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Canary in the Coal Mine: A Forgotten Rural Community, a Hidden Epidemic, and a Lone Doctor Battling for the Life, Health, and Soul of the People Hardcover – June 22, 2021

4.5 4.5 out of 5 stars 220 ratings
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One doctor’s courageous fight to save a small town from a silent epidemic that threatened the community’s future―and exposed a national health crisis.

When Dr. Will Cooke, an idealistic young physician just out of medical training, set up practice in the small rural community of Austin, Indiana, he had no idea that much of the town was being torn apart by poverty, addiction, and life-threatening illnesses. But he soon found himself at the crossroads of two unprecedented health-care disasters: a national opioid epidemic and the worst drug-fueled HIV outbreak ever seen in rural America.

Confronted with Austin’s hidden secrets, Dr. Cooke decided he had to do something about them. In taking up the fight for Austin’s people, however, he would have to battle some unanticipated foes: prejudice, political resistance, an entrenched bureaucracy―and the dark despair that threatened to overwhelm his own soul. Canary in the Coal Mine is a gripping account of the transformation of a man and his adopted community, a compelling and ultimately hopeful read in the vein of Hillbilly Elegy, Dreamland, and Educated.
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  1. Print length
    320 pages
  2. Language
    English
  3. Publisher
    Tyndale Refresh
  4. Publication date
    June 22, 2021
  5. Dimensions
    5.6 x 1.2 x 8.3 inches
  6. ISBN-10
    1496446488
  7. ISBN-13
    978-1496446480
  8. See all details
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From the Publisher

Editorial Reviews

Review

From the first poignant vignette through many dramatic moments to its inspiringly compassionate conclusion, Dr. William Cooke's book is a gripping medical chronicle infused with wisdom, science, and deep humanity.

GABOR MATÉ, MD, author, In the Realm of Hungry Ghosts:
Close Encounters with Addiction

A very powerful and immensely moving must-read for anyone working to end the syndemics of opioid use disorder, poverty, and the HIV/hepatitis C epidemics among people who inject drugs in rural America. Dr. Cooke eloquently blends historical research with first-person stories of tragedy and triumph along with his journey as a healer and frontline experience as the lone clinician who bore witness--and responded compassionately--to the largest HIV outbreak among people who inject drugs in recent US history. Against overwhelming odds entrenched in immense socioeconomic barriers and the stigma of drug use in his small town of Austin, Indiana, Cooke shows how perseverance, love, and compassion are key to effectively addressing substance use disorder and HIV epidemics in his and similar communities. This book is a major contribution that challenges us to see the humanness in everyone and inspires us to care and work to end the suffering caused by the opioid crisis!

CARRIE FOOTE, sociology professor, Indiana University-Purdue University Indianapolis; chair of the HIV Modernization Movement-Indiana

Review

From the first poignant vignette through many dramatic moments to its inspiringly compassionate conclusion, Dr. William Cooke’s book is a gripping medical chronicle infused with wisdom, science, and deep humanity. Gabor Maté, MD, author, In the Realm of Hungry Ghosts: Close Encounters with Addiction

You couldn’t find more authoritative tour guides of rural America than Dr. Cooke and Laura Ungar, who have lived and worked among its people―their people―for decades. The pair’s medical savvy and crackling prose can compete with the best out there. . . . This gripping, heartbreaking, and ultimately hopeful book is about far more than a tiny town and its hardscrabble people, many of whom were affected by one of the biggest HIV outbreaks in US history. It’s a look at where so much of America has been heading when so many others weren’t watching. Jayne O'Donnell, health policy reporter, USA Today; cofounder, Urban Health Media Project

A very powerful and immensely moving must-read for anyone working to end the syndemics of opioid use disorder, poverty, and the HIV/hepatitis C epidemics among people who inject drugs in rural America. . . . This book is a major contribution that challenges us to see the humanness in everyone and inspires us to care and work to end the suffering caused by the opioid crisis! Carrie Foote, sociology professor, Indiana University--Purdue University Indianapolis; chair of the HIV Modernization Movement--Indiana

What a fantastic, inspiring, and informative book on how one person made the difference in leading a rural community from a devastating HIV outbreak and opioid addiction problem to a community of hope and healing. Dr. Will Cooke superbly tells the story of how he, the only physician in the community, guided a small rural town in southern Indiana to recovery by focusing on compassionate, person-centered care. This book is a must-read for all medical students and other health-care professionals. Once you start reading it, you won’t be able to stop. Dr. William l. Yarber, senior director, Rural Center for AIDS/STD Prevention; Provost Professor, Indiana University School of Public Health

