Senior ophthalmologists share the best of what they’re reading this spring. Share what you’re reading and send your review to our book review editor, Robert L. Stamper, MD, at scope@aao.org.
The Song of the Cell: An Exploration of Medicine and the New Human
By Siddharta Mukherjee
Reviewed by Susan Ryu, MD
Author Siddhartha Mukherjee takes the reader through an enthralling story of discovery regarding the cell, the basic unit of life, which he describes as having “touched and radically transformed biology, medicine, and our concept of humans.”
Along this journey of discovery, we learn about the organization of cells, division of cells, immunology of cells, and tampered cells, impacted by viral transformation or mutations. Woven into this biological story is an equally revealing and inspiring story of dedicated scientists, researchers, and patients who have contributed to our better understanding of biology.
One of the many inspiring examples is the story of Emily, 7, who was diagnosed in May 2010 with acute lymphoblastic leukemia (ALL). Six months after undergoing a grueling regimen of chemotherapy, she relapsed and was placed on a bone marrow transplant list. Her disease progressed while waiting for a suitable donor. She was enrolled in a trial. Her T cells were extracted, grown outside her body, treated with gene therapy and then were reinfused into her body to fight the cancer cells.
On the third day of treatment, she developed raging fevers and multi-organ failure, causing her to slip into a coma. Her blood test showed 1,000 times the normal level of cytokines, mostly interleukin 6. Fortunately, she was treated with a new therapy that had just been approved. She woke up after two days. Her bone marrow biopsy at day 23 was clear of cancer cells. She has remained disease free to this day.
For those of you who have wondered about the advances in cell biology but were turned off by the complexity of the concepts, this author provides a captivating guide into the subject, which he makes eminently readable and understandable. Equally important, he describes how our modern understanding of the cell is blazing new trails in medicine and improving life for many.
The Masters of Medicine: Our Greatest Triumphs in the Race to Cure Humanity’s Deadliest Diseases by By Andrew Lam, MD
Reviewed by J. Kemper Campbell, MD
The confusion and mixed messaging of our public health officials during the Covid-19 pandemic has resulted in a loss of confidence by the American public in the medical profession. Now the most significant book to be reviewed in this space should reverse this misperception.
“The Masters of Medicine” by Andrew Lam, MD, restores the lost faith in the integrity of men and women whose aspirations were to improve the lives of all fellow humans. The book describes the innovators who risked their professional reputations and sometimes their lives to advance our medical knowledge to its present state.
Dr. Lam, who majored in history as an undergraduate at Yale and is a retinal surgeon in Massachusetts, includes an extensive bibliography, copious notes documenting his conclusions, and appropriate vintage photographs. He has also authored two novels, “Two Sons of China,” and “Repentance.”
His new book chronicles the remarkable but true stories of those unique individuals who have helped increase our average life expectancy from 48 years in 1900 to our present 78 years. The seven chapters are organized into the deadliest afflictions which have affected mankind from past centuries to the recent pandemic and the progress made in eradicating each one.
The first chapter deals with heart disease which still accounts for 25% of all deaths in the U.S. Fittingly, it begins with Dick Cheney the former vice president and secretary of defense, who had his first heart attack at age 37. Subsequently, he benefited from each new improvement in the treatment of heart disease by having a quadruple coronary bypass at age 47; an implanted defibrillator; a mechanical external ventricular assist device for his heart failure; and finally, a heart transplant in 2012. Cheney lives in Wyoming today.
Equally impressive is the progress in diabetes management since 1900 when a Type-1 diabetic’s life expectancy was less than 1 year, and the only treatment was near starvation. The rivalry between the discoverers of insulin is mirrored by other medical pioneers. France’s Louis Pasteur and Germany’s Robert Koch raced each other to find treatments for new deadly microbes. Jonas Salk and Albert Sabine vied to find the best vaccine to defeat the poliomyelitis virus.
Advances in treating the myriad variations of cancer include the immunotherapy which cured former President Jimmy Carter of metastatic malignant melanoma. Deaths from war trauma and childbirth have likewise been decreased dramatically by dedicated and innovative physicians.
