When you are part of book discussion group, you often find yourself reading books that you might not have chosen on your own. A book about a stuffy British retired Major would not normally be my cup of tea and I felt that way for the first few chapters of the book. However the issues, which the characters were dealing with, began to stimulate my thinking. The  Major was obsessed  whether he would get the other half of a pair of old shooting pistols with a meaningful family history that had been in the possession of his recently deceased brother since he always felt that they both should have bequeathed to himself by their father. I could not help but think of all the stories I have heard about hurt feelings that have revolved around inheritances and the life long bitterness that sometimes follows such circumstances. Also quite thought provoking was  the main theme of this novel which  was romance that the Major and a similarly “older” Pakistanian women were developing. .It confronted the issue of how family, friends so often try to define what the boundaries of a relationship should be , especially when there might be differences of  race, religion and culture. The author really looks at what the obstacles could be to joining a country club as well as the obstacles  for two good people joining together in a relationship. While a story of  love occurring at the tail end of the age spectrum will not come as a surprise to senior citizens, their children’s generation  can find it hard to believe This was one of the reasons why  the way the main character  had to consider had to be thoughtful of how he was now viewing his own son. In the end I decided that I did like this British cup of tea and suggest it can be savored for some good reading.

If you are to read one book about the contemporary US socio-political and economic condition, That Used to Be Us is the book to read. The book is written by  Tom Friedman, the popular NY Times columnist and author and his good friend and colleague Michael Mandelbaum,  Professor and Director of American Foreign Policy  at the Johns Hopkins University School of Advanced School of Advanced International Studies who is also author or co-author of several important books. They have collaborated on a very well thought out analysis how the US is on the path to becoming a second rate country and how we can get back to the way we used to be.

The case is made that there are four essential new realities, which our country is now confronted:

1-      Globalization

2-      The IT Revolution

3-      The Nation’s budgetary  deficit

4-      The Pattern of Energy Use

Each of these issues is dissected and it is shown how we have failed to adequately deal with each of them. The authors analyzed why we have been unsuccessful but they also tried to delineated the pathway that the US could  follow back to greatness. Their style is one of facts and logic with numerous examples. They present their analysis with an empathic approach, which clearly comes from two people who clearly care about the country. While, I believe that they have  some political bias, the book is not written from an ideological viewpoint or with a particular political agenda.

They explain at this time of globalization and the IT revolution, it is essential that the country address education, infrastructure, immigration, research and development and appropriate regulations which controls each of this categories. The failure of the US to rebuild it’s infrastructure of roads, rails, schools etc. misses the opportunity to create sorely needed new jobs and the failure to recognize global warming is a missed opportunity to develop new green industries. The authors repeat a suggestion that Friedman has been making for years that an oil tax would be a significant step in making the US less dependent on foreign oil and would also facilitate the development of  a valuable alternate industry in the US. They explained that the budget deficit problem has to be understood by realizing that unemployment is remaining high even with the return of a great deal of the lost productivity. This is because of the IT revolution and the ability of computers and digitization to replace many old jobs. The authors make no bones about the absolute necessity of raising taxes and reducing entitlements in a bipartisan manner. They contrast the philosophy of the “Greatest Generation.” of saving  for the future and the “Baby Boomers who are borrowing from future generations.

This book is geared towards the future and therefore, the discussion of education was one it’s most important contributions in this comprehensive look at Problem America.

Starting off with the simple statistic that we have had zero job creations since 1999 and taking into account the nature of globalization and the IT revolution, it is no surprise that a good part of the solution is investing in education. This means valuing teachers, principals, and an education system which can not only produce students who score on world wide standardized tests but students who from an early age can learn how think innovatively and creatively. A wonderful example is given how teachers can be valued comes from Williams College. In preparation for their graduation their seniors nominate their best high school teachers. The nominees are then carefully vetted .The top twenty or so are chosen to be honored at the Williams graduation and partake in special seminars in their honor during graduation week. Other such programs are described which are examples how teachers and principals can be rewarded in intangible as well as monetary ways.

