Books like Impure Science — picked by fans

Every book by Annemarie Mol is good but The Logic of Care is simply the best book on what medicine should be. It is short, deceptively simple but leaves no hiding places. Everyone will be able to understand it in the same way from a teenager up through a Professor of Medicine to a Minister for Health but don’t expect any Ministers to admit to reading it any time soon. Mol outlines a relationship-based rather than technology-based medicine. How do we ensure medical techniques help us to live the lives we want to live rather than force us to live lives that suit the companies that make the technologies want us to live? How do we care for people rather than service them?

Medicine loves stories about heroic men who made breakthroughs that have saved lives and given us the life expectancies we have today. It has never celebrated women and yet it was a woman, Josephine Baker, who in two decades starting in 1908, by focusing on antenatal and postnatal care, laid a basis for saving lives that has given us the life expectancies we have today. She did so against fierce opposition from doctors who argued that creating conditions that make infants and children healthy would be bad for medical business. Now that life expectancies are falling, and were falling before Covid, we desperately need to recover Baker and her insights. Her book written in 1939 gives clear hints of how unimpressed she would likely be with today’s medical business.

Modern medicine has dramatically extended life expectancies. But as our life spans extend, our fear of death grows. As our hope of living a long life and seeing our children survive grew, we became more rather than less anxious about losing out. We might have expected the opposite. Aries vividly illustrates how people viewed death as a part of life before the nineteenth century and how they reconciled themselves to it. He picks out 1886 as the point where Tolstoy in The Death of Ivan Illych recognized that medical advances were creating anxiety rather than hope. This book may make you less fearful of death. It will ask you whether you can now achieve serenity half as well as those before us did and whether medicine is bad for our sanity? 

Most of us figure doing evil, even if good results, is not ethical but without this, there would be no medicine. Martin Pernick covers the discovery of anesthesia and the ethical dilemmas this new ability to save lives by poisoning people posed. Anesthesia is a technique and techniques are amoral. How do we ensure they enhance rather than diminish us? How do we avoid seduction into a sleep during which we can be cosmetically enhanced? Is there a limit to how many drugs we give children to manage their behaviour – just because we can? Treating and stopping are not the same as not treating. Pernick doesn’t tell us how to manage this calculus, but he makes us aware modern life involves more of a calculus than we might have thought.   

Emily Martin’s work was some of the first things I read when I wanted to understand how we understand medicine.

There’s such a gap between the health information we’re given and what we actually believe and Martin really covers how Americans have understood the concept of immunity and how we’re influenced by popular culture and the media.

This book is absolutely crucial for understanding both how we look at immunity and understanding how doctors are not free of bias. 

This collection of previously published essays by Charles Rosenberg elaborates many of his ideas about how people make meaning out of epidemics, including his famous theory that epidemics are understood in a dramatic tripartite structure (see “What Is an Epidemic? AIDS in Historical Perspective”). Rosenberg shows not only how the history of medicine illuminates larger themes, but why it matters, both to those of us interested in history and those interested in medical science itself. 

A few years ago, I had the chance to write about Allan Gurganus for Harper’s magazine. That gave me a reason to read his entire oeuvre. There’s a lot of great stuff in there, but Plays Well With Others is my favorite. Published in 1997, it was the eagerly awaited follow-up to Oldest Living Confederate Widow Tells All, Gurganus’s smash hit debut, which had come out in 1989. That book sold several million copies and was adapted into a TV miniseries as well as a Broadway show.

Unfortunately, Plays Well could not escape the long shadow cast by Widow. But I am here to tell you that this story of a queer friend-group weathering the worst of the AIDS crisis in 1980s New York City is a sui generis work of genius: a sexually graphic, laugh-out-loud funny, emotionally devastating tour-de-force, as beautiful and bonkers as it is… show more.

This is the first book I read about sex tourism, which is a growing part of the market for sex work in developing countries. 

This book focuses on the men who provide services to men who are travelling to the Dominican Republic to engage with sex workers. Most of the men in this book identify as “straight” and have to navigate their personal identity and relationships while earning a living providing this service to other men.

I also really like the way this book discusses the health risks and how sex workers use various strategies to minimize the risk to themselves and their partners in an occupation that places them in the cross-hairs of an international market for sex tourism.

I’m going to say right off the top that this book is not well written: it’s turgid and florid and hard to follow. But it’s also recent, unlike most of the books on my list, and it’s the first comprehensive accounting of PEPFAR, the extraordinary US intervention into the African pandemic.

It’s impossible to understand the huge shift in the dynamic of the pandemic without understanding how massively George Bush’s decision to support HIV treatment in Africa changed – well, everything – and Bass is the first writer to try to really dig into that story.

I was involved in the HIV epidemic from the very beginning as President of the Hemophilia Association of New York.

The behind-the-scenes information that Dr. Fauci provides helped inform me and remind me of what we – and the world – went through. During the COVID epidemic, Dr. Fauci had to manage the crazy political system more than he ever had to, and he is very frank about what he experienced.

The book and its details made me grateful for his lifetime of wonderful work.