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A Disease Called Childhood: Why ADHD Became an American Epidemic By Marilyn Wedge, PhD Avery, 2015 As an American nurse, you've more likely than not encountered kids medicated for childhood attention deficit and hyperactivity disorder (ADHD), whether as a clinician, as a mother, father, or grandparent with your own fami- ly's children, or as an observer of others' children. In A Disease Called Childhood, Marilyn Wedge, a practicing family thera- pist with a doctorate in social psy- chology, argues persuasively that ADHD is largely a social con- struct created by a small faction of the psychiatric community, by the media, and by Big Pharma that has brainwashed American doc- tors and parents into unnecessarily drugging a huge swath of our youngest patients—often with serious and dangerous side effects. Wedge makes a compelling case. In 1987, only 3 percent of Amer- ican children were diagnosed with ADHD. By 2000, that number was up to 7 percent and by 2014, 11 percent for children and 15 per- cent for high schoolers. About two-thirds of those diagnosed take medication, often powerful stimulants like Ritalin and Adderall and even anti-psychotics like Risperdal. Wedge writes that by 2012, almost 21 million prescriptions for those drugs were being dis- pensed for children each year, up from fewer than 3 million in 1990. Other countries do not seem to share the United States' ADHD epi- demic; our country consumes 70 percent of the world's stimulant drugs even though we represent only 4 percent of the world's popu- lation. In Finland, about 0.1 percent of the child population is med- icated for ADHD, compared to about 6 percent in the United States. Are our children different than other countries' children? Of course not. But our mass culture, medical community, business environment, socioeconomic conditions, and school systems are. Wedge explains how each contributed to the situation we face now. An ADHD "diagnosis" does not depend on a biological test but merely qualification from a checklist of symptoms, yet both doctors and the public now tend to think of ADHD as a genetic, neurological condition. The United States is one of the few countries where phar- maceutical companies are allowed to directly market to consumers, which they have done aggressively, in order to create demand for ADHD drugs to turn huge profits. Our public schooling system, and especially after passage of No Child Left Behind, requires the youngest of our children to sit quietly for longer stretches of time in order to "teach toward the test." Socioeconomic factors, such as our high rates of poverty, put tremendous stress on parents and families, resulting in trauma, chaos, parental conflict, and suffering by kids that can surface as unruly behavior. Our mass culture—how and what we eat (The studies showing the negative effects of artificial food dyes was surprising to me!), what we watch on our screens, what we think is "normal" behavior for children—also plays a role in contributing to ADHD diagnoses and, Wedge argues, a role in miti- gating ADHD behaviors without the use of drugs. In her practice, Wedge has found that most cases of ADHD can be successfully treated without drugs by resolving the root causes of the child's undesired behavior. This often requires a combination of family and individual talk therapy, parenting classes and guidance, establishing greater structure and routine as well as consistent disci- pline in the household, changes toward a healthier diet, less screen time and more physical activity, education and cooperation of schools and teachers, and sometimes simply maturation of the child. Nurses would do well to read this thoughtful and well-written book, especially those who work with children or in pediatrics. Wedge is a good storyteller, artfully weaving many patient case studies together with the points of her thesis. My only criticism may be that, as a private family therapist, she is dealing with patient populations from higher income households who have the resources to seek out her help. We don't see or hear about our country's most disadvantaged ADHD patients, who are likely suffering even more severely from this epidem- ic. Still, this book is eye opening and a timely read. —Lucia Hwang An American Sickness: How Healthcare Became Big Business and How You Can Take It Back By Elisabeth Rosenthal Penguin Press, 2017 In An American Sickness, Elisa- beth Rosenthal, the former award-winning New York Times reporter and Harvard Medical School-trained physician, builds upon the extensive reporting she's already done on how profit motives drive American health- care to ridiculously high and untenable prices. Our country's symptoms are well documented: We spend more than any other nation and among industrialized nations of the world on health- care, approximately 17.5 percent of our GDP and about $9,500 per capita, yet rank only about 37th in global health outcomes rankings. Rosenthal approaches the problem, or illness, as a doctor would, by first taking a complete history of the situation and then offering short-term and long-term options for treatment. As registered nurses in the belly of the healthcare beast, you are all sure to be much more well versed than the normal reader on the tricks of the trade that healthcare corporations use to maximize profit. As someone who has reported on healthcare and listened to nurses' sto- ries for years, I certainly thought I was. But I still learned much more. Rosenthal dives really, really deep into each sector of the healthcare industry: insurers, doctors, hospitals, pharmaceutical companies, medical device companies, testing and ancillary services companies, contractors and consultants, and even medical societies and nonprofits dedicated to particular diseases. With each sector, she uses reporting and quick but on-point patient anecdotes to show how all healthcare players at all stages of the American healthcare game exploit patient dollars and public tax dollars to simply rake in as much money as pos- sible. Healthcare in the United States is not about achieving healing or promoting health; it is simply a vehicle for making profit. J U LY | A U G U S T | S E P T E M B E R 2 0 1 6 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 13