Author: thepassionatereader

First, the positives.This account by a Madison, Wisconsin surgeon, gives readers with no medical background a wealth of information about the history of organ transplantation. The discussion, scattered throughout it, of the many ethical dilemmas with no easy answers is quite profound and appropriate. The tragedy of people dying while waiting for a vital transplant is coupled with an earnest plea for more donors. The description of the driven quirky personalities of the early pioneers in liver transplantation, some of whom I knew, seems accurate and insightful.

Now some negatives. It takes the author only 40 pages of writing and three years in medical school to begin to belittle the lesser beings choosing paediatrics, obstetrics, gynaecology, and internal medicine as inferior to that of miracle-working God-like surgeons. Even in the Acknowledgments there is no recognition that hepatologists, cardiologists, nephrologists, pulmonologists, or endocrinologists have ever contributed to the rapid advances in clinical transplantation. Part of the less glamorous jobs of these medical specialists is to prevent the need for patients to ever meet a transplant surgeon in the first place by developing increasingly successful medical treatments. They also provide much of the care for the patients after transplantation, along with family doctors, nurses, physiotherapists and social workers, and develop better drugs for this aspect of patient care. If it seems that I am exaggerating about the author’s surgical hubris, consider this immodest statement: “…I was considered one of the best residents in the hospital.” To be fair, he admits that he was filled with self-doubt at that point.

At one point he ludicrously asserts that “If we got everyone to stop smoking and abusing alcohol and drugs, eating better, and to clean up the environment, we doctors would probably have very little to do.” Has he ever heard of genetic and autoimmune diseases and those caused by the vagaries of nature?

The errors of fact include the the assertion that there are no medical treatments for the itch of chronic liver disease, nor for the diseases that cause it, and that high cholesterol is a major cause of NASH. (If I recall correctly, high triglyceride levels are more important). Some of the minutiae of some of the surgical techniques seem unneeded in a book for the general public and may be difficult for even other specialists to fully understand. While the description of individual patients and diseases is informative for the public and sends the right message about the need for organ donation, it is also melodramatic and problematic. Did it never occur to him that he legally needs consent to identify his patients by name in writing for the public or to give identifying information about donors to recipients and visa versa to deceased donor families about the recipients? In Canada, this is prohibited by law. He ignores the major role of Western University and its ethics committee in developing (at our request) guidelines for transplanting livers into people with alcoholic liver disease; those were subsequently adopted by many transplant centres around the world.

I recognized the names of many people, procedures, routines, drugs, and complications; some of the people were colleagues and collaborators and a few were friends or at least acquaintances; others failed to earn my respect.

I can understand why many people with no medical background will enjoy this book. But to me it is the most blatant example of surgical arrogance and rah-rah Americanism that I have ever read. No one outside of the U.S. except for the surgeons Sir Roy Calne, Dr. Joel Cooper in Toronto, and Christian Barnard in Cape Town, South Africa, all of whom trained in the U.S., are given any credit for breakthroughs in the field.

Not all surgeons are so self-centred and hubristic. For more than I worked closely with my medical school classmate, the very skilled and innovative Dr. Bill Wall, who was trained by Sir Roy Calne in Cambridge. He was one of four surgeons in the world doing successful liver transplants in the early 1980s, the others being Sir Roy Calne, Tom Starzl in Denver, and and Rudolf Pichlmayr in Hanover Germany and Bill was the only one doing so in Canada, but he is never mentioned in the long chapter on liver transplantation, nor is Pichlmayar, Anything but hubristic, Dr. Wall demanded perfection in the O.R. but sought and valued the input of all team members from social workers and physiotherapists to dedicated nurses and medical types like me. He also relied heavily on transplant coordinators, intensive care specialists, and anesthesiologists. Although we not infrequently disagreed about the best course of action, I cannot recall an angry word from Bill. The failure of many Lone Ranger cowboy surgeons like the writer of this book to assemble and value such teams no doubt greatly delayed progress in the field. In retirement, instead of writing the definitive treatise on liver transplantation, Bill has honed his skill as an artist and written a delightful illustrated children’s book, The Ant Who Needed a Transplant, due to be published next month.

If you want to read about the history of organ transplantation, choose the very different Spare Parts by Paul Craddock, published earlier this year.

⭐️

Thanks, Floyd

A peculiar amalgam of historical facts and pure fiction, this novel by a Canadian best known as a conservative, often controversial, Ottawa broadcaster and radio talk show host, was abandoned in the William’s Court mailroom from whence I rescued it from an uncertain future. It doesn’t fit neatly into the usual historical fiction mold as most of the verifiable facts are contained in footnotes, but it does provide a rather unique Belorussian survivor’s perspective on WWII and the subsequent Cold War, even if that survivor’s story as presented here is largely fictional. He provides the documentation of events by a long tape recording supposedly delivered anonymously to the author.

Suspense spy thriller lovers will delight in the hijinks involved in the true, but probably embellished, episode of the killing of the incredibly sadistic Nazi chief administrator of Belorussia and the even more embellished adventures of the young real Soviet Igor Gouzenko, allegedly a defector from the their embassy in Ottawa in 1945, the speaker on the tapes, as he evades would-be killers around the world.

As the story progresses, the realism completely vanishes as Igor’s wild travels around the U.S., the Bahamas and Scotland evading FBI chasers, become ever more unrealistic and stuffed with cheap dramatically overblown adventures and all the tricks of writing a mystery thriller, including beautiful women to bed down, hidden document drops, doubles, and harrowing escapes. All of the major spies on both sides of the Cold War including Julius and Ethyl Rosenberg, Alger Hiss, Kim Philby, Guy Burgess, Anthony Blunt, Julius Fuchs, and even the Nazi sympathizer King Edward the XIIl after his abdication make an appearance. Although a lot of details of the lives of the very real Igor Gouzenko and his wife Valentina were undoubtedly adventurous and remain mysterious, this wildly imaginative account does little to fill in the many blanks. Fun entertainment but little enlightenment.

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In the mid 2010s, a huge California tech company called The Circle, staffed by young idealist utopians collects information on everyone in the world, and basically takes over every aspect of everyone’s life, all in the name of improving their quality of life. From equipping all children with embedded monitors and thereby eliminating abductions to cameras with facial recognition worn by almost everyone everywhere and placed invisibly in billions of sites, to politicians ‘going transparent’ with audio and camera monitoring 24/7, nothing is beyond the reach of The Circle. The extent of sharing of info is perhaps best illustrated when a Scottish online follower of Mae Holland, the main character, who like all Circle employees has become what would now be called an ‘Influencer’, correlates her online DNA markers with her online vital signs and points out to her Circle doctor that her diet contains too much nitrates for someone with those characteristics thereby increasing her risk of cancer. There is constant skillful preying on the Circlers’ and the publics’ need to connect with others and to satisfy huge unacknowledged egos. Besides the Three Wise Men of The Circle leadership, there is the inevitable ‘Gang Of Forty that decides on all major projects.

