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 15, 2021

Kirkus Reviews Issue: July 1, 2021


A clearly delineated guide to finally eradicate poverty in America.

A thoughtful program for eradicating poverty from the Pulitzer Prize–winning author of Evicted.

“America’s poverty is not for lack of resources,” writes Desmond. “We lack something else.” That something else is compassion, in part, but it’s also the lack of a social system that insists that everyone pull their weight—and that includes the corporations and wealthy individuals who, the IRS estimates, get away without paying upward of $1 trillion per year. Desmond, who grew up in modest circumstances and suffered poverty in young adulthood, points to the deleterious effects of being poor—among countless others, the precarity of health care and housing (with no meaningful controls on rent), lack of transportation, the constant threat of losing one’s job due to illness, and the need to care for dependent children. It does not help, Desmond adds, that so few working people are represented by unions or that Black Americans, even those who have followed the “three rules” (graduate from high school, get a full-time job, wait until marriage to have children), are far likelier to be poor than their White compatriots. Furthermore, so many full-time jobs are being recast as contracted, fire-at-will gigs, “not a break from the norm as much as an extension of it, a continuation of corporations finding new ways to limit their obligations to workers.” By Desmond’s reckoning, besides amending these conditions, it would not take a miracle to eliminate poverty: about $177 billion, which would help end hunger and homelessness and “make immense headway in driving down the many agonizing correlates of poverty, like violence, sickness, and despair.” These are matters requiring systemic reform, which will in turn require Americans to elect officials who will enact that reform. And all of us, the author urges, must become “poverty abolitionists…refusing to live as unwitting enemies of the poor.” Fortune 500 CEOs won’t like Desmond’s message for rewriting the social contract—which is precisely the point.

A clearly delineated guide to finally eradicate poverty in America.

Pub Date: March 21, 2023

ISBN: 9780593239919

Page Count: 288

Publisher: Crown

Review Posted Online: Nov. 30, 2022

Kirkus Reviews Issue: Jan. 1, 2023


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

Close Quickview