One of the things that makes this book so special is that there are not only many micro-examples such as this one but there are macro-examples as well as metaphors, stories from films, books and everyday life. There also is a concluding chapter about “shock therapy” which is a potential   political event, which if it happens  might just cause  the turning point that we need. You come away from reading this book with a feeling that the US is clearly in trouble but we have a 200-year history of pulling together to solve problems and of rising to the occasion to  achieve leadership and greatness in the world.  The book provides some well needed optimisms as to whether we can  become “the way that used to be us.”

Buy now on Amazon: Just Kids

If you don’t know much about Patti Smith and you look her up you will see that she is a very accomplished poet, visual artist, song writer and performer.   Her music is of the punk rock variety. She even co-wrote a song with Bruce Springsteen that made it to #13 and she has received all kinds of recognition for her body of work including being inducted into the Rock and Roll Hall of Fame. This book touches upon some of the many things that she has done but it is really a story of  her relationship with a man who wasn’t her husband or the father of her children and wasn’t even a musician. The man however, was an artist and although I don’t believe she used the term about him, it is fair to say that he was her “soul mate.” The man is Robert Mapplethorpe and if by chance you don’t know much about him and look him up you will see that he was a preeminent photographer known best for mostly black and white photos, many Polaroid, and many  of flowers and nude men . His photos were frequently known for their homoerotism. He also took many portraits including  photos of Patti Smith and did the cover for many of her albums.

The both were born in 1946. Patti was born in Chicago and grew up in New Jersey in alower middle class religious family. At age 21 she left college and religion as she headed to New York City with  some vague ideas about being a writer and a poet.  Robert Mapplethorpe was born in Queens and went to Pratt College and studied drawing, painting and sculpture and then set about trying to figure out how to become the artist that he knew he was destined to be. Smith and Mapplethorpe literally ran into each other and became a struggling, symbiotic and literally a starving duo. They had no or little money, at times very little food but clearly had found each other. They shared whatever they had including their bed and themselves. They supported each other in every way. They understood each other and their aspirations. They both believed in each other’s art and destiny to be artists. One time they overhear an older couple talking about them in the park saying, “They are just kids.”

Although she barely mentioned it , Smith obviously kept a diary . She has written this book in a continuous flow as she tells about the everyday events of her life especially about the first several years of her relationship with “ Robert” During most of the book , Smith has not started to sing and is only writing mostly poetry. Similarly for  the majority of the narrative, Mapplethorpe has not picked up a camera yet  and is drawing, making collages and various complex pieces to express himself. We hear  of the names of the many people who were the underground artistic life in New York City. The reader is introduced to life at the Chelsea Hotel with all the great conversations at the big round table in the back room. Some people’s names are more recognizable than others at least to this writer, ie. Alan Ginsberg , Andy Warhol, Sam Shepherd but I am sure that many others would be recognized by the  aficionados of the poetry and art scene of that time  but such familiarity is not necessary to appreciate this story.

Things do happen, these people grow up, establish adult important meaningful connections, opportunities appear, but these two are also always there for each other. Robert begins to confront his own sexuality and establishes various relationships with men. His own art flourishes and he explores his expression through photography. Patti has success with her poetry, publishes, adds music to her work and eventually becomes an important singer. We watch them come into their own and by necessity drift apart but yet are always connected. It is Robert who can photograph Patti for the perfect picture for her latest album. When the deadly scourge of the 1980s especially for the gay community strikes Robert, he asks Patti to some day tell their story. It has taken Patti more than 20 years to be able to do it and we feel enriched by being allowed to share it.

Buy now on Amazon: Witness to an Extreme Century: A Memoir

I had always wanted to learn more about the interesting work of psychiatrist Robert J. Lipton that I had heard about, but I never got around to reading his various books and other writings. This is the reason that I was pleased to embark upon reading this recent memoir. The author not only reviews his four main projects but he shares his recollections and feelings about the many people he has met along the way of his fascinating life’s work.