Sprinkled throughout is enough graphic sex and vulgar language to satisfy the most prurient reader. There are a few weak attempts to develop suspense such as when Mae kayaks across the shipping lanes off California’s coast in a stolen unlit kayak at night or threatens sabotage of her former fat boyfriend’s artistic creations after previously promoting them online, but they fizzle quickly. The former episode is used by one of the Three Wise Men of the Circle leadership to make her confess publicly to her millions of followers and then spout and promote their meaningless slogans (and feel good about doing so). Still later, the high-tech search by millions of Circle followers that leads to the death of the reclusive former boyfriend is distorted by one of the Wise Men as a reason for them to adopt ever higher tech solutions to social problems.

The writer’s imagination is enormous and the plot is complex but not hard to follow. There re no chapter divisions and the whole story spans less than a year. A visual depiction of a shark devouring everything in a large aquarium serves as a symbol for the Circle.

Picture a future world where Elon Musk, Jeff Bezos, and Jack Ma control everything and everyone, spewing Chairman Xi Jinping aphorisms and jingoistic meaningless slogans such as

Sharing is Caring

Privacy is Theft

Secrets are Lies

and you have some image of what is portrayed in this dystopian novel-one that has become frighteningly ever closer to reality.

⭐️⭐️⭐️⭐️

Thanks, Ian and Vera.

Basically this is a ten-year extensively revised update to the University of Lancaster researcher’s 2010 How Bad Are Bananas? that I greatly enjoyed reading when it was first printed. He also owns a company called Small World Consulting. More scholarly and less politically charged than Naomi Klein’s 2014 This Changes Everything, or Al Gore’s 2006 An Inconvenient Truth, there is something here for every thinking human being. Throughout, he expresses the carbon footprint of various activities in carbon dioxide equivalents, in metric units of weight.

No human activity except dying is entirely devoid of some impact on carbon emissions and even that has a one-time effect, depending on how one’s corpse is disposed of. (He concludes that cremation is the least harmful, but does not mention the possibility of acid decomposition.) I would prefer burial at sea, only allowed if you die on an isolated boat or in a shipwreck.

Berners-Lee acknowledges the often extensive uncertainties in his calculations, and provides detailed notes and a long index. Often his conclusions are counterintuitive e.g. electric bikes are better for the environment than standard ones because they allow for travelling twice the distance for the same amount of energy expenditure and exercise, thereby decreasing the need for travel by motor cars. Texting is more eco-friendly than emailing, though neither are very harmful. He accepts that there are often ‘truncation errors’ in calculations because not all inputs can be included.

Space travel, sea cruises, air travel and air transport are large sources of greenhouse gases, often not included in official reports of government bodies. But cryptocurrency mining is particularly harmful, because of the massive amount of energy used for cooling their stacks of computers. “Some are worried that if the trend continues, Bitcoin alone could push the world over 2 degrees C warming within the next 20 years.”

Obviously, not everything is included. I would have liked to see a comparison of living in a multi-story apartment vs row housing vs single family home with similar amenities and of similar size. I have some lingering concern about accepting nuclear power plants as a source of green energy, not because of radiation hazards, which are minuscule, but because of the massive amounts of energy used in the mining of the minerals, the construction materials, especially cement, and the disposal of the spent ingredients.

While I do not doubt the author’s honesty, brilliance, and integrity, close attention is needed as he spells out wide estimates of the carbon footprint of various activities, lest you lose track when he is comparing items and activities that are not at all alike in their effects.

The chapter on negative emissions is thought-provoking but leaves out one intriguing possibility that I just read about. Geneticists have tweaked the genes of soy beans and rice to ramp up their chlorophyll efficiency by up to 25%. This would seem to me to be a win-win development-more carbon capture with more production of sugar, water, and oxygen. But if the plant material is then used as fodder for methane-belching ruminants such as cattle and sheep, that could at least partially negate the benefit. Could this maneuver be scaled up to broad-leafed grasses and trees?

Loaded with pie charts, graphs, and lists, this is a valuable reference work. The two charts in appendices, of the carbon footprint of some foods (36 items purchased in Britain) and the carbon footprint of spending money (48 items, expressed in British pounds) could usefully be referred to frequently by any shopper.

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Thanks, Vera.

Set in the late 16th century in a fictional British town near, and later right in Stratford, this novel initially concerns itself with the not uncommon problem of an unwed pregnant teenage girl in a blended family with strict adults and rebellious children. With stretched imaginations, the story is said by critical reviewers to parallel the life of a youth that Shakespeare supposedly based his Hamlet on, and they also claim that the pregnant girl is modelled after Anne Hathaway, Shakespeare’s wife. None of the allusions to Shakespearian themes were obvious to this reader. Later chapters relate the fraught relationships between in-laws of different generations and world outlooks and divergent levels of urbanized culture, from a glove-maker strict cruel patriarch to a young Latin-tutor son.

A circuitous route of the Black Plague bacteria via fleas from a monkey in Alexandria to London via a ship’s cats and rats, Damascus, Aleppo, Venice, Sicily, Barcelona, Porto, London, Stratford, and on to Warwickshire via a horse, is detailed. It infects and kills many people en route, including one of the main characters, a good illustration of the ignorance of infectious disease transmission of the era, long before Robert Koch, Louis Pasteur, Ignaz Semmelweis, and John Snow. Likewise, the fragility of life in the era before any effective medicines and antibiotics is made clear by the common and unpredictable deaths of children such a Hamnet, and the widespread use of quackery and sorcery. With this in mind, and the fact that in that era at least one in five children died before age five, the extreme and prolonged grief and pathos to the point of psychotic delusions of Hamnet’s mother and other members of the family upon his death seems unrealistic. Readers are also accurately reminded about the primitive state of communication channels of the era with most of the population being illiterate, having no railroads, cars or telegraph, and no reliable postal services.

The present tense is used throughout the entire narrative but the chronology of events skips back and forth and can be confusing. There is a dearth of dates and ages of the children as different events are discussed non-sequentially with gaps of time left out entirely. If one leaves the story and then comes back to it as I did it becomes difficult to pick up the thread and distinguish the characters from each other. Unrealistic abilities of the young mother to smell distinctive odours of her own very early pregnancy and her husband’s melancholy border on magic realism. The bloody details of childbirth hardly make for entertaining reading, no matter how realistic.

Equally unrealistic is Hamnet at age eleven changing clothes with his dying twin sister to fool Death into taking him instead of her and his mother’s earlier frantic distressed musings as she goes into premature labour with the twins. As Hamnet’s father, playwright, theatre company owner, director, and actor reincarnates his dead son as Hamlet, what plot there is drowns in a sea of grief, sentimentalism, and nostalgia.

For me, there is an excess of the flowery meaningless descriptions that seems to please many professional reviewers of books who belong to the ‘creative writing’ set. There are twelve sentences on one page page starting with “She sees…”. Excessive long descriptions of scenes and people abound and metaphors often contradict others in the same sentence.

I found nothing very educational, enlightening, enjoyable, or memorable about this book. Others with a more literary bent may well disagree.

