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.
In this revelatory memoir, Doctor Cynthia Li shares the truth about her disabling autoimmune illness, the limitations of Western medicine, and her hard-won lessons on healing—mind, body, and spirit. Li had it all: a successful career in medicine, a loving marriage, children on the horizon. But it all came crashing down when, after developing an autoimmune thyroid condition, mysterious symptoms began consuming her body. Test after test came back "within normal limits," baffling her doctors—and baffling herself. Housebound with two young children, Li began a solo odyssey from her living room couch to find a way to heal. Brave New Medicine details the physical and existential crisis that forces a young doctor to question her own medical training. She dives into the root causes of her illness, learning to unlock her body's innate intelligence and wholeness. Li relates her story with the insight of a scientist, and the humility and candor of a patient, exploring the emotional and spiritual shifts beyond the physical body. Millions of people worldwide are affected by autoimmune disease. While complex conditions like chronic fatigue syndrome (ME/CFS) are gaining attention, patients struggling with these mysterious ailments remain largely dismissed by their doctors, families, and friends. This is the harsh reality that doctor-turned-"difficult patient" Li faced firsthand. Drawing on cutting-edge science, ancient healing arts, and the power of intuition, this memoir offers support, validation, and a new perspective for doctors and patients alike. Through her story, you can find the wisdom and heart to start your own healing journey, too.
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