Lifton’s psychiatric training was interrupted by having to join the military as a physician during the Korean War. Although he was able to resume and even ultimately have some training at the Boston Psychoanalytic Institute, he never became a conventional psychiatrist or analyst. After spending sometime in Hong Kong Lifton became intensely interested what had become known as Chinese thought control. The Chinese communists had embarked upon what they had called a “reeducation” program aimed at indoctrinating everyone in the country but especially the educated and the young people to completely and without any question accept the sanctity of their leader and the validity of their doctrine.. Lifton’s technique of gathering data was to make contact with appropriate subjects and then hold open ended exploratory interviews. He used a trusted translator most of the time. He had made friends and contacts in Hong Kong who led him to meet various people from China who had been subjected to this mind control. A variation of this technique was applied to the Americans airmen taken prisoner of war by the Chinese in the Korean War. At that time the term “ brain washing” became popularly applied to what was being done .The techniques involved isolation, repetition of ideas, raising self doubts about old ideas. It was a relentless style of re-education which also included the encouragement of reporting to the authorities anyone known to rebel and not accept this new way of thinking. As Lifton saw the overall impact on Chinese society, he applied the term “totalism” to the complete penetration of this doctrinal thinking in all phases of living in China. Lifton was to also use this term when he studied other groups particularly the German people falling under the influence of Hitler. His suggestion that any group whether it be religious, political or even social which makes an all out effort to control the thinking of it’s potential followers should be identified as applying “totalism” to its efforts. He is very clear about the destructive nature of such thinking and the reader cannot but think how various modern day movements may be leaning in this direction.

While it is difficult to say which of his experiences had the greatest impact on him as they all obviously did and each embellished on the other. However, it seemed to me that his study of the survivors of the Hiroshima atomic bombing which he did when he was in his early 30s, emotionally penetrated deeper than anything he subsequently experienced and irreversibly changed him. Through his personal interviews with the subjects of his research, as a relatively young man he repeatedly encountered the meaning of death, destruction and mutilation. He appeared to feel their despair. While he intellectually understood and scientifically described the complicated grief and walking death that so many of the Japanese were to live throughout the rest of their lives, Lifton was transformed into a lifelong and very effective pacifist. Those of us who never had the emotional confrontation with the results of the A Bomb, might be able to accept President Truman’s decision to bomb Hiroshima and Nagasaki based on the calculation to save the lives of many thousands of Americans who would have invaded Japan. Lifton I believe, never raised this issue and appeared to believe in retrospect it had to be the wrong decision. He continues to bring a pacifist point of view to every relevant modern political and social issue of his time.

While I never met with anyone who went through anything approaching the magnitude of Hiroshima, my experience as a consultant to a major burn unit and having had some professional work in the aftermath of 9/11 gave me some perspective to to relate to his writing on this subject. However his decision to attempt to interview the Nazi doctors was “ mind boggling” to me, meaning that I had no frame of reference to this subject. Since this was his memoir, it probably was relatively short on the details of this work and conclusions which was covered in his earlier published work. But this book was relatively long on his personal reactions to the people with whom he met. His own perspective in approaching the Nazi doctors was as physican, psychiatrist, pacifist and a Jew. He seemed to have no trouble making the contacts and finding the surviving doctors who were willing to speak with him. In this memoir Lifton shares his struggle to understand whether these doctors were inherently evil people or whether circumstances might induce people to do terrible things to other people.

Lifton’s analysis and discussion of his experience in looking at the Viet Nam War and anti-war movement carried through to his comments on the U.S. war in Iraq. His reasoning and anti-war point of view is not simply founded upon his pacifist point of view but brings in a political and historical analysis. He also describes his interest in understanding post traumatic stress. He may have originated the term psychic numbing based on his earlier observations as well as those on the returning Viet Nam veterans. It is not surprising that he had great interest in understanding the My Lai massacre and raised once again how could descent people (in ths case the American soldiers) do horrifying deeds.

It was a special treat to learn about the many writers, historians and other intellectuals with whom Lifton interacted over the years. His personal discussions with people as diverse as Erik Erikson and Norman Mailer were recounted. Many of them took place at seminars he and his wife held at their summer home in Wellfleet. Betty Jean Lifton died shortly after her husband finished most of his memoir She was a writer mostly of children’s books but she shared his passion for psychohistory and their relationship is warmly reflected at many places in this book.