I found this book to be an inspiring autobiography of how one committed physician truly made a difference in addressing an urgent public health problem through partnerships, persistence, and compassion. Jim Curran, dean, Rollins School of Public Health, Emory University; former head of the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention

People who use drugs haven’t changed. What has changed is the way physicians and society have become more willing and able to see the humanity of people instead of only their disease and substance use. In his book Canary in the Coal Mine, Will Cooke reaches inward and articulates the steps of his change in a personal treatise of a family physician working to care for an onslaught of opioid injection–related HIV and hepatitis C infection in a small rural town. A black doctor in Chicago reminds Dr. Cooke that blacks have been in the midst of a heroin and HIV epidemic for years. Society was too ready to see this as a problem of “other” and embark on a drug war instead of a treatment war. Dr. Cooke’s care transforms to embrace the tenets of treatment and harm reduction that characterize the care of most diseases, and he articulates their application to mental health and addiction. Primary care serves as the de facto mental health and addiction treatment system in the US. Canary in the Coal Mine reminds us how woefully unprepared and under-resourced these front-line clinicians are. His book provides a wake-up call to the structural violence suffered by too many and should serve as a humanitarian roadmap to address these challenges. David A. Fiellin, MD, professor of medicine and director of program in addiction medicine, Yale School of Medicine

Product details

  • Publisher ‏ : ‎ Tyndale Refresh (June 22, 2021)
  • Language ‏ : ‎ English
  • Hardcover ‏ : ‎ 320 pages
  • ISBN-10 ‏ : ‎ 1496446488
  • ISBN-13 ‏ : ‎ 978-1496446480
  • Item Weight ‏ : ‎ 1.01 pounds
  • Dimensions ‏ : ‎ 5.6 x 1.2 x 8.3 inches
  • Customer Reviews:
    4.5 4.5 out of 5 stars 220 ratings

About the author

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Dr. William Cooke

Dr. William Cooke

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I’ve spent 20 years working as a physician to increase access to health, hope, and opportunity to all people, regardless of their social status. That turned out to be much more challenging than I could have ever imagined.

I quickly discovered medical school hadn’t prepared me for the unanticipated political resistance, community backlash, or structural inequities I’d face. But what surprised me most was to find my most stubborn opponent lived within me.

I am a fellow of the American Academy of Family Medicine and the American Society of Addiction Medicine. My work has received national recognition including being named Physician of the Year by the American Academy of Family Physicians, joining the ranks of two US surgeons general by receiving the Ryan White Distinguished Leadership Award, and becoming the first physician in the nation to be awarded the Pillar of Excellence by Addiction Policy Forum.

I live with my wife and six kids in my home town of New Albany, Indiana.

Customer reviews

4.5 out of 5 stars
4.5 out of 5
220 global ratings
One book that can change the world !
5 Stars
One book that can change the world !
Every college student needs to read this book regardless of major. It is inspirational and insightful. A road map if you will to build more resilient communities!
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Top reviews from the United States

Jacob Lee
5.0 out of 5 stars A human story that put a face to an epidemic
Reviewed in the United States on February 1, 2023
Verified Purchase
Good. An eye-opening account from a small town family doctor whose town was ravaged by opiate epidemic — and HIV. The compassion is palpable.

This quote stood out:

“Communities do not fail because the people within them fail. They fail because we allow those who stumble to be dehumanized. This only encourages people to hide pain and deny mistakes. Communities fail because we keep painting over the cracks in the foundations instead of being willing to accept the struggling among us as our neighbors. We must not banish broken people but rather reject a broken culture that forbids vulnerability.”

I’d probably have slight point of departure with the author as it pertains to the extent of depravity and sin that is at play; without a full body emphasis on the spiritual aspect of knowing Christ we’re simply healing wounds lightly.

I thought the 10 Biblical Principles of Harm Reduction were very helpful, though again my theological under pinnings for many of them would be much more robust at important points.

All in all, it was a human story that put a face to an epidemic that’s still ravaging this country and tearing families asunder.
One person found this helpful
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diana kelly
5.0 out of 5 stars Read this book. Everyone should STOP what they are doing and read this book.
Reviewed in the United States on June 25, 2021
Verified Purchase
This book is tragic, and beautiful. It’s hard for me to find a book that will literally move me to tears and in the flip of a page make me want to throw it against the wall.

