A good education on addiction, fascinating case histories, and a sensible formula for treatment.



An addiction specialist discusses her patients’ problems and how she deals with them, and it’s an unsettling picture.

Lembke, medical director of the Stanford Addiction Medicine clinic, begins with a lesson in neuroscience. Nerves along brain pathways that process rewards (i.e., pleasure) use dopamine as a “neurotransmitter”—to deliver signals. The more dopamine an experience releases, the more we enjoy it. However, dopamine processes pain as well as pleasure, and a healthy brain maintains a balance. Most of us stop eating when we feel full. Coffee often provides all the stimulation we need. Gambling, drinking, shopping, or watching pornography are intermittent activities. Addiction, the mark of an unhealthy brain, is a compulsive behavior that continues despite the harm it causes, and it’s a worldwide epidemic. The biggest risk factor is easy access. History books proclaim Prohibition a failure, but it produced a big drop in alcoholism, public drunkenness, and alcohol-caused liver disease, which rose again after repeal. Today, it seems, all indulgences are accessible. Since around 2000, the rampant overprescription of narcotics has produced skyrocketing addiction and death. The internet allows us to engage in social as well as unseemly activities in private. Popular medical books rely on vivid case histories, and Lembke offers plenty. Her first is a lifelong masturbation addict who was ultimately able to achieve control. There follow accounts of other types of addicts, and she describes her treatment strategy based on the acronym DOPAMINE: data, objectives, problems, abstinence, mindfulness, insight, next steps, and experiment. Most readers will find it reasonable, and the author does not trumpet its success rate. Some of the most insightful passages involve lying, a malignant process in a cooperative society but essential to maintaining addictive behavior. Many people believe that honesty—unmasking our flaws—will drive people away, but it does the opposite.

A good education on addiction, fascinating case histories, and a sensible formula for treatment.

Pub Date: Aug. 24, 2021

ISBN: 978-1-5247-4672-8

Page Count: 304

Publisher: Dutton

Review Posted Online: June 16, 2021

Kirkus Reviews Issue: July 1, 2021

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Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and...


A dense, absorbing investigation into the medical community's exploitation of a dying woman and her family's struggle to salvage truth and dignity decades later.

In a well-paced, vibrant narrative, Popular Science contributor and Culture Dish blogger Skloot (Creative Writing/Univ. of Memphis) demonstrates that for every human cell put under a microscope, a complex life story is inexorably attached, to which doctors, researchers and laboratories have often been woefully insensitive and unaccountable. In 1951, Henrietta Lacks, an African-American mother of five, was diagnosed with what proved to be a fatal form of cervical cancer. At Johns Hopkins, the doctors harvested cells from her cervix without her permission and distributed them to labs around the globe, where they were multiplied and used for a diverse array of treatments. Known as HeLa cells, they became one of the world's most ubiquitous sources for medical research of everything from hormones, steroids and vitamins to gene mapping, in vitro fertilization, even the polio vaccine—all without the knowledge, must less consent, of the Lacks family. Skloot spent a decade interviewing every relative of Lacks she could find, excavating difficult memories and long-simmering outrage that had lay dormant since their loved one's sorrowful demise. Equal parts intimate biography and brutal clinical reportage, Skloot's graceful narrative adeptly navigates the wrenching Lack family recollections and the sobering, overarching realities of poverty and pre–civil-rights racism. The author's style is matched by a methodical scientific rigor and manifest expertise in the field.

Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and Petri dish politics.

Pub Date: Feb. 9, 2010

ISBN: 978-1-4000-5217-2

Page Count: 320

Publisher: Crown

Review Posted Online: Dec. 22, 2010

Kirkus Reviews Issue: Jan. 1, 2010

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A sweet-and-sour set of pieces on loss, absurdity, and places they intersect.


Sedaris remains stubbornly irreverent even in the face of pandemic lockdowns and social upheaval.

In his previous collection of original essays, Calypso (2018), the author was unusually downbeat, fixated on aging and the deaths of his mother and sister. There’s bad news in this book, too—most notably, the death of his problematic and seemingly indestructible father at 96—but Sedaris generally carries himself more lightly. On a trip to a gun range, he’s puzzled by boxer shorts with a holster feature, which he wishes were called “gunderpants.” He plays along with nursing-home staffers who, hearing a funnyman named David is on the premises, think he’s Dave Chappelle. He’s bemused by his sister Amy’s landing a new apartment to escape her territorial pet rabbit. On tour, he collects sheaves of off-color jokes and tales of sexual self-gratification gone wrong. His relationship with his partner, Hugh, remains contentious, but it’s mellowing. (“After thirty years, sleeping is the new having sex.”) Even more serious stuff rolls off him. Of Covid-19, he writes that “more than eight hundred thousand people have died to date, and I didn’t get to choose a one of them.” The author’s support of Black Lives Matter is tempered by his interest in the earnest conscientiousness of organizers ensuring everyone is fed and hydrated. (He refers to one such person as a “snacktivist.”) Such impolitic material, though, puts serious essays in sharper, more powerful relief. He recalls fending off the flirtations of a 12-year-old boy in France, frustrated by the language barrier and other factors that kept him from supporting a young gay man. His father’s death unlocks a crushing piece about dad’s inappropriate, sexualizing treatment of his children. For years—chronicled in many books—Sedaris labored to elude his father’s criticism. Even in death, though, it proves hard to escape or laugh off.

A sweet-and-sour set of pieces on loss, absurdity, and places they intersect.

Pub Date: May 31, 2022

ISBN: 978-0-316-39245-7

Page Count: 272

Publisher: Little, Brown

Review Posted Online: March 11, 2022

Kirkus Reviews Issue: April 1, 2022

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