Random Acts of Medicine

We are used to thinking that as long as we eat healthily, wear seatbelts, quit smoking, and take our medicine on time and in the right dose, we can control our own health; doctors, too, often assume that prescribing drugs, performing surgery, and ordering tests are all deliberate acts grounded in scientific research and statistical data. But medicine in reality is often chaotic, complex, and full of uncertainty: a chance encounter in a waiting room, a sudden traffic jam, or whether a doctor is out of town can all imperceptibly change the outcome of diagnosis and treatment and the course of life and death. The authors, Anupam Jena, a professor and physician at Harvard Medical School who also trained in economics, and Christopher Worsham, a Harvard researcher and pulmonary and critical care physician at Massachusetts General Hospital, use the method of the "natural experiment," treating chance events in real life as natural control groups and using real-world data to pursue seemingly odd yet life-and-death questions: Why are children born in summer more likely to be diagnosed with attention deficit hyperactivity disorder? Do marathons help or harm the health of nearby residents? When cardiologists are all out of town, are emergency patients actually luckier? Can a surgeon's birthday affect his decision to operate? Can the political leanings of a hospital's attending physicians change patients' treatment plans? The book links medical common sense and tools for medical decision-making through case after case, revealing the hidden forces that shape health while offering judgment methods ordinary patients can use; it is a work of medical popular science that balances scientific, humanistic, and clinical perspectives.