Senior ophthalmologists share the best of what they’re reading this fall. Share what you’re reading and send your review to our book review editor, Robert L. Stamper, MD, at scope@aao.org.
The Beauty of Dusk: On Vision Lost and Found
By Frank Bruni
Reviewed by Stephen A. Obstbaum, MD
A friend, a professor of English literature and an avid reader gifted me a book, “The Beauty of Dusk: On Vision Lost and Found” since she thought the subject matter might interest me. She could not have imagined how profoundly Bruni’s message, of visual loss as an impetus for a reevaluation of how we view life, affected my own perspectives.
Frank Bruni is a respected journalist and author. At 52 and in otherwise good health, he awakes one morning with vision loss in his right eye that is ultimately diagnosed as nonarteritic ischemic optic neuropathy. He initially takes us through his fears, concerns, and obsessions about his condition and how it might potentially affect his professional and personal life. He enthusiastically enters two clinical trials, neither of which provide positive outcomes.
In time he accepts the physical consequences of his condition, and his trepidation lessens as he navigates his new reality. Bruni seizes the opportunity to examine his life, behavior and relationships. He recognizes he is not indestructible but that his medical condition has provided greater awareness and appreciation of his life experience.
As the title suggests, he acknowledges the anatomical basis for the loss of vision of his right eye and in dealing with the challenges it imposes, delves into a process of self-examination and the recognition of a spiritual, philosophical vision formerly hidden. There is heightened appreciation of the resilience of the human spirit and the triumph of accomplishments in the face of adversity. Bruni uses his own voice and intertwines the voices of others, who have overcome visual or physical deficiencies to lead rich, reinvigorated, and meaningful lives.
Bruni’s style is clear and fresh. He extols the appreciation of life. It was a joy for me to read this book.
Braiding Sweetgrass: Indigenous Wisdom, Scientific Knowledge and the Teachings of Plants
By Robin Wall Kimmerer
Reviewed by George L. Spaeth, MD
“Braiding Sweetgrass” by Robin Wall Kimmerer, is a powerful, beautiful book. Kimmerer is a botanist, scientist, professor, mother, distinguished professor, ecologist, visionary, poet and Native American. It is rare that such characteristics are present in one person. She is also an astute, kindly observer.
The subjects of the different chapters are as different as the special significance of wild strawberries, how planting beans, corn and squash together improves the harvest from all three, a field trip initiating young students into the wonders of nature and the importance of changing to a gift economy. The styles of the different chapters also vary, from professorial to poetic.
Every page brings insights.
A person who wants to see the world more accurately, and who wants to play a role in creating a world based on good sense — biologically, ecologically, emotionally, pragmatically, and morally — will be enlightened and heartened.
A thoughtful neighbor whose values and behavior are inspiring to me gave me a hard copy; the first thing that struck me was the fine bookmaking craft. As I started reading it, the words evoked were "respectful skepticism." But I soon realized that I was being gently introduced, never coerced, into a new, better world view, abstractly, rationally, emotionally and tangibly. The book now remains in my living room, where I reread it frequently. I have gotten notes of deep gratitude from those to whom I have given the book.
Its initial reception in the literary world was enthusiastic — a New York Times bestseller. More recently, talk about it seems to have largely disappeared. This is not surprising It is more like a Mary Oliver poem than Karl Marx's call for a "forcible overthrow of all existing social conditions" or Thomas Jefferson's Declaration of Independence. However, it is a paean to a behavior that has worked for some but is uncomfortable to most cultures since neolithic times.
Empire of Pain: The Secret History of the Sackler Dynasty
By Patrick Radden Keefe
Reviewed by John R. Stechschulte, MD
Have any of your family members or friends been impacted by opioid addiction? For those that have experienced such a nightmare, you must read this book.
For those few fortunate readers that have not been directly affected, you probably know that we are all in a deadly health crisis due to drugs, so you also should read this book.
Author Patrick Radden Keene reveals the history of the Sackler family empire and its influence on marketing of pharmaceuticals, its development and sale of OxyContin by its privately held company Purdue Pharma and the family’s tireless efforts to hide the source of their wealth. This narrative report describes how three brothers, all physicians, emerged from the Depression, researched drug treatments in psychiatric hospitals, espoused the use of minor tranquilizers, joined and eventually (one brother, Arthur) owned a small advertising firm that aggressively marketed Valium.
The Sacklers’ first large fortune came from pharmaceutical advertising. That fortune was used to buy numerous small medical companies for which the second and third brothers, Mortimer, and Raymond, took over leadership. They owned Napp Laboratories, which produced a morphine pill and then developed a special coating which slowed diffusion of the drug into the bloodstream. Their company, Purdue Frederick’s, opioid research brought about oxycodone, which the Sacklers’ then manufactured and sold without even alerting the Food and Drug Administration. This is how they made their second huge fortune.