Dr. Lam writes in terms which the nonscientific reader can understand. For example, he describes a pancreas as resembling Jabba the Hutt of “Star Wars” fame. He acknowledges the difficulties of achieving success in academic medicine and the future ethical risks and potential triumphs of genetic manipulation. His opinions seem well-reasoned and based upon common sense rather than political bias. This book should be read both for its homage to the heroes of medicine’s past and for its optimism regarding medicine’s future possibilities.
The Nazi Conspiracy: The Secret Plot to Kill Roosevelt, Stalin and Churchill
By Brad Meltzer and Josh Mensch
Reviewed by Samuel Masket MD
With age I have developed a keener interest in history than I had when younger, and I find Nazi and Holocaust era related material particularly compelling.
Perhaps that is because I sense and fear a global shift towards the right along with authoritarianism. I have an eerie feeling that we have “seen this picture before” and can only observe the trends. Moreover, I likely appreciate a sense of survivor’s guilt; I experienced no loss of family members during that period, given that my progenitors came to the United States far earlier, allowing me to be insulated from the horrors of the World War II era.
As a result, I could not resist reading “The Nazi Conspiracy” once it appeared on The New York Times bestseller list after being released in January 2023. As it turns out, the subject of the book is actually an isolated event regarding the “Big Three” meeting of Franklin D. Roosevelt, Winston Churchill and Josef Stalin in Tehran in 1943. That said, the book still contains numerous references to the atrocities of the Holocaust, as some of those key Nazi players are involved in the main plot of this book.
As the story opens, the reader is taken to an unmarked car traversing the back streets of Tehran at high speed with the key occupant heavily cloaked and hidden away on the floor behind the front seats; the precious cargo was FDR. Not unlike Hollywood film noir movies that fade to black and take the viewer to earlier times, the authors then revert to the delicate and deft politics played out by FDR in order to bring together the three global leaders of the Nazi opposition.
As history has taught us, the Nazi invasion of the USSR in 1942 was particularly brutal for both parties. Millions died of starvation, freezing conditions and horrific battles. Stalin was insistent on having the Allies attack the Germans from the rear through France via England in order to establish a second front, potentially easing Stalin’s burden.
On the other hand, Churchill was reluctant to proceed as he sensed that Britain was not as yet prepared to invade, and that failure would cost Europe any hope for success against the Nazi war machine. Interestingly, Churchill would continue to express that same concern even into 1944 in advance of the June D-Day invasion that ultimately sealed the fate of the Nazis. There was little evidence of true harmony among the “Big Three,” but Roosevelt’s cunning and astute political skills led the way for a public meeting to be planned, though timing and location were contentious and caused significant logistic and security snafus. But the public relations benefit of such a meeting loomed very large as it would demonstrate to the world that the Allies had the unity, ability, and resolve to bring down Hitler and in turn the Japanese.
The “back story,” however, is that German intelligence got wind of the proposed meeting and planned to assassinate the “Big Three” and turn the battle for public relations to their favor. The details of their plans and the operatives who would carry them out read like a spy novel, bringing the reader to frenzied page turning. The man in charge of the Nazi conspiracy operation was responsible earlier for a nearly unimaginable rescue of Italian dictator Benito Mussolini after his capitulation and capture by the Allies.
Of course, by history we know that the meeting of the “Big Three” occurred, was successful, and that the Nazi conspiracy failed to carry out the assassinations. Interestingly, records of all of these activities are sparse, and some critics have doubted that the event actually occurred, though the authors make a compelling argument for it. So, in the end the reader must decide if the assassination plot was fact or fiction, but the remainder of the history is essential reading for those interested in the details of that era.
The End of Drum-Time
By Hanna Pylväinen
Reviewed by Robert L. Stamper, MD
I remember, in high school, learning a bit about the Laplanders, a people living in the far north of Scandinavia earning a living by hunting and herding reindeer.
Although there is nothing in the actual word “lapp” that is inherently pejorative, many today feel that it is better to use their own word for themselves which is “Sami.” The Sami have their own language and culture which the Swedes, Norwegians, Finns and Russians from the more southern parts of their countries have spent hundreds of years trying to squelch.
The push on the part of Lutheran evangelicals to Christianize these semi-nomadic and spiritually devout people was particularly intense. Some of these evangelicals were not necessarily driven only by theological motives. Enter an unusual Lutheran evangelical, Lars Levi Laestadius in the mid-19th century. Part Sami himself, he preached a form of Christianity that appealed to many Sami’s based on forgiveness for sins that were openly confessed. He was particularly successful at reducing rampant alcoholism, often encouraged by his predecessors. Some of his teachings persist in small colonies in Scandinavia, Russia, North America and Africa as Laestadian Lutheranism.
