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There’s a running joke among radiologists: finding a tumor in a mammogram is akin to finding a snowball in a blizzard. A bit of medical gallows humor, this simile illustrates the difficulties of finding signals (the snowball) against a background of noise (the blizzard). Doctors are faced with similar difficulties every day when sifting through piles of data from blood tests to X-rays to endless lists of patient symptoms.
Diagnoses are often just educated guesses, and prognoses less certain still. There is a significant amount of uncertainty in the daily practice of medicine, resulting in confusion and potentially deadly complications. Dr. Steven Hatch argues that instead of ignoring this uncertainty, we should embrace it. By digging deeply into a number of rancorous controversies, from breast cancer screening to blood pressure management, Hatch shows us how medicine can fail—sometimes spectacularly—when patients and doctors alike place too much faith in modern medical technology. The key to good health might lie in the ability to recognize the hype created by so many medical reports, sense when to push a physician for more testing, or resist a physician’s enthusiasm when unnecessary tests or treatments are being offered.
Both humbling and empowering, Snowball in a Blizzard lays bare the inescapable murkiness that permeates the theory and practice of modern medicine. Essential reading for physicians and patients alike, this book shows how, by recognizing rather than denying that uncertainty, we can all make better health decisions.
- Sales Rank: #90254 in Books
- Published on: 2016-02-23
- Original language: English
- Number of items: 1
- Dimensions: 9.25" h x 1.03" w x 6.13" l, .0 pounds
- Binding: Hardcover
- 312 pages
Review
PRAISE FOR SNOWBALL IN A BLIZZARD:
“Informative…Snowball in a Blizzard adds an important perspective…[The book] rightly sounds the alarm: Better communication between doctors and patients is essential to improve medical decision making.”
—Wall Street Journal
“[Snowball in a Blizzard is a] penetrating examination of uncertainty in diagnoses and treatment.”
—Nature
“Snowball in a Blizzard is Hatch's first book, but the clarity and wit of his discussions rank with that of the best science writers.”
—Shelf Awareness
“This intriguing perspective on the obscurity of medicine…is highly recommended for health-care professionals, health-conscious patients, and well-informed consumer health readers.”
—Library Journal, starred review
“[Snowball in a Blizzard is a] carefully argued, unsettling, and important work.”
—Publishers Weekly
“In writing, Hatch strives to find ‘that sweet spot where readability and scholarliness overlap’… he succeeds, telling stories that clarify the points he's making, and he even includes a highly personal anecdote that shows him struggling to deal with doctors who were sure they knew the right treatment for his elderly, hospitalized father… Hatch ably reveals the shortcomings of medicine.”
—Kirkus Reviews
“Hatch’s Snowball in a Blizzard is like Carl Sagan’s famous “baloney detection kit” for medical scientific research. How can we figure out which “discoveries” to trust or to take with a grain of salt? First step: Read this book.”
—Katrina Firlik, MD, Author of Another Day in the Frontal Lobe: A Brain Surgeon Exposes Life on the Inside
“I can say with certainty that Steven Hatch’s Snowball astutely deconstructs the uncertainty in the practice of medicine—from diagnosis to treatment to media coverage—as well as this important topic has ever been tackled.”
—Eric Topol, author of The Patient Will See You Now, Professor, The Scripps Research Institute
“What could be more intuitive: that physicians should be humble, admitting the uncertainty of their medical sciences and treating their patients like equals. Would that it were. Although who knows—if enough doctors and patients read Steve Hatch's masterfully-argued Snowball—maybe someday it will be.”
—Larry Tye, Director of the Boston-based Health Coverage Fellowship and author of New York Times bestseller Satchel
About the Author
Steven Hatch is an assistant professor of medicine at the University of Massachusetts Medical School, working in the Division of Infectious Disease and Immunology. He lives in Newton, Massachusetts.
Most helpful customer reviews
16 of 16 people found the following review helpful.
Fascinating book about the uncertainty of medical statistics
By Prufrock
This is a book about uncertainty in the theory and practice of modern medicine. Its premise is simple: namely, that doctors do not often “know” what they are doing with the kind of mathematical precision that we associate with rocket scientists or chemical engineers. A diagnosis is, much more often than not, an educated guess, and a prognosis is typically less certain than that.
What makes this book special is the remarkable style of the author.. It should be of interest to all the readers who are fascinated with popular statistics - think Nate Silver -, behavioral economics - think Daniel Kahneman’s bestselling book Thinking Fast and slow, and books about how doctors think and how medicine really works - think Jerome Groopman .
11 of 11 people found the following review helpful.
Great food for thought
By Isaac P Hazard
Great book! Dr. Hatch illustrates the importance of understanding the level of uncertainty that health care professionals (and patients) face daily. While the content relates specifically to medicine, the lessons can be extrapolated to our approach to the rest of the sciences and even to life in general. In today's world, both professional and lay person alike are bombarded with information. As humans we are predisposed to fit that information into a category of true/untrue. While this mode of thinking has many advantages (speed, simplicity) it also leads to placing too much confidence in some information and not in others which can in turn lead to bad choices.
More and more we live in a society that deifies the role of the expert. When faced with a question outside of our own particular milieu, we place near 100% faith in the recommendations of one or more selected experts without appreciating the level to which that expert is or should be confident in that recommendation. In this book, Dr. Hatch helps us to identify when this type of mistake is likely to happen and provides us with a framework (the 'spectrum of uncertainty') to place this information in a more rational context. Let's hope we listen.
7 of 8 people found the following review helpful.
Certainly Uncertain
By IN8
Medicine has protected itself, its providers and its recipients from uncertainty and yet we know so little about health and illness, aetiology, diagnosis, treatment and prognosis. We have blurred the lines between normal and abnormal, and medicalised where we don't know whether we should or should not. While this is perhaps hard to accept, given our diet of fads and fantasies, our short term memory and even shorter term attention span, it's certainly the case. The risk however is when we finally set a certainty point that it's an ever moving point. While I like this book, a lot, at times it falls for the very dynamic it seeks to unveil, trying to soothe us with moments of certainty. For instance - yes, vaccines are without a doubt one of medicine's current strongest certainties - but what might tomorrow bring? Is it the same for all vaccines? Will we one day have something more reliable than statistics on which to judge certainty? I think an open mind to uncertainty to the end of the book would have done the topic more justice.
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