Entries from May 1, 2013 - May 31, 2013

MOSER/BECKER HEART BOOK REHABILITATED

'Not So Bad After All,'

Says Co-Author 20 Years Later

 [Not the New York Times, May 22, 2013] Trendy claims may sell books, but when it comes to medical advice, boring may be beautiful, according to Brenda L. Becker, the persistently obscure co-author of Week by Week to a Strong Heart. The book, which the perennially unknown medical writer ghost-wrote 20 years ago with Yale University hypertension authority Marvin Moser, MD, remains best known in her mind for its rock-bottom production values (thanks to a shoestring budget by Rodale Book Club, its publisher) and for Moser's insistence on maddeningly cautious medical advice at a time when oat-bran books and Dean Ornish's guru-like prescriptions for meditation and vegetarianism dominated the health best-seller lists and enriched their authors.

 Published in 1992, well past the height of the public's first wave of obsession with cholesterol and heart disease and just before the statin era began, "Week by Week" sank out of sight after its brief book-club life span expired—although, Becker recalls, Moser never stopped believing that some day the public would tire of "miracle cures" and flock to their common-sense plan for gradually healthier habits. In the ensuing decades, she admits, she came to dismiss the book as a dated hack job, one that eventually yielded her "somewhere in the low three figures" in royalties. Now, however, upon rereading one of her several author copies (stockpiled once friends began refusing to take the extras, even as gifts), Becker acknowledges that her co-author may have been prophetic in his insistence on affordable, low-tech health interventions and incremental change.

Nor is the book as dated as she had feared, Becker adds, although Moser's rather laid-back approach to cholesterol risk has been replaced by aggressive prescribing. (Maybe too aggressive, according to a trickle of new safety signals about statins.) Countless other new medications have been introduced, of course, and some aspects of cardiology, such as understanding of the mechanisms underlying atherosclerosis and metabolic syndrome, have advanced greatly. The obesity epidemic has exploded since the book's publication, along with drastic measures such as Lap-Band procedures. But the book’s premise remains remarkably sound, if spectacularly uncommercial: Common-sense, simple improvements in diet, exercise, and risk-factor control can save your life.

Certainly, the book’s primary author would seem to be a good advertisement for his own advice. Becker, who has not been in touch with Moser for most of the years since its publication, recently “Googled” him, expecting to find a respectful obituary for a clinician and researcher old enough to remember Franklin D. Roosevelt’s death by malignant hypertension—or at least to read news of a retirement crowned with professional laurels. She was astonished to discover that Moser, now 87, is not only still alive and honored with a named award by the American Society of Hypertension, but still actively teaching at Yale. His familiar, George Bush the Elder-sounding voice invites callers to leave a message with easy, Locust-Valley lockjaw authority that Becker remembered well from marathon editing sessions. She recalled that Moser, for all his high-profile schedule as a hypertension talking-head and his relentless presence at prestigious medical meetings, was first and always a compassionate and practical advocate for his patients. And, while Becker ghosted much of the text, he did pen its best line: "I have reversed cardiac arrest with a chest thump on two occasions, once on a tennis court and once on an airplane."

Becker, no spring chicken herself, has recently been put on a high dose of an expensive new statin for her high cholesterol; the drug, she says, has left her with muscle cramps and weakness. Having reread the book and been surprised by its evergreen (if totally unheralded and unremunerated) wisdom, she left a message for Moser and got a prompt callback. His advice: Try a cheaper generic like simvastatin. "It's a little less effective, but take a few milligrams more." His other advice: Let's get somebody to re-issue the book!

Meanwhile, Becker recommends snapping up a rare copy of the original, which can be found on Amazon and other outlets starting at $.01...plus shipping. Do it for yourself, not for her; she hasn't gotten a royalty check since the George H.W. Bush administration.