医疗
地平线系列:止痛药上瘾 (2020) 豆瓣
Horizon: Addicted to Painkillers? Britain’s Opioid Crisis
演员: Michael Mosley
其它标题: Horizon: Addicted to Painkillers? Britain’s Opioid Crisis / Addicted to Painkillers? Britain's Opioid Crisis
In America it’s an epidemic. Now new evidence raises concern about the UK’s use of prescription opioids. Michael Mosley goes on an immersive journey to ask what can be done about it.
The opioid epidemic has devastated America. But what’s the situation here? A new report from Public Health England raises serious concerns about Britain's own relationship with painkillers. Dr Michael Mosley embarks on an immersive journey to Britain’s opioid frontline and meets patients struggling with addiction and GPs fighting a constant battle to help those suffering from chronic pain. He also uncovers worrying evidence of people abusing over-the-counter opioids and discovers how easy it is to buy strong opioids online.
Nearly six million people in England and Wales were prescribed an opioid last year. Michael wants to uncover how and why we’re consuming twice the amount of opioids as twenty years ago, especially when the scientific evidence he encounters disturbingly suggests that for the majority of people taking them for chronic pain, these drugs mostly don’t even work. Though a vital tool in our doctors’ armoury to combat acute pain and in cancer and end-of-life care, the Public Health England report revealed that more than half a million people have been on opioids for more than three years.
Michael cautions that people taking these drugs should not suddenly stop taking them. Nevertheless, as he discovers, long term or high dose use does leave them exposed to greater risk of side effects including dependency, addiction and even accidental death by overdose.
As many as 28 million Britons endure chronic pain - and if we’re to kick what seems like a dangerous national opioid habit, Michael believes that the critical issue is deprescribing. Millions now require help coming off opioids and drug-free alternatives to them. For Michael this is nothing short of a challenge as important as the fight against cancer and heart disease.
So how much do people on the ground really know about these powerful painkillers, some of which, including fentanyl, can be many times stronger than heroin? On his travels, Michael meets Karen in Hastings who now believes her five years on increasingly strong opioids ‘turned her into a zombie’. But he also encounters Brenda in Salford who thinks the morphine she has taken for fifteen years to help with her excruciating back pain is the thing that makes her life just about bearable. And he spends time with Vicki whose 50+-a-day over-the-counter painkiller habit led to overdose and near death before she finally admitted her addiction and started detox.
2021年11月18日 看过
挺有意思的,止痛药只能用来应对急性疼痛,对于长期疼痛应该有可替代的方法而不是简单粗暴地加大剂量,但是最后的长期疼痛都是急性疼痛演变来的,即便是医生这样的专业人士也很难判断转折点在哪里……几个实验也做得很有意思,而且居然真的协助规范了止痛药在网上的销售渠道!但是最后说出alternative ways还是比直接开止痛药要开销大的时候还是感觉很无奈……
医疗 科普 英国
This is Going to Hurt 豆瓣
9.0 (34 个评分) 作者: Adam Kay Picador 2017 - 9
Welcome to 97-hour weeks. Welcome to life and death decisions. Welcome to a constant tsunami of bodily fluids. Welcome to earning less than the hospital parking meter. Wave goodbye to your friends and relationships. Welcome to the life of a junior doctor. Scribbled in secret after endless days, sleepless nights and missed weekends, comedian and former junior doctor Adam Kay’s This Is Going to Hurt provides a no-holds-barred account of his time on the NHS front line (with a foreword attempting to explain the National Health Service to a non-UK audience). Hilarious, horrifying and heartbreaking by turns, this is everything you wanted to know—and more than a few things you didn't—about life on and off the hospital ward. And yes, it may leave a scar.
2020年5月7日 已读
仔细想了想决定给个五星,虽然很多好笑的故事,但是内核其实很深刻,Doctors are human那一段真的让人内心很复杂,很理解作者最后说的虽然很怀念但不会再回去做医生了,希望医疗系统和病人都可以对医生温柔一点啊
医疗 纪实 英国
Being Mortal 豆瓣
9.0 (28 个评分) 作者: Atul Gawande Metropolitan Books 2014 - 10
In Being Mortal, bestselling author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its ending
Medicine has triumphed in modern times, transforming birth, injury, and infectious disease from harrowing to manageable. But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering.
Gawande, a practicing surgeon, addresses his profession’s ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified.
Full of eye-opening research and riveting storytelling, Being Mortal asserts that medicine can comfort and enhance our experience even to the end, providing not only a good life but also a good end.
