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N. Joseph Espat, MD

Associate Professor, Department of Surgery and Department of Pharmacology, University of Illinois at Chicago

REVIEW

I anticipated that the contents of Dr. Polansky's book would be philosophical and purely subjective. I sat down to read it with such a mental focus, and was completely knocked off my feet by the plethora of data provided in support of his stated theories and observations.

The book is exceedingly well-written and formatted. I confess that not all of the topics were of interest to me or within my field of expertise; however the sections pertaining to inflammation, obesity and malignancy were of the utmost substance. As we charge forward into the future of evidence-based medicine, it is difficult to cast aside novel theories such the concepts of "microcompetition," particularly when the objective data is so overwhelming.

Dr. Polansky's work is a completely original and novel examination of the world around us. The style is very tutorial however the complexity of the material makes it difficult to read in sections. A significant amount of abstract thinking and symbolic logic are required to grasp the author's core message. However, even if the reader is not versed in symbolic logic or mathematical equations, as presented in the first sections of the book; significant information can be gleaned. The structure of the scientific theorem is well-put-forth and the arguments in support are convincing. The author's arguments are supported by the evidence cited.

Recently, while on an abstract program committee, one of the members of the group noted that it was odd how far we had come when papers were being submitted about HIV+ patients that were developing obesity problems. I had recently read the section on obesity and HIV in Dr. Polansky's book and found it interesting that independent of any perspective I might hold, others independently were making note of the 'unusual' biologic behavior becoming apparent.

The book is suitable for the reader interested in novel biologic theory. It will challenge what we consider to be 'truisms' and has the potential to incite new thinking to old problems. Anyone in the biomedical, medical or basic science research fields would benefit from reading it.

It is not suitable as a textbook in a large scale sense. The role of such a work is likely in a "theory of …" class, or an advanced science theory series. While the theorems are well-supported, the vast amount of information already required in the medical curriculum which barely covers significant clinical matters such as nutrition, end of life issues etc., would be overwhelmed by trying to incorporate this book beyond a very superficial level.

Medical research and drug discovery are likely to be impacted by the concepts proposed in this book, similar to the impact that molecular level technologies have enabled us to dissect a more mechanism-based understanding of biology, as opposed to pure association. However, the impact of Dr. Polansky's book may take some time to be noticed.

Overall, I recommend this book to anyone interested in mechanism-based science and who is able to think "outside the box." To truly begin to understand some of the radical paradigm shifts proposed by Dr. Polansky it will require that the reader have an open mind beyond the standard explanations that have been accepted by conventional wisdom.

BIOGRAPHY

N. Joseph Espat, MD, MS, FACS is an Associate Professor in the Departments of Surgery and Pharmacology at the University of Illinois at Chicago. He earned a Bachelors degree in Biology and Philosophy (University of South Florida); MD at the University of Florida, Gainesville, and General surgery training at the University of Florida, Gainesville; Master of Science (University of Illinois); and completed a prestigious Fellowship at the Memorial Sloan Kettering Cancer Center, New York. Dr. Espat is a Fellow of the American College of Surgeons and has authored over a 100 scientific publications. He is a member of the Editorial Board of several scientific journals such as Journal of Parenteral and Enteral Nutrition, Surgical Oncology. He has also been a consultant for several companies. He has obtained various research awards for his work on nutrition and cancer. He is currently Director of Hepatic Regional Therapies Program and research director of the University Of Illinois Laboratories Of Surgical Metabolism.

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