100 books like Impure Science

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 big mistake in much radical analysis is to characterize problems in dualistic terms that externalize responsibility from Africa (Rodney, of course, is wide open to that critique). Thus, colonialism is not just irredeemably bad but simple to identify and directly related to white skin. The end of formal colonialism provided new targets in sometimes caricature form: black-skin-white-mask neocolonialism and neoliberalism, notably. Such things undoubtedly exist. However, Kenworthy’s brilliant, gob-smacking analysis of the unintended consequences of life-saving technologies reveals levels of complexity and complicity that belie easy dualisms. How does something that promises liberation from mass suffering and death (anti-retroviral drugs) become a machine to entrench corrupt elites and opportunistic NGOs, to sell cheap textiles in America, and to exploit poor women’s unremunerated care work? Read, weep, and lose your illusions about corporate social responsibility.

Craig Timberg was a reporting colleague when I was a correspondent in South Africa, and became a friend, one with whom I often passionately disagreed.

That’s why I suggest this book: it offers a very different perspective than mine. Craig and his co-author Halperin, an epidemiologist whose work had a big influence on Craig’s thinking, draw a clear through-line for how Western powers created the sparks of the African epidemic then vigorously fanned them.

A significant chunk of the book focuses on solutions (Halperin is a vociferous champion of male circumcision as an intervention to drive down the spread of the virus). It’s a brisk read that makes complex epidemiological dynamics accessible.

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.

This book is exactly what the title promises, and a great place to start.

It’s written by a Swazi health economist who has worked on HIV in Africa for more than 30 years; I have learned a lot from Whiteside and his research over my years of covering this issue. The book looks at the biology and epidemiology of HIV, and also at all the ways it shapes societies.

Whiteside takes complicated concepts of population dynamics, sexual networking, AIDS, and geopolitical security and explains them briskly, clearly, concisely. His focus is the global AIDS epidemic, but his own work and the book are both deeply rooted in Africa.