A passionate and eloquent memoir about one woman’s battle with breast cancer.
Award-winning poet and essayist Boyer (Creative Writing/Kansas City Art Institute; A Handbook of Disappointed Fate, 2018, etc.), a single mother living on a tight budget, was diagnosed with highly aggressive breast cancer when she was 41. Her doctor (who she later replaced) said her tumor was “necrotic, which meant that it was growing so quickly it failed to build infrastructure for itself.” He recommended chemotherapy right away. Her treatment with Neulasta cost $7,000 per shot. As the author writes, “someone once said that choosing chemotherapy is like choosing to jump off a building when someone is holding a gun to your head.” Boyer looked for guidance and inspiration from other women artists who suffered from the disease, including Susan Sontag, Alice James, Rachel Carson, Audre Lorde, Fanny Burney, Kathy Acker, and Eve Kosofsky Sedgwick. Boyer kept a journal, a “minor form of reparative magic,” which she abandoned hundreds of times. John Donne’s “sickbed masterpiece,” Devotions Upon Emergent Occasions, written when he thought he was dying, casts an influential shadow over her book. Both have complex structures and are highly meditative, but Boyer’s “exercise in lamentation” is secular where Donne’s was religious. She takes us on a deeply personal journey into “my body in pain,” “eviscerating sadness,” and profound loss—eyelashes, eyebrows, toenails, nerves, brain cells, her hair. “I like wigs,” she writes. “I wear wigs. People I like wear wigs. Dolly Parton wears wigs….Medusa wore a wig made of snakes.” Eventually, Boyer had a double mastectomy. “In the capitalist medical universe in which all bodies must orbit around profit at all times,” she writes, “even a double mastectomy is considered an outpatient procedure.” She learned that everyone lies, from pharmaceutical companies to doctors and researchers and the internet. “Now that I am undying,” she writes, “the world is full of possibility.”
Told with brutal clarity, this is a haunting testimony about death that is filled with life.
Given the greed of pharmaceutical companies, writes investigative journalist Eban (Dangerous Doses: How Counterfeiters Are Contaminating America's Drug Supply, 2005), cheap generics are essential to money-strapped consumers—and that just may be a death sentence. There are many players and levels in this excellent book, a solid mix of the history of generic drugs, whistleblower tale, and pharmaceutical detective story. The whistleblower in question is a young executive and systems engineer from India, lured home after being educated in the United States to work for a huge pharmacological concern that specializes in making generic drugs. There’s a fortune to be made there, Eban writes, especially for the first to market, who can enjoy a brief monopoly. The margins are further improved by eliminating key steps in the quality-control process—and then cooking the books when investigators from the Food and Drug Administration come to inspect. The executive in question sounded the alarm, his charge backed by on-the-ground evidence from an FDA investigator. However, he faced prosecution, not least on the part of the FDA and U.S. attorney Rod Rosenstein. “My reporting,” writes Eban early on, “led me into a web of global deception”—and, she makes clear throughout this long but tightly narrated book, that deception may well prove fatal to medical consumers. This is especially true in the developing world, she writes, for if substandard drugs are regularly shipped from plants in India, China, and elsewhere to the U.S. and Europe, the really ineffective, dangerous stuff is headed for markets in Africa, South America, and Asia: EpiPens, AIDS cocktails, cures that may turn out to be poisons. For all the efforts of that FDA inspector, writes the author, the new antiregulatory FDA now gives foreign companies advance warning of inspections, allowing the deception to grow and flourish as suspect drugs continue to roll in, "including a crucial chemotherapy drug for treating leukemia and breast and ovarian cancers.”
An urgent, alarming work of health reporting that will make you question every drug in your medicine cabinet.
A sprawling, packed-to-the-brim study of the art and science of music, as monumental and as busy as a Bach fugue.
