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.
Ghosts of the Orphanage
By Christine Kenneally
Reviewed by Robert L. Stamper, MD
As a teen, I remember being horrified by the abuses of orphans depicted in Charles Dickens’ “Oliver Twist.”
Based on my impressions from the movies, radio shows, early TV shows and the “he’s not heavy; he’s my brother” ads, I had assumed we, as a society, had moved way past the Dickensian portrayal of orphanages.
Author, Christine Kenneally interviewed survivors and some staff of mid-20th century orphanages from places as widely separated as Australia, Canada, England and the U.S. She scrutinized court and institutional records (often hidden or destroyed) and tells the personal stories of several of these children, now adults. She documents a litany of physical, sexual and mental abuse. Sometimes the extent of the cruelty exceeded anything I could imagine.
Often these institutions were run by religious orders but not always. Children who complained were brutally punished. Escapees were hunted down and, following their capture, occasionally disappeared entirely. Children were expected to witness the punishments which sometimes resulted in serious injury or death. Children who survived often suppressed the scenes of brutality to themselves and others — usually unable to speak of them out loud even as adults. Those who did complain were not believed. The nature and extent of these crimes were deliberately covered up by the higher-ups akin to what happened with clergy sexual abuse.
The book is well-written and impeccably documented. It is not easy to read; however, because this is not ancient history or fiction, we should all be aware of what can happen to a society who turns a blind eye to those less fortunate.
The Book of Charlie: Wisdom from the Remarkable American Life of a 109-Year-Old Man
By David Von Drehle
Reviewed by J. Kemper Campbell, MD
Rarely does a human live 109 years. Rarer yet does a gifted writer have the opportunity to chronicle that individual’s biography firsthand. Rarest of all is a book reviewer fortunate enough to discover this gem of a book and recommend it to future readers.
“The Book of Charlie” by David Von Drehle provides exactly that Russian-nesting-doll type of experience. The book’s titular Charlie is Charles White, MD, born in 1905, who became a pioneer anesthesiologist in Kansas City and died as author Von Drehle’s neighbor in 2014.
This reviewer will not interrupt an old man’s reminiscences by relating any of the fantastic experiences of his adventurous youth. Suffice it to say that Charlie seems to be a person who could be the product of a marriage between Indiana Jones and Auntie Mame.
Charlie’s life mimics two of the reviewer’s favorite movies based on stories by F. Scott Fitzgerald and Winston Groom: “The Curious Case of Benjamin Button” and “Forrest Gump.” His sage advice for living a fulfilling life while attaining the span of Methuselah is certainly worth pondering.
Author Von Drehle is an editor and columnist for The Washington Post. He moved his family to a staid suburb of Kansas City in 2007 and became acquainted with his 102-year-old neighbor.
Through years of friendly conversations, he gradually absorbed the wisdom Charlie had painfully accrued and wrote the book to pass along this knowledge to his own children.
Von Drehle is a facile writer, and the anecdotes flow seamlessly with pertinent references to writers as disparate as stoic Roman emperor Marcus Aurelius, psychiatrist Viktor Frankl and “Game of Thrones” author George R.R. Martin strewn at appropriate intervals.
This slim book, without photos or illustrations, reads like a fascinating magazine article and could be finished in one sitting. However, Charlie’s lessons would be better savored slowly, and multiple readings would be preferable.
Babi Yar
By Anatoly Kuznetsov
Reviewed by Samuel Masket, MD
Babi Yar is a large ravine in the outskirts of Kiev, the present-day capital of Ukraine. But it is also a euphemism for the “unimaginable horrors of war” that plagued the people who lived in the vicinity when the Nazis invaded in 1941, during the early days of WWII.
In that location the Nazis machine gunned 34,000 local Jewish residents in very short order, in fact, less than two days. Later they would execute Romas, prisoners of war, partisan fighters, dissident citizens and even the local soccer team for defeating the German team. Young women were physically abused and then bludgeoned to death in the ravine. The rat-a-tat-tats of machine gunfire seemed to go on 24 hours a day and unendingly.
