Book Review

Title: The Masters of Medicine: Our Greatest Triumphs in the Race to Cure Humanity’s Deadliest Diseases by Andrew Lam M.D.

Genre: Non-Fiction, Science, Medicine

Rating: 5 Stars

In this book Dr. Andrew Lam looks at some of the most ground-breaking discoveries in modern medicine, which sounded intriguing to me. The introduction was well laid out with Lam’s goal being to walk us through these discoveries and introduces us to the people behind them, starting with the mavericks behind the advances in cardiac medicine.

Chapter 1 looks at heart disease because even today it is the biggest killer, more than all forms of cancer combined, even with our medical advances. The first person we look at is James Herrick who believed in 1913 that sudden deaths he was observed were caused by heart attacks but this wouldn’t be recognised until 1918. This was termed myocardial infarction and later in 1929, Werner Forssmann created the heart catheter which he experimented on himself. Dr. Mason Sones further this developed by finding that contrast dyes could be used for heart imaging. In 1963 Charles Dotter and Dr. Melvin Judkins used catheters of increasing size to remove blockages in arteries which was further developed into the balloon catheter by Andreas Grüntzig. In May 1977, Grüntzig and Myler performed the world’s first successful coronary balloon angioplasty on a patient undergoing coronary bypass. Many wouldn’t believe that the first heart operation was perform in 1896 by Ludwig Rehn but many still believed that damage to the heart was fatal since they didn’t have any way of stopping the heart.

In 1944, Dwight Harken performed heart repairs on wounded soldiers while their hearts will still beating and he made it his mission to treat mitral stenosis. The following year Charles Bailey attempts this very procedure unsuccessfully while William Mustard and Walt Lillehei began trying to oxygenate blood outside the body. Their initial experiments were unsuccessful but they were on the right track. They were ultimately successful a handful of times but the amount of deaths caused overshadowed this. Their work was continued by John Gibbon as he was trying to remove blood clots without killing the patient. He ended up creating a prototype heart-lung bypass machine which was funded by Thomas Watson, the CEO of IBM. On May 6, 1953, the first successful operation was performed using the heart-lung bypass system. Within eight years, the first coronary artery bypass graft operation (CABG) had been performed and later on December 3, 1967, surgeon Christiaan Barnard performed the first heart transplant.

Chapter 2 looks at diabetes which is the 8^th biggest killer in the USA today. Diabetes was the first time in history people were dying from eating too much instead of too little. Diabetes affected more than 422 million people worldwide which is around 10% of the population. The link between diabetes and pancreas was confirmed in 1889 by German physicians Oskar Minkowski and Josef von Merin but wasn’t investigated further until 1920. In 1920, Dr. Frederick Banting wanted to isolate the pancreas secretions to see if it helped diabetes and was helped by John Macleod and Charles Best. Banting and Best succeed in isolating insulin and treated dogs but they needed to perfect their method to harvest the secretions easily. They were joined by James Bertram Collip who helped them increase the purity of their compound creating what we know as insulin today. Insulin became available to the public in limited quantities but the results spoke for themselves as families witness their loved ones regain their health in a matter of days.

Banting and Macleod were awarded a Nobel Prize which they shared with Best and Collip. Banting’s greatest desire was for insulin to be produced inexpensively and made available to all patients, rich and poor which is something I greatly admire. In modern society, diabetes is still a big problem as a study from Finland shows a 34% concordance rate for identical twins to develop type 2 diabetes meaning there might be a genetic factor as well as lifestyle factor. Further advances were made in 1967 by Dorothy Crowfoot Hodgkin who used X-ray diffraction to determine insulin’s precise chemical structure. This meant in 1978, Genentech, the pioneering biotechnology company, was the first to produce synthetic insulin which was approved for human use in 1982. Even today, in November 2021, advances are still being made as the first patient to receive stem cell–derived islet cells was cured of type 1 diabetes.

Chapter 3 focuses on bacterial infections, which has been debated a lot throughout history and seems to be an interesting chapter. In 1940, Albert Alexnader got a serious bacterial infection from shrapnel and was near death when he was offered and experimental medicine and although it was successful in part, he would later die from sepsis. Antonie van Leeuwenhoek was the first person to identify bacterial microorganisms, he learnt that bacteria could be classified based on shape and colour when dyed. The Gram Stain was devised by Hans Christian Gram in 1884 and this led to two competing beliefs that claimed to explain the spread of disease. Contagionists believed that disease was passed via personal contact which were later labelled germs. They believed they had to separate sick people from healthy in quarantines, while anti-contagionists believed the environment was more blameworthy than human contact. They believed that miasmas or bad air caused illness and that the best way to combat an epidemic was to clean up squalid streets in order to properly cleanse the air.