Why does one person like the Rolling Stones and another like Celine Dion? Why does anyone like the Eagles? Are there human universals at play in musical preferences? Gasser, the polymathic mind behind Pandora Radio’s Music Genome Project, probes the “sources, nature, and implications of our own, personal musical taste,” a taste that cannot always be easily reduced to buy- or listen-next algorithms. Music has features that are essentially invariant among human cultures: It is shaped by rhythm, “the overriding parameter wherein the listener gains an intuitive understanding of the music as a whole,” and it comprises melody, harmony, and other sonic elements. But more individually, our musical taste is shaped by all sorts of factors, socio-economic and psychological, that sometimes anticipate and sometimes follow “our membership in intracultures,” whether goth or mod or lite-classical. Gasser’s overarching aim is not just descriptive. In his forays into all imaginable corners of the musical world, he seeks to soften prejudices and broaden horizons, posing exercises and suggestions such as identifying syncopation in hip-hop tunes and appreciating the power of pre-Islamic chants sung by Saharan women “aimed at bringing the listener into a state of ecstasy.” The author’s body of examples—backed by a vast online site—is fittingly broad-ranging, featuring tunes from “Old MacDonald” to “Lucy in the Sky with Diamonds" and Leonard Bernstein’s Candide overture, all of which have something to say about why we like what we like. And while there’s no disputing taste, as the old Latin tag has it, there is much to know about how our psyches play in our musicality, what recreational drugs can contribute to the enjoyment of a Grateful Dead song, and the many ways in which music can make us better and happier people.
Like Nathan Myhrvold’s like-minded explorations of cooking, Gasser’s enterprise has a pleasingly mad-scientist feel to it, one that will attract music theory geeks as much as neuroscientists, anthropologists, psychologists, and Skynyrd fans.
A vivacious portrait of a therapist from both sides of the couch.
With great empathy and compassion, psychotherapist and Atlantic columnist and contributing editor Gottlieb (Marry Him: The Case for Settling for Mr. Good Enough, 2010, etc.) chronicles the many problems facing the “struggling humans” in her stable of therapy patients. The intimate connection between patient and therapist established through the experience of psychic suffering forms the core of the memoir, as the author plumbs the multifaceted themes of belonging, emotional pain, and healing. “Therapists…deal with the daily challenges of living just like everyone else….Our training has taught us theories and tools and techniques, but whirring beneath our hard-earned expertise is the fact that we know just how hard it is to be a person,” she writes. Through Gottlieb’s stories of her sessions with a wide array of clients, readers will identify with the author as both a mid-40s single mother and a perceptive, often humorous psychotherapist. In addition to its smooth, conversational tone and frank honesty, the book is also entertainingly voyeuristic, as readers get to eavesdrop on Gottlieb’s therapy sessions with intriguing patients in all states of distress. She also includes tales of her appointments with her own therapist, whom she turned to in her time of personal crisis. Success stories sit alongside poignant profiles of a newly married cancer patient’s desperation, a divorced woman with a stern ultimatum for her future, and women who seem stuck in a cycle of unchecked alcoholism or toxic relationships. These episodes afford Gottlieb time for insightful reflection and self-analysis, and she also imparts eye-opening insider details on how patients perceive their therapists and the many unscripted rules psychotherapists must live by, especially when spotted in public (“often when patients see our humanity, they leave us”). Throughout, the author puts a very human face on the delicate yet intensive process of psychotherapy while baring her own demons.
Saturated with self-awareness and compassion, this is an irresistibly addictive tour of the human condition.
An outstanding memoir by a transplant surgeon who combines an autobiography and operating room dramatics with an equally engrossing history of his profession.
