• What We’re Reading This Summer 2021


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

    Gambling with Armageddon: Nuclear Roulette from Hiroshima to the Cuban Missile Crisis

    By Martin J. Sherwin
    Reviewed by Samuel Masket, MD

    Fascination with the administration of President John F. Kennedy continues today despite the fact that it is more than 60 years since his inauguration.

    We can consider his persona, looks and “breeding,” Jackie Kennedy’s captivating charm, their adorable children and certainly his cataclysmic assassination for much of the ongoing interest. But the Cuban missile crisis and Kennedy’s credit for managing it successfully remains center stage as the outcome impacted nearly everyone on earth. As our youngest elected president, he came under scrutiny for his early failures, notably the Bay of Pigs debacle and his diplomatic “manhandling” by Russian Premier Nikita Khrushchev during their first meeting in Vienna in 1961.

    However, as we come to learn from the author’s remarkable research, the Bay of Pigs invasion was the brainchild of the prior Eisenhower administration and very consistent with the covert actions of his intelligence team; President Dwight D. Eisenhower was every bit a hawk, although this may not have been apparent to the public. Indeed, the nuclear arms race between the U.S. and the Soviet Union was due in great part to Eisenhower’s policies, according to the author.

    The missile crisis was brought about by the alliance between Khrushchev and Fidel Castro in Cuba. Surreptitiously, in 1962 launch pads for nuclear war head missiles were being constructed in Cuba by Russian engineers with the purpose of pressuring the U.S. and changing the balance of global nuclear power, as the U.S. had nuclear weapons on the ready in Turkey and elsewhere in Europe. Once construction was observed and photo documented the crisis was underway. Although much of this saga represents well-known history, the author’s detailed research, garnering notes and audiotapes brings a clear picture to the actual events. These documents only became available when declassified in the 1990s.

    What is most remarkable about the book is that the reader surely knows the outcome and the actions of many of the players, yet the writing is so suspenseful in style and the knowledge gained so vast, that the book commands one to keep turning the pages as though reading a spy thriller. Although Fidel Castro cajoled Khrushchev to attack and military leaders and other advisors egged on Kennedy in similar fashion, neither of the principal players wanted a nuclear holocaust and wisdom prevailed. That said, however, there were other heroes and a good bit of serendipity on both sides, allowing for a negotiated settlement.

    I so appreciate the education gained from good nonfiction writing and I genuinely recommend this book for what the reader will learn while being entertained.

    Tiger in the Sea: The Ditching of Tiger 923 and the Desperate Struggle for Survival

    By Eric Lindner
    Reviewed by J. Kemper Campbell, MD

    Seldom does a book’s content match the hype of a cover designed to attract the attention of potential buyers. However, in the case of “Tiger in the Sea” by Eric Lindner, the abject terror of a passenger plane’s night-time plunge into the frigid North Atlantic not far from the Titanic’s watery grave is mirrored by the prose within. The striking cover illustrates the hopelessness of the situation.

    In 1962, flight Tiger 923, a Lockheed four-propeller Super Constellation aircraft with 76 people on board crashed into stormy seas 500 miles off the coast of Ireland. Miraculously, 48 people survived despite having to cling to a capsized raft meant to accommodate only 20 while resisting the battering by 30-foot-high waves.

    The book, which is meticulously documented by author Lindner from official records, memoirs and personal interviews with remaining survivors, describes the events leading to the crash, the massive rescue efforts, and the subsequent investigation of the causes. Lindner’s efforts were hampered by the government’s desire to conceal safety concerns of Flying Tiger Lines, a civilian subcontractor hired to fly military personnel.

    Two of the airline’s Super Constellations had already crashed in 1962 and most commercial carriers had switched to the more effective Boeing jet engines. Nevertheless, Flying Tiger remained the Pentagon’s largest civilian contractor during the sixties by ferrying troops to and from South Vietnam. Also complicating the investigation was the cold war consideration of explaining the presence of members of the 82nd Airborne paratroopers bound for Germany on board.

    Somehow the official Civil Aeronautics Board inquiry was conveniently “lost” by the U.S. National Archives, despite considerable national publicity including the personal attention of President John F. Kennedy. Lindner’s persistence in overcoming these obstacles is understandable. He was motivated by the fact that the heroic pilot of the doomed aircraft, Capt. John Murray, was his father-in-law.

    Although the harrowing tale of the crash and rescue efforts is riveting, the greatest strength of the book is the detailed descriptions of how the survivors used their “borrowed time” throughout the remainder of their lives. Rescue efforts were difficult because of the violent storm, the lack of communications other than a single flashlight, and the loss of the other four life rafts attached to the sinking plane. Obviously, the experience left an indelible imprint upon both survivors and rescuers. Some were left with life-long PTSD, feelings of “survivor guilt” and fear of flying.

    However, one passenger, Maj. Dick Elander, who was the ophthalmologist at West Point, prevailed and became a prominent physician in California. His son, Troy, also an ophthalmologist, has flown around the world providing free eye care and training in third world countries on the Orbis Flying Eye Hospital. Ironically, FedEx provided the plane after acquiring the Flying Tiger Line in 1989.

    Capt. Murray continued to pursue his illustrious flying career until his tragic demise in a 1966 swimming accident.

    This book is an example of the ability of the human spirit to overcome even the direst circumstances. The bravery and cooperation of the international, multiethnic and racially diverse victims and rescuers is truly inspirational.

