Senior ophthalmologists share the best of what they’re reading this winter. Share what you’re reading and send your review to our book review editor, Robert L. Stamper, MD, at scope@aao.org.
The Mysterious Case of Rudolf Diesel
By Douglas Brunt
Reviewed by J. Kemper Campbell, MD
“The Mysterious Case of Rudolf Diesel” is a true tale of a neglected historic figure whose disappearance on the cusp of World War I has never been explained. Author Douglas Brunt has written three bestselling novels and is the spouse of television personality Megyn Kelly.
The life of Rudolf Diesel is worthy of remembrance since his invention of the internal combustion engine bearing his name was instrumental in propelling the Industrial Revolution and fundamental to the development of all the transportation modes of the 20th century. He disappeared under mysterious circumstances while crossing the English Channel in September 1913.
The success of Diesel’s engine design enabled him to overcome an impoverished childhood as a Bavarian living in Paris and London. He succeeded by using his German academic credentials to become a brilliant student of thermodynamics.
His natural courtesy, civility and artistic temperament allowed him access to the highest levels of society. The worldwide acceptance of his revolutionary engine made him financially secure. He later traveled extensively, enjoying universal acclaim and visited the United States in March 1912 after cancelling his initial plan to sail aboard the maiden voyage of the Titanic.
Despite Diesel’s altruistic aspiration to improve conditions for middle class workers, corporate and governmental institutions prevailed, and he gained the animosity of both Kaiser Wilhelm II for his link to England and America’s richest man, John D. Rockefeller, who feared his oil monopoly might lose profit if his engines became universally accepted. His death was reported as a suicide by a compliant press, and his name rapidly faded from history’s pages as the horrors of World War I intervened.
This book is recommended for its review of pre-World War I history, augmented by a helpful appendix and index with a four-page insert of vintage photos of people and events from Diesel’s life.
The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions
By Jonathan Rosen
Reviewed by Robert Stamper, MD
In a most readable way, the author depicts the evolution of his intense boyhood friendship through the trials and tribulations of maturing and finally into psychosis.
Both are children of college professors growing up in a middle-class neighborhood. Along the way, we get a wonderful picture of Michael, a person almost effortlessly successful at everything he tries from schoolwork to friendships to sports.
In contrast, the author is a self-described “slow reader.” We get a very well-depicted transition into puberty, where Michael’s challenges are rare, contrasting with the frequent and more “normal” ones for Jonathan. Surprisingly, this results in some interesting competition between the two friends which threatens their friendship.
Both are accepted to Yale University. Michael finishes in three years, graduating summa cum laude. He becomes a Wall Street wunderkind and is extremely successful until suddenly he becomes paranoid and threatening. Nine months in Columbia University’s psych ward seems to help a little and he is released to the care of his parents. He seems well enough that he applies and is accepted to Yale Law School as a sort-of poster child for mental illness as just another disability. That the story has a tragic ending is easily predictable by the subtitle.
In the meantime, we learn that Jonathan goes on to advanced degrees and a modestly successful career as an author.
This is not just a true story of one person, it is a well-researched riff on the status (or lack thereof) of care for serious mental illness in the United States. Laws prevent involuntary treatment of seriously mentally ill patients unless they are clearly dangerous to themselves or others; this, combined with the lack of any major therapeutic facilities to care for psychotic individuals, leaves the care of most people with early to moderate psychoses to their family and friends who are ill-equipped for the burden (and who sometimes become victims).
Community mental health facilities, promised when the old-fashioned and unlamented custodial, punitive, anti-therapeutic mental hospitals were closed never materialized. The community psychiatry establishment, based on principles developed by Freud and Jung, among others (who themselves had little or no experience with psychoses), have little to offer except medications; often the side effects of these medications interfere with voluntary adherence.
