• What We’re Reading This Winter 2021


    His Truth is Marching On: John Lewis and the Power of Hope
    By Jon Meacham
    Reviewed by M. Bruce Shields, MD

    The tumultuous year of 2020 will go down in history for many reasons. One of those will be the passing of the civil rights icon and longtime U.S. congressman Rep. John Lewis, on July 17, 2020.

    The significance of his contributions to racial justice in the twentieth and twenty-first centuries makes this account of his life by Pulitzer Prize-winning author Jon Meacham one of the most important books of the year.

    Lewis was an advocate of nonviolence, a philosophy he learned from Martin Luther King Jr. and others. He also aspired to be a minister. As a child on his family’s Alabama tenant farm, he preached to the chickens. In fact, his first act of nonviolence was refusing to eat them. At age 25, he participated in the march over Pettus Bridge in Selma, Ala., where he was beaten and taken to the hospital with a concussion. But he and the others returned two weeks later and completed the march from Selma to Montgomery (54 miles) in three days.

    It is hard to imagine what it must be like to allow another person to beat you without retaliating and to even convince yourself that you love that person. But that is what Lewis and many others like him did repeatedly. He was jailed 40 times, five during his time in Congress, where he served with distinction for 34 years. In 2011, he received the Presidential Medal of Freedom.

    If and when our country achieves true racial equality, it will be to the credit of men like Lewis. For those who hope for that day, I highly recommend Meacham’s book.

    Being Mortal
    By Atul Gawande, MD, MPH
    Reviewed by Alfredo A. Sadun, MD, PhD

    I am afraid of dying.  And why not? I’m 70 and need to come to terms with that eventuality.

    When I was younger, the issues of life and death had deep philosophical and psychological implications that I felt were overwhelming.  Now, as I’ve learned more about life, it’s less about these theoretical concerns and more about the ugly process. 

    This New York Times bestseller by practicing general surgeon Atul Gawande, MD, MPH, argues the point we’ve often heard:  Quality of life should take priority over quantity of life. He offers models for assisting the infirm and the elderly, but more importantly, demonstrates that a person's last months can be elevated to maintain value and dignity.

    The first half of “Being Mortal” was good, but it was largely sociology.  It asked what’s wrong with our society and health care systems and what remedies could be considered to better handle the challenges of people too old and too sick to take care of themselves.  But it was the second half of the book that was profound as it ranged from philosophical to practical.  The anecdotal stories were deeply moving but also grounded in evidence.  I was surprised to find the answers to some problems that I had pondered much of my life.  

    For example, Gawande described the difference between transactional loyalty (which is bad, at least in excess) and loyalty to something grander than ourselves (church, community, country, idea).  "Loyalty to causes that have nothing to do with self-interest …” is its own reward.  And this gives life meaning, even when confronting the pain and loneliness of the final months of terminal illness.  Gawande argues that the key to facing our mortality is to have a voice in facing it. 

    Orson Welles famously said, "You are born alone, and you die alone.”  This need not be true in the physical sense.  The dying can and should feel their family connected and condensing around them.  Yet maybe it is true in the deeper spiritual sense.  You can hold hands, but at the end of the day, only one of you is gone, so it can't be a completely shared experience. 

    There is inherent loneliness in dying but that can be partly mitigated.   As Woody Allen said, "It's not death I fear.  It's the dying."  Gawande did a masterful job explaining how we dread the loss of dignity, of control, of no longer being the author of our own narrative — that's all worth fearing.  But much can be done to address this.  And having read the book, I think I'll do a better job talking to my seriously ill patients.  I'll stop to ask them what they hope for, what they fear, and what their priorities are. These are the three key questions for us to ask of them.  And for us to ask our family members and, most importantly, to ask ourselves. 

    This is a good read for all, but especially for those who have family approaching their last decade and especially for physicians who may be called upon to help with difficult decisions.  But it is also a guide and comfort for ourselves.

    Red Stilts
    By Ted Kooser
    Reviewed by J. Kemper Campbell, MD

    At 81, Pulitzer Prize-winning poet Ted Kooser seems as firmly rooted in the Nebraska landscape as the Bohemian Alps in which he resides.

