BOOK AND MEDIA REVIEWS
                                     Oxford Textbook of Palliative                                              The section on the terminal phase of life 
                                     Medicine, Fourth Edition                                               included excellent discussions on cardiopul-
                                     Geoffrey	Hanks,	Nathan	I.	Cherny,	Nicholas	A.	                         monary resuscitation, seeking guidance from 
                                     Christakis,	Marie	Fallon,	Stein	Kassa,	Russell	                        substitute decision makers, situations regard-
                                     K.	Portenoy,	eds                                                       ing decreased oral intake, and routes of admin-
                                     Oxford, UK, Oxford University Press, 2010, 1,666 pp., $345,            istering medications. This is important reading 
                                     hardcover.                                                             for all primary care providers. The chapter on 
                                                                 The fourth edition of the  Sedation in palliative medicine is thought pro-
                                                                                                            voking and deals with many of the ethical is-
                                                                 Oxford Textbook of Pallia-                 sues that we address every day in our goal to 
                                                                 tive Medicine has been re-                 provide hope and appropriate caring for those 
                                                                 published and updated in  that are suffering despite our best efforts. 
                                                                 2010 with the participation                    As an educator in family medicine and in 
                                                                 of four new editors, includ-               geriatrics, I found the section on Education 
                                                                 ing Russell K. Portenoy  and Training to be an essential tool. This new 
                                                                 and Nicholas A. Christa-                   chapter addresses curricular and educational 
                                                                 kis from the United States.                issues important in this discipline. An appen-
                                                                 This textbook continues to                 dix clearly outlines the basic competencies in 
                                     be the premier textbook in the emerging field                          palliative medicine and gives educators an ap-
                                     of palliative medicine. It is written in a cultur-                     propriate structure from which to evaluate and 
                                     ally sensitive way so that it appeals to medi-                         teach our colleagues.
                                     cal students, resident physicians, attending                               There are two suggestions for improvement 
                                     physicians in primary care fields, palliative                          for future editions of this text. In some cases, 
                                     medicine, and oncology, as well as pastoral  references were not consistently updated in 
                                     care specialists, social workers, and nurses.                          the index so that the references were some-
                                     As a teacher of palliative medicine principles                         times one page off from where they were sup-
                                     in a family medicine residency, I am aware of                          posed to be in the text. Also, there were some 
                                     the difficulties in influencing young physicians                       misspelled words scattered randomly in the 
                                     to be team players and sensitive to other dis-                         text. However, these are relatively minor con-
                                     ciplines when it comes to patient care. This                           cerns for what generally is a superb addition 
                                     textbook is written with the unifying theme of                         to every health care professional’s library.
                                     presenting new information in this burgeon-                                This textbook is the “Bible” in palliative 
                                     ing field and at the same time respecting the                          medicine and should be in every primary care 
                                     wealth of knowledge that all of the various  residency’s library. In addition, certain sections 
                                     fields contribute to end-of-life care. I can re-                       should be required reading for all of those that 
                                     ally see this text being used as a major refer-                        are providing end-of-life care or trying to re-
                                     ence for physicians, nurses, social workers, and                       lieve suffering. The Oxford Textbook of Pallia-
                                     pastoral care counselors.                                              tive Medicine is a “must have” reference book.