As any of us who live in cities are becoming increasingly aware, this is a problem that should concern us all. We have a duty to those who are ill to find effective methods of treatment and, when treatment fails or is inadequate, involuntary confinement in humane, treatment-oriented facilities until the ability to function in society is returned. This is a well-written, well-documented story of one nightmare that should be a wake-up call to everyone.
Tyranny of the Minority: Why American Democracy Reached the Breaking Point
By Steven Levitsky and Daniel Ziblatt
Reviewed by Samuel Masket MD
“Tyranny of the Minority,” written by two Harvard Professors, a New York Times Bestseller, and a Newsweek Best Book of the Year, provides a comprehensive review of American democracy from its outset with the framing of the Constitution to its current threatened status.
As the authors suggest, owing to demographic changes, the U.S. is moving either toward an unprecedented multiracial democracy or toward the end of democracy as we have known it.
The book provides an excellent review of the compromises that were made when our country was in its infancy and the Constitution was being enacted. What may not be apparent to many is that there were always deep divides between the North and the South, particularly regarding “states’ rights,” perhaps a euphemism for slavery.
But the long and short of it is that, absent significant acquiescence by the larger North, a union would not have been possible and, as history has taught us, that union is tenuous at best as evidenced by the Civil War. Key among the compromises made to persuade the less populated South to join the new country were the electoral college and the U.S. Senate; the latter has equal representation across all states, such that the same power exists between all states in that body, despite wide variation in population.
Furthermore, with regard to the Senate, precedent (the filibuster) now requires that a super majority of 60 or more votes is needed to enact most, but not all, legislation. The electoral college’s indirect election of the president in lieu of a simple majority vote was agreed upon in order to assure the smaller populated South that the presidency would not always go to the more populous North. As another compromise, Supreme Court justices were to be appointed by the president, and for life.
Finally, the framers agreed to a very rigorous means for amending the Constitution. All of these factors combined, now enable a governing minority to determine policy rather than have the rule of the majority establish policy, programs and law for the country. The authors give examples of the sense of the majority that are in contradiction to the government; they include legislation for gun control, separation of church and state, voting rights for all, women’s freedom to choose means for birth control, etc. Polls clearly indicate that majority opinion differs from current public policy for those issues.
A recent example of minority rule is that in 2016, the electoral college elected Donald Trump president with a minority of the popular vote. He actually “lost” to Hillary Clinton by nearly 3 million in the popular vote. By happenstance, Trump was able to appoint three Supreme Court justices — one third of the court — in a single four-year term.
The authors provide historic comparisons to other democracies and give clear examples of how some countries failed, but others evolved to remain current in order to provide for majority rule, the essence of a democracy. As they suggest, it is now imperative that we also make progressive changes to our Constitution, etc., or face the likely end of our current democracy.
One wonders whether the framers would create the same document if they were present today or if they had had today’s precedents nearly 250 years ago. I consider this book to be essential and urgent reading for all American citizens.
Determined: A Science of Life Without Free Will
By Robert Sapolsky
Reviewed by Alfredo Sadun, MD, PhD
Robert Sapolsky is correct, of course: There is no free will.
Most physicists agree. But in other fields, some intelligent professors will argue that there is free will. When asked whether he believed in free will, Albert Einstein famously said no. When asked how he could go on, day after day, knowing he had no free will, Einstein said, and I paraphrase: Because millions of years of evolution have determined that I would harbor this illusion. And he quoted the philosopher Arthur Schopenhauer, “Man can do what he will, but cannot will what he wills.”
We are wired to feel that our will is free. That’s a great boon for us as natural selection prefers that we feel in control. Indeed, the arts such as literature and music, tap into this powerful feeling. When I hear Beethoven’s 9th symphony, the music makes me swell with a sense of agency and even power.
Indeed, “Ode to Joy” is about the exhilaration of agency. That’s what our hearts say. Hence, the overwhelming popularity of free will. As for, Einstein, his attitude seems to be, “Just roll with it and compartmentalize. Let your heart feel the music but don’t let your mind fool itself.” And here’s where Sapolsky brilliantly lays it out.