Dr. Cooke’s courage, and resilience in the face of such a dire situation is beyond inspiring and moving. My heart was with the people of Austin, Dr. Cooke, his staff the harm reduction allies, peer recovery coaches, and anyone who helped those in Scott County during this difficult time.

Hard to believe here we are in 2021 and same program that saved so many is being taken away because people appeared “ungrateful” or because of individual moral beliefs and not data. -it’s actually not hard to believe which is even more unsettling.

This book is not just about an opioid outbreak in a small Indiana town. It highlights systemic issues, generational poverty, and trauma. Most importantly this book highlights incredible bravery, courage and the resiliency of the human spirit and a community in the face of adversity.
20 people found this helpful
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K. Laura
4.0 out of 5 stars A "must read" for 2021
Reviewed in the United States on July 8, 2021
Verified Purchase
This book does an amazing job of humanizing a population of people who are often treated as "less than." The story of Austin and how the situation became so dire was interesting and at the same time so sadly predictable. Cooke weaves his strong faith throughout this story and at times conversations and scenes seem a little contrived, but you can tell he has a huge heart and has dedicated his life to this cause. I highly recommend this book to anyone who works in social services, addiction & recovery, the foster care system, etc. or anyone looking to deepen their understanding of our broken system of addiction treatment in America.
8 people found this helpful
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Meghan Miller
5.0 out of 5 stars Heartfelt and impactful.
Reviewed in the United States on September 17, 2021
Verified Purchase
I am a family physician in Indianapolis and I am sitting here in tears reading this book. I’m only half way through but it is just singing to me. I work in underserved communities in areas of addiction and hepatitis in addition to full primary care. I also go to church in inner city Indianapolis. I haven’t faced near the scrutiny, backlash and threats Dr Cooke received but I have sat with patients who told me they cannot find a provider to ever treat them like a person with compassion. I am so inspired by this work and can see that I was able to do the work because he paved the way in our state. I kept thinking “there has to be someone in this state that sees patients like Christ would, not just me.” I feel seen by this book. Thank you.
15 people found this helpful
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P. LaBelle
5.0 out of 5 stars A book I may never have picked up and a town I may have just driven through
Reviewed in the United States on August 15, 2022
Verified Purchase
I never cease to be in awe of what our God puts in our path, in this case, a book. A book that came at the right time in my personal life, spiritual life and geographical location. Newly moving to Southern Indiana from New England I discovered I was just due south of Austin. While getting to know and serve my new community I was also spreading my spiritual wings a new Christian. I picked up this book just before I was about to begin my Emmaus Walk and actually read it during my Walk. So much in this book was speaking to me about what I need to do in my life and what my discipleship would look like.
The content of this book helped me embrace my new community from a compassionate point of view and how I would in turn serve it. This book is written like a well told story but not lacking in the details to fully understand the severity of what was happening and the impact those that cared had in this community. My favorite line from the book, "“We do not become less of who we are by surrendering [to Christ]; rather we become who we were created to be." Well done!!
4 people found this helpful
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Justin Funk
3.0 out of 5 stars Just okay
Reviewed in the United States on December 2, 2021
Verified Purchase
I was very interested in the story, not being from the area, I had heard about the HIV epidemic in Indiana in 2015 and how it happened but not much more. I was very intrigued by the first person perspective.

What I got was so-so writing in a book that was at least 30% about the authors love of his religion. If that’s what he wanted to write about, fine, but I reread all of the summaries after finishing the book and there’s definitely no indication he was going to spend so much time writing about (what I feel like) were unrelated stories about his christian missions, influences of faith, and ‘conversations with god’. The latter definitely did not help his credibility.

You could shave 100 pages of fluff off this book and it would be a significantly better read.

I’m not disappointed to have read it, but I can’t recommend others do.
9 people found this helpful
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Dr. Carrie Foote
5.0 out of 5 stars Informative, powerful and inspiring book!
Reviewed in the United States on June 25, 2021
Verified Purchase
From the time I started reading, I could not put this down. This is a very powerful and immensely moving must read for anyone working to end the syndemics of opioid use disorder, poverty, and the HIV/HCV epidemics among people who inject drugs in rural America. I teach a course on the Social Dimensions of HIV and this would also be an excellent book to assign to students as its very readable and filled with history, and social explanations of the public health crisis that happened among people living with HIV in southern Indiana. It shows the power of the human spirit and our ability to care and how that caring truly does make a difference despite all odds. Highly recommend!
11 people found this helpful
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