I first learned of Illich's anti-industrialist, slightly Marxist perspective, as an A-level sociology student studying education. Ten years later, being a disillusioned health professional in the NHS, I was inexorably drawn to this book when searching for works on medical sociology. Although the book was written over twenty years ago the general theme remains relevant (perhaps even more so with increased spending on health) in the first decade of the twentieth century. The central idea of the book is 'iatrogenesis' or, the creation of ill health through medical intervention. This is either directly in the form of unnecessary surgery gone wrong or the latent undermining of the population's acceptance of responsibility for their own health and healing. Both the medical profession and the public are equally to blame in this process. While it is hard to disagree with many of the ideas proposed it is the style of the prose which is the most challenging aspect of the work. One assumes that Illich has never heard of the practise of circumlocution and many passages are extremely tortuous and convoluted, making it pretty hard going to get to the end; especially when the main ideas are to be found in the first three chapters. On the whole I would say the challenge is worth undertaking particularly if you like to explore radical perspectives on issues central to life.