What topics do you like to discuss?

It largely depends on who I am conversing with but I enjoy discussing current affairs, anything related to science, and history. We are told to avoid discussion of politics, sex, and religion with people we do not know well, but those are never off the table if someone else introduces them.

Risks

Describe a risk you took that you do not regret.

When I left a secure position as an associate professor at Western, after being denied a promotion to full professor, I had concerns about my future as a private practitioner dedicated solely to hepatology. But my research, teaching, and patient care flourished without the restrictions of university and hospital politics, And it proved at least as remunerative as practice within academia without all the stress and boring committee meetings. No regrets.

Long Way Down. Jason Reynolds. 2017. Approx 180 pages (no numbers to the pages)

I am thrilled that all four of my grandchildren have become avid readers, so when the 12 year old suggested this book, said to be for “14 and up”, I felt I owed him the courtesy to check it out. I expected something light and fluffy, not a dark graphic novel composed entirely of cartoons set in a black ghetto in an unidentified city.

The loose plot is of one boy in the world of street gangs warring over territory for drug dealing and includes a lot of street gang lingo, shootings, and revenge. It realistically includes the broken families and lawlessness of the setting. But it also includes some magic as the lead character plans to revenge the shooting of his older brother, uncle and father by talking to them for advice.

The artistry is more like graffiti than anything closely attached to the plot, but that is probably intentional. All in all, a dark but interesting and very uniquely American three hour read.

⭐️⭐️⭐️

Thanks, Kiran.

My Best Mistake. Terry O’Reilly. 2020. 9 hours, 2 minutes. (Audiobook)

In his distinctive voice, the Canadian advertising executive and host of CBC radio’s Under The Influence builds on a common observation. Big mistakes often become positive turning points for the individuals involved. Not limited to those in the advertising industry, he delves into the lives of entrepreneurs, Hollywood moguls, inventors, sports stars, and entertainers whose apparent massive mistakes changed their lives forever for the better.

I found some of the 20 short profiles mesmerizing, and others a bit confusing. Among my favourites is the story of how a massive overestimate of the demand for Thanksgiving turkeys lead to the timely creation of the very profitable Swanson TV dinner enterprise, the uncanny mistake of getting drunk and hungover making Seth McFarlane miss his plane on 9/11, the second one that flew into the World Trade Centre, and the creator of the Old Farmer’s Almanac leaving the predictions for July, 1816 missing, with a kid adding in snow and sleet as a joke, which proved accurate. I won’t spoil the read for others by detailing other unlikely but true tales.

Reading this engaging, carefully researched book made me reflect on my own many mistakes and pick the one that best fits the category. That would have to be applying for a promotion to full professor in academic university medicine at The University of Western Ontario. That was denied by my duplicitous colleagues, some after assuring me that they would support me. That led me, with my wife’s encouragement, to leave the academic world and set up a private practice dedicated wholly to liver diseases, the first in Canada, while retaining hospital privileges, based on legal precedent. It proved to be much more relaxing, less restrained by university and hospital rules, and at least as remunerative as full time academic practice. I set my own schedule, hired my own staff, and attended few committee meetings. I conducted more research and teaching with much less stress for the next 15 years than I would have ever done as a full professor, and enjoyed it far more, right up to when retirement called.

⭐️⭐️⭐️⭐️

How do you use social media?

Obviously, I use this site to publish my book reviews. In addition, I use Facebook to keep in touch with many friends. I use Safari to find answers to questions that pop into my head, And google maps to plan trips, mostly to local spots. I play Scrabble on line with a few friends, subscribe to three magazines online and borrow ebooks or audiobooks from the library. Since Covid, I have used Zoom to connect into three educational outfits. I guess some of these uses are not strictly social media, but more just internet use.

What place in the world do you never want to visit? Why?

The interior of Antarctica. I have been as far as several stations on the Antarctic peninsula, and greatly enjoyed that but the loneliness, endless whiteness and desolation of anywhere closer to the South Pole would be pretty boring.

the Myth of Normal. Gabriel Mate. 2022. 18 hour, 24 minutes. (Audiobook)

This is the very iconoclastic rant of an Hungarian Jewish physician and prolific writer and speaker working with the downtrodden population of lower east side Vancouver, mostly with drug addicts. His previous books and his film “Trauma Awareness” have been very well received and apparently are sort of background material for this one. (I have not read or seen these.) He shows throughout the book distain for the capitalistic, consumerist ‘toxic culture’ of the subtitle but only gives some tentative suggestions for society-wide changes needed in the last half hour of this read, including changes in educational institutions, medical and legal training and in so-called correctional institutions. His disillusion with communism in his youth, with American atrocities in Iraq, and with Israel’s cruelty to Palestinians no doubt colour his current opinions.

