Musings on why we do bad things to ourselves.

Portmann (When Bad Things Happen to Other People, not reviewed, etc.) approaches the problem of self-harm by looking first at how much we really know about what is good for us. Prevailing social attitudes, he asserts, are the means by which we determine what acts, whether to ourselves or others, are harmful. He examines several specific kinds of self-harm that he says one might want or need to do at least on occasion, based on society’s current moral expectations. These are masturbation, sadomasochism and voluntary slavery, prostitution, humiliating oneself on a talk show, posing naked in front of a camera, not striving to reach one’s potential, drug abuse, and self-neglect. All are illustrated with examples from literature or life. Next he considers briefly four ways in which self-harm can be inflicted: physically, spiritually, socially, and emotionally. In the second part, he turns to self-control, focusing first on the phenomenon of unnecessary self-control. He illustrates this idea by describing at considerable length the present-day behavior of undergraduate men in the locker room at the University of Virginia, where he finds that they hide themselves from the view of other men to protect their sexual reputation. He then considers the limits of self-control, as, for example, in clinical depression. In the final section, Portmann gets down to his central thesis, the paradox that both a sense of self-control and loss of self-control are essential. He uses the word “raving” to designate an intentional leap into rebellion, an act by which one throws off self-control in order to find one’s true self. From the point of view of an observer, the one raving is harming himself, but from the raver’s point of view, he is trying out a new identity. The danger, of course, is that the raver who has little self-control may put himself on a self-destructive path. However, says Portmann, those with adequate self-control have the ability to cut their raving short and pull back from the brink of disaster. In essence, raving is a mark of strength, the act of an individual consciously liberating himself from a restrictive culture. Self-harm is its risk.

Earnest and drawn-out.

Pub Date: July 1, 2004

ISBN: 0-8070-1618-7

Page Count: 224

Publisher: Beacon Press

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: April 15, 2004

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A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...

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A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.

Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.

Pub Date: Jan. 19, 2016

ISBN: 978-0-8129-8840-6

Page Count: 248

Publisher: Random House

Review Posted Online: Sept. 30, 2015

Kirkus Reviews Issue: Oct. 15, 2015

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Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.


“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues.

It’s no secret, write Banerjee and Duflo (co-authors: Poor Economics: A Radical Rethinking of the Way To Fight Global Poverty, 2011), that “we seem to have fallen on hard times.” Immigration, trade, inequality, and taxation problems present themselves daily, and they seem to be intractable. Economics can be put to use in figuring out these big-issue questions. Data can be adduced, for example, to answer the question of whether immigration tends to suppress wages. The answer: “There is no evidence low-skilled migration to rich countries drives wage and employment down for the natives.” In fact, it opens up opportunities for those natives by freeing them to look for better work. The problem becomes thornier when it comes to the matter of free trade; as the authors observe, “left-behind people live in left-behind places,” which explains why regional poverty descended on Appalachia when so many manufacturing jobs left for China in the age of globalism, leaving behind not just left-behind people but also people ripe for exploitation by nationalist politicians. The authors add, interestingly, that the same thing occurred in parts of Germany, Spain, and Norway that fell victim to the “China shock.” In what they call a “slightly technical aside,” they build a case for addressing trade issues not with trade wars but with consumption taxes: “It makes no sense to ask agricultural workers to lose their jobs just so steelworkers can keep theirs, which is what tariffs accomplish.” Policymakers might want to consider such counsel, especially when it is coupled with the observation that free trade benefits workers in poor countries but punishes workers in rich ones.

Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.

Pub Date: Nov. 12, 2019

ISBN: 978-1-61039-950-0

Page Count: 432

Publisher: PublicAffairs

Review Posted Online: Aug. 29, 2019

Kirkus Reviews Issue: Sept. 15, 2019

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