• What We’re Reading This Fall 2019

    Senior ophthalmologists share the best of what they’re reading this Fall. Share what you’re reading and send your review to scope@aao.org

    Bad Blood: Secrets and Lies in a Silicon Valley Startup
    By John Carreyrou
    Reviewed by Samuel Masket, MD

    From the outset, we learn that the chief character, Elizabeth Holmes, a 20-something Stanford dropout was obsessed with money.

    As a child of privilege and promise, at her seventh birthday she was asked if she hoped to be an astronaut. Eschewing that career path, she said: “No, I want to be a billionaire.” That response presaged her path. She left college after one year to pursue her dream and to “conquer” Silicon Valley. She idolized Apple CEO Steve Jobs and eventually adopted his style of dress and manner of speaking.

    Holmes’ plan was to develop a new device for clinical blood testing that would revolutionize the process. She envisioned and designed a machine that could rely on only a few drops of blood (from a fingerstick) to analyze hundreds of parameters.

    Combining the words therapy and diagnosis, she named the company Theranos. She recognized that the pharmaceutical industry could use such a device to help speed new drugs through the approval process, and she helped capitalize the project early on by getting advances from GlaxoSmithKline and Pfizer.

    Holmes did her own public relations and marketing and was able to use contacts, guile and charm to assemble a board of directors of notables, including George Schultz and Henry Kissinger. And she was able to raise investment funds from Rupert Murdoch, Betsy DeVos and Robert Kraft, among others. Safeway and Walgreens were convinced to build mini-labs in selected stores using her services.

    All of that said, the project was a total falsehood, likely from the beginning, and it became all too apparent that the she could not create the device that she sought and promoted. Holmes hid that information from clients, investors, etc. She became very secretive in her business practices, and she isolated herself from staff, fired employees and threatened her detractors. She hired and used the bullying lawyer, David Boies, to fend off and intimidate those who sought to investigate and expose her ruse.

    Ultimately, the author, John Carreyrou, then a reporter for The Wall Street Journal, launched an investigation after he became aware of the concerns around Theranos. Against pressure and threats, Carreyrou was able to uncloak the malfeasance and wrote a nail-biting account of the deceptions and fraud enveloping Holmes and Theranos. The book is a most fascinating read and, for me, was a genuine page-turner.

    The British Are Coming: The War for America, Lexington to Princeton 1775-1777 (The Revolution Trilogy)
    By Rick Atkinson
    Reviewed by J. Kemper Campbell, MD

    “The British Are Coming” is the first volume of Rick Atkinson’s Revolutionary Trilogy, destined to become a definitive account of the eight-year civil war known as the American War of Independence.

    The author’s prodigious research included special access to King George III’s recently available personal papers. Atkinson’s attention to detail has already established his reputation as one of America’s foremost popular historians.

    In 2002, Atkinson began his Liberation Trilogy with “An Army at Dawn” which won the Pulitzer Prize. The final volume of the trilogy, “The Guns at Last Light,” was not published until 2013, and completed his acclaimed history of the United States’ role in the liberation of Europe and defeat of Nazi Germany in WWII.

    Now the author turns his attention to the American Revolution and shows that his exquisite skills as a writer and dramatic narrator have not waned.

    The sights and sounds of 18th century London, Paris, Boston and New York become familiar to readers of this initial volume. Rather than the two-dimensional heroes and villains portrayed to students in elementary school, the multifaceted characters of George Washington, Ben Franklin, Benedict Arnold, and King George III and his red-coated minions are brought to vivid life. The smell of blood and gunpowder and the chill wind as Washington crosses the Delaware are palpable in Atkinson’s prose.

    “The British Are Coming” only deals with the first two years of the conflict and ends when Washington’s tattered soldiers make his famous Christmas Eve attack across the frozen river.

    Canada is won and lost by American troops in this volume, France is not yet involved, and the outcome of the war is certainly in doubt at the book’s end. However, the inevitability of England’s ultimate loss of its colony is portended as the difficulty of managing the 3,000-mile separation of the protagonists becomes obvious.

    This book draws readers into a world and time which permanently changed the course of history and formed the new and unique nation which became the United States. Those who open this volume must now patiently await the next installment.

    The Soul of America: The Battle for Our Better Angels
    By Jon Meacham
    Reviewed by M. Bruce Shields, MD

    The current climate of partisan discord in our country seems to be spawning books that attempt to make sense of it and offer hopeful answers. In the Book Review section of the winter 2019 issue of Scope, we reviewed one such book by Doris Kearns Goodwin, “Leadership in Turbulent Times,” which recounts how four U.S. presidents – Abraham Lincoln, Theodore Roosevelt, Franklin D. Roosevelt and Lyndon B. Johnson – and our country, rose to challenging times and left the country better than they found it.

    Another book in this genre is “The Soul of America: The Battle for Our Better Angels,” by the Pulitzer Prize-winning biographer Jon Meacham. Like Goodwin, he encapsulates the history of several American presidents, as well as citizen activists such as Martin Luther King Jr., Rosa Parks and Eleanor Roosevelt, to remind us that our country has come through many dark times in the past and always seems to be sustained by what Lincoln called “the better angels of our nature” and to find a way to prevail.

    Meacham covers a wide swath of American history from the Civil War to Johnson’s crusade against Jim Crow laws. It is a reminder that race relations, the backlash against immigrants and the fight for women’s rights are among the key issues that our country has been facing with varying emphasis since the birth of our nation.