If you are any kind of a fan of Carl Reiner, you would have loved to have been a fly on the wall as he was developing his ideas for the 2000 Year Old Man with Mel Brooks or writing the Dick Van Dyke Show or the Show of Show of Shows with Sid Caesar or directing the Jerk or any of the numerous comedic works that this now almost 90 year man has created in his career. The format of this 2006 novel by Reiner gives the reader the opportunity to get a glimpse into his genius and his sense of humor. You view most of the book through the eyes of Nat Noland who is a novelist struggling to write his 5th novel appropriately titled NNNNN: A Novel, (You might guess the names of his first 4 which each increased in length by one letter and since they all were successful, he couldn’t go wrong with this title). Nat happens to have a problem of constantly talking to himself which disturbs him and his wife so he eventually goes to see a New York Viennese psychiatrist Dr. Frucht. However, this trait of carrying on a conversation with himself gives the reader some insight into his thinking as he struggles with his novel and then with an unusual discovery he is about to make about himself. His topic for his book is a proposed new version of Genesis. He starts off recounting his imagined conversation of the two brothers in the Garden of Eden when Abel reports to Cain that he has seen another women other than “Mama.” She was of dark skin and made him feel that he wanted to lie with her. Cain can’t believe him and insists it must have been Mama how terrible it is that he should want to lie with Mama. The story goes on from there with the novelist debating with himself how to develop the plot. While in the midst or writing this novel and going for his sessions with Dr. Frucht, he runs into Dr. Gertrude Trampleasure who has an office in the same building of the good psychiatrist. Dr.Trampleasure herself is an “empathologist” and by coincidence she thought she recognized Nat Noland as a good friend she knew many years ago. Turns out that pictures of this other person look exactly like Nat suggesting he may have been a twin. The twists and turns of the story multiple a couple of times and we come to share the workings of Carl Reiner’s comedic mind in a funny and intriguing novel.

If The Invisible Bridge is ever made into a movie, it will be almost impossible to capture the depth and nuances of the characters and the complicated stream of events with all the twists and turns in the playing tome of a typical film. The author, by giving us chance to focus on just a few people and essentially one family, mostly over an eight year period, allows us to witness and emotionally understand how the evil decisions made by one group of people actually effected the lives of so many more people. Ms Orringer ‘s narrative allowed us to identify with her characters as they lived their lives, made their decisions, had pieces of good or bad luck but aspired towards their ambitions, loves and the future. As we watched their journey, we saw that they had no idea what was in store for them but we knew what was coming. The focus was 1937 and a young Jewish man from a poor village in Hungry has worked out the details to study architecture in Paris while another brother figured out how to study medicine in Italy. In order to do this it involved persistence, hard work and good strokes of luck. Each person that they met on each step of their journey had their own story which we are allowed to understand and appreciate. Had this been in a better time and a better place, their struggles and tribulations would be something that we could all say, “ we did something like that “. The circumstances of falling in love and finding your partner for life are unique for each couple but we all know how meaningful it is to each person. However, since in this case the reader was omnipotent and knew that the insipient winds of anti-Semitism which were in the atmosphere of their lives were not only just unfair but portended a doomsday scenarios for them and their families. This knowledge creates anxiety in the reader but at the same time I felt that I was developing much more of an appreciation about this time period than I did from reading some other books which directly chronicled the concentration camps and the holocaust. The window from Shindler’s List, as I recall, while as vivid and poignant as could be, takes us mostly into the worst of it, rather than showing how they got there. It is easy to say that one can’t imagine what it might be like to be forced to move from your home or family apartment as did the these young men and their families, and be forced to live in small quarters
(with much more to come) or have to give up your job or your position in the university and wear a yellow arm band with a Jewish star, hoping that it would be temporary or even be “ drafted “ in to the military work force supporting the troops (the Nazis) under horrendous of conditions. But when a book allows you to care about the characters whom you have know for quite awhile, you feel that you are living through this experience with them. In the end when we glimpse at those who survived and see how they are perceived by their grandchildren, I realize that I too never got enough details of the first hand story from the previous generations of my family as to how their youth evolved into the horror they survived to see our generation live a better life. That is the beauty and the great value of books such as this one.