While the second belief did lead to proper sewage systems and better hygiene, it was John Snow in 1854 who realised that cholera, a major problem at the time, was a water-borne illness. His discovery was used to support contagionists’ “germ theory” of disease and 1856, Louis Pasteur discovered microorganisms souring wine. He ordered contaminated casks to be destroyed and realised that these microorganisms could be killed with heat later called pasteurisation, a method still used today. Robert Koch, a bacteriologist was Pasteur’s nemesis and later events would lead to a war between the two. In, 1873, an anthrax outbreak was caused by spores of dormant bacilli that didn’t die with heat. Koch determined the lifecycle of the disease and asked Ferdinand Cohn to review his experiment before publishing, thus proved germ theory was true. Pasteur in 1879, took on a new investigation—an epidemic of chicken cholera and found that old cultures didn’t kill injected chicken as the pathogenic microorganisms lost ability to cause disease, due to time and oxygen exposure.

Pasteur had accidentally discovered vaccination, due to this Pasteur isolated the anthrax microbe and weakened it using potassium dichromate and heat and on May 5, 1881, he initiated a public test. This test was successful and in 1882, 85,000 animals were vaccinated in France, decreasing mortality due to anthrax from 9.01 percent to 0.65 percent. At the same time, Koch was studying tuberculosis and isolated it. Koch was critical of Pasteur’s work and in August 1883, Koch discovered the source of cholera giving him the edge over his rival. However, Pasteur studied rabies and created a vaccine. In July 6, 1885, he treated a young boy bitten by a rabid dog which was a success and by October 1886, 2,500 people had received the vaccine. Koch tried to cure TB and failed but his work was carried on by Paul Ehrlich working with Emil von Behring, a scientist with an interest in diphtheria and alongside Shibasaburo Kitasato. They found blood of diphtheria patients contained a toxin produced by bacteria and it was this toxin not bacteria responsible for disease. They also discovered that animals produce antitoxins and these were used to cure animals, from this they began trying to create antitoxins for humans. First humans received antitoxins in 1892 but another discovery was made.

Paul Ehrlich found dyes stained and killed bacteria and in 1909 began working with Sahachiro Hata. Hata found a dye that killed the bacteria that caused syphilis which worked in animals and humans, the drug was named Salvarsan. This was a major turning point in medicine and in 1928, Fleming embarked on a study of staphylococcus where he discovered penicillin but there wasn’t much interest in it at the time. In 1938, Howard Florey was working on sulfonamides that had been developed in oral medicine but he aimed from more powerful medicines. He began working with Ernst Chain and they came across Fleming’s work with penicillin. Together with Norman Heatley, they worked to create more of the secretions which continued through the war. Eventually, they had a form of penicillin pure enough for testing which worked well in mice but the war overshadowed their achievements. They did treat several people successfully but they needed a large scale production method and ended up in North America to see Warren Weaver. Penicillin came to the market in mass during the war but there were issues of credit to be given since Fleming discovered it but others had put in more work.

All the men were eventually credited for their roles in the discovery and creation of modern penicillin but antibiotic resistance becoming a major problem even then. Overuse of antibiotics dramatically hastens this process by wiping out the weak and the vulnerable, allowing survivors to gain increased dominance. One study of antibiotic prescriptions written in the U.S. in 2010–2011 estimated that approximately 30% were unwarranted.

