The Machine at the Bedside: Strategies for Using Technology in Patient Care Book

This is now one of my new favorite one volume histories of medicine. Even though it concentrates on the development of technology in medicine, and the author's underlying concern from the beginning is that physicians have sacrificed much of their personal relationship with the patient by adopting technology, it is a great and detailed discussion of auscultation, microscopy, the ophthalmoscope, the EKG, the roentgenogram, clinical chemistry and more. All histories must mention RTH Laennec, relate a tired discovery story, leave the reader to assume that the technology was adopted immediately and without complaint and then move on to the next item on the list, but Professor Reiser discusses the environment that the technology developed in, what the known probable sources were, who disliked or refused to use the new technology and why, and how and when it came to be used in common practice. All fascinating stuff; real history. This book was published in 1978 so its discussion of computers is dated in some ways, but in its essence nothing is really lost. As a personal complaint only, I think the book would be strengthened by more mention of the deleterious effects of the philosophy of mass automated screening of normal people - the false positives, the uncertain value to the patient of finding a true positive that might have had no effect on their life, whether a test is useful when it's clear that nothing can be done with the result, and what is sacrificed to pay for it all.