    Despite his recent second retirement from his teaching position at the University of Nebraska and as editor of his syndicated newspaper column, “American Life in Poetry,” he continues to write daily. His 15th book of poetry, “Red Stilts,” demonstrates that poets, like fine wines, continue to improve with age.

    Poetry, perhaps more than any type of written communication, relies upon that invisible bond formed between author and audience. The emotions evoked by the poet in each reader are unique and result in a shared intimacy between the two.

    Fittingly, this book begins with a letter from the poet to his readers. As the sights, sounds and ambiance of a summer night in a small town are carefully assembled, the reader discovers that the scene has been conjured entirely from the poet’s nostalgia for an imaginary time. Fortunately, as his childhood footsteps fade into the night, he leaves the hint of his future return.

    With his opening three-page letter the longest poem, the remaining short poems are divided into four sections corresponding to Midwestern seasons, beginning with those appropriate for Winter and ending with Autumn. Those familiar with Kooser’s work will recognize his skill at connecting the ordinary events of daily life to the sublime.

    His observations of a dead vole or a field mouse struggling in the talons of a red hawk will lead to meditations on the transitory nature of existence. A neighbor watering her petunias can remind readers of the beauty available in any of the mundane moments which, when connected, form our lives.

    An old man’s mind, as this reviewer can verify, is able to recreate vanished scenes with a miraculous clarity. The footprints left in the morning snow by a father seventy years ago will remain untouched by the sunlight and a long gone, familiar Sherwin-Williams signboard retains its brilliant red hue. Rummaging through Kooser’s memories is like visiting an antique store in which every corner yields a fresh delight.

    As one of the truly accessible poets, Ted Kooser is the ideal companion for those plagued by the anxieties of the pandemic. Keeping this slim volume at bedside for re-reading will soothe the jangled nerves unleashed by the daily news. Rather than a dictionary, readers need only bring a welcoming heart.  

    The Angel and the Assassin: The Tiny Brain Cell that Changed the Course of Medicine
    By Donna Jackson Nakazawa
    Reviewed by Thomas S. Harbin, MD, MBA

    Microglia- Who knew? We were taught that microglia were inert and the brain was immunologically privileged with no connections to our systemic immunology reactions and processes.

    Research in the last few years has refuted this dogma and provided potential avenues for diagnosing and treating many brain disorders.

    Microglia constitute 10% of brain cells and are neither glial cells nor nerve cells. Instead they are immune cells, not inert but actively pruning and reshaping the synapses in our brains, usually for the good, but sometimes for the bad.  Just as our systemic immune calls almost always protect us but can sometimes become destructive and cause the various autoimmune diseases, so can microglia. 

    The author discusses the research that has led to the new knowledge of microglia both in imaging and diagnosing problems, but possibly in treating a number of diseases including dementia.  Sometimes a bit repetitive, but always interesting.

    A Gentleman in Moscow
    By Amor Towles
    Reviewed by Laurie Gray Barber, MD

    Amor Towles, author of The New York Times bestseller “Rules of Civility,” penned this marvel of a life elegantly lived.

    Released in 2016, a “Gentleman in Moscow,” is a study in emotional discovery while forcibly losing contact with the outside world. The introspection and the wonderful treasures that can be found while limited spatially is correlative to 2020, our pandemic year.

    Our protagonist, Count Alexander Rostov, appears before the Emergency Committee of the People’s Commissariat for Internal Affairs in 1922. His life prior has consisted of, as he mentions in his tribunal, “Dining, discussing. Reading, reflecting. The usual rigamarole.” Because the apparently rudderless count had written a poem construed by the Emergency Committee as insurrectionist and elitist, he was sentenced not to the firing squad, but to a lifetime of house arrest. The Metropol, a grand hotel facing the Kremlin, would be his jail and his awakening.

    Count Rostov proceeds to press his indelible mark into surroundings of opulence while ensconced in an attic space, as well as into his newfound friends who previously served him and into other hotel guests that saw his potential before he realized it.

