In the late 1980s, a promising new treatment for breast cancer emerged: high-dose chemotherapy with autologous bone marrow transplantation or HDC/ABMT. By the 1990s, it had burst upon the oncology scene and disseminated rapidly before having been carefully evaluated. By the time published studies showed that the procedure was ineffective, more than 30,000 women had received the treatment, shortening their lives and adding to their suffering. This book tells of the rise and demise of HDC/ABMT for metastatic and early stage breast cancer, and fully explores the story's implications, which go well beyond the immediate procedure, and beyond breast cancer, to how we in the United States evaluate other medical procedures, especially life-saving ones. It details how the factors that drove clinical use--patient demand, physician enthusiasm, media reporting, litigation, economic exploitation, and legislative and administrative mandates--converged to propel the procedure forward despite a lack of proven clinical effectiveness. It also analyzes the limited effect of technology assessments before randomized clinical trials evaluated decisively the procedure and the ramifications of this system on healthcare today. Sections of the book consider the initial conditions surrounding the emergence of the new breast cancer treatment, the drivers of clinical use, and the struggle for evidence-based medicine. A concluding section considers the significance of the story for our healthcare system.

A bright young comic talent presents 18 bitterly funny--and frighteningly universal--tales of rejection, humiliation, and misfortune.

This text exposes the cause of the health care crisis and proposes an alternative to make care affordable and available to all. It shows how the quest for perfection is the core of the crisis, and suggests a medicine that bows to the limits of human nature and gives priority to meeting basic needs.

Robbie Castleman believes reclaiming purity in relationships is a journey toward holiness. In sprightly, straight-for-the-target prose, she shows how unmarried Christians can wait until marriage without turning into prudes or wallflowers.

Ranging widely over human history and culture, from ancient Greece to the current global economic downturn, Scruton makes a counterintuitive yet persuasive case that optimists and idealists -- with their ignorance about the truths of human nature and human society, and their naive hopes about what can be changed -- have wrought havoc for centuries. Scruton's argument is nuanced, however, and his preference for pessimism is not a dark view of human nature; rather his is a 'hopeful pessimism' which urges that instead of utopian efforts to reform human society or human nature, we focus on the only reform that we can truly master -- the improvement of ourselves through the cultivation of our better instincts. Written in Scruton's trademark style-- erudite, sweeping in scope across centuries and cultures, and unafraid to offend-- this book is sure to intrigue and provoke readers concerned with the state of Western culture, the nature of human beings, and the question of whether social progress is truly possible.