Two years later, as the Nazis were being driven back from the region by the advancing Soviet Army, the Germans tried desperately to cover up their acts by having prisoners dig up the bodies and incinerate them. Because the prisoners were underfed and horribly overworked, they either died or were murdered on-site to prevent their story from being told. However, at the very end of the German occupation, a 300-prisoner uprising occurred; only 13 survived. Nonetheless, those few gave testimony to the events at Babi Yar. Make no mistake, this is a very difficult, albeit truly enlightening book to read.
The ravine, although central to the book, is not the entire story. The book was written from the diaries, hidden notes and viewpoint of the author who was a 12-year-old when the Nazis first occupied the area. We learn much about the marvels of his survival during the two years of occupation as well as the general history of the region from the czarist era, through Stalinism and the war years. Starvation was always rampant.
Kuznetsov, under the pseudonym A. Anatoli, first published this memoir in Russia in 1966 and then defected to the United Kingdom in 1969. In the current version, it is interesting to note that there are portions in bold type that were edited out by Russians censors, and there are other segments in parentheses that were added later after the author’s defection. Seeing the world through the eyes of a 12- to 14-year-old boy resourcefully living in a virtual hell creates indelible images for the reader.
Finally, there is an important parallel to some current events. When the Nazis warned all local households to get rid of existing Soviet publications, the author’s mother said to him: “You have your life ahead of you, so just remember that this is the first sign of trouble — if books are banned, that means things are going wrong. It means that you are surrounded by force, fear and ignorance, that power is in the hands of barbarians.”
Transformer: The Deep Chemistry of Life and Death
By Nick Lane
Reviewed by Alfredo A Sadun, MD, PhD
I’ve always been very impressed by the books written by Nick Lane, a professor of evolutionary biochemistry at University College of London. Most of my Scope readers, like me, studied the Krebs Cycle in college.
But what I never understood, is that the Krebs Cycle can also run backwards. That makes all the difference.
Lane explains that evolution began with running the Krebs Cycle in what we think of as reverse. In that direction, it is very useful for making many of the building blocks needed for growth and development (and cell division). We eukaryotes have learned to run it on forward for more efficient energy production which works in connection with the mitochondrial electron transport chain. Various tissues use it forwards (like the brain) or backwards (like the liver) as needed most. Here, it gets pretty technical with biochemistry, but it’s worth the effort for the stakes are critical.
As Lane says, “To understand this cycle of energy and matter is to resolve the deep chemical coherence of the living world, connecting the origin of life with the devastation of cancer, the first photosynthetic bacteria with our own mitochondria, the abrupt evolutionary leap to animals with sulfurous sludge, the big history of our planet with the trivial differences between ourselves, perhaps even the stream of consciousness.”
I found this both amazing and illuminating. For example, I knew the Warburg effect, enhanced glycolysis that happens with most cancers. But I always wondered why cancer cells avoid mitochondrial respiration in favor of the less efficient use of glycolysis. Warburg said it was because cancers degenerate to more primitive chemistry. Which is sort of saying cancer cells mess up. Nonsense. Like all life, cancer cells are under selection pressure and evolve. They have the Warburg effect because growth and cell division favor cancer growth.
Energy production in the form of ATP is less important. In fact, too much ATP actually harms cancers, since ATP is the final product of several key growth pathways and having a lot of ATP around backs the reactions up and leads to less of the useful products.
For an in-depth dive into biochemistry, Lane does a fantastic job of keeping the book readable and, indeed, animated. Lane’s excitement comes through. And now I understand both aging and cancer a lot better. And my own work on mitochondria makes a lot more sense. Mitochondria are, as Lane reminds us, the 2-billion-year-old remnants of ancient bacteria that were taken into our ancestral cell as part of a biological symbiosis. Lane also reminded me that mitochondria do much more than provide our cells with energy.
They, and their maternally derived DNA, do a delicate dance with our nuclear DNA to control metabolism and help evolve us to adapt to changes in our environment and diet. And when this adaptation works less well, we succumb to the changes with accelerated aging and cancer.