Buy it now on Amazon: The Wings of the Sphinx by Andrea Camilleri

I decided that I could like to sample this popular Italian mystery writer after a friend recommended him to me. On the second page of the book there is a picture of the fifty something author smoking a cigarette and looking very tough, much as I pictured the fifty something Inspector Montalbano. The author gives us glimpses into the thinking of the Italian police detective as he obsesses whether or not to call his girl friend or is solving the crime which is on his plate. While I did not know the locale of the setting of this book, one easily get a feeling for the Italian atmosphere by the names of streets and towns as well as the various meals which are consumed. We learn that the police department doesn’t have enough gasoline assigned to it so the various policemen at times have to use their own cars and even pay for the gas. The story line mentions an actual recent controversial government reform which is also explained in a note at the end of the book. That is a relaxation of the requirements for the right to bear arms and led to people feeling justified to shoot anyone who is burglarizing their house or whom they feel they might be threatened by and have to shoot in self-defense. The English translation captures the accent of some of the characters as one might try to record a Brooklyn accent. Naturally, Inspector Montalbano is very clever but very human and certainly not larger than life. The plot held my interest but it only took about 200 pages of pocketsize book to resolve which makes for quick easy and relatively light reading. Inspector Montalbano and author Camilleri do keep busy as there are at least ten other books in this series.

Buy now on Amazon: Cutting for Stone

This book  is a fictional story narrated in the first person by  someone who  spends most of his life in a setting that most of us would not expect to identify with or relate to. That is growing up on the grounds of a hospital in Eithopia with one’s identical twin and loving adoptive Indian parents who are physicians along with the dedicated servant staff including the daughter of one them who is your age. You only know that your biological mother was a nun who died in childbirth and your biological father was a brilliant surgeon at the hospital who fled the country  after an abortive effort of crushing the skull of your identical twin in order to try to  extract him in a stalled delivery prior to you and your brother ultimately being saved through a Caesarian section performed by your soon to be adoptive father who was internist. Shortly thereafter your adoptive fathers would marry your adoptive mother who was the Ob-Gyn physician at the hospital who happened to be out of the country at the time of the tragic circumstances of the beginning of you and your brother’s life. As unique as all these circumstances seem to be, the subsequent issues in the life of the narrator while unusual are things that do happen in the course of human events and become powerful determinants of one’s life story.  Despite being identical twins, the narrator’s brother seems to be on the “autism spectrum”, talking at a late age and usually saying very little, having minimal capacity for experiencing and expressing interpersonal emotions, although being objective to the point of ultimately developing an interest and a single minded obsession in women’s fistulas which leads him to wide recognition for his knowledge and advocacy in this arena . His directness as a young man leads him to a sexual experience with the daughter of the household servant which sets off a crescendo of events that go on through a lifetime of the characters in this book. As is so often the case of lives and events, each intersection makes a change which will be so important in another significant event  which will change another one. One misunderstanding or missed opportunity has set up a future event, which will forever change one’s life.  Because the author has chosen to follow his characters for significant portions of their life cycle we come to know them in great depth so we empathize with most of them in a very meaningful way. We do pay a price for this depth of knowledge and understanding of the characters as the author has intertwined his narrative with endless detail about external events of climate, vegetation and seemingly unrelated incidental thoughts of the characters.  I had to fight my obsessive style of not skipping sentences or paragraphs in a book as I usually deplore the style, which skims ahead for dialog or events in a wordy book although at times I lost this battle.  The final reward for reading this book is an insight into one family and a glimpse of life in Ethiopia during the regime of Halle Sal isse as well as a little bit of the feel of the revolution which disposed him . The author being a physician also writes in great detail (sometimes more than you need) about the medical issues of the people who come to the hospital and as well those of some of the characters whom you have come to care bout.  He also blends in some ethical dilemmas which not only challenged the characters but will most likely fascinate the reader. In the end the reader has taken a meaningful journey  with the narrator and the people close to him and you cannot help but feel you are the richer for it.

Hidden Impact: What You Need to Know for the Next Disaster: a Practical Mental Health Guide for Clinicians: A Practical Mental Health Guide for Clinicians, by Frederick J. Stoddard, Jr., Craig L. Katz and Joseph P. Merlino,  Published by Jones and Bartlett Publishers, Boston, 2010, 249 pages

Review originally published in the Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry

Most clinicians who have expertise in mental health aspects of disaster developed their skills in this area after they found themselves seeing patients following some tragic event. It is true that well trained clinicians know about acute stress, loss, grief and PTSD since these conditions come up in many forms with many patients. However, the application of their clinical skills in the midst and in the aftermath of disaster is a whole different ballgame. Having co-taught a course in disaster psychiatry for several years at the annual meeting of the  American Psychiatric Association, I heard this story many times as colleagues joined us for the course after experiencing a disaster in their area.