                                        The book is arranged so that the early  James Schneid, MD
                                     part of the text gives the reader an overall                           Maine	Dartmouth	Family	Medicine	Residency
                                     understanding of the history of the field and                          Augusta,	ME
                                     its international roots. Subsequent chapters 
                                     concentrate on giving the reader up-to-date 
                                     knowledge of pharmacology, new techniques  The Addict: One Patient, 
                                     in cancer management, and the management  One Doctor, One Year
                                     of common symptoms and disorders. I particu-
                                     larly found the section on symptom manage-                             Michael	Stein
                                     ment to be well written and a “must read” for                          New York, Harper Collins, 2009, 276 pp., $25.99, hardcover
                                     family medicine resident physicians. The sec-                                                        Michael Stein is a profes-
                                     tions on pediatric care and symptom manage-                                                          sor of medicine and com-
                                     ment were presented well, and this  important                                                        munity health at Brown 
                                     aspect of palliative medicine is not always cov-                                                     University and an inter-
                                     ered in primary care curriculum.                                                                     nist certified to admin-
                                        The authors spent an appropriate section                                                          ister buprenorphine. He 
                                     discussing the latest complementary therapies                                                        has worked with and 
                                     in palliative medicine. This is an area that is                                                      been fascinated by addicts 
                                     not covered in other textbooks in the field and                                                      since he was in medical 
                                     is certainly on the minds of all our patients.                                                       school. He is the author of 
                       FAMILY MEDICINE	                                                                                                   VOL.	43,	NO.	2	•	FEBRUARY	2011                         131
                     BOOK AND MEDIA REVIEWS
                                  five books, including The Lonely Patient—How                    treatment and maintaining a life goal and an-
                                  We Experience Illness. In The Addict, Stein ex-                 other wanting to continue using a drug. The 
                                  plains several concepts about addiction to the                  third chapter reports on commencement of 
                                  lay reader in simple prose.                                     treatment and stages of withdrawal. Chapter 
                                     The intended audience includes primary  Four documents continued Vicodin use and 
                                  care physicians and the lay public. The goal                    discusses differences between methadone and 
                                  of the book is to chronicle the life of an ad-                  buprenorphine therapies for addiction. The 
                                  dict as it intersects with treatment—detailing                  next chapter considers how depression could 
                                  her aspirations and struggles. It examines of-                  be a co-morbidity, cause, or effect of addiction. 
                                  fice treatment with buprenorphine as an op-                     Chapter Six notes that deceit may character-
                                  portunity for the addict to avoid the stigma  ize the operations of an addict but likely pre-
                                  associated with methadone, noting that the  date the addiction rather than result from it. 
                                  behavior of persons on either drug is likely  The following two chapters review relapse and 
                                  similar. Stein effectively demystifies outpa-                   admission of anxiety predating drug use as 
                                  tient addiction treatment for physicians and                    well as the ease of relapse. The ninth chapter 
                                  potential patients alike; he describes the art                  asks “When is addiction over?” and reviews 
                                  of history-taking as well as initiation of a phy-               the use of substances to assuage preexisting 
                                  sician-patient relationship to persons naïve to                 guilt. Chapter Ten chronicles successes in ad-
                                  medical care.                                                   diction treatment and ends with an epilogue.
                                     This book includes up-to-date information                        The book an excellent value, engaging and 
                                  about buprenorphine and methadone pre-                          well-written, and worth the time spent read-
                                  scribing in the United States. The narrative is                 ing. I am unaware of any similar books. I rec-
                                  chronologically arranged in 10 chapters span-                   ommend it to students and practitioners of 
                                  ning a 1-year timeline with 2 additional years                  medicine, indeed all who prescribe drugs with 
                                  of follow-through. The first chapter introduces                 addictive potential or who may encounter an 
                                  the primary patient of the book, a 29-year-old                  “addict.”
                                  female college graduate who presented unre-                     Victor O. Kolade, MD 
                                  ferred for treatment after 16 years of addiction                Department	of	Medicine
                                  to various substances, stating “There’s never                   University	of	Tennessee		
                                  been a drug I didn’t like.” Next is described                   Chattanooga,	TN
                                  a contrast between one addict submitting to 
                                  Publishers	who	wish	to	submit	books	for	possible	inclusion	in	Family Medicine’s 
                                  book	reviews	section	should	send	texts	to	Cathleen	Morrow,	MD,	Family Medicine 
                                  book	reviews	editor,	Dartmouth-Hitchcock	Medical	Center,	Department	of	
                                  Community	and	Family	Medicine,	HB	7015,	1	Medical	Center	Drive,	Lebanon,	NH	
                                  03756.	cathleen.morrow@dartmouth.edu.	Reviewers	interested	in	writing	reviews	
                                  for	publication	should	contact	Dr	Morrow	as	well.	William	E.	Cayley,	Jr,	MD,	serves	
                                  as	Book	and	Media	Reviews	Associate	Editor.
                                  All	books	reviewed	in	this	column	are	available	for	purchase	at	amazon.com	
                                  through	the	STFM	portal	at	www.stfm.org/bookstore.
            132      FEBRUARY	2011	•	VOL.	43,	NO.	2	                                                                                               FAMILY MEDICINE