⭐️⭐️

Thanks, Alana

The Umwelten (the various sensory input modalities) available to different species are explored in detail by this D.C.-based science writer for The Atlantic. Our human limitations in sensory inputs lead us to ignore those that are used by many other species and force us to interpret their behaviour in the light of what we can perceive, to our detriment. Some humans with special abilities such as those with synestheia (crossed sensory inputs such as seeing sounds or hearing colours), usually viewed as disabilities, may be more capable of sensing the world around them as other species do. And the blind and deaf develop heightened senses of smell, touch, and position, like dogs.

Viruses, which some scientists say do not qualify as living organisms, can ‘smell’ or in some other way locate vulnerable bacteria to attack. From these to elephants and orcas, every species has developed a unique Umwelten and there is considerable variation of these sensory perception abilities between individuals within the same species, much of it genetically determined; some is from training such as dogs trained to sniff out drugs or detect some human diseases.

Most vertebrates smell odourants stereoscopically with a two-chambered nose but insects do so with feet, legs or antennae, and snakes and scorpions with a forked tongue. Catfish have taste buds scattered all over their scaleless skin. In the chapter on sight the widely different eyes (single-called bacteria can detect light) to the 10.6 diameter eye of the giant deep water squid are discussed. There is astonishing variability in acuity, visual fields, detectable wavelengths and practical uses. “ Frustrating though it may be, most of us simply cannot imagine what other animals look like to each other, or how varied their sense of color can be”, Malcolm Gladwell’S 2009 book What the Dog Saw (which has very little to do with dogs or vision) notwithstanding.

The chapter on colour perception is too detailed and technical for my simple mind to get around, with opsins, receptors, different kinds of polarization of wavelengths of light, and the different abilities of species resulting from those factors. The pugnacious mantis shrimp and the peacock shrimp with small brains but at least 11 classes of photoreceptors seem to outperform our own proportionately larger brains but only two, three, for four photoreceptors in our eyes when it comes to perception of colours.

The chapter on heat and cold is also very detailed but does not mention an unusual human aberration that I have observed. Some people with ciguatera poisoning from eating toxic tropical fish develop temporary temperature perception reversal-hot environments are perceived as cold and visa versa. An acquaintance with this showed up at work all summer wearing a parka and winter mitts. As far a l know, no neuroscientist has been able to explain this.

The age-old question of which creatures are able to feel pain is addressed in fresh terms but seems unanswerable as Young decries the strong human tendency to anthropomorphize. He distinguishes between nociception (the ability to detect harmful stimuli) and the experience of pain.

The infrasonic sounds made by whales and the ultrasonic ones of many insects and some land mammals are documented in some detail although the uses of these are often a mystery to us with our limited range of hearing frequency. The chapter on echolocation by bats outlining the ten challenges they have overcome to make it into an effective hunting tool is the best explanation of this that I have ever encountered. and whale and dolphin echolocation is equally fascinating.

Overstuffed with astounding facts about the complexities of the natural world, there is something to delight the nature lover on every page e.g. female moths and elephant cows secrete the same chemical pheromone to attract a mate. Elephants ‘listen’ with their feet to interpret horizontal vibrations of the earth as do small planthopper insects). Tactile sense, electric, magnetic and gravitational fields, and echolocation are all explored. Some blind people have learned to navigate with the aid of echolocation, like bats and dolphins. A few have even taken up mountain biking!

Among the more interesting -to me at least- having observed several barn owls- their ears are asymmetrical, the left higher than the right, allowing them to locate the direction of a sound in 3D to within two degrees.

I have a couple of negative comments. Among the hundreds of facts discussed, a few will be intuitive to many readers and could have been omitted wile others may be too complex for readers with little or no science background. Some of the most interesting bits of trivia are confined to small-print footnotes that could have been incorporated into the main body. The last two chapters urging us to reduce our sound, light and other forms of pollution , while important advice, to me sound a preachy note and I do not take sermons very seriously

Nothing in nature is as simple as it seems to us, as Hamlet reminded Horacio: “There are more things in Heaven and earth …than are dreamt of in your philosophy.” Ed Young proves that truth with hundreds of examples.

⭐️⭐️⭐️⭐️

Thanks,

The Atlantic. (where I first encountered Young’s writing)

Sergey Sergeyi and his frenemy Pasha Khmelenko are the only two natives remaining in a village in the Donbas region of eastern Ukraine after the Russian attack in 2014. They are somewhere in the gray neutral area between Russian and Ukrainian forces. Sergey, a beekeeper abandoned by his wife and 4 year old daughter before the Russian assault, is strongly pro-Ukrainian and Pasha is equally pro-Russian but they are forced to cooperate to survive.

Sergey leaves the area to find a suitable place to set out his six beehives away from the constant shelling, and travels in his beat up old Lada with a trailer throughout Ukrainian and then Russian-controlled areas ending up in Crimea at the home of a Muslim Tartar, the widow of a murdered former fellow beekeeper, enduring cruel bureaucratic persecution by Russian officials at border crossings.

I could easily understand the loving attention of beekeepers for their charges and the amazingly complex life of bees, having grown up next door to my beekeeper uncle. The author relates such details of the trade as use of the honey extractor machine and how to return rogue swarms to the hive, that I concluded that he must have first-hand experience with it. I watched as the honey extractor machine was used at Hutchinson’s apiary in Mount Forest, and as Uncle Tom removed a swarm of his bees from a tree on our farm. The title refers to the sickly bees in one hive after Russian officials took it away temporarily, supposedly for a health inspection.

Sergey’s vivid and complex emotional musings and dreams are mixed in with his real life experiences. A missing grenade adds some tension to the story, but the plot is not very complex and the characters are easy to follow. The fictional characters are made to seem so real that I found myself wondering what has happened to them since the full-scale Russian invasion of Ukraine earlier this year, after the story was published. Silly, I know.

My only criticism is the lack of a geographic sketch of the area as the many small villages, towns and cities with long foreign names can be confusing to readers who, like me, are geographically challenged.

The writing style is best described as simple but perceptive and delightful with a deep appreciation of everything in the natural world. “All of a sudden, outside the window, the February sun began to shimmer and shine playfully, as if enjoying the first taste of freedom after long months of captivity.”

This is a timely, beautifully written story obviously aimed mainly for a Ukrainian readership, but has universal appeal.

⭐️⭐️⭐️⭐️⭐️

Thanks

The New Yorker.

A short review for this short beautiful novel by the acclaimed Irish writer. This is based on the life of an ordinary coal merchant, Bill Furlong, who never knew who his father was, in a small coastal town. His silent internal philosophical musings, as he reflects on doing nothing but working to support his family, eating, and sleeping are actually quite perceptive, He asks quite profound questions about the meaning of his life, like the Peggy Lee song Is That All There Is? “It seemed both proper and at the same time somehow deeply unfair that so much of life was left to chance.”

“Lately, he had begun to wonder what mattered….and could not help but wonder what the days were for.”