Against this historical backdrop, Hanna Pylväinen has constructed a sweeping saga set in 1851 in a small town well north of the Arctic Circle and in an area where the fuzzy borders of Norway, Sweden, Finland and Russia meet. Lars Levi Laestadius is one of the central characters. Her novel encompasses forbidden love, competing evangelical tactics, brute force, and international politics all in a beautiful but desolate landscape. There is even some of the inevitable conflict between ranchers and farmers that characterized the settling of the American Midwest.
We learn a lot about Sami culture, at least amongst the nomadic, reindeer herding, mountain Sami’s. Her prose is evocative and helps us understand the forces of nature and politics that impinge on a millennium old culture that is being targeted (like so many indigenous peoples of the New World) for extinction by the forces of “civilization”. We learn how the Sami’s eke out their hard-scrabble existence in this harsh and unforgiving climate.
After finishing the novel, I was motivated to do some internet searching on Wikipedia, amongst other sources, to learn more about these interesting people and this era; after researching the subject, I wished I had read the material before or early on in the novel. It would have helped to decipher some Sami terms and understand the larger picture. The book would have benefitted from a glossary of Sami terms. The novel is a great read on its own but is historically accurate in some of the politics, theology and history; knowing some of that only enhances the full understanding of its engrossing story.
The Crimean War: A History
By Orlando Figes
Reviewed by Alfredo A. Sadun, MD, PhD
"The Crimean War" is a well-researched account of a conflict that reshaped the political landscape of Europe in the mid-19th century. What fascinated me most is that the book is a preamble to and a parallel of the present war in Ukraine. The same geopolitics. The book offers a detailed overview of the war and the political tensions that led to the conflict when Russia invaded the lands near the Crimean Peninsula.
The Crimean War was fought from 1853 to 1856 between Russia and the allies, which were mainly the United Kingdom, France, Turkey, Austria-Hungary, Prussia (Poland) and Sardinia-Piedmont. Sound familiar? What we have now as NATO were the allies then. Ironically, Russia invaded the countries around the Black Sea then because the czar was convinced such an invasion would drive the countries of Europe apart as they would never support Turkey, a Muslim country.
That miscalculation is repeated again now. Another interesting aspects of Figes’ "Crimean War" is the focus on the role of technological innovation in the conflict. The Crimean War saw the first use of the telegraph and the railroad in military operations, and these innovations changed the nature of warfare just as satellites and drones changed the nature of warfare in Ukraine. These new technologies made the cavalry charge (remember the “Charge of the Light Brigade” at Balaclava) ineffectual just as drones and shoulder mounted guided missiles now make tanks less effectual in the Ukrainian war.
I learned the extent to which Russia views itself as the protector of the Eastern Orthodox Church then, and now. The Eastern Orthodox Church began in 11th-century Crimea, and so Crimea is viewed as holy ground. Some of this symbolism is lost on us in the present war in Ukraine. Czar Nicholas went to war as he was personally offended by his exclusion and lack of influence from European affairs. Later Czar Alexander continued the war as he could not lose face and autocratic control. Sound familiar? Putin is still fighting that war.
The war opened when the Russians acted in a brutal manner in the Battle of Sinope when a squadron of Russian ships assaulted the harbor in 1853 pulverizing the infrastructure and non-combatants. They did this thinking it would impress and discourage involvement by the West, much as the brutalities at Bucha were made to discourage resistance. It might be argued that Russia was used to brutal tactics in suppressing their Serfs (actually slaves in their society) and thus completely misread the West’s reactions then, and again now. The war showed the corruption in the Imperial Russian Army. It also drained Russia of blood and treasure and deeply undermined Russia's influence in Europe.
Peace came when the Russians, finding themselves exhausted and at war with most of the rest of the world, came to terms with the Treaty of Paris in 1856. This treaty forbade Russia to base warships in the Black Sea. The present war in Ukraine is the continuation of that conflict as Russia has always been humiliated and handicapped by that limitation.
“The more things change, the more they remain the same.”