• What We’re Reading This Fall 2021


    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.

    The Ice Pick Surgeon: Murder, Fraud, Sabotage, Piracy and Other Dastardly Deeds Perpetuated in the Name of Science
    By Sam Kean
    Reviewed by Thomas S. Harbin, MD, MBA

    Albert Einstein once said, “Most people say that it is the intellect which makes a great scientist. They are wrong: it is character”.

    Of the 12 chapters discussing terrible deeds done in the name of science, four are devoted to physicians. Walter Freeman, the “Ice Pick Surgeon” the book is named for, performed a lobotomy on Joseph Kennedy’s daughter, Rosemary and went on to perfect transorbital lobotomy. He used an instrument like an ice pick and would perform as many as two dozen a day without anesthesia, gloves or skin prep. He traveled the country teaching the technique at various asylums. It is not surprising that infections, bleeding and even death followed some of these.

    Other physicians who employed this technique include Nazi doctors, seven of whom were hanged for war crimes, and those doctors involved with the Tuskegee syphilis studies. Grave robbing and murder at Harvard complete the list.

    The other chapters spark interest as well: Espionage, animal cruelty in the name of studying electricity, and bone wars to name a few.

    This book reminds us that ethical problems have been with us for centuries.

    Endpapers: A Family Story of Books, War, Escape, and Home
    By Alexander Wolff
    Reviewed by J. Kemper Campbell, MD

    Excellent books occasionally arrive serendipitously. An intriguing title noted while browsing a bookstore, an acquaintance’s chance recommendation or an obscure reviewer’s fleeting mention may cause the reader to open a book he might otherwise ignore. “Endpapers” by Alexander Wolff proved to be one such example for this reviewer.

    Despite its eye-catching jacket and a glowing endorsement by an unlikely source, former U.S. Rep. Beto O’Rourke, the deciding factor in beginning this daunting tome was its author. Alexander Wolff was remembered as an elegant writer for Sports Illustrated magazine at its apex, covering the basketball scene and topics as weighty as the 1972 Munich Olympics tragedy. His journalistic gift for giving familiar historical facts a fresh approach has remained intact.

    This book is essentially a personal memoir, and readers will necessarily need to refer to the attached and extensive Wolff family tree stretching back to 18th-century Germany to prevent confusion between the multiple characters connected by blood, divorce, and dalliances. The diligent reader will be rewarded by a panorama of the modern history which connects America and Germany from two wars to the present day.

    The main protagonists are the author himself, his father Nico, and his grandfather Kurt. By the book’s end the personalities of all three men have been exposed almost voyeuristically by the family photographs and intimate correspondences available to Wolff.

    The main protagonists are the author himself, his father Nico, and his grandfather Kurt. By the book’s end the personalities of all three men have been exposed almost voyeuristically by the family photographs and intimate correspondences available to Alexander.

    Into this complex and intricate family tapestry author Wolff weaves his own search in modern Berlin for a resolution to the guilt he feels from his family’s acquiescence with the Nazi extermination of six million Jews. Alexander’s conscience is further compromised by his maternal connection to the massive Merck pharmaceutical company which provided the funds for his father to begin his life in America. Merck manufactured the cocaine and Eukodal, an addictive opiate, which fueled Germany’s soldiers and eventually Adolph Hitler during his megalomaniac final days in his bunker.

    This book should appeal to any reader willing to examine the tendrils of guilt attached to any individual by the ghosts of his family’s past.

    The Mind’s Eye
    By Oliver Sacks
    Reviewed by Alfredo A. Sadun, MD, PhD

    We ophthalmologists think that the eye is the organ of vision. But as Goethe said, “What the eye sees is what the brain thinks.”

    There is a well-known and wonderful writer who looks at vision as a neurologist and as a philosopher. He considers what we see as more than optics; it’s about perception and behaving and thinking. You already know of him: Oliver Sacks. He wrote “The Man Who Mistook his Wife for a Hat” and other classics that describe alterations in how the brain organizes perception.

    In “The Mind’s Eye,” Sacks pursues vision related strange syndromes. He describes prosopagnosia, whereby people who see perfectly well can’t recognize others, perhaps even their own family members. Sacks also philosophizes. What is seeing? What is perception? How does this effect how we think? This is what Goethe meant. But the best part is when Oliver Sacks provides a rare glimpse from within, for he was also a patient with vision problems.

    Dr. Sacks describes the symptoms of his retinal detachment in a way that we will all appreciate. He then describes the diagnosis and treatment of his ocular melanoma. We see the story of his altered perception through the lens of fear and bewilderment. I found particularly useful his description of how he lost stereopsis when he lost vision in one eye.

    I knew Dr. Sacks personally, as he was my attending in medical school. I was struck by his careful and precise prose and his delicate sensitivity and respect towards patients. For those who saw Robin Williams playing him in the movie “Awakenings,” you’ll recognize this side of Dr. Sacks. Knowing this, I once wrote him regarding a recent publication of his. I suggested minor corrections that I, as a neuro-ophthalmologist could nit-pick. Sacks soon sent me back a three-paged typed letter (not computer generated: hand typed!).

    This paper contained several typos that were corrected with white-out tape. Other typos had been corrected by hand with white-out after the paper had come out of his typewriter. And then, one word was precisely crossed out by fountain pen and a better synonym used in its place in the margin. Dr. Sacks had high standards for his writing, and it comes across in all his publications.