His encounter with a postpartum teen girl locked into the convent coal bin from the school for unwed mothers/laundry/jail shocks him into moral reckoning with himself and raises troublesome questions about the whole community almost totally under the control of the Catholic Church. It is based loosely on the real experiences of many of the Irish folk by their troubled relationship to Catholicism and the Madeline laundries operated by it until 1097. No easy answers are provided.

A beautifully written tale that is both simple and profound, inviting and appalling at the same time. Highly recommended.

⭐️⭐️⭐️⭐️⭐️

Thanks, Din.

First a full disclosure. Whenever I am very disappointed on reading a book that has been given a rave review by persons unknown to me, I suspect that the review was written by a close relative or friend of the author, or worse, was paid for their praise. Such is the nature of marketing. The author of this history is an journalist/sports writer/biographer/historian, acquaintance of mine from my years in London, Ontario, and a friend on Facebook, but not a close personal friend. We both had previous book published by a small, now defunct Ontario publishing house. When I heard about this book to be published in October, I asked him if I could buy an advance copy for review, and the publicist at ECW Press was kind enough to send a free preprint ‘for promotional purposes only’. But I think I can still provide a relatively unbiased assessment of it. Hence this paragraph written before I even opened the gifted preprint.

Now my review.

All the 1850’s, 60s, and 70s Canadian and American history that we were never taught in high school or even in university, and should have been, is served up here in rich, scholarly, entertaining detail by the London, Ontario journalist/sportswriter/biographer/historian, extending the documentation briefly into the 1930s.

Far from passive bystanders watching the war from ‘America’s attic’ Canadians were intimately involved in far more complex ways than most of us heretofore appreciated. Before the war, Canadians were active participants in providing safe passage for escaping slaves to safety in the free north U.S. and southern Canada via the Underground Railroad. They usually settled in cities and towns close to the border, where they generally, but not always, were welcomed. Lucan, north of London, Ontario, was at that time named Wilberforce, after the British abolitionist.

The 1857 racist precedent-setting Dred Scott decision by the U.S. Supreme Court did much to precipitate the war. (Will another recent similar packed Supreme Court decision precipitate the next one?) Canadian adventurers, dedicated idealists, abolitionists, white supremists, many with American relatives and a few duped, drugged, or hijacked youths joined American forces on both sides and thousands of them never returned home. At least a few Canadian women disguised themselves as men to enlist on one side or the other to take up arms, probably unintentionally killing fellow Canadians. The border crossings, particularly at Detroit and Buffalo, became two-way thoroughfares with Canadians heading south to fight and thousands of Americans of various stripes, and for various reasons finding a usually friendly welcome in Canada. It was not just people who used this highway- farm produce from rich southwestern Ontario soil and fabric from its urban factories crossed the porous border with compliant, bribable guards to feed and clothe armies. Of particular interest to me was the arc of Bennett Young’s life from childhood poverty in Kentucky to Confederate soldier, to leader of a raid on St. Albans, Vermont from Lower Canada (Quebec) in an attempt to drag Britain into the war. He became a fugitive after the war living in Canada with clusters of former fellow Confederate bigwigs in sympathetic towns and cities. After education in Europe he then returned to Kentucky and a thriving law practice and founded Eastern Kentucky University where my daughter teaches theatre arts. Small world!

The various attempts by the Confederate forces to drag Britain into the war and open up a northern battlefront against the Unionist army fighting them in the south was a serious concern to Canadians in what was then pre-Confederation Upper and Lower Canada, as was worry about being annexed to the States at various times, a serious proposal endorsed by Lincoln’s Secretary of State, William Seward among others. Following the war, impoverished southern plantation owners deprived of their slaves, some of them former Ku Klux vigilantes (the forerunner of the KKK) found their way to Canada spewing hateful racist language, many of them setting in London, Ontario, where they thrived. Several families of them are buried under big monuments on Millionaire’s Row in Woodland Cemetery.there. Jefferson Davis, president of the Confederate State during the war, found temporary refuge in Montreal after it ended. John Wilkes Booth hatched his plans to kill Abe Lincoln in Quebec. The late attempts of a newer KKK to establish cells in Canadian cities succeeded briefly in the 1920s but floundered in part because the racist anti-Catholic Loyal Orange Lodge “had effectively cornered the market on bigotry…”

The book is divided logically into three parts covering the periods in the 1850’s just before the war to during it, and then after the war during Reconstruction. The writing is straightforward easy prose, and while there are far more names and places than I can possibly remember, there are also a surprising number that I am familiar with as many of the towns, streets and family names are common around southwestern Ontario.

I hope this enlightening book will become available in ebook and audiobook formats, as it can easily be widely appreciated even without the helpful photographs and maps.

This should be obligatory reading for serious Civil War, Canadian and international history buffs; I highly recommend it even for the Canadian and American general public as well. I learned a lot of unique Canadian history and enjoyed it immensely, something I cannot say about my high school history class.

⭐️⭐️⭐️⭐️

The author, a Senior Research Associate in Surgery at University College London, divides the discussion chronologically and logically starting with mythological transplantation in the ancient world in the Prologue, then chapters dealing with skin in the ancient world and dark ages when noses were often reconstructed after being lost in conflicts (and later from syphilis), then Blood, first from animal to animal, then from animal to humans, then Teeth, then Organs -kidneys and hearts. There are no separate chapters for the numerous other organs that are now routinely transplanted, including livers, lungs, corneas, pancreases, islet cells, heart valves (usually from pigs), corneas, bowels, bone marrow, and stem cells. And the old adage that xenotransplantation (transplanting animal organs into humans) is just around the corner and always will be is no longer true, with some limited successes.

Many pioneers in transplantation were masters of self deception, seeing the impossible results that they hoped to see, such as the success of Europeans grinding up and eating dried skin of Egyptian mummies restoring their youthful appearances. The power of the placebo effect was not widely appreciated until the 1950s.They skirted issues of ethics such as the cruelty of vivisection, the economics of sale of organs, and use of organs from executed prisoners, some of which still plague transplant medicine in places.

In the mid 1600s there was intense rivalry between the English and the French over animal to human blood transfusion with opponents of interfering with the natural life forces symbolized by blood in both groups. Rivalry for the fame to be first continues to plague and impede progress in most areas of most sciences.

“ But 17th century transfusions were never supposed to provide a replacement for lost blood. The blood itself, still entangled with ancient humoral and religious ideas, was rather a vehicle for something “intangible and unquantifiable like youth, meekness or strength.”

Old vigorous philosophical debates about vitalism vs mechanical explanations of life that have wide implications are discussed in some detail here. Is the soul separate from the body? Pessimistic Hobbesian views of men lacking authoritarian control, even of their thought processes, living lives that were “solitary, poor, nasty, brutish, and short” crept into all developing fields of science with restrictions handed down through rigid hierarchy and church dogma, limiting what one was permitted to research or even think about.

“…during this time we went from seeing ourselves as essences to seeing ourselves as compositions.” Who “owns” my body?