The book is an agonizing history of the luxurious lives of three generations of the Sackler family, who misled doctors, improperly influenced the FDA, denied any addictiveness of their stronger opioid pill (OxyContin) based solely on its slow-release mechanism, utilized many of America’s most powerful lawyers for influence or protection, gamed the tax code and then sapped tens of billions of dollars from Purdue before the company — but not the family — was granted bankruptcy status, just before OxyContin’s exclusive patents expired.
The family hid their source of income while they gave very generously to many universities, museums and medical and research institutes who named buildings after the Sacklers’. Starting in 2017, many of these famous entities began refusing gifts from the family and removed the Sackler name from their buildings.
After reading this book you will be more accepting of strict FDA approval processes including post-approval requirements. We should be more willing to require greater transparency for privately held corporations so owners and officers of a corporation can be found both financially and criminally liable for their actions. It was unlikely the Sacklers’ will ever be punished enough, but they must live with the shame they brought to the Sackler name. As their father Isaac said, “If you lose a fortune, you can always earn another. But if you lose your good name, you can never get it back.”
In the Houses of Their Dead: The Lincolns, The Booths, and The Spirits
By Terry Alford
Review by J. Kemper Campbell, MD
Readers might assume that the lives of Abraham Lincoln and John Wilkes Booth have been fully explored over the past century and a half. Authors from Carl Sandburg to Bill O’Reilly have described the pair, and actors from Henry Fonda to Daniel Day Lewis have attempted to capture Lincoln’s character.
Yet Terry Alford, a retired Virginia professor who has written a previous book on Booth, has managed to uncover fresh linkages between the two intertwined families which inexorably led to that fateful night in Ford’s Theatre.
In his new book, “In the Houses of Their Dead.” Alford recounts how the Lincolns and the Booths both dabbled in spiritualism, a belief that the spirits of the dead could communicate with the living through a medium and that supernatural sources could predict future fates.
This reviewer has had an abiding interest in Lincoln’s assassination since viewing the grisly relics collected and displayed at the Armed Forces Institute of Pathology in Washington, D.C.
Spiritualism was a common belief in the mid-19th century and persisted through the World War I and 1918 influenza pandemic when nearly every family was touched by the death of a loved one.
The Booths were a family of noted actors, especially Junius, the father, and sons, Edwin, and John. However, Junius, an alcoholic, was also intermittently deranged, even exhuming the corpse of a daughter who died of cholera with the goal of removing her “impure blood” to revive her.
Edwin and John Booth were idolized for their handsome appearances and thespian skills and the only childhood hint of future catastrophe was John’s ailurophobia, causing him to torture and kill cats.
Lincoln, on the other hand, suffered from bouts of melancholia and premonitions of his own early death. His wife, Mary, was driven to the madhouse by the premature loss of three sons, Eddie, Willie and Tad, and her husband. She frequently invited mediums to the White House to commune with their ghosts. Remarkably, both Lincoln and Booth shared the same charlatan medium, Charles Colchester, who tried to warn Lincoln of his imminent danger.
To summarize, this fascinating book contains a myriad of previously unknown connections between Lincoln and Booth which occurred both before and after the nefarious deed.
First Principles: What America’s Founders Learned from the Greeks, and Romans and How that Shaped our Country
By Thomas E. Ricks
Reviewed by Alfredo A. Sadun, MD, PhD
Thomas Ricks is a Pulitzer Prize-winning historian who began researching this book the day after the 2016 presidential election.
Ricks asked himself what had happened to the U.S.; did he know this country? And if not, was it because half the country did not know what America was founded for? And if they didn’t, was it because history is taught poorly or too theoretically? What were the founders thinking? What did they read? Who were their heroes and what were their goals? He researched answers to these questions mostly by finding and reading the philosophy and literature that shaped the founders’ thinking, supplemented by the letters they wrote to each other.
Ricks delved particularly on the experiences and education of George Washington, John Adams, Thomas Jefferson, and James Madison. All four spoke often of public “virtue” (a word that appears five times as often as freedom in the Federalist Papers). Public virtue was placing the public good before private interest. A convenient anchor to each section was that the Founding Fathers individually had a different role model that had epitomized “virtue.” Each of these famous men inspired our founding fathers as they tried to live their lives in accordance with these luminaries of ancient Greece and Rome.
