susan cohen

The New England Journal of Medicine review found Normal at Any Cost "compelling." That was the first sentence. The last was this:

"This book serves as a timely reminder for parents and physicians that caring for children is a sacred trust, and that the short-term and long-term well-being of the children must be considered carefully with every treatment decision for every child, every time."

Hooray! In between,the tone of the review was defensive. My sense was that, since the review was written by two doctors, one wanted to stress the value of the cautionary tale we tell, while the other felt compelled to defend pediatric endocrinologists. We are very happy to see this story move into the hands of physicians and to encourage response and debate of the issues it raises.

My personal quibble with the review is that it makes a book that is based on years of reporting and a lot of thought sound as if it is a screed. Just one example: They say we "suggest" that companies marketed growth hormone off-label. We don't "suggest" it. We report that two manufacturers paid large criminal fines for promoting growth hormone off label -- for use in short,normal kids.

We have sent a brief letter to the editor clarifying that we don't, as the reviewers write, say that those who treat healthy kids for height are "evil." What we do write in the book is that the best and worst motives combined. We acknowledge parents' concerns for their kids, doctors' desires to help, researchers' search for knowledge. But those combined with the fact that there is a whole lot of money to be made. On the other hand, there were few incentives to follow up and investigate the effects of these treatments decades later -- which is why we focus on people who suffered tragic consequences, while acknowledging that others remain glad they were treated.

There are doctors who have been very appreciative of "Normal at Any Cost," including the Danish pediatric endocrinologist who wrote a customer review on Amazon uk saying the book was not only thoughtful but "essential reading" for physicians. And the blogging doc who said it should be on everybody's reading list.

Now, we've been asked to write an essay for The Lancet, which is the major medical journal published in England. Can't wait for the reaction to that.