Chapter 4 look at viral infections with the Polio epidemic which many had been exposed young due to poor sanitation and thus developed immunity. Polio was though to be caused by bacteria but this was disproven in 1908 by Austrian physicians Karl Landsteiner and Erwin Popper. The Virus theory was supported by Simon Flexner and Paul Lewis and in the 1930s the advent of the electron microscope would make viruses visible for the first time. The 1916 epidemic caused 27,000 cases of paralysis and 6,000 deaths and in New York City alone, there were 8,900 cases and 2,400 deaths. 80% of victims were children younger than five, including many babies and in August 1921, Franklin Delano Roosevelt developed polio and he would never walk again. The National Foundation was founded by Roosevelt and funded multi-decade research effort to combat polio as they needed a vaccine. The progress for this vaccine was actually made due to an outbreak of smallpox, where Edward Jenner learnt that cowpox wasn’t fatal like smallpox and those who got cowpox would only develop a mild form of smallpox and recover or not catch it at all. He infected a boy with cowpox who recovered and then infected him with smallpox, but he didn’t get ill. Vaccination was quickly adopted and virology’s pioneers did not know they were working in a field that would be called immunology.

In the 1930s, Max Theiler and Hugh Smith, were studying yellow fever and found with each passage through culture, the virus became weaker and caused less severe disease. They theorised that we had an innate immune system, which we are born with, and the acquired immune system, which is influenced by pathogens we encounter throughout our lives. The acquired, “specific” immune system is pertinent to the study of vaccines and found that successful attenuated-virus vaccines could be used. However, these vaccines could not be weakened so much that it loses its antigenicity, which is its ability to be recognized as a pathogen by the acquired immune system. During this time polio was becoming more of an issue, in 1946, there were 25,000 polio cases in the United States, in 1949, 42,000 cases and by 1952, there were 58,000 cases. Jonas Salk who studied influenza during the war, turned his attention to polio and believed a killed-virus vaccine would be the most realistic strategy for success with polio despite the fact that a live-virus vaccine would produce lifelong immunity by replicating a natural infection in the body. It was believed that poliovirus entered the nasal passages and travelled straight to the central nervous system but this was debunked by Albert Sabin in 1941.

Sabin discovered that the digestive tract was the mode of entry for poliovirus and started a typing program would last for three years, from 1949 to 1951 where three types of polio were identified. In 1948, John Enders and two assistants, Thomas Weller and Frederick Robbins, were working to grow chicken pox, in cultures of foetal muscle and skin tissue and tested same process on polio and found it thrived in the muscle and skin tissue. While these discoveries were being made, Salk and Sabin warred over the correct course for the vaccine. The first vaccine was developed by Salk and testing began in June 1952. In January 1953, Salk reported his study results at a conference of prominent virologists but the safety of his vaccine was questioned. In November 1953, the National Foundation’s Vaccine Advisory Board voted to embark on a large study of Salk’s vaccine and the vaccine trial of 1954 was the largest medical study in history to date.

Salk’s vaccine was safe and essentially 80-90% effective but there was an issue with one manufacturer. Cutter was not properly adhering to the strict safety protocols leading to its vaccine being pulled as polio numbers continued to decline. Sabin continued to pursue a live, attenuated-virus vaccine by targeting the digestive tract with an oral vaccine would also eliminate passive transfer of the poliovirus. During the winter of 1954–1955, Sabin tested his vaccine in thirty inmates at a prison where all survived and developed antibodies. Sabin went to the Soviet Union because many in US had been vaccinated already and because Soviets had difficulty with Salk’s vaccine due to a shortage of glass syringes. In 1961, Sabin’s vaccine was officially licensed for use in the U.S. and supplanted Salk’s vaccine nationwide, between 1952 to 1981 paralysis from polio per 100,000 people dropped from 13.7 to 0.003 but it didn’t eradicate polio. It was decided to give combined vaccines and in 2000, the CDC switched fully to the use of the Salk vaccine. Lam does go into corona virus but my thoughts on this are clear in other reviews so I am not going to discuss it here, if you want to know my thoughts see Slaying the Virus and Vaccine Dragon.

Chapter 5 focuses on cancer which is something that many of us will suffer with even today. Approximately 1.9 million Americans receive the bad news that they have cancer, 21% of deaths in the United States are due to cancer and it will eventually kill one out of every three of us. By 1938, cancer had risen to become the second most prolific killer in the US and we have to remember that cancer is a term that describes more than a hundred different diseases although all generally stem from the same fundamental problem, unwanted cell division. In 1971, the war on cancer began with William Halsted who developed operations for range of conditions, including hernias, aneurysms, and diseases of the thyroid and gallbladder. He reasoned that cancer likely spread directly outward from the tumour and in 1894, would pioneer what would become known as the radical mastectomy. The following year, Wilhelm Röntgen discovered that X-rays could be used to treat cancer but it was Émil Grubbé, who first used radiation to treat a local tumour in 1896. Pierre and Marie Curie recognized radium’s promise as a new way to treat cancer and Stewart Alexander found mustard gas lowered white blood cell count and again theorised it could be used to treat cancer.