(Sorry, Dr. Mate, my iPad refuses to enter the diacritical e in your name) Mate’s definition of trauma as an internal response rather than external events that we have little or no control over is a little peculiar and leads to dissection of emotional responses to physical events ad nauseam. His definition of addiction is also complex and makes everyone fit in as an addict to something, but he counterintuitively relates it mainly to early childhood adverse events that fit with his definition of trauma. He does not indulge in the debate about whether or not there is such a thing as a mind, soul, or spirit separate from the molecules in one’s nervous system, as many philosophers do endlessly, but uses the word bodymind as a unity, not a dichotomy, and as an intricately interconnected entity. Later chapters suggest that he accepts that there are such entities as a soul and a spirit separate from the body, but what they are is vague at best, and no specific religion is endorsed, with just a hint of praise of Buddhism.

The modern biologic sciences are not neglected and he discusses subjects such as the effects of stresses on telomere shortening, epigenetic expression of genes and inflammation as a mediator of all kinds of diseases, often originating in changes in neuronal wiring and transmitters from trauma. Surprising observations such as that only 25 % of the increased longevity in Canada over yeas is attributable to health care interventions, that no genes for addiction have been found, and that loneliness is as big a public health crisis as devastating as the obesity epidemic seem to rest on solid evidence. Other accepted assertions based on social science association studies may suffer from the common problem of equating correlation with causation, and anecdotal observations e.g. that patients who develop ALS share a distinct personality, though not easily dismissed, are on shaky ground and not statistically analyzed at all.

There is a great chapter on the medicalization of childbirth and the need to revert to some more traditional practices in that field. At the same time, while critical of much of mainstream medical care practices, in this field and many others, He is careful to include disclaimers about not totally dismissing them and about not blaming victims who develop diseases that he believes are caused by their unwitting compliance with expectations of a ‘toxic culture’. The child rearing industry also comes in to severe criticism and the proliferation of parenting advice is referred to as the “parenting industrial complex”.

In chapter 23 rampant misogyny in a patriarchal society is alleged to explain gender discrepancies in incidence and severity of almost all debilitating diseases -but that, I note does not explain why women on average outlive men. In the next chapter, the author’s remote dissection of both Donald Trump’s and Hilary Clinton’s psyches is interesting but the conclusion that their personas are entirely explained by their childhood traumas as he defines trauma seems a bit simplistic. His penchant for analyzing the rich and famous without any need to meet them extends to our last two Canadian prime ministers and predictably he cites childhood trauma as the reason for most of their actions and beliefs. He seems to think that no one has had a happy childhood, and if they claim to have had one, they must be suppressing memories of abuse. The suppressed memories phenomenon is real but probably rarer than claimed by many writers. (What memories have I suppressed to recall mainly happiness and little ‘trauma’ in my childhood?)

Robin Williams’ suicide is traced to his insecurity, loneliness and bullying as a child even though he was aware that he was losing his mind and the autopsy showed that he had Lewy Body dementia, a disease that has never been linked to any mental stress or trauma. It is sporadic and labelled as idiopathic, a medical term for something of unknown cause. But almost nothing is of unknown cause if one follows all the links created here, mostly to childhood trauma.

This author shows a disturbing distain for and demeaning of mainstream medical advice, practices, and prognostications with selective documentation of miraculous recovery from apparently terminal illnesses. It seems odd that he never offers any opinion on the harm reduction strategies such as needle exchanges and safe injection sites for addicts, given his work environment.

Mate asserts that both higher than normal blood cortisol blood levels and lower than normal levels signal an unhealthy stress level, but ironically for someone whose book is titled “the Myth of Normal”, never questions how the margins of the normal or reference levels are set for this and many other ‘normal ranges’. One of my favourite beefs is when ‘normal’ is used wheree ‘average’ or ‘mean’ or ‘usual’ is the appropriate term as in weather reports of temperatures. For medical lab data, the normal or reference range is often set as what 95 or 98 % of what may be a highly unrepresentative population of hospital employees or university student volunteers has.