The 54 page long chapter on teeth provides an intro to the world of the history of dentistry, first with dispensing of the belief in the nonexistent tooth worm as the cause of all dental problems. The cosmetic use of transplanted teeth from animals, poor children, and serfs to enhance the smile of both French and English social climbers in the early 1700s, presages the frowned-upon modern practice of selling organs for pecuniary gain. The 18th century also was when the separation of dentistry from mainstream medicine became established. Many “tooth drawers” were charlatans of various dubious backgrounds, performing extractions in public displays for profit. In view of these ethical considerations, the fact that few dental transplants worked seems irrelevant.

The fame and esteem of the collaborators Alexis Carrel of the famous Carell vascular patch fame and Charles Lindbergh in developing an organ perfusion pump, the precursor of the heart lung machine, is marred by their 1936 mutual enthusiasm for Nazism, racism, and eugenics.

I encountered dozens of familiar names from the history of medicine, going back to Galen, and learned details about them never taught in my history of medicine course. I was a tad disappointed that there was only one sentence about liver transplantation, the most technically challenging of all transplants.

I once met the late haughty, egocentric, playboy, Christiaan Barnard on his 1969 world lecture tour, touting his as the first human heart transplant, and got to know the humble and gracious Sir Roy Calne at liver conferences and on his visits to his illustrious former trainee, my colleague, Dr. Bill Wall at Western.

This is a very enlightening scholarly book on a subject dear to my heart. (Oops! There is one of many ingrained phrases falsely identifying the heart is the seat of emotions.)

⭐️⭐️⭐️⭐️

Thanks, Alana.

When I ran out of available appealing books to read recently, I searched for something about Paul Robeson, as he is one of my heroes . I had only vague memories of reading his 1958 autobiography and polemic, Here I Stand, many years ago. When I listen and watch him singing on one of many platforms, particularly his various renditions of Old Man River, from Showboat, as I have many times, it always brings tears of joy to my eyes and a chill up my spine as I marvel at his deep bass reverberating voice. His handsome face and expressive gestures as he sings are, in my opinion, unparalleled in the world of theatre, so I yearned to learn more about him-his radical political views, his unflinching championship for all oppressed people, his illustrious acting, including controversial stage productions of Othello, his championship sports career at Princeton and Rutgers and his private life, of which I knew only snippets. I had not realized that many of the songs and stage roles were changed as they were vilified as racist or politically unacceptable by both the blacks and whites and by the left and the right alike, until I read this book. It seems that the minefield of political correctness is not new.

He can be viewed as the successor of such black leaders as John Brown, Frederick Douglas, and Washington T. Booker and the forerunner of Malcolm X and Martin Luther King Jr. but on a more global scale. He championed the cause of Welsh coal miners, Australian construction workers, and the Republicans fighting the Fascists in the Spanish Civil War, where he risked his life to entertain and encourage the troops.

Put in the context of his poverty-stricken background as the son of a former slave who became a starving clergyman, and his experiences with overt American racism, his endorsement of communism that resulted in him twice losing his American passport and to hounding by McCarthyite red baiters in the 1950s is entirely understandable. He never denounced communism, but his late recognition of the terrors of Stalinism probably contributed to his late-life angst.

But he was also human, experiencing marital difficulties, yielding to temptations for affairs with numerous women who were seduced by his unequalled charisma, experiencing severe depression when one of them, British actress Yolanda Jackson, backed out of plans to move to America and marry him after he obtained a divorce. The divorce never transpired, although he and his wife thereafter led largely separate but supportive lives. He had some elements of the imposter syndrome, doubting that he deserved his fame and wealth. Late in his career, he experienced many further episodes of severe suicidal depression before succumbing to a stroke at age 75.

The Aussie author’s format of the book is to relay to readers the details of his own travels around the world as he tries to retrace those of his subject. But this fails to follow Robeson’s life accurately chronologically. The details related to the lives of those travels and interviews with locals who could shed light on Robeson’s life are distracting, and largely irrelevant. The first section of 95 pages presents a somewhat confusing maze of his family history and background history of slavery in the North Carolina, his youth in segregated Princeton, his athletic career there and at Rutgers and his rise in Harlem, mixed in with comments about current American racial conflicts.There is extensive name-dropping as Robeson’s encounters with the rich and famous in the arts and politics are recounted.

Although I learned a lot of world history, particularly about the Spanish Civil War, from this book, I was a bit disappointed in this biography because of the author’s lack of focus on his subject and inclusion of a lot of his own irrelevant personal details.

⭐️⭐️⭐️

I am not sure when or how this novel, now also a TV movie that I have not seen, came to my attention. A 15 year old Swindon boy with autism and some combination of ADHD, OCD, and a hint of paranoia, is a student at a special needs school, living with his widowed father. In his night wandering he finds his neighbour’s dog named Wellington dead on her lawn with a garden fork through its body. He undertakes a detective search to find the killer, disobeying his father’s specific orders. To him everything is related to the precision of mathematics, sciences, and linguistics, as he is limited to literal logical thinking but is a genius in those fields. As the narrator, dreaming of becoming an astronaut, he is very precise in his likes and dislikes. He has a photographic memory and an aversion to anything yellow or brown, explaining these quirks in detail.

With impeccable logic, he cites historical details and old literature provides quirky interpretations, including a superb explanation of the meaning of Occam’s razor. By chapter 137, (In keeping with his mathematical genius, the chapters are numbered by prime numbers up to 233 rather than sequentially.) the plot becomes very complex and unpredictable with his late discovery of multiple enigmatic long letters addressed from a London address (that he naturally commits to memory), to him from his supposedly deceased mother, dated long after she died, among other twists that I won’t divulge.

The Oxford author has an uncanny ability to characterize the mental processes of the autistic idiot savant genius with his need for ritualistic unvarying routines and for the difficulties encountered by those living with them, to the point that I suspect that he has had close experience with such an individual. The narrator of the audiobook totally nails the dialects and voices. Although there is a lot of foul language and shouting, this seems to fit with the uncouth characters doing the cursing and shouting. The writing in the first person singular is mostly in the typical short dialogue and observations of an idiot savant. Likewise, the unusual gestures of someone with autism and OCD such as head banking curling up on the floor, and aversion to any intimacy or touching are frequently described. It reminded me of the films The Rain Maker and Forest Gump.

I really, really enjoyed this read and devoured it in one day. I will recommend it to our book club.

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With our Rogers connection down last week, unable to figure out how to navigate my new iPad to download my digital subscriptions and the library not providing for downloading of e or audio books, I scanned our book shelves for something to waste my time on and this one sure is a waste or time. I can hardly believe that it survived our downsizing move five years ago. I suspect that it was a gift from my daughter ages ago, one I had not even checked out. Someone had yellow highlighted several sentences.

Long on ethereal, banal platitudes, parables, and allegories with no easy interpretations, and a lot of utter nonsense, at least this, unlike the Christian Bible and the Islamic Koran does not encourage followers of Buddhism to wage war against nonbelievers or against nature. The many fables with magical features never made any sense to me unlike Aesop’ fables. And it does not imply that Buddhism is the one and only true religion, nor does it claim exclusive insights and guidance. Like much of the teaching of Islam, there is a heavy emphasis on spiritual striving for perfection. There are abundant blatant inconsistencies and contradictions that I doubt can be explained away by difficulties in translation from Sanskrit to English.