    It is also a reminder that dealing with them during especially challenging times throughout the course of our history has demonstrated the resilience of our society and our ability to rise above partisan fury and to find a better way.

    The Library Book
    By Susan Orlean
    Reviewed by John R. Stechschulte, MD

    “The Library Book” is much more than a book about books. It is the story of a huge fire that destroyed the Los Angeles Public Library on April 29, 1986.

    While the world’s attention was focused instead on the Chernobyl nuclear plant meltdown that led to fears that we were witnessing the end of the world, the Central Library burned for seven hours.

    Author Susan Orlean explains how the library fire investigation was altered over the years as arson and fire scientific principles were found to be very unreliable, which also led to major changes in criminal prosecutions of suspected and guilty arsonists across the country. You’ll need to read the book in order to learn the outcome of the case against actor and suspect Harry Peak.

    The Library Book also describes an interesting cast of former librarians who have grown libraries from humble metropolitan charitable initiatives into today’s crucial social institutions. It shows the shift from a once male-dominated profession to its current superb female leadership.

    Orlean, a master journalist, shows how the immense value of libraries has been recognized throughout history. Their power was problematic to leaders like Chinese emperor Qin Shi Huang, Adolph Hitler, the Khmer Rouge and the Iraqi army while in Kuwait, who burned libraries and books. As the author states, “War has been the greatest slayer of libraries.”

    Finally, this book brings back fond childhood memories of visiting community libraries with family. It also illustrates their tremendous evolution into modern treasures. Libraries will always play essential and many times unique roles in American life while serving as cornerstones of the national identity.

    How to Change Your Mind
    By Michael Pollan
    Reviewed by Thomas S. Harbin, MD, MBA

    Turn on, tune in, drop out!

    Admit it, we all knew that phrase although, of course, we never partook. Well, psychedelics are back. The full title of Michael Pollan’s book says it all: How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence. 

    Timothy Leary’s flamboyant enthusiasm of LSD helped lead to a ban on all psychedelics in the early 1960’s. At that time, there were almost 1,000 trials involving 40,000 participants studying the effects of LSD on alcoholism, schizophrenia and other mental disorders and end-of-life experiences. All were halted when Sandoz stopped supplying the drug.

    The new era of psychedelics began in 2006, and now there are multiple studies looking at the effects of either psilocybin or LSD on addiction, depression and end-of-life problems. Several cities have decriminalized these substances. Favorable anecdotes abound and psychedelic-assisted psychotherapy is spreading.

    This book very thoroughly covers the history and current status of psychedelics and provides an interesting introduction to a topic you will be hearing more about.

    The Assault on Intelligence: American National Security in an Age of Lies
    By Michael V. Hayden
    Reviewed by Marcia D. Carney, MD

    “The Assault on Intelligence: American National Security in an Age of Lies” by Michael V. Hayden is probably going to be known for its well woven historical perspective. However, the poor appreciation for the United States president is the book’s echo.

    Gen. Michael Hayden, former head of the CIA and national intelligence with seven decades of experience, initially gives good former intelligence history of when the world was “truly dangerous” as he describes, such as during the Cuban Missile Crisis and armor standoffs at the old Checkpoint Charlie in Berlin, to nuclear alerts in 1973 with the Soviets threatening intervention as their Arab allies were collapsing. The author describes this history as a “dangerous past.” However, he is quick to weigh in on what he considers faux pas of current U.S. President Trump, a totally different recent past.

    Things in the world now are more interconnected, Hayden concedes, even more dangerous, as he describes, “one such tectonic is the rise of substrate actors – groups, gangs, even individuals – who can visit the kind of destructive effects on our society that we used to associate only with malevolent state power”. He voices the increased strengths of community crimes, transnational crimes, terrorism related to the “empowerment and connectedness of the post-industrial world.” All truisms.

    Although most of the world sees China as a country rising to power, China is quick to point out that this is not the case, according to Hayden. China sees its position in the world as a restoration to power, implying that Chinese power was present prior to any power of the United States.

    For me it was somewhat of a difficult read, and I did not expect that. I had to go back to find the reason for the book. Every line is filled with history of our nation in relation to other nations (when I was probably studying for some ophthalmology presentation and teaching the importance of ophthalmology).

    However, in reference to a “seasoned panel convened in early 2016 (during the presidential election),” Hayden was meeting with a panel on global security questions in front of the Republican caucus from both the House and the Senate, and my questions were answered. A panel was convened which set the stage. The description of the setting created such clarity for the rest of the book (though still a difficult read).

    “Look! What’s going on here is the melting down of the post-World War II, American liberal, Bretton Woods, World Bank, IMF world order. Kagan pointed out that the world had enjoyed three-quarters of a century of relative peace and prosperity shaped by Americans.” The America-centered global structure has changed dramatically, leaving the question: What role does America see for itself in creating and sustaining world order 2.0?

    Previously America had placed global interests before its own, its narrowly defined national interests, all of which were being challenged by President Trump. Although our American community (Trump?) wanted to hold on to America and not globalism,” Hayden forecasts the direction of America under President Trump.

    “On Feb. 16, 2018, Rod Rosenstein in the Dept. of Justice auditorium announced to the press, to the world and to Vladimir Putin that the USA was indicting 13 Russian nationals and three Russian companies for committing federal crimes while seeking to interfere in the U.S. political system, including the 2016 presidential election.” And for Hayden, the story continued. Russia interfered in the 2016 election and 2018 elections. According to Hayden, American Intelligence remains steadfast on this issue. The book ends in threatening tones. What happens next, phase four, with the president and the intelligence community. The next book?