The therapeutic use of the ‘magic mushroom’ hallucinogenic psyllium is endorsed and he relates his use of it in a Peruvian ceremonial retreat. Yoga, meditation, and mindfulness practices are also praised. I will never condemn such practices, but they do not appeal to me.

In later chapters, healing, which everyone apparently needs, is described as a journey, not a destination. This leads to a long dissertation with fuzzy definitions of various mental exercises. Five levels of compassion are delineated with a lot of mystic opaque mumbo-jumbo and promotion of his own “Compassionate Inquiry” program that I found confusing.

Given the opportunity, there is no doubt that this author, on a panel to judge various phenomena, would invariably issue a minority opinion, rather than that of ‘conventional wisdom’ a term coined by the late economist John Kenneth Galbraith. But he provides sage wide-ranging counterintuitive and informative insights about our current economic, political, societal, and cultural milieu that made the read quite enjoyable and worthwhile for me.

⭐️⭐️⭐️

Thanks, Mike I. and Pat C.

What is your favorite restaurant?

Close to home there is a great Italian restaurant called Viamarzo, that has a good selection of unusual combinations including lot of choices for vegans, and great wines at reasonable prices. We take guests there quite often and have never been disappointed.

Surrender. Bono. 2022. 555 pages. 25 hours.

Surrender. Bono. 2022. 555 pages (Hardcover), 25 Hours (Audiobook).

Born in sectarian northern Dublin in 1960 to a Protestant mother and a Catholic father, Paul David Huston, nicknamed Bono by a childhood playmate, early on espoused a generic Christianity. But that Christianity rejects most of the St. Paul add-on doctrines dividing modern denominations, and is more like a moral code to live by as taught by Jesus than any specific religion. The god he prays to before every performance of his famous U2 band is seemingly capable of intervening in human affairs but is a bit ethereal and distant.

His mother died suddenly when he was 14 and much of his early life dwells on his mourning and insecurity as his distant father was unable to provide much guidance and/or praise. But he produced his first album of rock music at age 18, and soon thereafter established the famous quartet named U2 that stuck with him for the rest of his career to date, touring the world, playing to huge crowds and producing many albums. In later years, his music career was intimately interconnected with social and political activism, often incorporated into the lyrics. The impressive list of world leaders that he was and is on a first name basis includes Bill Clinton, Mikhail Gorbachov, Tony Blair, Angela Merkel, Pope John Paul II , Nelson Mandela, Lady Diana, Condoleezza Rice, George W. Bush, Volodymyr Zelenskyy, Bill Gates, Steve Jobs, Warren Buffet, and Oprah. Too many famous modern musicians to list were or are his pals. Perhaps most notably they include Frank Sinatra and Luciano Pavarotti. I may have forgotten others but notably absent from this list are Donald Trump and Vladimir Putin. His lobbying of movers and shakers contributed in a major way to such developments as the Good Friday Accord, the cancellation of billions of dollars of debts of poor countries to rich ones, making anti-retroviral drugs available and affordable to Africans, the end of the siege of Sarajevo, and action on climate change.

Bono’s Christianity apparently does not preclude overindulgence in alcohol and drugs, nor the liberal use of foul language, but he seemingly remained faithful to his childhood sweetheart wife Ali (or conveniently omitted mention of any affairs.) He admits to having an bad case of imposter syndrome with a strong belief that he does not deserve his fame and fortune, even though at times he comes across as having a Messiah Complex, solely responsible for saving the world. But for someone without a university degree, he demonstrates an immersive knowledge of literature and history. There is lot of navel gazing self examination about who U2 were and what they wanted in life with fuzzy distinctions between different messages they wanted to convey that were lost on me. But there is no doubt that Bono has been a positive force for good in the world over the last 45 years.

A few memorable quotes: “It takes great faith to have no faith.”

“If you don’t have a seat at the table, you’re probably on the menu.”

“Living well, as someone put it, is the best revenge. Come to think of it, just living will do.”

There are a few interesting insights into the increasingly complex world of music production and distribution in the age of digital remakes, and live streaming.

