‘A searing, deeply humane collection of essays about medical practice that has all the makings of a modern classic’


Particular Reference to the Medical Profession,” in G. Teeling-



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Particular Reference to the Medical Profession,” in G. Teeling-
Smith and N. Wells, eds., 
Medicines for the Year 2000
(London:
Office of Health Economics, 1979).
190 Watson Bowes Jr. and V. L. Katz published a 1994 review of
studies of forceps deliveries, including a comparison with Ce-
sarean sections, entitled “Operative Vaginal Delivery,” in 
Cur-
rent Problems in Obstetrics, Gynecology, and Fertility
17 (1994): 86.
A 1979 Australian study, for example, compared 296 forceps de-
liveries with 101 Cesarean sections and 207 spontaneous vaginal
deliveries. The children did equally well, including on IQ and
motor tests at age five (W. G. McBride et al., “Method of Deliv-
ery and Developmental Outcome at Five Years of Age,” 
Med-
ical Journal of Australia
1, no. 8 [1979]: 301–4). A few studies
showed some practitioners could achieve better results with
forceps. A 1990 study, for example, compared 358 forceps deliv-
eries with 486 Cesarean sections at UCLA and found that,
while the infants had no differences in their Apgar scores or
rates of birth trauma, the mothers had fewer complications
and less blood loss with forceps (R. A. Bashore, W. H. Phillips
Jr., C. R. Brinkman III, “A Comparison of the Morbidity of
Midforceps and Cesarean Delivery,” 
American Journal of Obstet-
rics & Gynecology
162, no. 6 [1990]: 1428–34).
197 A definitive review of the benefit and risks of elective Cesarean
sections for pregnant mothers at full term was published in
March 2006 by the National Institutes of Health and is available
from their Web site, www.nih.gov. It is entitled “National Insti-
tutes of Health State-of-the-Science Conference Statement: Ce-
sarean Delivery on Maternal Request.” See also H. Minkoff
and F. A. Chervenak, “Elective Primary Cesarean Delivery,”
New England Journal of Medicine
348 (2003): 946–50.
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268
Notes on Sources
The Bell Curve
206 Information on bell curves in hernia repair is from data col-
lected for a Veterans Administration study: R. J. Fitzgibbons et
al., “Watchful Waiting vs. Repair of Inguinal Hernia in Mini-
mally Symptomatic Men,” 
JAMA
295 (2006): 285–92. Risk-
adjusted neonatal ICU outcomes are from the Vermont Oxford
Network Database (
Health Affairs
23 [2004]: 89). In vitro fertil-
ization center outcomes are available from the CDC at www
.cdc.gov/ART.
208 An intriguing examination of the U.S. government’s ill-fated
Death List is S. T. Mennemeyer, M. A. Morrisey, and L. Z.
Howard’s “Death and Reputation: How Consumers Acted
upon HCFA Mortality Information,” 
Inquiry
34 (1997): 117–28.
209 For more on the superior performance of LeRoy Matthews’s
CF treatment program in Cleveland, see W. J. Warwick, “Cystic
Fibrosis: Nature and Prognosis,” 
Minnesota Medicine
50 (1967):
1049–53; L. W. Matthews and C. F. Doershuk, “Management-
Comprehensive Treatment of Cystic Fibrosis,” 
Minnesota Medi-
cine
52 (1969): 1506–14; and American Thoracic Society, “The
Treatment of Cystic Fibrosis: A Statement by the Committee
on Therapy,” 
American Review of Respiratory Disease
97 (1968):
730–34.
211
No one has done more to tease apart the relative contributions
of genetics, sociodemographics, and differences in treatment
programs in cystic fibrosis than Michael S. Schecter, a pediatric
pulmonologist and CF expert at Hasbro Children’s Hospital,
Providence, Rhode Island. See in particular his article “Non-
Genetic Influences on CF Lung Disease: The Role of Socio-
demographic Characteristics, Environmental Exposures, and
Healthcare Interventions,” 
Pediatric Pulmonology
26 (2004):
82–85.
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Notes on Sources     269
For Performance
237 Data on the inadequacies of mammography screening in the
United States come from two articles: K. A. Phillips et al., “Fac-
tors Associated with Women’s Adherence to Mammography
Screening Guidelines,” 
Health Services Research
33 (1998): 29–53,
and K. Blanchard et al., “Mammographic Screening: Patterns
of Use and Estimated Impact on Breast Carcinoma Survival,”
Cancer
101 (2005): 495–507.
242 For more on the increasing longevity of much of the world’s
population and the resulting shift in patterns of disease, see the
World Health Organization’s 
The World Health Report 1999:
Making a Difference
(Geneva: World Health Organization, 1999),
and J. A. Salomon and C. J. L. Murray, “The Epidemiologic
Transition Revisited: Compositional Models for Causes of
Death by Age and Sex,” 
Population and Development Review
28
(2002): 205–28.
Afterword: Suggestions for Becoming a Positive
Deviant
251 That favorite essay of Paul Auster’s is “Gotham Handbook,” in
Collected Prose
(New York: Picador, 2003), and I owe to it not
only the first rule but the structure of this chapter—and an un-
derstanding of the importance of talking about the weather.
255 The study of forgotten surgical tools was published in the 
New
England Journal of Medicine
348 (2003): 229–35.
255 Lewis Thomas’s quoting of John Ziman is in his essay “On Soci-
eties as Organisms,” in 
Lives of a Cell
(New York: Penguin, 1974).
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