2021年6月8日 已读
非常不错的生命教育和死亡教育,人一生中都会遇到却怯于谈论的老、病、死,对医疗系统的思考很值得一听,医疗不应该仅仅给人「生」的选择,更重要的也许是让人在生理和心理上平和地渡过老、病的痛苦,并且准备好平静地迎接不可避免的「死」,大多数人从在家死到在医院/机构死又回到在家死的大趋势很能说明问题
医疗 死亡 美国
药物简史 豆瓣
Taking the Medicine: A Short History of Medicine's Beautiful Idea, and our Difficulty Swallowing It
8.1 (13 个评分) 作者: [英]德劳因·伯奇(Druin Burch) 译者: 梁余音 中信出版集团·见识城邦 2019 - 5
深受医生、诗人、战士喜爱的鸦片怎么风靡世界6000年?
奎宁在英国怎么就成了禁用药,后来又怎么再次崛起的?
煤渣中提炼出来的染料如何带来了抗生素,改变整个医药行业?
用不起眼的柳树皮造出来的阿司匹林如何逆袭成为百药之王?
◎你吞下的每一粒药丸,背后都有一段精彩绝伦的传奇故事。
化学制药兴起之前,人们能够享用到的真正有用的药物其实只有罂粟、金鸡纳树皮、柳树皮等寥寥几种,即便到了20世纪初期,大多数医生治疗疾病采用的方法一般是砒霜、水银和泻药,偶尔加上不限量的咖啡和威士忌……真正改变药物历史的是化学家和生物学家,他们带来了抗生素,带来了更有针对性的施医用药的方法,也让我们看见药物、疾病、身体之间的关联。这本书是他们的故事。
◎与众不同的医学史读物,观点很颠覆,很有启发。
药物由前现代到现代的演变,不是传统医学史著作所讲述的英雄人物和伟大发现的历史,是我们用智慧与愚昧艰难抗争的历史。我们会看到,18/19世纪的医生深信自己的神圣和仁慈,怯于承认产褥热导致的大量产妇死亡是因为他们的手上带着细菌,从而大大推迟了消毒水的普及。这样的案例太多。我们在享受药物带来的好处的时候,需要感谢亚里士多德、培根、洛克这样的主张“理论需要用可靠的试验来验证”的哲学家,以及威廉·哈维、托马斯·西德纳姆、奥利弗·温德尔·霍姆斯、弗朗西斯·高尔顿这样的敢于怀疑传统并且不厌其烦进行医学统计分析的医生,他们最终建立了“循证医学”,因为在人类历史上大部分时期,医生害死的病人远比救活的病人多,医生治病太多凭借直觉和传统。
◎讲历史的手法很新奇,层次很丰富。
这是一本用药物串起来的医学历史,有很多有意思的趣味知识,从古巴比伦的鸦片、教皇的奎宁,到强大的德国制药工业、百药之王阿司匹林,每一种经典药物的诞生都有化学、生理学、生物学的厮杀、进步。这也是一本饱含思想的科技社会史,带你思考现代医药是怎么脱离无知,造福人类的,是人们如何用更可靠的统计方法进行试验,与不顾伦理追逐利润的制药工业进行抗争,一步步实现规范的药物监管,让生命的价值更好地被尊重的历史。
◎对我们实际生活中的求医问药大有帮助。
提供了很多关于药物的基本常识:时刻保持怀疑精神,用可靠的理性方法客观检验某种说法,这是我们求医问药的第一步;凡是能够起到药效的药物,都是因为其中包含的某种活性成分,不存在所谓的“偏方”“独家药方”“祖传秘方”;了解了药物的历史,就能正确理解抗生素,是人们依照化学规律制造出来的对疾病造成伤害同时也会对人体产生副作用的药品;放下对医生、医学的神圣迷信,再高明的专家也有骄傲自大的时候,普通人因为总是抱有太高的期待,也会有丧失理性的时刻……
◎《星期日电讯报》《金融时报》《星期日泰晤士报》《新科学家》等主流媒体好评推荐。
“伯奇带领我们走过一段令人惊叹的医药实践之旅。”“每一章都是一则犀利的短小寓言。”作者求学和执教于牛津大学医学院,曾在多家医院工作,医疗经验和教学经验都很丰富,文笔耿直,擅长用机智的方式将医学教科书和现实生活里有关医药的槽点一一拎出,讲清楚每一桩诡异的医学事情背后,都有深厚的错误传统和大众心态在作祟,并把医学史上各种怪诞的典故直言不讳地呈现出来,既让人发笑,又引人深思。
亚历山大大帝临终前说:我死在太多医生的帮助下。享年33岁。
普林尼记录了当时流行的墓志铭:就是那帮医生杀了我。
华盛顿死前最后一句话是:让我安静地去吧。此前他被灌了大量水银,还被放了2.5升血。
乔治·奥威尔去世前两年一直与一种新药链霉素奋战,他躺在病床上说:我觉得使用这种药物,就好像把船凿沉,来驱赶船上的老鼠。这种有效药物的副作用本来是可以避免的。
即便到了20世纪,医学教科书仍然充斥着自相矛盾的教导和未经检验的谬误传统,人类与疾病的抗争,同时也是与谬误的抗争。《药物简史》考察古巴比伦到当代6000年的一系列经典药物,每一种药物的背后,都是一段精彩的传奇故事。
奎宁与英国人——1651年,奎宁正式进入《罗马药典》,是药典中为数不多的有效药,风靡全欧洲,不过英国却是个例外。有人发烧,服用了奎宁之后,死掉了。英国人认为这是“天主教的阴谋”,这种药就成了非法药物。塔尔博特偷偷引进了这种药物,加上玫瑰叶、柠檬汁和混合各种原料的葡萄酒组成一种“神秘药方”。他的推销大为成功,查理二世重金聘请他为医师,并且赐给骑士爵位,并让他透露到底是什么药物这么有效。那医生回答:耶稣会士树皮(英国人对奎宁的称呼)。查理二世大为惊骇:这药早就已经明确禁止使用,为什么以前害人的药物,现在这么有效呢?