There are many courses seminars, journal articles and books which will inform you in great depth about the essential topics in disaster mental health, many of them written and edited by the editors and contributors of Hidden Impact. The book is originated from the Group for the Advancement of Psychiatry (GAP) where the authors ore members of the Committee on Disasters and Terrorism . GAP has a tradition of identifying important areas of mental health and supporting publications in these areas. In my opinion this book fits the bill as the first book on this subject you should read or if you were only reading one book this is the one to read. It is the book that you will throw in your suitcase if you find yourself traveling to a site to render care in the aftermath of a disaster

In 250 pages this is  as comprehensive a course of study on this subject as I have ever seen in a book this size. It is well written, interesting and quite practical. Each chapter starts with a vignette, which either centers on victims of a disaster or on the caretakers faced with the dilemma of dealing with the aftermath of such an event.  The book is filled with practical information such as a comprehensive check list (and I do mean comprehensive) of  what to take with you if you go into an area to render care.( ie, pack your own power, take local maps, support socks, brimmed hat, iodine for water decontamination etc. There are clinical tables and charts to be sure you don’t miss the basics such as what to expect during the impact phase (first 48 hours) acute phase (1-8 weeks), post acute phase (2 months and beyond). There are many clinical screening tables such as the one for PTSD in children. There is a discussion and review of pharmacology in disaster situations. There are chapters on the use of telepsychiatry, liability, ethics, staff support as well as some of the latest thinking on resiliency. There is also a list of useful resources including websites

You should not be surprised to  find that if you are working in a  disaster situation, you will be interacting with the media as well with community leaders who have the responsibility to make reports to the media . In this regard the topic of risk communication and “how to do it“ is well covered in a succinct chapter. By the way, your clinical skills can also be useful to members of the working press who are often traumatized by working in a disaster environment. This latter clinical issue is discussed in the chapter about  understanding and helping first  responders. It is clear that the we need to apply our knowledge of the psychological impact of disasters not only to the primary victims  but also to the secondary victims who come to the aid of others. That of course includes ourselves. Perhaps one of the most valuable tables offered in the book is a table from SAMHSA (Substance Abuse and Mental Health Services Administration) about  managing and preventing stress, which includes the signs that you may need stress management assistance and ways to help manage your own stress.

As an added bonus the book is approved for AMA PRA Category 1 CME credits with instructions for getting Continuing Medical Education Credits from the Medical Society of The State of New York.

Addendum:  This review would not be complete without mentioning a recent book which should be a companion piece to this one. It is edited also by two of the same authors Fredderick J Stoddard and Craig Katz along with Anand Pandya and includes chapters by Merlino and many others on similar and related topics. It is titled Disaster Psychiatry: Readiness, Evaluation and Treatment. Published by the American Psychiatric Press, 2011.

On the same day as I started writing this review, I heard a report on NPR of a group of Saudi women who are protesting the law in their country that women can’t drive a car and must be driven around by men or take a taxi. The subjugation of women in Saudi Arabia and other Moslem countries was the underlying theme of this novel Finding Nouf. It is a mystery of the disappearance and death of a young wealthy women and the efforts of mainly two people who are trying figure out what happened to her. It is through their eyes that we appreciate how the everyday life of women must be hidden behind the berka where her ankles should never show in public and the vail so no man but her husband or immediate family should look at her face. At the same time we see how the rules are neglected at times despite the fact that there are actually religious police who patrol the streets demanding proof of marriage between a man and women who are together in public. As the mystery of what happened to Nouf unfolds, we also appreciate the yearning of this woman and so many others of this culture to be freed from their oppression. We know about CSI NY and CSI Miami but do we have a CSI Saudi ? We do have a death, an autopsy, fingerprints, DNA, footprints (this time in the dessert aided by a expert footprint tracker) as well as some unexpected twists and turns. If the subtext of the Moslem culture were well known to us, I don’t think I would have been fascinated enough to stay turned in.