Buddha is described as a fifth century B.C. aesthetic prince from central India or alternatively as an eternal spiritual presence within everyone and all of nature or a state of Enlightenment achieved by few. What seems clear is that he (women barely rate a mention in this book) was not one discrete individual unlike the founders of Christianity and Islamism. And as in all religions, Buddhism is not one religion, but many sects with different outlooks, as one would expect from any belief system based on oral traditions that became written texts only centuries after their founding. There is only passing reference to an afterlife, but I guess one does not need advance detailed description of what is in store for you if reincarnation is universal- just wait for the surprise. Unlike most flavours of Christianity and Islamism, there is apparently no expectation for aggressive evangelism but there are long lists of negatives to avoid.

“If the three ways of practice are analyzed, they will reveal the eightfold noble path, the four viewpoints to be considered, the four right procedures, the five faculties of power to be employed, and the perfection of six practices.”

Two more nonsense quotes and one of dubious advice:

“This conception of universal oneness- that things in their essential nature have no distinguishing marks- is called “Sunyata.” Sunyata means non-substantiality, the in-born, having no self-nature, no duality.”

“ The delusions of reasoning are based upon ignorance and the delusions of practice are based on desire, so that the two sets are one set after all and together they are the source of all unhappiness.”

“One must not kill any living creature.” Does this include insects and microbes that bring us disease? This admonition is later modified to include only sentient creatures. But determining which species are sentient is problematic. What do you eat if you do not kill any living creature?

This volume does convey hard to follow, common sense bits of advice on how to maintain your equanimity in the face of the slings and arrows of outrageous fortune but there is nothing of great importance. It’s message was even more lost on me than Jean-Paul Sarte’s Being and Nothingness. I cannot recommend it for anyone who already has a smidgeon of common sense.

Perhaps to round out my religious education, I should study texts of Hinduism, Shintoism, Sikhism, Judaism, or Zoroastrianism, but that is not likely to happen. Thus endeth today’s rant.

⭐️

The grumpy self deprecating Miami-based NPR journalist goes on a personal quest for the source of happiness, visiting many countries, and interviewing locals and experts on the study of happiness. There is a surprisingly extensive scientific literature and research into what makes people happy and several official listings of countries based on data collected from surveys, the most common one being the World Happiness Report, updated annually.

Holland, Switzerland, Moldavia, Bhutan, Kuwait, Qatar, Iceland, Thailand, India, Great Britain and his native United States are the main countries he visits and discusses, but he includes notes and quotes from philosophers, scientists, and academics from many others, old and modern.

The very different cultures and norms of the countries he visits are captured with informative characterizations and unique comparisons.

He only obliquely acknowledges the problem of establishing linguistic equivalence of words for various emotional states across different languages, and the limitations of data comparisons based on the demographics of populations surveyed and the survey questions. One Moldavian interviewee claimed that happiness and unhappiness coexist in his brain. (I guess that is possible if one is fond of moroseness.) In English there are far more words to express unhappiness than for happiness.

The cultures of the countries he studies are described accurately as far as I can tell having only spent any appreciable time in three of them (Thailand, Qatar, and the U.S.) I enjoyed reading about the dour, trusting, humourless Swiss, the permissive Dutch, the morose despairing Moldavians, the happy atheistic weekend drunks of Iceland with many myths, the uptight regimented stiff upper lip Brits and the surprisingly happy spiritually-minded Indians, although these are all obviously generalizations and at best only a snapshot at one point in time.The Bhutanese monarchy encodes a dress code for men and the pursuit of Gross National Happiness as government policy.

The writing is full of apt analogies and metaphors with quirky twists. In an Indian Hindu ashram the lotus position is described as the HOV lane to bliss.

“God is currently not taking complaints. His inbox is full.”

“The problem with finding paradise is that others that might find it too.”

“Soviets did for architecture what Burger King did for fine cuisine.”

There is at least one error common to U.S. writers. The U.S. is described as the wealthiest country on earth. By any conventional measure Qatar is wealthier and has been for many years.

To check out the ranking of countries on the World Happiness Report go to World Happiness Report 2022. As usual, Finland is #1 with other Nordic countries, and Iceland, Luxembourg, Israel, and New Zealand also in the top ten. Canada has fallen to #15 of 145 but is still ahead of the U.S., Great Britain, Australia, and Ireland.

⭐️⭐️⭐️⭐️

Thanks, Neil.

As an amateur but avid if only mediocre fly fisherman and fly tier, when I came across this new title reviewed on Goodreads, I knew I had to read it. The cover picture alone was enough to entice me to borrow it from the library. The B.C. environmental journalist conveys an infectious enthusiasm for fly fishing and his love of the outdoors with great elan.

The trajectory of his fishing experiences starting as a preteen with a homemade pole and dew-worms attached to a hook on a string, then progressing to spin casting and then to fly fishing mimics my own fishing history and probably that of most fly fishing aficionados. Many of us then become conservationists practicing catch and release fishing and championing the wider cause of protection of nature, opposing clearcutting of forests and lamenting the decline of the appreciation of our connection to all of nature. I related to this so intimately that I feel at liberty to tell some of my own fishing experiences, and adventures in the natural world, which were and are much less expert than his. For example, we found the biggest fattest dew worms by overturning the half-dry cow manure droppings in the pasture on the way to the stream where we fished with willow sticks, strings, and dew worms as he did.

As a teen, in the spring, we netted hundreds of small smelt that are similar to west coast Eulachon in the shallow Leigth River outside Owen Sound, bringing buckets full of them home, and gutting them by secretly putting them through mother’s old hand ringer on the washing machine. (The bones are soft enough to eat and mother cooked them well.) Both species are now greatly depleted.

Hume addresses the ethics of inflicting pain on fish when their mouths are pierced by a hook. He often uses barbless hooks to minimize this. When I joined the Humanist Association of London and Area and revealed that I had a fly fishing addiction, some members expressed dismay that I was being cruel to fish. I pointed out that I usually practiced catch and release, often with barbless hooks, and thought that the fish were so overcome with relief and joy when released that any pain from the hook was forgotten. And the whole question of whether or not they feel pain from the hook is debatable. I have several times caught the same fish on the same fly within a hour, hardly a ringing endorsement of their memory of painful experiences.

When I am fighting a trout, salmon, or bass on a fly I have tied, all the problems in the rest of the world seem trivial and are forgotten for a while until I can make eye contact with that beautiful creature.

I am familiar with and have tied and used many of the flies he describes tying and using, and the casting techniques he describes although some of the flies used in eastern rivers and lakes differ somewhat from those that work in the west, and the possibilities are endless. One of my favourite effective flies that I tie for trout and steelhead is one I invented that I call ‘roe caught in river snot’. He never mentions the difficult double haul casting manoeuvre for long casts that I have only partially mastered.