Later chapters detail a mystical searching for the Other, the meaning of existence, with no clear answers and a continuation of doubt that I found to be ethereal. The whole book is chronologically and geographically disjointed jumping all over in space and time like an agitated drunk rock star, for no obvious reason.

As someone born before the Baby Boomers, my music tastes tend toward the 19 and early to mid 20th century: I have never been a U2 fan and have trouble even understanding the sometimes subtle differences in genres labelled as rock, punk, punk rock, grunge, pop, soul, hip hop beat, but I do admire the socially-directed lyrics of many of the band’s songs such as Bloody Sunday. That one was attacked by both sides of the Irish conflict, and is, if I am honest, the only one I knew about before reading this autobiography.

⭐️⭐️⭐️

Thanks Ian G.

What are your morning rituals? What does the first hour of your day look like?

I rise between 5 a.m. and 5:30, without an alarm clock, open curtains to assess the weather, get dressed, have a sip of lukewarm coffee made the evening before, go out for a 20 minute walk, regardless of the weather, to think up a starting word for Wordle, come back and try it out out on my iPad, and play the Wordle, then respond to emails and scrabble games with friends, while finishing the coffee. Then try Worldle, the Guess The Country online game. Not very good at the latter. By 7, it is time to check the local obits online to be sure my name is not there.

Dinosaurs. Lydia Millit. 2022. 230 pages (Hardcover)

Dinosaurs. Lydia Millet. 2022. 230 pages. (Hardcover.)

The Tucson, Az. prolific novelist chooses Gil, a middle-aged bachelor from the east coast as the main character in this brief tale. In 2016, he sells his home in NYC and relocates to Phoenix. In very small morsels, his unusual personal history is revealed to the reader, and is tied to his very eccentric behaviour and his difficulties with relationships. He is orphaned, insecure, altruistic, wealthy from an inheritance, philanthropic, averse to conflict and confrontation, and frugal in his personal life, but why he has developed these traits is a mystery only slowly revealed.

The title refers to a growing interest shared with a friend in various bird species, the modern descendants of ancient extinct dinosaurs, and different bird species head each of the unnumbered chapters. In a tenuous sense their characteristics are related to his.

There are lots of poorly concealed marital infidelities, but no explicit pornography. Weak attempts to impart universal profound truths about the human condition generally fall flat, and Gil seems almost too altruistic and kind to be real.

One quote worth considering, although a bit enigmatic: “Freedom can only be found in the mind, my dear” she said. “Not in the world.”

An interesting, well-written short but not very memorable read.

⭐️⭐️⭐️

Thanks, The New Yorker, Goodreads.

What’s something most people don’t understand?

There are lots of possible answers to this, but the one that impacted me the most in my former life was the widespread belief that most liver disease is due to alcohol abuse. In my practice, alcoholic liver disease was # 4 in frequency, after nonalcoholic fatty liver disease, autoimmune diseases, congenital diseases in children. And one does not need to consume socially unacceptable amounts of alcohol to develop liver disease if you are susceptible, especially if female.

How has technology changed your job?

I don’t have a regular job, so, in a way, this does not apply to me. But I do a lot of reading and reviewing of books, and now much of my reading is of library books that I borrow on line as either ebooks or audio books.

The Ministry For The Future. Kim Stanley Robinson. 2020. 529 pages. (Ebook)

For those who prefer to read about the looming crisis from global warming in fictional form rather than as speculation by the likes of Sir David Attenborough, this is the book for you. Beginning 2025, as a subsidiary body under the U.N and based in Zurich is led by former Irish foreign affairs minister who is a composite character of diplomats Mary Robinson, Christina Figueres, and Lawrence Tubiana.

Beginning in the 2030s (The only mentioned dates are 2032 when all of the Arctic ice melted and 2034 when a drought caused all the wells in an Indian town to go dry.) and extending for at least the next 30 years, the devastating effects are encountered mainly in poorer countries the least responsible for causing the crisis, with whole cities wiped out in a boiling heat and they are also least able to afford mitigating measures like powerful air conditioners or building dams to hold back rising sea levels. An unprecedented heat wave in India, killing 20,000,000 in one week is the spark that ignites massive unrest and controversy around the world.The United Nations forms a Zurich-based Ministry For The Future to give legal standing for people who don’t yet exist following a 2024 Paris Agreement, with the young widow, Irish diplomat Mary Murphy, the main protagonist, as it’s president. A sole aide worker survivor from that Indian disaster, Frank May, suffering from PTSD becomes a terrorist kidnapper and saboteur of leaders of capitalist companies most responsible for emitting greenhouse gases, is eventually jailed, and becomes a victim of one of the worst diseases I can think of. He also kidnaps Mary temporarily to indoctrinate her because he thinks she is not doing enough; she later befriends him in prison in an awkward example of the Stockholm Syndrome.