    Why Nations Fail: The Origins of Power, Prosperity, and Poverty

    By Daron Acemoglu and James A. Robinson
    Reviewed by Alfredo A. Sadun, MD, PhD

    Nogales is a small town in Southern Arizona and in Northern Mexico in the state of Sonora.

    It sits on the border and has a fence separating the two halves. It had two post offices, two police stations and, more importantly, two public school systems. There is a lot of cross-border movement. However, there are remarkable differences between the north and south sides of town. Those on the north live more than a decade longer than those on the south. And those on the north make, on average, three times as much as those on the south.

    Why? It isn’t because of ethnic differences; they are pretty much the same on both sides of the border. And, of course, the climate, terrain and geography are all one. One would have to conclude that the quality of the institutions is very different and that matters.

    Economist Daron Acemoglu and political scientist James A. Robinson study these two cities as well as many countries in societies, past and present and considered their economic, health and other factors to consider why some failed and others succeeded at what we consider important.

    In Africa, Somali is a failed state, but Botswana is not. Climate, natural resources and geography are only a small part of the problem and solution. What the authors found most important were the politics and cultures of each nation.

    The most powerful point I learned is that good economics does not mean good politics, and politicians choose poor economic policies on purpose as it serves their needs. A king or authority chooses to allocate his resources to appease his constituents, well aware that this comes at a great general economic cost.

    In the U.S. we are told, “It’s the economy, stupid.” But which economy? Some might want unemployment to be low and average income up. But others may prefer a low tax rate and highs in the stock market. Societies that are based on powerful (extractive) interests will likely indulge these interests over the health of the general economy.

    It’s also clear that economic markets work best when there is trust in leaders, in institutions, in our fellow human and in the future. I have traveled and heard it said that corruption without obvious victim is no big deal. But it is, for corruption removes trust in people and institutions. So political leadership matters a great deal. Furthermore, inclusive, non-extractive societies allow for power-sharing that will maximize the economy for most, whereas extractive societies will choose policies that only benefit their elite.

    Look at a satellite nighttime map of East Asia and you can clearly delineate the border between North and South Korea. On one side of the border the people live over a decade longer and are 10 times richer than the other. Politics, norms, culture and institutions matter.

    American Kingpin: The Epic Hunt for the Criminal Mastermind Behind the Silk Road

    By Nick Bilton

    Reviewed by Thomas Harbin, MD, MBA

    Remember the Silk Road? Not the one that connected the West with China and the East, but the online black marketplace.

    It flourished between 2011 and 2013, initially selling relatively harmless illegal drugs but expanding to arms, weapons, every kind of illegal drug and even body parts. Buyers and sellers lived all over the globe.

    Ross Ulbricht, an aimless but brilliant young libertarian who felt that the government should not control what someone put in their bodies, started the website in 2011. It rapidly expanded to a multi-million enterprise and Ulbricht became the target of law enforcement agencies. They hunted him in vain for two years, finally catching him and shutting the site down. By then, Ulbricht had accumulated close to a billion dollars in Bitcoin.

    The book provides amazing personal details on Ulbricht as well as the FBI and other agents who hunted him. A tad long and a bit wordy, but fascinating.

    Galileo: And the Science Deniers

    By Mario Livio
    Reviewed by Alfredo A. Sadun, MD, PhD

    Why a new biography of Galileo in 2020? There have been plenty before.

    It’s because Livio’s story is not so much about Galileo as about the Galileo affair. This affair was about the church’s denial that the earth moved, and that controversy mirrors the modern versions of science denial. Livio wrote this as an allegory of how, now, politics drives many powerful people to deny global warming.

    But as I read the book, I thought it applied to the anti-science sentiments of anti-vaxxers. Why do one-third of Americans plan to avoid the COVID-19 vaccine even after abundant evidence that it is relatively safe? I kept asking myself that question, and this book had some answers.

    Galileo, with formal application of the scientific method, mathematics and his telescope, was able to demonstrate convincingly that the Copernicus model of the sun in the center of the solar system was correct, and therefore the earth was neither central nor stationary. But these thoughts were vehemently challenged by the Roman Catholic Church.

    In 1616, the Inquisition declared his claims of heliocentrism to be "formally heretical." One interesting insight is that the pope and the cardinals were not fools. As individuals, they had tried his new telescopes and seen for themselves that the moon was a planet with mountains and craters and that Jupiter had moons that circled about it. They had studied Galileo’s works and understood the science. Galileo had initially succeeded in convincing most of them.

    Further, they agreed that as long as Galileo limited himself to science they would limit themselves to interpreting scripture. But as a political body under pressure (this was shortly after the Protestant Reformation), they backed away from this compromise and doubled down on the broader claim that scripture also taught physics. Then, as now, the science was nuanced and complicated. Science can’t be absolute. It keeps approaching the truth with new evidence and subtle revision. How can that compete with simple conviction? Then, as now, there were those that used science to embarrass their political foes.

    Predictably, those in power, so humiliated, pushed back. And they can find resonance in the general fear of science by the ignorant and the specific fear by many intelligent people that science undermines their claim that the future is politically malleable. Science deniers in Italy in the early 17th century and today as well resented that science may seem to arrogantly set the agenda.

    Those of us who believe in science like to think it solves problems. Galileo was astounded that his inventions, including the telescope, weren’t perceived as useful to mankind. Despite his genius, he failed to appreciate the distrust of or even the threat of knowledge and reason to people in power. Science is again under attack by leaders, who in rejecting scientific claims, consolidate their political power. How can we avoid the same conflicts and mistakes?