Most minds are lesser to Einstein, and they fool themselves. It justifies individuals who puff themselves up with feelings of superiority for being so clever and hardworking as to deserve to win the human race. It is bad, but much worse is that we judge and condemn others for their shortcomings. I would contend that it’s OK to punish offenders in order to create deterrence or keep serious criminals in jail to safeguard society. But Sapolsky argues brilliantly that to pretend that this is justice, much less to contend that it is moral to punish, is terribly wrong.
Sapolsky is the consummate educator. He cleverly uses metaphors and analogies to bring concepts to life. His delightful sense of humor reminds me of another author, Douglas Adams. He freely digresses because many scientific truths are just too cool not to mention. And his breadth is amazing. He is also able to show consilience between subjects as varied as quantum physics, neuroscience, thermodynamics, and the philosophy of ethics.
Surely, this book and its message will elicit a great blowback. Sapolsky knew that going in and he should be commended for his great courage in pursuing this enterprise. Religious fundamentalists of all faiths will say that there has to be agency for a soul and to have sin, and they want to keep blaming the sinner. Left wingers will argue that the absence of free will gives misogynists and anti-LGBTQ moralists a free pass. Both the left and right wing love the idea of moral accountability, and how can you have that if we have no real agency?
Yet Sapolsky proves with a meticulous recitation of quality neuroscience studies that those that we condemn never had a chance. This is why Sapolsky wrote this book. He painstakingly researched and built his case against free will to save us from the self-serving and arrogant attitude that everyone has a fair chance, that luck averages out, that freely made bad choices are what keeps others from living lives as good as ours.
Sapolsky taught me that this is rubbish because bad choices began from a legacy of evolution, cultural as well as biological, and that antecedent bad choices compound the problem all the way to the present. Bad luck with genes, culture, parents, socioeconomics, etc. are like compound interest, and it all just gets worse over time. When you see revolting behavior, remember, it’s all determined, and that should help us remember that the quality of mercy is not strained.
All The Broken Places
By John Boyne
Reviewed by Robert Stamper, MD
John Boyne, an Irish author, some of whose many novels have been New York Times bestsellers, wrote a gut-wrenching novel almost 20 years ago called, “The Boy in the Striped Pajamas.”
This book about a friendship between the son of the Auschwitz concentration camp commandant and one of the Jewish boys incarcerated there became a bestseller and was turned into a movie still viewable on some streaming services. His newest book’s subject, a sort of a sequel, was conceived shortly after the previous novel was written but was shelved in the author’s back burner until Covid enforced some solitary time. The long wait was worth it. This novel is a worthy successor in every way although with a different premise.
Imagine, if you will, that you are a 12-year-old child whose father is daily committing horrible crimes. He is a loving father dedicated to his family but also to his work. You are dimly aware of what he is doing but have pushed it to the back of your mind until he takes you one day to actually see what his work is about. Your father is ultimately caught and executed for his crimes. You and your mother are forced to assume new identities to escape immediate punishment. But, somehow, throughout your life, the past has a way of rearing its terrible head. You are racked by guilt but not entirely free of the past doctrines your parents and your schooling drilled into you as a child.
This is a fascinating story of a 92-year-old woman, who, the usual definition of “holocaust survivor” notwithstanding, is indeed a survivor. Her past intrudes itself in multiple different ways into her relationships and her many attempts at assuming a “normal” existence during her long life. She recognizes that although she was still a child at the time, she is not the entirely innocent, helpless bystander she wishes she were.
How she deals with her guilt throughout her life and how that guilt informs a major challenge she faces in her old age make compelling reading. We, as readers, are faced with the question: Is there a difference between evil done with no remorse and evil done with remorse? Another question raised is can remorse absolve someone from complicity in a crime?
In twists and surprising turns, we find out that, in both small and large ways, at least some atonement may be attainable.