Later, the dark offshoot of the Ministry, the Children of Kali, holds Davos attendees hostage to highlight the need to change, downs corporate jets with drones, assassinates fossil fuel company executives, infects beef herds with mad cow disease, and sabotages fossil fuel plants and cargo ships, all with ‘plausible deniability’ on her part.

Remediation efforts include pumping vast quantities of lubricating sub-glacier Antarctic water to the top of the glaciers to slow their slide into the Antarctic Ocean by increasing friction on their under surfaces, a carbon-sequestration currency offered by central banks and backed by longterm bonds offered at attractive rates (“go long on civilization”), using idled fossil fuel company kit in reverse to bury captured carbon dioxide in emptied oil and gas wells, and covering open Arctic water with yellow dye to reflect sunlight back into space. India engages in

geo-engineering, spraying particulate sulphur dioxide at 60,000 feet to act as a shield from the sun. Electric-powered airships (dirigibles) and sailing schooners with solar panels and kites largely replace jet planes and cargo ships.

The 106 chapters are generally short, but one pithy one discussing the concept of discount rates in the fields of markets, economics, and insurance as applied to the lives of future generations was particularly poignant to me. Why should my great great granddaughter’s life be of lower value than mine?

In one of the longer chapters, Mary Murphy, that President of The Ministry of the Future, a then low budget almost powerless institution, fails in attempts to engage the world financial system and very powerful central bankers, in the decarbonization efforts, but later they see the need and establish a world carbon cryptocurrency using block-chain and distributed ledger technology to reward people and companies for reducing their carbon footprint. The House of Saudi is dethroned and it’s replacement is rewarded for oil not burned and for switching to solar energy with trillions of dollar-equivalents in the new carbon coins. The world eventually sees a steady decrease in atmospheric carbon dioxide levels. Remaining global problems are not glossed over, including income inequality, gender discrimination, mass migration, and ozone layer and biodiversity depletion. In spite of development of a vast network of wildlife corridors around the world, creation of huge wildlife reserves, and promotion of regenerative farming, protecting biodiversity remains a global problem.

The American author’s impressively broad knowledge of atmospheric science, human psychology, (Jevon’s Paradox and Lima Syndrome are discussed) philosophy, and literature, languages, geography, macro economics, international law, inequality, biodiversity, mass migration of many species including Homo sapiens, regenerative farming, is all integrated in a complex and imaginative plot.

.

Some great quotes:

“Of course there is always resistance, always a drag on movement toward better things.The dead hand of the past clutches us by way of living people who are too frightened to accept change.”

“Maybe that was what PTSD was- the inability to do the work of forgetting or of not recalling.”

“Easier to imagine the end of the world than the end of capitalism.”

The Tipping Point, a phrase made famous by Malcolm Gladwell, is a valid concept that could be applied to the climate crisis. In Europe, it appears that that point with respect to converting to electric vehicles is when 10% of vehicles seen on roadways are electrically powered. Will it be the same in N.A.?

I see one theoretical contradiction in this great science fiction story. The new Carbon Coalition of Central Banks for Carbon Currency the agency urged on to the central banks by the Ministry For The Future uses block-chain and distributed ledgers in administering the carbon cryptocurrency. Most computer geeks I know allege that these are tech solutions looking for a problem to solve and need huge amounts of energy to operate, most of it currently coming from the burning of fossil fuels; they are helpful only to criminals trying to hide money, as the recent FTX fiasco has demonstrated long after this book was published.

⭐️⭐️⭐️⭐️

Thanks, Mike I.

Who was your most influential teacher? Why?

Dr. GERALD Klatskin of the Yale Liver Study Unit. He only took on two fellows each year, and his door was always open. I could go in at any time of the day, ask a question and he would launch into a long detailed long answer.