    A piece of historical fiction, the book informs readers of the many dark years Russia suffered before and during the count’s incarceration. Before, Russia suffered through a world war, a civil war, and two famines.  During his incarceration, Russia began “collectivization,” where farms served the “common good”, the elite were brought low or killed, organized religion shuttered, and the Great Purge, followed by World War II.  Throughout the historical events, the count could only watch through the window of the Metropol and hear through the conversations of other hotel guests that which was transpiring.

    Both incarcerated and sheltered in the magnificent Metropol, the count observes and describes intricate details of his small space, magnifying significance and beauty.  Amor Towles deftly weaves a tale of a man who flourished, searching for a “deeper understanding of what it means to be a man of purpose.” Humor, romance, cuisine and wine appreciation are woven into the tale of a man who relishes, regardless.

    This book has inspired my husband to research and then prepare Latvian stew (which uses dried plums and apricots, as well as fine cuts of pork).  It encouraged me to smell fennel in the spice drawer, sip a fine brandy and gaze around the immediate world rather than glimpsing quickly.  May the book, and the stew, bring richness and life flavor as well! 

    The Boys in the Boat
    By Daniel James Brown
    Reviewed by Samuel Masket, MD

    For those who relish nonfiction, love to read of triumph over tragedy, appreciate that work ethic and team play still matter and enjoy the juxtaposition of world history with sporting events, Dan Brown’s book will thrill you. 

    The story is based on the University of Washington’s crew team in the mid-1930s and their quest to reach Hitler’s 1936 Berlin Olympic Games.  But underneath the vicissitudes of training, racing, qualifying, etc., is the personal and difficult story of the protagonist, Joe Rantz, a child of the Great Depression who was left to his own abilities after being abandoned by his family at a young age.

    Although his story is a remarkable tale of will and survival, he forged a bond with his teammates, coaches, and a young sweetheart; those relationships propelled him to achieve his potential.

    The UW team was considered ragtag, comprised of the sons of loggers and other blue-collar workers of the Pacific Northwest; they competed against the scions of the very rich at meets across the country, with remarkable success against the “smart money.” 

    Each competition is described with such verisimilitude and excitement that the reader will literally turn the pages in anticipation.  But this story is far more than racing competition; it is a metaphor for the struggles of the Great Depression and the virtues of perseverance. This book remains among my all-time favorites. 

    The Lost Continent
    By Bill Bryson
    Reviewed by John Stechschulte, MD

    2021 will be a good year in which to read “The Lost Continent,” by Bill Bryson. The book will help the reader laugh while bringing back childhood memories (some awful) of long family vacations taken by automobile to distant places. This is a funny, insightful, and touching book about the author’s search for the heart and soul of America. 

    Bryson drives across the U.S. visiting 38 states looking for the perfect town. He tries to retrace some long road trips he took with his father to tiny towns. He remembers how cheap his father was and his father’s “ability to get hopelessly lost without ever actually losing sight of his target.”

    On his own solo journey, Bryson vividly explains his opinions of the people he meets and the places he encounters. He is seldom polite or positive, but he did like the genuine feel of Leadville, Colo. He drove 14,000 miles in search of the ideal city he called “Amalgam,” whining about nearly every state that he entered.

    The author ends his drive and concludes the book by returning to his hometown where he finds that he is finally “almost serene”. Brian Bryson grew up in Des Moines and begins his trip in Iowa. For 10 years prior to this book he lived in England. He obviously adopted too much of the dry British wit, but that makes the reader chuckle on nearly every page of the book. If you grew up in a small town, you’ll turn the pages quickly hoping to find that he visited your hometown and discovered a “pleasantly acceptable” Howard Johnson’s meal there. Newsweek described his book as a “snide travelogue”.

    Bryson describes most towns as hypnotic and devoid of stimulus, but he says one city, Charleston, is enchanting. He says people in the Midwest are friendly, farmers never feel any pain, and that all Americans are “slow but overall good”. He claims these facts - Maine grows more potatoes than Idaho, nearly every Nevadan was born elsewhere, RV’s are life-support systems on wheels, and that England has more hikers than the U.S. Bryson has written other humorous books about backpacking across Europe, the small island (England), and the English language. “The Lost Continent” may make us more adventuresome in the New Year.