In his first book, Mezrich (Surgery/Univ. of Wisconsin School of Medicine and Public Health) avoids standard-issue jokes about motorcyclists who don’t wear helmets but reminds readers that, except for the occasional live donor, a tragedy usually precedes every transplant. “Someone who had just died had saved the life of someone he had never met,” he writes, “and we were the ones that made it happen.” The author touches all bases with a masterly hand. He trained as a surgery resident, undergoing the usual mixture of servitude and inspiration. He graduated to a fellowship, during which skill and satisfaction increased with no decrease in the workload. Readers will share the author’s exhilaration at the end of a procedure when, for example, the clamps are released, blood flow turns a new kidney pink, and urine flows out before his eyes. At intervals, the author digresses, offering a cogent history of transplants. These sections will enthrall most readers save animal rights proponents, who will recoil at the myriad of animals sacrificed along the way. However, plenty of human recipients also died miserably, except for the rare identical twin, in the decades before doctors realized that they required immunosuppression. About half died during the 1960s and ’70s, when surgeons used early versions of anti-rejection drugs. After the first effective immunosuppressant, cyclosporine, was approved by the Food and Drug Administration in 1983, success rates exceeded 90 percent. As a result, transplanting many organs has become routine. Still, recent doctor-authors give equal time to failures, so Mezrich recounts plenty of painful experiences.
Medical memoirs have become a significant genre over the past two decades, and this one ranks near the top, in a class that includes arguably the best, Henry Marsh’s Do No Harm (2015).
Scientists routinely explain that humans rule the planet because of our intelligence, tools, or language, but this eye-opening account will convince most readers that our biggest asset is our ability to be comfortable around strangers.
A research associate at the Smithsonian and a visiting scholar at Harvard’s Department of Human Evolutionary Biology, Moffett (Adventures Among Ants: A Global Safari with a Cast of Trillions, 2010, etc.) points out that humans will walk into a cafe or stadium full of unfamiliar people without thinking twice. A chimpanzee, wolf, lion, or mouse encountering strangers could be attacked and perhaps killed. This ability—not IQ—has allowed humans to swarm over the world, argues the author. We belong to a society Moffett defines as “a discrete group of individuals amounting to more than a simple family…whose shared identity sets them apart from other such groups and is sustained continuously across the generations.” Most animal colonies, flocks, herds, schools, packs, swarms, or prides are simply creatures getting together informally, but a small minority qualify as societies because members recognize who belongs and who doesn’t. These provide access to resources and protection; however, despite the popular belief, cooperation is optional among higher animals. Lions do not necessarily hunt as a team, and a chimpanzee feels no obligation to share food. The author leaves no doubt that ants form the only society rivaling that of humans, featuring mutual cooperation, division of labor, and self-sacrifice. Much of the book is a fascinating exploration of how members of human societies identify who belongs and why most believe that their society is superior. Flags, food, hairstyle, dress, and heroic founding myths (their truth is irrelevant) all play significant roles, and infants absorb the prejudices of the adults around them as effortlessly as they do language.
A delightfully accessible and ingenious series of lessons on humans and our societies.
An expert examination of the immune system and recent impressive advances in treating immune diseases.
Scientists describe the brain as the most complex organ, but novelist and Pulitzer Prize–winning New York Times journalist Richtel (A Deadly Wandering: A Tale of Tragedy and Redemption in the Age of Attention, 2014, etc.) maintains that our immune system gives it a run for its money. Around 3.5 billion years ago, the earliest cells developed means to identify alien threats and (usually) fight them off. As organisms evolved greater complexity, their immune systems kept pace with mammals, humans included, which possess a dazzling collection of organs, tissues, wandering cells, DNA, messengers, and chemicals keeping watch on our “festival of life.” “The thymus makes T cells,” writes the author. “The bone marrow is the origin of B cells….The T cells, when alerted by dendritic cells, behave as soldiers, spitting out cytokines; the B cells use antibodies to connect to antigens as if they are keys in search of a lock. Macrophages, neutrophils, and natural killer cells roam the body, tasting, exploring, and killing.” In the first of many jolts, Richtel downplays the claims of enthusiasts who urge us to attain the strongest possible immune system. Immunity resembles less a comic-book superhero than a trigger-happy police force, equally capable of smiting villains and wreaking havoc on innocent bystanders. To illustrate, the author devotes equal space to its role in fending off threats (infections, cancer) and attacking healthy tissues during allergies and autoimmune diseases such as asthma, diabetes, colitis, rheumatoid arthritis, and lupus. Scientific breakthroughs in producing specific antibodies have led to spectacularly effective—if toxic and wildly expensive—treatments for many. A newsman’s truism insists that readers love articles that include real people, so the author introduces us to four. All illustrate the good and bad features of modern immunotherapy, but the courses of their diseases are too bizarre to be typical.