George Washington was the least well-educated of the four. He was not particularly well read until later in his life. He was jealous of the education of most of his contemporaries, but he admired them for it. But Washington knew himself and kept himself from most vanities. He valued sober discipline and virtue the most. The man he read who epitomized these values was Cato (the Younger). Cato was the man that initially defended the Roman Republic from the dictatorial Julius Caesar. Caesar eventually won and Cato committed suicide. Washington had no admiration for naked ambition like Caesar’s.
John Adams was educated at Harvard College and was a steadfast classicist. Though much better read than Washington, Adams also sought to manifest virtue though he chose, as his role model, Cicero. Cicero also died violently in defense of the Republic. Though, it should be said, Adams also felt a kinship with the man who closely matched Adams in personality. Both felt themselves to be outsiders who were envied and insulted more than loved. Jefferson was the philosopher who soared with ideas, no matter how impractical. He chose as his inspiration Epictetus, whom, you will recall, gave a strong argument for happiness as the aim of life. Now you know where the phrase in the Declaration of Independence for the fundamental human right for “the pursuit of happiness,” comes from.
Finally, there is Madison, the most practical scholar of the four. He studied the weaknesses of Greek and Roman governments and had a healthy skepticism for government power. For dealing with this, he often turned to Aristotle who was a psychologist as well as a philosopher and argued that ham-stringing the state was a good thing. This was much more practical than Jefferson’s lofty appeals to Locke’s defense of natural law. It is interesting that though several were rich, none of these four men were interested in getting richer.
As intended, this is a timely piece. For we are judged not only by our words and our deeds, but by our companions and by those we hold out as role models. It’s a shame that most of our current political leaders have little knowledge of Cato, Cicero, Epictetus or even Aristotle. Thus, they are less likely to admire virtue and more likely to see the state as an opportunity to promote their own self interests. Undoubtedly, our Founding fathers are rolling in their graves.
Haben: The Deafblind Woman Who Conquered Harvard Law School
By Haben Girma
Reviewed by Robert L. Stamper, MD
As an ophthalmologist, I have all too often encountered people with loss of some or all their vision, due both to congenital and acquired causes.
I often get to know them well due to frequent visits but reading this book made me very aware how little I really knew about their day-to-day life and struggles. In this relatively short, easily readable work, Haben Girma recounts in a refreshingly earnest and often humorous way her early life with stories and examples of her battles from the mundane to the exotic. Facing a set of triple hurdles that could have left her homebound and totally dependent, Girma found ways both courageous and innovative to achieve lofty goals and find fulfillment.
An Eritrean immigrant, she had visual problems from early childhood. She had some visual function which gradually faded as she entered her teen years. In addition, she also began to lose her hearing. She had an older brother with a similar condition suggesting Usher’s syndrome or something similar (although her exact diagnosis is never mentioned). She likens her many challenges to those experienced by her family fleeing a civil war to a foreign country.
With support of her sometimes-reluctant parents and the California disabilities program, she was able to attend a mainstream high-school. She chose a small liberal arts college in Oregon where the challenges facing a blind-deaf woman came to the fore. Using native intelligence and dogged persistence, she was able to overcome many hurdles that would have stymied someone less determined. She recounts daunting tasks and sometimes downright comical episodes and their innovative solutions. She even helped design electronics that not only allowed her to have her lectures translated into Braille but had applicability to the broader group of deafblind. She describes her experiences in college and her successful completion of Harvard Law School as its first deafblind graduate. She became a well-known disability lawyer and more recently a disability advocate.
In addition to her successes in the legal profession, she has traveled the world inspiring others with handicaps to succeed. She is a brave and adventuresome individual who has, among many other feats, helped construct a school in Mali, climbed a glacier and danced salsa.
Although her personal accomplishments are noteworthy, even admirable, she would not have us awestruck. She feels that many people with handicaps small and large are underestimated. Given the right encouragement and environmental support, many handicapped people can accomplish much more than society expects of them.
While learning of some her hair-raising and funny experiences, I also came to appreciate what grit, determination, and a refusal to be boxed in by physical impediments can bring to an individual; not only that, but, if shared, can pave the way for a better world for many others. As successful as she has become as a person, her even greater successes are what she has given back to the broader society. In addition to a better appreciation of the barriers that a largely visual and aural society makes for those deficient in one or both of those senses, reading this book provides insights into how we can be truly helpful to those with handicaps without getting in the way of their reaching their full potential and enjoying a satisfying life.
Bad City: Peril and Power in the City of Angels
By Paul Pringle
Reviewed by Samuel Masket MD
As a disclaimer from the outset, ophthalmologists should be aware that this book concerns our colleagues. Carmen Puliafito, is a well-known ophthalmologist and former dean of the University of Southern California Keck School of Medicine; he is portrayed in a very salacious light. He is at the center of a scandal that occupies a large portion of the book. The book alleges severe depravity on his part and the reader may not wish to read further.
