Breakthrough!: How the 10 Greatest Discoveries in Medicine Saved Millions and Changed Our View of the World (FT Press Science) [Kindle Edition]

This is a strong book and could have been a great one.

The basic idea is to outline how the ten greatest medical breakthroughs came about and the impact each of them had on humanity. Queijo is a fine writer and has a good eye for just how much detail he can include without losing the attention of non-scientists. In fact, I think this book can be read by people as young as their early teenage years.

Queijo has kept the book just about as jargon free as he can, and he has a great ear for the facts you think you know but don't. As an example, everyone knows how Joseph Lister, returning from vacation, discovered a mold in a dirty petri dish that killed the surrounding germs. That mold was penicillin.

However, what you don't know is that there are many different types of penicillin, and only one has the magic anti-baterial properties. You also don't know that there was a particular and improbable temperature change required for the penicillin to be effective at all. Finally, you don't know that there was no penicillin spores of the effective type anywhere on the floor of Lister's lab, so how did it get there? Queijo knows it all and he tells the story well.

He also knows why inventor's discovered effective anesthetic agents a half century before they were deployed, and why no one thought it was worth following up. Or that Gregor Mendel went to his deathbed knowing the importance of his genetic experiments, but was unable to convince anyone else of same.

These stories are all important and told with a riveting pace that reminds one of one of the finer whodunits.

Unfortunately, in the last chapter, he abandons all objectivity and names 'alternative medicine' as the tenth breakthrough, largely on the high rate of current usage by the public and the combination of several different alternative medicines into one category. Try as he might, he is not going to convince me that chiropractic techniques and homeopathic medicines are similar enough to be lumped into the same category. And it is interesting how he goes from compelling personal stories and brief statistics to prove his points with the first 9 breakthroughs, to long numerical tables showing public consumption of many different alternative medicines with the tenth.

To me this sounded like listing private label groceries as one of the most important breakthroughs in food because so many people prefer store-brands. Not very convincing.

He does wrap the book up with four lessons to take away from the history, and that is written well. Still, I was so excited about this book until I hit the final 'breakthrough.' I'll still recommend it to a few people, but fewer than I would have. As with so many recent books, the hand of a first rate editor could have really improved the product.

The author describes what he believes are the 10 greatest discoveries in medicine that have saved millions, etc. 9 of them are uncontroversial discoveries that have been on other top-10 lists, but his 10th choice is one that no other list of top discoveries has ever included. He realizes that, and even admits in his introduction that a former editor of The New England Journal of Medicine refused to review his book because there is no such thing as alternative medicine, only treatments that work and treatments that don't. But he "respectfully disagrees."

Hippocrates' discovery that disease had natural causes, sanitation, germ theory, anesthesia, X-rays, vaccines, antibiotics, genetics, and treatments for mental disorders are all worthy candidates for the list. But Queijo ludicrously lists the "rediscovery of alternative medicine" as the tenth "great discovery." He presents no evidence (because there is no evidence) that alternative medicine has "saved millions" or that it has saved anyone. He doesn't realize that alternative medicine represents a betrayal of exactly the kind of rigorous scientific thinking and testing that led to all the other discoveries. His list of ten breakthroughs is actually a list of 9 breakthroughs and one breakdown.

He tells compelling human-interest stories about the discoveries. The complexities, the mis-steps, the near-misses, and the ups and downs make fascinating reading. He offers fascinating tidbits of historical information. He tells how, in the early days after the discovery of x-rays, Thomas Edison received a request to "Please send me one pound of X-rays and bill as soon as possible."

Most of the book is entertaining and informative, but in the chapter on alternative medicine, Queijo loses it entirely. He seems to think that modern medicine has become so fixated on diseases and technology that alternative medicine had to rediscover that diseases occur in people. He criticizes the reductionism of the scientific approach, but offers no evidence that a non-reductionist approach has ever resulted in discoveries or provided better patient outcomes. He sees the struggles between scientific medicine and alternative medicine as politically motivated turf wars rather than as efforts to establish the truth.

He accepts homeopathy uncritically and seems to think it is supported by science. He likes the idea of homeopathy because it "shares some underlying values seen in ancient traditional medicines" such as vitalistic energy concepts, detailed interviews to inquire into every detail of the patient's life, stressing the healer-patient relationship, and deriving many of its remedies from natural products.

He says, "Alternative medicine offered something Western medicine had too often abandoned: the view that every patient was an individual, that natural treatments were sometimes better than dramatic surgery and dangerous drugs; and that the essence of medicine begins with a caring relationship between healer and patient."

This is a straw man argument that badly mischaracterizes mainstream medicine, and it fails to show that alternative medicine has any advantage over scientific medicine practiced with judgment and empathy. He even goes as far as to accuse the stethoscope of being a nefarious device that distances practitioners from patients! He calls its invention "a dark omen for the terrible turn Western medicine was about to take." Now, really!

Much of this book is an eloquent paean to the value of science. Unfortunately, it abandons science in its discussion of alternative medicine. It deteriorates into apologetics for belief-based medicine based on misunderstandings and opinions rather than on any evidence. Alternative medicine represents a breakdown of the process that led to the real breakthroughs.

If you read this book, I recommend skipping chapter 10.

This book provides an overview of the most important developments in the history of medical science. Queijo is a journalist with a longstanding interest in medicine. In this book, he selects 10 developments in medical history, describes how they came about and details their impact on public health. The developments Queijo chose for this project include Hippocrates and his approach to scientific medicine, sanitation, germ theory, anesthesia, X-rays, vaccines, antibiotics, genetics, psychoactive medications, and alternative health care. In each chapter, Queijo provides a brief description of the historical context in which the development or discovery was made, often including case histories, then he identifies a series of "milestones", illustrating that these historic developments were not instantaneous discoveries, but rather long, often vitriolic processes, in which a series of crucial clues had to be uncovered, discussed, and further researched before being accepted as scientific truths or proper practices. End material includes a listing of the milestones and a list of references for further reading.

I found this book quite interesting as well as informative. Queijo's descriptions of key medical discoveries, while brief, include background details that aren't as well known as the popular myths that have grown up around such stories as Fleming's accidental discovery of penicillin. What makes Queijo's accounts unique is that he stresses the long processes of discovery, and he emphasizes throughout the book that when evidence necessitating a paradigm shift is discovered, acceptance of the new ideas is not immediate, but rather takes many years and repeated efforts on the part of the researchers. Current practitioners may be extremely skeptical, and may never accept new approaches to old problems, despite the overwhelming evidence.

Although the book is quite well-written, Queijo's choice of the last two topics, psychoactive medicines and alternative health care seem a bit idiosyncratic and out of balance with the rest of the book. These topics are certainly important, but it's hard to see them as having the same magnitude of effects as the previous topics. Perhaps because these developments are still under way, their full impact is not yet apparent. If I were to enumerate my own choices of the 10 most important developments for medicine and public health, I would want to include the application of statistics and double-blind trials somewhere on the list, a topic that might subsume both psychoactive medicines and alternative health care. In any case, the book provides an informative and critical overview of medical history and the ethics of medical research.