Richtel illuminates a complex subject so well that even physicians will learn.
A shape-shifting debut memoir about a family’s coming to terms with schizophrenia—or not.
Essayist and critic Sardy delivers an extraordinarily ambitious and accomplished narrative about significant challenges. She chronicles the immense difficulties in trying to maintain a semblance of sanity while both her mother and brother suffer through schizophrenia that they refuse to acknowledge, with the rest of the family in various states of denial as well. The structure keeps readers off balance, as the author refuses to follow conventional notions of chronology or connection, illuminating mental illness from the inside out. “Mental illness is not contagious, but madness often is,” she writes, a crucial distinction in her exploration of how, “in my family, psychotic illness has threaded its way through four generations in a row” and how those not afflicted have suffered through the effects of coming to terms with the delusions of schizophrenia, which seem so real to the one suffering and so outlandish to anyone else. At the outset, the book seems to be a memoir about coming-of-age while the author’s mother was falling apart, refusing to acknowledge her condition, spending all of her sizable inheritance, and telling her daughter that now is a particularly good time to emigrate to Pluto. Meanwhile, her father, whom her mother refused to acknowledge as such, remained in a state of denial while trying to provide a safe harbor when he had the children. Yet much more of the narrative concerns her relationship through her 20s with her brother, who showed similar signs of disintegration from schizophrenia, resisted diagnosis and treatment, and suffered from increasingly harmful delusions, leaving him in jail or homeless—though rarely completely out of touch with his family. The author herself suffers from bouts of depression, which she acknowledges and probes in her unsettling narrative.
Both powerful and disturbing, this impressive debut memoir suggests just how challenging it can be to regain some semblance of balance after that balance is lost.
A powerful exploration of the sinister, insidious nature of domestic violence in America.
As an international reporter for more than two decades, Snyder (Literature/American Univ.; What We've Lost Is Nothing, 2014, etc.) encountered regular acts of violence against women adjacent to the issues she covered. The grim statistics about and the prevalence of unreported incidents both startled and motivated her to begin chronicling the universality of an issue that “is too often hidden.” Through a graphically portrayed series of in-depth profiles, the author discusses how domestic violence has reached epidemic levels while efforts to curb the trend have been historically underfunded and ineffective. She elucidates this point in stories spotlighting both victims and assailants alongside the investigators and family members who’ve become all-consumed with sleuthing the crimes that have torn their relationships apart. She also tackles the complex conundrum facing victims of familial violence who choose to remain in abusive households. Intriguingly, Snyder probes the chilling territory of the perpetrators, sketching them from the inside out. Especially memorable is the author’s incisive coverage of the communities responsible for creating change through victim advocacy, rehabilitative jail programs, batterer intervention groups, and transitional housing. In one scene, Snyder describes a state prison’s group therapy session in which former abusers discuss “their own incidents of violence, times they…denied any wrongdoing, moments they manipulated or verbally threatened partners [and] instances of trivializing their own violent events. They begin to see, some of them for the first time ever, the effect their violence may have had on their victims.” As these stories and perspectives evolve and deepen, the author contributes her own profound introspection on the nature of empathy and relatability, weaving in themes of enduring emotional trauma, the resilience of “deep stereotypes,” and the many manifestations of physical and emotional violence.