The central theme of the book is the purported common interest bond for respect and power in Los Angeles between the LA Times and USC. The author accuses the editorial hierarchy of the LA Times of a conspiracy to protect the well-entrenched position of control that USC is seemingly entitled to. His senior editors at the LA Times do not agree and push back strongly against the concept of a conflict of interest between the two institutions, but in the end, readers must decide on their own.
The book opens with the narrative from the manager of a small luxury hotel in Pasadena, home of the Rose Bowl and a staid bedroom community for many USC faculty. A very young woman has overdosed on illicit drugs while in the company of Dr. Puliafito, to whom the room is registered, and there are drugs and drug paraphernalia strewn about. Methamphetamine is found in the room’s safe. The young woman is unconscious but breathing; paramedics are called, and both the police and fire departments respond.
This tidbit was passed as a tip to the author of the book, Paul Pringle, an investigative reporter for the LA Times. Pringle tries to follow the leads only to discover sizeable roadblocks from the Pasadena Police Department and other powerful institutions; interestingly enough, an official police report of the event was not filed until three months later, and only after Pringle’s incessant search for evidence.
The young woman in question came from an upstanding family but became addicted to drugs and turned to prostitution in order to support her drug habit. Dr. Puliafito became sexually involved with and heavily fixated on her, maintained apartments for her in his name and kept her readily supplied with drugs that he obtained from an assortment of felonious dealers who became his regular acquaintances. She was placed in several high-end drug rehab centers by her parents, but Dr. Puliafito would find her and surreptitiously bring her drugs even while she was under the tight control of the facilities.
Pringle became enraged that there was no public record of the initial event. Further, upon learning that Dr. Puliafito had stepped down as dean to follow “other pursuits,” he attempted to reach out to all involved parties, including USC President, Max Nikias, Dr. Puliafito directly, the city of Pasadena and the Pasadena Police Department. He put together an initial draft for a blockbuster news article but was seemingly stonewalled by the senior editors.
Realizing the importance of exposing a treating physician and medical school dean, the author encountered a conspiracy to protect USC as well as Dr. Puliafito. Ultimately, after more than a year, with the help of other writers, the story broke. Dr. Puliafito did not face criminal charges but lost his medical license. At present, the young woman in question is apparently doing well.
The story does not end there for USC and ophthalmology. Rohit Varma, another well-known ophthalmologist, was appointed as interim dean but quickly stepped down after it was revealed that he also had prior sexual harassment charges. Far worse for USC, however, was the saga of George Tyndall, a campus gynecologist, who for 30 years was a sexual predator of young (primarily Asian) women students. He performed examinations behind locked doors (despite his instructions not to do so); in total, he allegedly verbally and physically abused a reported 700 female students.
It took a very courageous nurse to finally sound the alarm, at great cost to her personal and professional life. The school allowed this to transpire despite copious evidence. Ultimately, USC paid out approximately $1 billion to settle the matter, but only after providing Tyndall with a healthy buyout and retirement. Pringle was part of an LA Times investigative team that received the Pulitzer Prize for bringing this story to light.
As if this wasn’t enough, USC was also involved in the “Varsity Blues” bribery scandal that allowed high paying parents to have their children admitted to high tier schools as athletes, though they had no skill in those sports.
In time, the senior editors in question at the LA Times who allegedly suppressed Pringle’s work on the Dr. Puliafito story and USC President Nikias all lost their jobs. However, the book only offers Pringle’s perspective. There may be those who harbor concerns that Pringle’s initial work was not fully substantiated, and prudence required further investigation, evidence and editing. The reader will find the story compelling and truly astonishing.
Bomb Shelter: A Memoir in Essays. Love, Time, and Other Explosives
By Mary Laura Philpott
Reviewed by Laurie Gray Barber, MD
Mary Laura Philpott gifts a delightful, yet convicting, autobiographical essay of a contemporary worrier’s life. She touches on everything from her family’s love of a wild turtle, spatchcocking (badly) a turkey and surviving early in the pandemic. As a fellow worrier, the apt descriptions and everyday stories drew me in, inciting laughter and tears.
We join her on a journey through serious family health concerns and also empathize with angst over comments of her whimsical attire. Philpott radiates optimism amid anxiety, but not always winning the tough balancing act, remaining relatable.
With chapters titled “Hello from Upside Down,” “To the Woman Screaming in the Quad” and “The Great Fortune of Ordinary Sadness,” the book is a gently bumpy ride. Reading this book motivates me to find her national bestseller, “I Miss You When I Blink” and track down Philpott feature stories in the Washington Post, The Atlantic and more.