Alexander’s work was noticed by Colonel Cornelius Rhoads and in 1944, Rhoads organized a classified clinical trial of 160 cancer patients who were treated with nitrogen mustard, a derivative of the chemical used in mustard gas. This produced positive results in patients with lymphoma and in 1949, became the first cancer chemotherapy medication. Sidney Farber was a huge figure in the field as he saw childhood leukemia was death sentence and was inspired by Lucy Wills. Wills had corrected blood production in patients by giving them folic acid and Yellapragada Subbarao supplied Farber with a folic acid antagonist molecule, a medicine that would later be called aminopterin. On December 28, 1947, Farber used this on a young boy, his white cell count, which had risen as high as 60,000 per microliter dropped, into the normal range within three days. In a 1948 article, he reported that ten of the first sixteen patients he treated benefited from temporary remissions and helped establish the Children’s Cancer Research Fund in 1948.

By 1951, two biochemists George Hitchings and Gertrude Elion synthesized a new compound called 6-mercaptopurine which could inhibit cellular DNA function and cell division. In 1952, Clark Noble received a sample of the periwinkle plant which significantly reduced white blood cell production and became an effective cancer chemotherapeutic drug named vinblastine. These were the first of a new class of chemotherapeutic agents termed alkaloids. Emil Frei and Emil J. Freireich had been treating leukemic patients with two drugs, the children suffered greatly, but there was a definite increase in remission duration. They increased this to four drugs commonly called VAMP. Many considered VAMP to be not only unethical but unconscionably cruel but it had a 60% achieved remission rate. In 1975, the five-year survival rate for childhood leukemia had risen to 53%, by 1963, the all-cancer five-year survival rate in the United States was approximately 37%. A 1986 study revealed that cancer deaths were not decreasing in the United States, in fact, they had increased by 8.7% between 1962 and 1982.

In the 1930s urologist, Charles Huggins studied the prostate glands of dogs and wondered if diminishing testosterone might have a beneficial impact on prostate cancer. He found that some cancers could be influenced by hormones. This had been seen back in 1896 when George Beatson observed that removing the ovaries of women with breast cancer led to reduction of the size of their tumours. Later, drugs like tamoxifen, an estrogen antagonist were shown in 1971 to effectively reduce both breast tumours and lung metastases. In 2004, the first FDA-approved anti-angiogenesis drug hit the market and Avastin is used to treat colon cancer, as well as malignancies of the lung, kidney, and brain.

Chapter 6 looks at medical trauma beginning with the shooting of James A. Garfield in an assassination attempt by Charles Guiteau. Many doctors examined Garfield but Dr. D. Willard Bliss took charge, however, he ignored sterile practices when examining the President. Effective management of traumatic injuries in modern time hinge on anesthesia and antisepsis. In 1842 Dr. Crawford Williamson Long became the first surgeon to employ anesthesia while Joseph Lister began to tackle infection. It is important to remember around this time over 80% of operations resulted in infections and half of those died but only 10% of patients undergoing amputations outside of hospitals died. In 1864, Lister read Louis Pasteur’s work about fermentation and realized that microbes could be the source of wound infections and that he might be able employ antimicrobial substances to combat these organisms.

He used carbolic acid as a preventative measure and set a compound fracture, which would normally need amputation successfully. Lister extended his use of carbolic acid antisepsis to abscesses, superficial wounds, and surgical incisions. During this time, infection declined dramatically; over nine months in 1866–1867, not a single case of sepsis, gangrene, or erysipelas occurred in Lister’s hospital wards. While Lister was ignored by his peers, he ended up treating Queen Victoria in 1871 and gained respect. Before the adoption of Lister’s principles, about 50% of amputation patients died and afterward, mortality dropped to less than 10%. Garfield’s doctors didn’t adopt Lister’s method and eventually died from sepsis. These reforms lead to more dramatic advances, especially in trauma treatment in the war.