Bracing and gut-wrenching, with slivers of hope throughout, this is exemplary, moving reportage on an important subject that often remains in the dark due to shame and/or fear.
How a lethal synthetic opioid and its manufacturer is creating a global drug addiction crisis.
In 2013, investigative journalist Westhoff (Original Gangstas: Tupac Shakur, Dr. Dre, Eazy-E, Ice Cube, and the Birth of West Coast Rap, 2016) began researching potently addictive street drugs, and he learned about Fentanyl and other “novel psychoactive substances” while writing about “why so many people were dying at raves.” The author describes Fentanyl and synthetic drugs (including K2 and Spice) as formerly medically sound panaceas whose formulas were hijacked and re-created with unpredictable potencies and physical effects. The staggering statistics he presents tell a much darker tale, as he shows how Fentanyl-laced cocaine and other new psychoactive substances are killing thousands of people. In order to uncover the origin of the epidemic and the epic race to develop effective deterrent systems, the author seamlessly blends past and present in his profiles of Belgian chemist Paul Janssen, who was responsible for Fentanyl’s initial development in 1959; police officers; politicians; LSD drug kingpins, and St. Louis street dealers. While promising, the harm-reduction initiatives remain diluted beneath the shifting weight and influence of political red tape, global capitalism, and the biological and psychological bondage of drug dependency. Perhaps most compelling is Westhoff’s undercover infiltration of several rogue Chinese drug operations. Some operate covertly, while others are blatantly transparent since China offers subsidies to companies manufacturing and distributing Fentanyl components. Also fascinating is the author’s charting of Fentanyl’s circulation from darknet marketplaces to overseas postal stops to regional distribution. While international interceptive efforts like “Operation Denial” have helped in the apprehension of the upper echelon of major distributors, they have failed to collar Fentanyl trafficking network kingpin Jian Zhang, who is believed to be largely responsible for the steady flow of the drug into the global market. Drawing material from official reports, drug databases, scores of interviews, and years of personal research, Westhoff presents an unflinching, illuminating portrait of a festering crisis involving a drug industry that thrives as effectively as it kills.
Highly sobering, exemplary reportage delivered through richly detailed scenarios and diversified perspectives.
An excellent argument that evolution applies to culture as well as organisms.
Most people, the uneducated included, have no objection to the concept of the Darwinian evolution of plants and animals. Evolution of humans won over scientists long ago. Applied to human behavior in the form of politics, economics, business, and war, evolutionary theories existed before Darwin but acquired a bad reputation by equating Darwinian “fitness” with wealth, social status, and belligerence. Evolutionary biologist Wilson (Biology and Anthropology/Binghamton Univ.; Does Altruism Exist?: Culture, Genes, and the Welfare of Others, 2015, etc.), the president of the Evolution Institute, points out that the 20th century was nearly over before scientists began to examine human institutions without the ideological distraction of social Darwinism. Ironically, this happened because of spectacular advances in biology, especially genetics: “Evolution…became associated with an incapacity for change (being stuck with our genes), with our capacity for change somehow residing outside the orbit of evolution. The term ‘Social Darwinism’ helps to buttress this bizarre configuration of ideas in ways that are almost childish, once they are seen clearly.” A masterful educator, Wilson begins with basics and then carefully amplifies them. To understand any product of evolution (a hand, cancer, aggression), one must address four areas: function, history, mechanism, and how it develops. A snowflake may be more complex than a hand, but it doesn’t qualify because it has no function. The problem of evil torments theologians but yields to evolutionary analysis. Thus, altruism seems a trait for wimps because selfish individuals prosper, but a group where everyone cooperates always outcompetes a group with selfish members. The author emphasizes that cultural evolution is a multilevel process. A learned behavior spreads by benefiting individuals compared to other individuals in the same group or the whole group compared to competing groups.
One of the major advances in modern biology receives a splendid overview.