I never was able to instil a love of fly fishing in my daughters as he did with his, although my busy son goes with me on fly fishing outings whenever he can. I share the author’s concern about the destruction of the natural world, the decline of fish populations, and global warming. But I am more wary of wild predators than the author was, careful to yield to bears whenever I encounter one fishing in the same river as I am and have only once encountered a mountain lion in the wild.

The last 55 or so pages relating his fear of dying, anxiety as his daughters leave home for university, his prostate cancer scare and depression and dealing with the death of his mother and friends is a tad too sentimental and introspective for my taste.

The writing flows naturally like a quiet trout stream with natural twists and turns, deep pools interspersed with faster sections. One need not be a fly fisher to enjoy this beautiful memoir, as the technical aspects of the sport I love are kept to a minimum.

⭐️⭐️⭐️⭐️

Thanks, Goodreads.



A quote from page 4 of the Introduction provides a hint of what is to come: “Evidently, normal everyday consciousness is not good enough for us humans; we seek to vary, intensify and sometimes transcend it and we have identified a whole collection of molecules in nature that allow us to do that.” Of the dozens of plant-derived mind-altering molecules, he chooses to discuss only three with which he has personal experience, namely opium, caffeine, and mescaline. He doesn’t completely ignore the longstanding love/hate relationship of humans to alcohol, capably discussed in Edward Slingerland’s 2021 book Drunk, and sees similarities between the hypocrisy of the 1990s ‘war on drugs’ and the 1920-33 prohibition laws.

The bulk of the discussion of opium is a reprint of a long article he had published in Harpers in 1996, with an added Prologue, an Epilogue and a section that he had deleted from the original for fear of litigation. A dedicated gardener living in Cornwall, Connecticut and Berkeley, California, he grew a variety of poppies whose seeds yield opium, a mixture of narcotic alkaloids, mostly morphine and codeine, in his garden, the seeds legally obtainable from a variety of seed catalogues. This was just when the Drug Enforcement Agency was ramping up their ‘war on drugs’ after the ‘war on poverty’ and before the ‘war on terror’. When will the U.S. government abandon military analogies to address their social ills? Criminal charges with heavy penalties and long jail terms were handed out to growers of such poppies even though they were bought legally and usually planted purely for their beauty. He notes that this was also the time when the Sackler’s Perdue Pharmacy, with FDA approval, was aggressively promoting their OxyContin with false claims of safety. That lead to the ongoing opioid epidemic that has killed thousands of Americans annually, though no Sackler has been put into prison. Only after the statute of limitations made it impossible to prosecute him, did he admit to a one-time use of the poppy seed extract as a tea which he found to be very bitter and the high not very euphoric and included that experience in this update. But one can still obtain narcotics by extracting them from legally grown poppies or from grocery store culinary seeds. But the rate of arrests for violation of drug laws in the U.S. has barely changed from 1,247713 in 1997 to 1,219,909 in 2019, not all related to narcotics.

The 62 page chapter on caffeine is equally loaded with multiple ironies. The history of how coffee and tea came to rule our daily lives, the exploitation of growers by imperial powers, and the positives and negatives of caffeine use in different cultures are explored in detail. His interview with fellow Berkeley researcher, Matthew Walker who wrote the insightful Why We Sleep is a wake-up call (pardon the pun) to the widespread prevalence of poor sleep quality and quantity in part attributable to the pharmacological effects of caffeine on our brains.

As the effects of his three month self-imposed abstinence from coffee take effect, Pollan notes: “I came to see how integral caffeine is to the knitting of ourselves back together after the fraying of consciousness during sleep.” There is no doubt that caffeine is an addictive drug even to bees that selectively pollinate plants that seductively lace their nectar with caffeine. In a Darwinian world do we or coffee plants benefit more from its addictive properties?

The final section on mescaline was a bit disappointing for me. Although there are reasonably well-controlled trials showing some benefits to the use of LSD and psilocybin in certain psychiatric conditions and addictions, there are none comparing mescaline to a placebo as far as I can tell, although a phase 1 trial is underway in Switzerland. Mescaline is readily available from several cactus species but can only be legally consumed, at least in the U.S., if you are a Native American on a reserve, and a member of the Native American Church, where it is used in sacred rituals. Nevertheless the author consumed it at least twice. He completely avoids discussion of the mechanism of mescaline effects on our brains but describes the effects in detail using woo woo mumbo jumbo spirit-world jargon that left me with a determination to avoid it at all costs. As a life-long scientist, my brain as long been programmed to linear concrete thinking and a world where plants give us advice and see and hear us is too foreign to take seriously.

The writing is scholarly and detailed that kept me fully engaged and I learned a lot. It is also very limited to a United States perspective. I have no idea what the legal status of mescaline or growing opium-producing poppies is in Canada.

⭐️⭐️⭐️⭐️

Thanks, Andra.

After the tanker Brilliante virtuoso with 100,000 tons of Ukrainian crude oil on its way to China was attacked and incapacitated off the coast of Yemen on July 5, 2011, unanswered questions piled up. By about one third of the way through this true crime murder mystery, most readers will begin to suspect that it was an inside job with some crew member(s) with criminal connections intimately involved.

The two Bloomberg BusinessWeek investigative reporters relate a tale of international intrigue and crime more complex than most spy novelists could dream up. This includes at least one murder, that of a British businessman working in Aden. The complex inner workings of stodgy Lloyds of London is exposed in a far from flattering way. Contrary to conventional characterization, Lloyds does not sell insurance but simply facilitates sales for a myriad of other ‘underwriters’. Corrupt lawyers, accountants and bankers, shell companies that conceal true ownership, fraud, conspiracies, tax evasion, and international criminal gangs were all involved in the carefully planned fate of the tanker, disguised to look like a pirate hijacking gone wrong, and it was almost certainly not the first planned maritime insurance fraud. The Greek oligarchs that are ultimate owners of much the modern cargo fleets, often registered in tax havens, are depicted as a cabal of amoral greedy thugs, although the authors do not state anything negative about the late Aristotle Onassis.

The most depressing conclusion for me from reading this tale is the suggestion that in the rarified realms of international shipping, banking, and insurance, crime pays big dividends and is seldom punished, and justice seldom prevails. The world isn’t fair and one should not expect it to be. Perhaps the fate of Hong Kong’s famous Jumbo Floating Restaurant which was losing money, is the latest attempt at marine insurance fraud.

The writing is straightforward and logical with easily understood time lines, although it takes careful reading to keep the names and roles of the many international players straight. This book will not suit many reader’s tastes but is enlightening and I quite enjoyed it.

⭐️⭐️⭐️⭐️

Thanks, The Economist.

After reading a review in The Economist, I borrowed the 680 page Legacy of Violence by Caroline Elkins, a history of the British Empire, from the library. But after the first 50 pages, I found it to be the perfect cure for insomnia, a condition I have never experienced. Ergo, I returned it and downloaded the audio edition of this book instead. At least this is not entirely about the history of human cruelty to other humans. The North Carolina State University evolutionary biologist speculates about the effects of all the damage we have wrought to the planet and other life forms and what will emerge in the way of new life forms as a result.

