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Books.FINAL:FINAL 2 8/21/08 11:04 PM Page 14 with typhoid fever despite never falling ill herself. When she resisted being cloistered in a hospital for the rest of her life, Mallon was vilified by the media as obstinate. Wald reveals the classist, xenophobic, and misogynist motives underlying Mallon's character assassination, referring often to the writings of epidemiologist George Soper, who relayed to the public his first-hand accounts of Mallon's squalid tenement home as well as her relationship with a man to whom she was not wed. Mallon became not just an embodiment of typhoid, but a personification of all that flew in the face of what society found "acceptable": Irish immigrant, working class, unwed woman. By assuming a gendered role such as cook, she did not redeem herself so much as further damn herself in the public's eye: by donning the burden of domestic duties, she infected "good" families, including virtuous wives. Wald evokes similar sympathy for Gaetan Dugas, the semifictional progenitor of the AIDS virus in North America, by analyzing how the HIV/AIDS outbreak narrative maligned the world against a gay subculture that was just beginning to gain mainstream visibility and empowerment. Dugas, dehumanized as "Patient Zero" in Randy Shilts' film And the Band Played On, is characterized, like Mallon, as flying in the face of the socially acceptable: foreign, gay, and unrepentant. Rumors swirled that Dugas refused to abstain from sex when cautioned by researchers, and one urban legend had it that he haunted dimly-lit bath houses in San Francisco with the intent of spreading the disease. Wald explores our obsession with the idea that illnesses are somehow "foreign" or "primitive," drawing upon Cold War-era media, the "Africanization" of the AIDS virus, and the litany of myths that arose from attempts to piece together the SARS outbreak narrative. Ironically, however, it is not the allegedly primitive beginnings of a virus that lend themselves to outbreaks so much as our modern progress, such as high-density urban populations and rapid global transportation. Wald's study, while dense at times, provides a compelling understanding of the subconscious emotional responses to an outbreak, and should provide an enlightening read for any care provider. As Wald's references to the SARS epidemic shows, diseases are evolving along 14 REGISTERED NURSE with our modernizing society. The prejudiced assumptions that accompany outbreaks will surely change, too. Wald provides an important reminder that our focus as a society should be on healing rather than blame.—erika larson The Corrosion of Medicine: Can the Profession Reclaim its Moral Legacy? By John Geyman, MD; Common Courage Press, 344 pp. n The Corrosion of Medicine, John Geyman describes the history of medicine as a moral enterprise. He then describes what happened when the business ethos and market forces began to influence the delivery of healthcare. Particularly disturbing is his description of the complicity of the medical profession in this transformation. His final section discusses options for reclaiming medicine's moral credibility. As a physician, this book was very difficult to read, not because of the complexity of the topic, but rather because of the anguish felt over what has happened to our profession. Although physicians have been complicit in the processes leading to the corrosion of medicine, their blame lies not with an active role in commercializing healthcare, but rather with passive acceptance of their role in our current model of healthcare that is controlled by business and market interests. When you ask a physician what his or her occupation is, he or she does not say that I am a businessperson in the healthcare industry. Almost without exception, the response is, "I'm a physician." That has much greater meaning than merely being engaged in an occupation that takes care of sick people. It is difficult to put into words, but every healthcare professional knows what I mean. Although it was painful to be reminded of the compromises being made on behalf of the business of medicine, there is also real hope in the message in this book. You realize that it doesn't have to be this way. We do not I W W W. C A L N U R S E S . O R G have to passively accept the role of being workers in an industry controlled by market entrepreneurs. We can become active advocates of reform that places our patients first. If we take healthcare financing out of the hands of the MBAs and place it under the control of our own universal public financing system, patients and physicians will be able to partner in achieving the best healthcare possible within the confines of our finite resources. Financing reform is only the first step, but it makes the other necessary reforms possible. Not only will we physicians restore our pride in ourselves when we say, "I am a physician," our patients will once again understand the special meaning of medicine as a profession rather than as a mere business.—don mccanne, md Epidemiology of Aging: An Ecological Approach By William A. Satariano; Jones and Bartlett Publishers, 424 pp. y the year 2050, the number of people aged 65 or older will increase from 600 million to two billion. The U.S. will double its over-65 population by 2030, and the fastest-growing demographic in the country is people over 85. The challenge to our society presented by these numbers does not make the evening news, but should capture our attention. At the same time as this population is on the rise, the number of doctors, nurses and caregivers who specialize in geriatrics is shrinking. There is one geriatrics doctor for every 5,000 patients, and only nine out of the 145 medical schools in the U.S. have geriatrics departments. Fewer than 1 percent of the 2.7 million nurses in the U.S. and Canada are trained in geriatrics, and the vast majority of nursing schools do not require courses in the subject. Lastly, the key demographic section of the population that currently cares for the elderly—women age 35 to 55—is shrinking. "The aging of the human populations represents one of the most significant public policy issues facing society," writes William A. Satariano, a professor of epidemiology and community health at the University of California at Berkeley. B J U LY | A U G U S T 2 0 0 8