Chapter 7 looks into trauma as two world wars produced a quantity and degree of trauma that had never been seen before. Casualties benefited from slow but undeniable improvements in triage, surgical technique, speed of care, and infection control but an examination of 48,000 British Army casualty records showed that 16% suffered face, head, and neck wounds. In 1914, at the outset of World War I, Harold Gillies was an otolaryngologist sent to oversee Charles Valadier, a dentist. Since  Valadier was not licensed to perform surgery without a qualified surgeon quickly became clear that the army needed Valadier’s skills working on wounds of the lower face and there was an immense need for new methods of handling facial trauma, so Gillies traveled to Paris to observe Hippolyte Morestin. Gillies gained a reputation for performing reconstructive surgeries and opened a facial trauma unit in 1916.

On July 1, 1916, one of the bloodiest battles in history commenced, Battle of the Somme and Gillies’s hospital soon received 2,000 dreadfully disfigured men so he began to experiment with new methods of moving tissue in and around the face. By August 1917, a hospital dedicated to facial and reconstructive surgery was opened and through 1917 to 1921, 11,752 surgeries on 8,749 patients would take place. During this time when burns exceed 30% of our total skin area, they are potentially fatal and Gillies’s treated Tom Gleave who had more than 50%. His skin covered with gentian violet and tannic acid, chemicals thought to prevent infection and promote tissue growth but this hindered the healing process in extensive burns. In October 1940, he was transferred to a specialized burn unit where Archibald McIndoe, distant cousin of Harold Gillies took over his treatment. At outbreak of the Second World War in 1939, McIndoe was in charge of the Queen Victoria hospital where 4,500 Allied airmen survived aircraft fires in crash landings or by bailing out. Physicians were largely ignorant of effective burn care treatment and McIndoe introduced several innovations.

Between 1940 and 1953, Gleave would endure at least ten operations but McIndoe saw another aspect of health where soldiers needed help. He realised that his patients’ psychological health was important as their physical health. McIndoe became the only civilian ever to have the honour of burial at the RAF church of St. Clement Danes. In more modern times, the advent of the operating microscope greatly enhanced surgeons’ ability to anastomose smaller blood vessels and allowed vascular, cardiothoracic, and plastic surgeons to accomplish feats their predecessors could have only dreamed of. By March 2011, plastic surgeon Bohdan Pomahač performed the first full face transplant. Technology promises to revolutionize what we view as the limits of trauma care with the first successful bioartificial transplant which took place in 2008. Advances in the field of tissue engineering raise hopes for a future where artificial organs be grown using a patient’s own cells and thus alleviating the challenges of immune rejection and organ scarcity.

The final chapter of the book looks into the advances made in childbirth. In 1817 Princess Charlotte of Wales was in labour and after labouring for fifty hours princess Charlotte delivered a stillborn, nine-pound boy. However, thirty minutes after the birth, the princess began to bleed, her doctors, Croft and Sims agreed that they had no choice attempt manual removal of placenta but at 2:30 a.m., she died. For millennia, childbirth was the major cause of maternal and foetal mortality with about 300,000 women dying from pregnancy and childbirth each year. In the developed world, maternal death in childbirth become rare in the last 70 years but this wasn’t always the case. This could have been for many reasons as when compared to other mammals, and primates, the human pelvis is narrow and a woman’s birth canal is constricted so that a baby’s head can only traverse it by rotating in transmit. The second half of this problematic equation is the baby’s enormous head as anatomical head size may be determining factor in length of human gestation.

For centuries, the physiology of pregnancy, labour were mysteries, especially to men as for most of history, older, experienced women helped new mothers give birth. Their role went beyond obstetrics as they delivered animals, provided pediatric care, and performed abortions which allowed midwives enjoyed a monopoly on their field because men were not allowed to attend births. This soon changed with the invention of obstetric forceps by Peter Chamberlen in the 1580s or 1590s. In 1670, Hugh Chamberlen attempted to profit from the invention and later sold the design to Roger van Roonhuysen in 1693. In the 1740s, William Smellie improved the forceps design by adding greater curvature to the blades but babies still suffered grievous head and facial trauma, or death, from forceps use. Obstetrical training remained woefully inadequate and it was not unusual for medical graduates to have never witnessed a live birth. In 1847, Ignaz Semmelweis discovered that doctors, were killing these mothers and that the death rate from puerperal fever was 11% in doctors’ clinic, but less than 3% midwives’ clinic. He was amazed to find that even mothers who delivered on the street had far less likelihood of getting childbed fever and began to collect data.