The topics discussed are wide-ranging from the Mesopotamian and biblical stories of floods (Noah as the ultimate conservationist) to the rate of mutation of fast reproducing microbes and the demise of rubber production because rubber trees may become extinct within a generation.

Millions of species will have to move to find new islands of suitable ecology for them to survive and many won’t be able to. The concepts of limited niches for all life forms and of conservation corridors that we can somewhat facilitate as those change are hardly new. But the urban corridors are of limited value for many immobile species. We inadvertently provide transit corridors for smaller species such as microbes that can move with us in cars, trains and planes.

Some of the so called laws of nature cited seem to be just common sense restated. It is hardly new to point out that diversity in crops with evenly distributed portfolios of different plants and crop rotations are good for stabilizing the environment. The ‘law’ of escape from predators may express a fact of natural evolution, but we are often ignorant about what eats what.The hour-long chapter on bird adaptations is reminiscent of Jennifer Ackerman’s The Genius of Birds. The long list of diseases attributed to birthing by Caesarian section and the resulting lack of maternal microbial transfer seems exaggerated to me and may conflate correlation with causation. There are stretched analogies such as that of antibiotic resistance in E. coli bacteria and broken levees on the Mississippi. Seeding humans with microbes that we need from seed banks and knowledge of our unique genomes would seem to me to be risky and far-fetched and hardly compatible with leaving nature undisturbed.

The audio book is limited in that readers obviously lack access to the charts and graphs that the author refers to. The very expanded tree of life that is available as a PDF document includes some very odd organisms; we, and our hominid relatives are out on a very small vulnerable twig on that tree. “Our end is far nearer than the end of nature.” (The end of nature would seem to me to be a philosophical imponderable.)

There is a hectoring tone as the author bemoans all the damage we have done and continue to do to nature rather than provide insights into the future as suggested by the title. The narrator’s somewhat monotonous voice must invite many readers to nap as the story continues. Overall, although it provided a fresh perspective and I learned a few bits of new information, I was disappointed with this book.

⭐️⭐️⭐️

Thanks, The Atlantic.

Born into a family of wealthy, privileged, American doctors, the late author of this autobiography was educated in classics, languages, and philosophy at Cambridge and undergraduate medicine at Yale. He married a fellow Eli, an internist now at UCLA, then pursued a career in academic neurosurgery at Stanford.

In Part 2 he waxes eloquently philosophical as he contemplates his own imminent death. Quoting poets and philosophers, he rejects determinism and, despite his experience seems to endorse the existence of a mind, or soul separate from the body. Paradoxically, at least from my viewpoint, he abandons scientific atheism and returns to a fervent if ephemeral Christianity in spite of the raw deal any hypothetical deity has dealt him, noting the limitations of what little meaning to life science can impart. However he never expresses any view about an afterlife. Unlike the advice given by fellow neurosurgeon Henry Marsh in Admissions, the author pursued every possible form of treatment even when his quality of life was awful and there was no hope of that improving. It seems his grasping-at-straws approach is more in line with that of Sanjay Gupta in Cheating Death. At one point near the end to his life his well-connected family had doctors from six different specialities caring for him. But it is never easy to know exactly when it is time to give up. Medical literature is rife with discussions of ‘futility’. He died in March, 2015, after writing the main part of this book leaving, one daughter, a toddler.

Before he outlines his privileged early life in Part 1, both a Forward by fellow Stanford physician Abraham Verghese (he of Cutting For Stone fame)and a Prologue by the author disclose that he was diagnosed with incurable metastatic lung cancer at age 36, just as he is finishing his training. There is just a whiff of self- congratulatory arrogance in Part 1 as he makes the case for neurosurgery being the noblest of all professions. He describes some of the life and death decisions he has to make, the intricacies of the operations, and dilemmas faced daily by brain surgeons-and the hard work and long hours required to reach such a pinnacle. But, apart from palliative care and transplant specialists, neurosurgeons do deal with death more often than most docs.

The epilogue written by his devoted wife is pathos personified and profiles him as the pinnacle of perfection. Perhaps that is how she remembers him, in spite of some mention earlier of marital difficulties. I am reminded of a quip from Garrison Keillor: “They say such kind things at one’s funeral that I am sorry I will miss mine by a few days.”

One memorable quote: “Humans are organisms, subject to physical laws, including, alas, the one that says entropy always increases. Diseases are molecules misbehaving…”

The writing is fluid and poetic. Hardly surprisingly, there is little humour and some scenes described are a bit melodramatic, at least for my taste. But this is a quite enjoyable read in spite of the morbid subject matter.

⭐️⭐️⭐️

Thanks, Michele.

An autographed copy of this book was loaned to us by a friend who formerly lived as a neighbour of the author in Haileybury, in northern Ontario. (Both have now moved to southern Ontario.) A graduate of McMaster medical school, Dr. Roedde has divided her career between a practice and family in northern Ontario and working with a huge variety of government and donor agencies to improve the dreadful plight of pregnant women and young children in at least 30 third world countries, mostly in Africa and Southeast Asia.

This is not an enjoyable read, but it is not meant to be. It is rather a stark reminder of the horrible conditions, high maternal and infant mortality rates, inequalities, pervasive misogyny, malnutrition, and high prevalence of infectious diseases experienced by women in impoverished rural outposts, and the distorted priorities of often corrupt government leaders in the countries she visits. Loaded with data about programs to improve health outcomes, she seems to have appropriate priorities in emphasizing interventions for pregnant women and children, with improved family planning, access to education, contraception, abortion services, and emergency obstetrical interventions. A lapsed Catholic, she praises the work of Catholic priests who deliver condoms and support abortion services in defiance of official church dogma. The dominant cultural role of polygamous unscrupulous males who fail to do anything to help their wives, and who often marry 13 year old girls in exchange for a cow or goat is appropriately scorned. Many of them then infect their wives with AIDS. But such gender discrimination is deeply ingrained in many parts of the world.

The author’s altruism, passion and dedication shine through as she endures endless hardships and hazards visiting remote medical outposts lacking the most basic medical kit, or trained personnel, collecting data and writing up recommendations.

Her keen insights into the distorted priorities of many governments and international agencies, such as providing expensive drug treatment for AIDS rather than cheap preventive measures is acknowledged. With respect to Obama’s Global Health Initiative she notes that “ It was easier for the United States to come up with a $700 billion bailout for highly paid Wall Street gamblers, but we haven’t raised the $10.2 billion needed annually to save the lives of six million pregnant women and newborns.”

The writing is a bit disjointed and repetitive with the same sad tales of pregnant women and newborns needlessly dying for lack of very basic services reported from many countries, although she does include a chart showing where improvements have been made and where conditions for pregnant women and newborns have worsened.

An important sobering work, but not to be read by the despondent. I would love to hear the author provide an update ten years after this book was published.

⭐️⭐️⭐️⭐️

Thanks,

Janet P