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  • The End of Medicine: How Silicon Valley (and Naked Mice) will Reboot your Doctor.
  • November 2006.

Books of the Week. What if I make poor choices about my medical care? Bad decisions can be detrimental over the long haul in ways that aren't immediately obvious.

The End of Medicine

Finally, a democratized medical system can make expert advice harder to come by. Systems that have a lot of choice tend towards a bimodal distribution, with poorer people forced to shoulder the burden of decision-making themselves without access to good support, while richer people buy advice from experts. Three, doctors aren't even sure scanning will be helpful. Routine whole-body MRIs can turn up scary things like brain tumors that, even if untreated, would never have affected the patient in their lifetime. The closest thing the medical industry has today to routine scanning is a mammogram, and doctors are still debating their effectiveness.

If Kessler has answers to these objections, his surface treatment of the subject and lack of organization hide them.

The book is a long series of meandering anecdotes presented in chronological order. Kessler spent a lot of his search flailing about and trying to figure out where to go in his search for computer-like increases in scale. We get to follow him down every abortive side trip. He begins the book by trying to fire his doctor and perform his own cholesterol tests, genetic tests, and more.

Then he begins investigating medical scanning, only to wander back to performing his own medical tests. It takes him until about page 70 to really get going, and once he does, he alternates between under-explained technical details and more anecdotes. The whole book is an object lesson in the old science saw that the plural of anecdote is not data. Moreover, the book's entire flow is choppy.

The average chapter is five pages long, with several two- and three-page chapters. Kessler makes no attempt to impose an overarching narrative flow. It's chaotic and dizzying, and in the end is like listening to a Chihuahua who's found the sugar stash. That's my objection to the writing's large-scale organization.

Nanotechnology and "The End of Medicine" - Andy Kessler

On the small scale, the writing is still sub-par. The text is peppered with sentence fragments, comma splices, and tense shifts.

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On several occasions I had to read and re-read sentences to understand what was being said. So why is Andy Kessler—the man who told you outrageous stories of Wall Street analysts gone bad in Wall Street Meat and tales from inside a hedge fund in Running Money —poking around medicine for the next big wave of technology?

It's because he smells change coming. Heart attacks, strokes, and cancer are a huge chunk of medical spending, yet there's surprisingly little effort to detect disease before it's life threatening.

The End of Medicine: How Silicon Valley (and Naked Mice) Will Reboot Your Doctor by Andy Kessler

How lame is that—especially since the technology exists today to create computer-generated maps of your heart and colon? Because it's too expensive—for now. But Silicon Valley has turned computing, telecom, finance, music, and media upside down by taking expensive new technologies and making them ridiculously cheap. Join Kessler's bizarre search for the next big breakthrough as he tries to keep from passing out while following cardiologists around, cracks jokes while reading mammograms, and watches twitching mice get injected with radioactive probes.

Looking for a breakthrough, Kessler even selflessly pokes, scans, and prods himself. CT scans of your heart will identify problems before you have a heart attack or stroke; a nanochip will search your blood for cancer cells--five years before they grow uncontrollably and kill you; and baby boomers can breathe a little easier because it's all starting to happen now. Your doctor can't be certain what's going on inside your body, but technology will. Embedding the knowledge of doctors in silicon will bring a breakout technology to health care, and we will soon see an end of medicine as we know it.


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