那医生回答:这种药的效果只有国王才配消受。
抗生素的革命——19世纪后期,化学家发现把从煤渣中提炼出来的染料涂在植物或动物组织上,染料会将纤维清晰地显现出来,并且顺着组织运动,进入各个器官。埃尔利希凭借这种方法弄清楚了血清的功能,里面具有某种“抗体”,像“魔法子弹”一样对病菌进行打击。细菌表面存在与人体细胞不一样的接收器,如果能让毒素进入这些地方,就能在不杀死正常细胞的情况下杀死细菌。化学家们造出了各种各样的“打靶”药物,这是抗生素时代的开端,这种思维方法也是“化学疗法”的开端。
这才开始了乙酰丙胺(退热冰)、乙酰水杨酸(阿司匹林)、二醋吗啡(海洛因)、百浪多息、盘尼西林、沙利度胺(反应停)等一系列经典药物的传奇故事,以及赫希斯特、默克、法本、拜耳等庞大的制药公司的崛起与药物生产和监管背后药效评估方法的革新和法律、伦理博弈。
--------见识城邦简史系列:《人类简史》 《世界简史》 《生命简史》 《社交媒体简史》 《时间简史》 《药物简史》 《时间哲学简史》 《纳粹德国简史》 《犯罪与惩罚简史》 《婚姻简史》 《隐私简史》 《语言简史》 《一战简史》 《二战简史》 《地图简史》 《上瘾五百年》 《舌尖上的历史》。
2022年5月2日 已读
这个作者相当会写了,把这个严肃且相当专业的话题说得深入浅出,并且不乏英式的dry humour(真的一看就是英国人写的……这个幽默感的笑到捂脸又觉得好像并不该笑oh the irony)……实际上标题的中译还是有些偏差,相比于“简史”,这本更像是对一些奇闻逸事及其背后的“哲理”是讨论和反思……读了这本书才意识到,人类在医疗方面,想当然地以形补形、动辄放血催吐开泻药的历史,远比科学实验和统计学支撑的循证医学悠久得多,能够活在这个时代已经是单抽SSR式的幸运,然而甚至直到现在还有大把医生宁愿相信自己的“直觉和经验”而不愿意相信文献数据,事实上人类对身体和医药了解的部分远小于尚未探索的部分,却又抱着自认为无所不知的自信,多少鲜活的生命为这种傲慢付出了代价
医疗 非虚构
This is Going to Hurt 豆瓣
作者: Adam Kay Picador 2018 - 4
2022年9月25日 已读
一个重读,之前听的有声书,不懂的医疗单词就跳过了,没想到看纸质书居然是这么漫长的过程……但还是,挺喜欢的,是一本充满黑色幽默的书。实话讲看了剧之后回来看感觉这本书里的处理已经看起来没那么黑暗了,甚至那个风扇梗我真的笑了好久,但还是很难改变它的底色,让一个人(尤其是需要时刻保持高度警惕的人)一周工作接近100个小时是不人道且不明智的,居然还有人去质疑他的工作动机更让人咋舌,至少这本书真的让人开始关注医疗系统了是件好事
医疗 非虚构
Twas The Nightshift Before Christmas 豆瓣
6.6 (5 个评分) 作者: Adam Kay Picador 2019 - 10
From the author of record-breaking million copy bestseller and 2018 Book of the Year, This is Going to Hurt
Christmas is coming, the goose is getting fat . . . but 1.4 million NHS workers are heading off to work. In this perfect present for anyone who has ever set foot in a hospital, Adam Kay delves back into his diaries for a hilarious and sometimes heart-breaking peek behind the blue curtain at Christmastime.
Twas the Nightshift Before Christmas is a love letter to all those who spend their festive season on the front line, removing babies and baubles from the various places they get stuck, at the most wonderful time of the year.
2022年10月7日 已读
看完就知道这些为什么没进This Is Going to Hurt了……有几篇还是很有意思的(比如终止妊娠手术那个……真的印象很深,也得谢谢他先给了trigger warning)但总体比较repetitive
医疗