech but human-paced, gave Sweet the opportunity to practice a kind of attentive medicine that has almost vanished. Gradually, the place transformed the way she understood her work. Alongside the modern view of the body as a machine to be fixed, her extraordinary patients evoked an older idea, of the body as a garden to be tended. God’s Hotel tells their story and the story of the hospital itself, which, as efficiency experts, politicians, and architects descended, determined to turn it into a modern “health care facility,” revealed its own surprising truths about the essence, cost, and value of caring for the body and the soul.

“[A] geriatrician’s guide to stepping in as escort, caregiver and advocate for your parent’s final journey . . . comforting in its compassion and detail.” —St. Petersburg Times Geriatrician Dennis McCullough has spent his life helping families to cope with their parents’ aging and eventual final passage, experiences he faced with his own mother. In this comforting and much-needed book, he recommends a new approach, which he terms “Slow Medicine.” Shaped by common sense and kindness, grounded in traditional medicine yet receptive to alternative therapies, Slow Medicine advocates for careful anticipatory “attending” to an elder’s changing needs rather than waiting for crises that force acute medical interventions—an approach that improves the quality of elders’ extended late lives without bankrupting their families financially or emotionally. As Dr. McCullough argues, we need to learn that time and kindness are sometimes more important and humane at these late stages than state-of-the-art medical interventions. My Mother, Your Mother will help you learn how to: Form an early and strong partnership with your parents and siblings Strategize on connecting with doctors and other care providers Navigate medical crises Create a committed Advocacy Team Reach out with greater empathy and awareness Face the end-of-life time with confidence and skill Although taking care of those who have always cared for us is not an easily navigated time of life, My Mother, Your Mother will help you and your family to prepare for this complex journey. This is not a plan for getting ready to die; it is a plan for understanding, for caring, and for helping those you love live well during their final years. And the time to start is now.

A nationally recognized expert describes seven widespread assumptions that encourage excessive, ineffective, and sometimes harmful medical care—for readers of Overdiagnosed and Malcolm Gladwell You might think the biggest problem in medical care is that it costs too much. Or that health insurance is too expensive, too uneven, too complicated—and gives you too many forms to fill out. But the central problem is that too much medical care has too little value. Dr. H. Gilbert Welch is worried about too much medical care. He doesn’t deny that some people get too little medical care—rather that the conventional concern about “too little” needs to be balanced with a concern about “too much”: too many people being made to worry about diseases they don’t have and are at only average risk to get; too many people being tested and exposed to the harmful effects of the testing process; too many people being subjected to treatments they don’t need or can’t benefit from. The American public has been sold the idea that seeking medical care is one of the most important steps to maintain wellness. Surprisingly, medical care is not, in fact, well correlated with good health. More medicine does not equal more health; in reality the opposite may be true. In Less Medicine, More Health, Dr. Welch pushes against established wisdom and suggests that medical care can be too aggressive. Drawing on his twenty-five years of medical practice and research, he notes that while economics and lawyers contribute to the excesses of American medicine, the problem is essentially created when the general public clings to these powerful assumptions about the value of tests and treatments—a number of which are just plain wrong. By telling fascinating (and occasionally amusing) stories backed by reliable data, Dr. Welch challenges patients and the health-care establishment to rethink some very fundamental practices. His provocative prescriptions hold the potential to save money and, more important, improve health outcomes for us all.

"Wonderful... Physicans would do well to learn this most important lesson about caring for patients." —The New York Times Book Review Over the years that Victoria Sweet has been a physician, “healthcare” has replaced medicine, “providers” look at their laptops more than at their patients, and costs keep soaring, all in the ruthless pursuit of efficiency. Yet the remedy that economists and policy makers continue to miss is also miraculously simple. Good medicine takes more than amazing technology; it takes time—time to respond to bodies as well as data, time to arrive at the right diagnosis and the right treatment. Sweet knows this because she has learned and lived it over the course of her remarkable career. Here she relates unforgettable stories of the teachers, doctors, nurses, and patients through whom she discovered the practice of Slow Medicine, in which she has been both pioneer and inspiration. Medicine, she helps us to see, is a craft and an art as well as a science. It is relational, personal, even spiritual. To do it well requires a hard-won wisdom that no algorithm can replace—that brings together “fast” and “slow” in a truly effective, efficient, sustainable, and humane way of healing.

DIVExplores issue of how we should think about postmodern bioethics and suggests that many of the questions that bioethicists pose as problematic in postmodernity are, in fact, reactions to Wittgensteinian thought-- yet bioethicists as a rule are unfamiliar/div

“Dr. Michael Finkelstein masterfully guides us through the 77 questions that connect the dots of our lives.” — Dr. Mehmet Oz, Vice Chair and Professor of Surgery, New York-Presbyterian Columbia “Everyone should read Slow Medicine.... Dr. Finkelstein is a visionary practitioner, with decades of experience combining a scientist’s perspective with common sense and wisdom. Slow Medicine represents a superbly insightful advancement in the literature of Integrative Health. It is important, fun to read, and potentially life changing.” — Andrew Weil, MD “Living a life of unthinking habit can lead to unhealthy outcomes, emotionally and spiritually as well as physically...Finkelstein’s queries reflect an approach that may start with one’s physical habits...but then go much deeper. Answering [them] may lead the way to a healthier, more aware life.” — Energy Times

Finalist for the Pulitzer Prize in General Nonfiction A New York Times Bestseller Longlisted for the Andrew Carnegie Medal for Excellence in Nonfiction Winner of the WSU AOS Bonner Book Award Winner of the 2022 At Home With Growing Older Impact Award As revelatory as Atul Gawande's Being Mortal, physician and award-winning author Louise Aronson's Elderhood is an essential, empathetic look at a vital but often disparaged stage of life. For more than 5,000 years, "old" has been defined as beginning between the ages of 60 and 70. That means most people alive today will spend more years in elderhood than in childhood, and many will be elders for 40 years or more. Yet at the very moment that humans are living longer than ever before, we've made old age into a disease, a condition to be dreaded, denigrated, neglected, and denied. Reminiscent of Oliver Sacks, noted Harvard-trained geriatrician Louise Aronson uses stories from her quarter century of caring for patients, and draws from history, science, literature, popular culture, and her own life to weave a vision of old age that's neither nightmare nor utopian fantasy--a vision full of joy, wonder, frustration, outrage, and hope about aging, medicine, and humanity itself. Elderhood is for anyone who is, in the author's own words, "an aging, i.e., still-breathing human being."

A contemporary exploration of death and dying by a young Duke Fellow who investigates the hows, whys, wheres, and whens of modern death and their cultural significance.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.