The only major difference between the clinics was one staffed by doctors and the other by midwives. In 1847, Semmelweis’s friend Jakob Kolletschka cut on the finger. The cut became infected, and Kolletschka developed sepsis and died, where Semmelweis realized the pathology affecting Kolletschka was identical to women who died from puerperal fever. He learnt that doctors were going back and forth between autopsies and deliveries multiple times and no washing their hands and set out to make immediate changes. He made every doctor wash his hands in chlorinated lime before and after autopsies and this had beneficial results as the mortality rate soon dropped to less than 2%. However, most doctors considered Semmelweis’s theory to be ludicrous and he became an increasingly ostracized figure. Failure to recognize the effectiveness of his methods resulted in enduring ignorance and hundreds of thousands of maternal deaths but he was eventually honoured around the world as the “saviour of mothers”. Additionally, the “Semmelweis reflex” refers to the rejection of new scientific ideas that come into conflict with traditional, established thought and practice.

Other major discoveries came from Dr. J. Marion Sims, but the discoveries he made came from experimenting on enslaved Black Americans. He used enslaved women as they were valued for their reproductive potential. He soon learnt prolonged pushing and contractions could tear the vaginal wall and these injuries could lead to vesicovaginal fistulas, and rectovaginal fistula’s which were extremely debilitating. Sims originally had no interest in these conditions but treated a white woman, Mrs. Merrill after traumatizing her sacrum. Sims realized the uterus was inverted and concluded that pressure and air from his manipulation had the uterus to right itself. He also realized it would be possible to fully examine and view the inside of the vagina clearly and saw no reason it could not be site of beneficial surgeries to correct anatomical disorders or injuries. Sims invented one of the first vaginal speculums and between 1845 and 1849 experimented with ways of suturing inside the vagina. Sims published a report in 1852 began performing fistula operations on white women and in 1863, he treated Emperor Napoleon III’s wife, Empress Eugénie, Sims is regarded as the “father of gynecology” even today.

During this time, James Young Simpson set out to find a better alternative to ether and onNovember 4, 1847, Simpson and two friends inhaled chloroform. Chloroform was inexpensive, easy to transport, nonflammable, and simple to administer and Simpson used on labouring mother successfully. Like many other advancements this wasn’t quickly adopted as it was opposed by the church. Simpson was unable to gain obstetric adoption of anesthesia as early adopters were imprecise in their administration of the drug. John Snow studied chloroform’s effects precisely and standardize its delivery but body weight affected proper dosing. Snow addressed these challenges and fabricated a brass vaporizer to administer the drug in a standardized, measurable way which meant that obstetric anesthesia would eventually prevail. Queen Victoria helped John Snow by inviting him to administer anesthesia during her eighth delivery and on April 7, 1853, as Victoria entered the second stage of labour, inhale a small amount of chloroform with each contraction. She delivered with minimal pain and was anesthetized her for her ninth and final pregnancy.

However, these “modern” obstetrical practices and the shift to hospital deliveries meant that childbirth was actually safer for U.S. mothers in 1800 than in 1930. Dr. Sara Josephine Baker considered the US to be the “most unsafe country in the world for the pregnant woman”. Baker’s claim was  supported by a startling 1933 study titled “Maternal Mortality in New York City” which unambiguously confirmed that most maternal and foetal deaths caused by poor physician care. Over a 3-year period, 65.8% of 2,000 maternal deaths would have been preventable and that 24.3% of women in labour had undergone an “operative intervention”. These women who had interventions were five times more likely to die until the arrival of antibiotics in the 1930s. By 1940, 55% of American mothers gave birth in hospitals and by 1950, this had increased to 88% with close to 100% giving birth in hospitals by 1960.

Overall, I found Masters of Medicine to be an extremely informative read with lots of supporting evidence throughout for these historical advancements. Seeing where the starting point was for a lot of these issues such as medical trauma and childbirth was interested and seeing how far we have come was astonishing. For me personally, some of these figures were shocking especially those about childbirth given the fact that dying in labour is so rare in our modern age although it does still happen occasionally. If you are interested in the history of medicine or just learning about how we can to have things like antibiotics and plastic surgery then I’d highly recommend picking this book up.

Buy it here:

Paperback/Hardcover: amazon.co.uk                                  amazon.com

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