Epic
Measures: One Doctor, Seven Billion Patients
by Jeremy N. Smith (HarperWave, 2015, 352 pages, $26.99/13.59)
explores and explains the importance of “big data” in analyzing
the state of world health, discovering the actual causes and relative
importance of death, disease, and examining the burden of disease at
it affects people's quality of life. This important and illuminating
book explores the causes of what it describes as the Global Burden
of Disease, the accumulated knowledge of when, where, and how people
are born and die, how disease affects not only lifespan, but quality
of life. To accurately discover this information, it's necessary to
collect, collate, compare data down to the level of small towns and
villages. The development of the data base required for this program
is perhaps the most complex and important compilation of information
about the state of humankind ever attempted, let alone accomplished.
Its implications for health care delivery and policy are world
shaking. The opportunities are truly breathtaking. This exploration
and accomplishment is told through the life and career of Chris
Murray, a physician, PHD epidemiologist, world traveler, high risk
skier, and first rate athlete who possesses the passion, energy,
intelligence, and vision to conceive and complete the largest catalog
of human health ever contemplated and achieved. This book is both
inspiring as Murray the person is revealed and important as it
explores the potential for solving many problems in world health.
Dr. Christopher J.L. Murray
Christopher Murray
is the youngest child of Minnesota physicians who gloried in world
adventure travel and rural medical practice. At the age of seven, he
was made responsible for charting a route across the trackless north
African dessert to a small medical clinic in South Sudan, where his
parents had contracted to run a clinic. When they arrived they found
a bare building with no equipment, staff, or patients. Within a few
days there were plenty of patients, but no medicine or equipment.
During their stay, young Christopher learned and watched, developing
a lifelong passion for the needs of the poor. He later enrolled at
Harvard College, spent a couple of years at Oxford on a Rhodes
Scholarship, where he picked up a Ph.D. and, soon after his return to
the U.S. Enrolled at Harvard Medical School, while simultaneously
running a program dedicated to collecting health data. Everyone who
knows Christopher Murray is impressed by his intelligence, energy,
commitment, and likability. His drive and single-minded commitment to
collecting and organizing an entire world's health data make him a
challenging colleague, a demanding boss, and a problematic leader.
His personality dominates this book, which is filled with able,
dynamic people.
While still a
relatively young man, Murray managed to be fired from institutions
which lesser men strive to head or serve in for decades. Along the
way, he developed metrics for creating a data base of the causes,
losses, and risks of a number of diseases on a world-wide scale. Many
of his studies were accepted and published in the world's most
important health journal, Britain's The Lancet. He also
conceived and helped develop a metric called Disability Adjusted Life
Years (DALY) which recognizes the costs to quality of life and
longevity of pain and suffering. He discovered that many of the
heretofore intractable problems of obstetric disaster and child
mortality had decreased loss at the level of early life, moving many
diseases and issues of adolescence and early adulthood into a higher
priority. Thus accidents, murder, HIV/AIDS, and diabetes forged into
the forefront of causes of early death. Not surprisingly the inertia
of national health agencies and world wide collectors of data were
challenged for their hidebound and sloppy systems of collection,
while private and public charities resisted Murray's findings because
of the threat to their fund raising capability. It was only after the
Bill & Melinda Gates Foundation discovered Murray's work and
established the Institute for
Health Metrics and Evaluation at the University of Washington,
that Murray and his team found a base from which to begin completion
(the data base will never, of course, be fully and finally complete)
of the first global catalog of the Burden of Disease, a data base
available to all for study, analysis, and data-based decision making.
The interactive charts and diagnoses, made available free worldwide
to researchers, health care decision makers, and private individuals,
can provide hours (years) of fascinating reading and analysis for
those interested in both general matters and specific risks of
specific diseases and syndromes. Take
a look!
The overall
analysis can pinpoint issues and diseases for health care decision
makers examining the cost effectiveness and efficacy of health care
efforts at the global, national, and local levels. If the death
panels that Sarah Pallin claimed would be a result of the Affordable
Care Act (Obama care) existed, this is where they would exist.
Instead, the Global Burden of Disease data base makes rational
decision making about the efficacy and efficiency of health care
decisions available and allows decision making based on available
resources with the assumption that each life is as worthy as every
other life. Playing with the data base is fun, too!
Jeremy N. Smith
Jeremy N. Smith has written for
Discover, the Christian Science Monitor, and the
Chicago Tribune, among many other publications. His first
book, Growing a Garden City, was one of Booklist's top ten
books on the environment for 2011. Born and raised in Evanston,
Illinois, he is a graduate of Harvard College and the University of
Montana. He lives in Missoula, Montana, with his wife and young
daughter. (Publisher Profile)
Jeremy
N. Smith's important book Epic
Measures: One Doctor, Seven Billion Patients (HarperWave,
2015, 352 pages, $26.99/13.59) works well on two levels. It offers a
fascinating portrait of Dr. Christopher Murray, a physician and
epidemiologist, whose driven commitment to accumulating accurate data
to catalog the state of world health in order to help develop
policies and practices leading to its improvement led to the
publication of the data in the Global Burden of Health. At the same
time, Smith describes the turf wars and bureaucratic in-fighting of
the health industry (for want of a better name) serving to maintain
the status-quo and cater to parochial self-interest. The tension
developed between Murray's drive against the lethargy and obfuscation
of the world's health powers forms the central themes of this
intriguing and illuminating tale. I recommend it highly to those who
are interested in health care policy and maintaining personal health
practices leading to longer, happier lifespans. Spending some time
studying the web site linked to above and here can increase the power
of this story. I read Epic
Measures as an electronic
galley provided by the publisher through Edelweiss.
I read it on my
Kindle app.
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