    By the way, a year later, I received from him a package containing a subsequent printing of the book in question with little notes tucked in-between the pages showing how he had revised the work, in response to my nitpicks. Dr. Sacks was a class act.

    The Bomber Mafia: A Dream, a Temptation, and the Longest Night of the Second World War
    By Malcom Gladwell
    Reviewed by Samuel Masket, MD

    For those familiar with Malcom Gladwell’s earlier bestselling book “Outliers,” his fascination with innovators is evident once again in his most recent non-fiction publication, “The Bomber Mafia.”

    The book’s title originates from a small group of military aviators, based in Montgomery, AL in the late 1930s; they predated the origin of the U.S. Air Force. They were mavericks with respect to the military, having a unique understanding of aeronautics along with their own concepts of the potential value of airpower in warfare. Being technically driven, they believed that precision bombing of vital areas of specific strategic value could assuredly defeat an enemy while greatly limiting civilian deaths. That moral view of prosecuting war was not universally accepted, as others believed that civilians were “fair game” as they manufactured war material.

    The “mafia” had opportunity to put their theories into practice with the advent of the “Battle of Britain” at the outset of WWII, employing air counterattacks of German cities while attempting to use the newly developed Norden bombsite. The theory was to bomb centers that manufacture ball bearings as war machinery was highly dependent on them.

    However, the bomb sites failed under the conditions of war and aggressive alternative tactics were initiated by Curtis LeMay who would go on to notoriety later in the Pacific theater of WWII, Vietnam and ultimately as the Air Force Chief of Staff during the Cuban Missile Crisis in 1962.

    As we come to learn later in the book, the concept of precision bombing was also attempted in the Pacific. However, there were many obstacles in trying to reach the Japanese mainland either directly from distant islands in the Pacific or from India, flying “over the Hump” via the Himalayas. Weather conditions, limited range of the craft and the “jet stream” all impacted attempts to reach and effectively impact war production.

    Once again, the reader is reunited with Curtis LeMay who assumes command of bases in the Pacific and alters attack planning. Simultaneously, the B-29 bomber, with far greater range and capacity than its predecessors, is developed and deployed to the Pacific. Additionally, napalm, (a portmanteau of two of the constituents of the original thickening and gelling agents naphthenic acid and aluminum palmitate) was developed at the same time at Harvard.

    It is a viscous (and vicious) incendiary material that sticks to its target at ultra-high temperatures and is intended for firebombing. LeMay conceived a plan to use napalm heavily in attacks on Tokyo that were successful in bringing the war to a close without the need to invade Japan, in theory saving civilian and military lives. However, the attacks on Tokyo killed more people at any one time than any other event in recorded history, including the atomic bombs in Hiroshima and Nagasaki.

    LeMay’s decisions and seemingly horrific actions remain controversial to this day, although after the war he was honored by the Japanese for bringing the war to a close without invasion. Gladwell again provides much food for thought in discussing the moralities of warfare and whether Le May’s tactics did indeed save lives.

    The Last Man Who Knew Everything: The Life and Times of Enrico Fermi, Father of the Nuclear Age
    By David Schwartz
    Reviewed by Alfredo A. Sadun, MD, PhD

    Enrico Fermi was indeed the father of the nuclear age. He was the first to create a nuclear “pile” that went critical in a squash court at the University of Chicago. It must have been a heady event. Being the first to create nuclear energy; flirting with disaster; putting the genie in a bottle that would help win World War II.

    Fermi was a child prodigy growing up in Rome in the early 1900s. He became a popular young professor of some of the most brilliant minds who came to Rome from all parts of Europe. He received a Nobel Prize in physics for the discovery of new elements induced by neutron bombardment. It later turned out that he was wrong, and he had actually split the atom. The new elements were later revealed to be nuclear fission products. He married a Jewish woman, and that may have contributed to his decision to escape fascism in Italy.

    Fermi came to America in 1938, the same year he won the Nobel Prize, and in New York City he found friendship with many of his old physics colleagues. He performed early work that led to the Manhattan Project. From Chicago, he directed the “Metallurgy Lab” that contributed greatly to the development of the atomic bomb. However, what I found most inspiring was his legacy as a brilliant teacher; many of his students went on to win Nobel Prizes themselves.

    Author David N. Schwartz earned a PhD in physics from MIT, and he writes knowingly of the mentorship of young physicists. A Fermi post-doctoral candidate knew that he would be assigned, almost every day, trivial but seemingly impossible problems for which they had to apply the “Fermi Method” of back of the envelope approximations to get good estimates. The goal was to use assumptions and estimates to get to within a factor of two in the overall calculation. All three of my children learned to use this method to calculate the number of blades of grass in the high school field or how much an elevator heats up from its occupants.

    Fermi attended the testing of the first nuclear bomb at “Trinity”. There, he famously applied his method by dropping strips of newspaper in front of the shock wave while observing from many miles away. He paced off the distance they were blown by the explosion and calculated the bomb’s yield which later turned out to be within a factor of two. Fermi the teacher inspired all his students who loved and revered him. Fermi enjoyed mentorship most of all. He died young, age 53, with much more than the legacy of the atomic bomb.