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UNDER OBSERVATION

LIFE INSIDE A PSYCHIATRIC HOSPITAL

Ostensibly a slice of life inside McLean Hospital in Belmont, Mass., during a two-week period in the spring of 1993, but actually a report on the status of psychiatric treatment today. Berger first wrote about McLean in We Heard the Angels of Madness (1992), a book that she co-authored with her sister Diane, describing her nephew's descent into manic depression. Here, her co-author is a psychiatrist in charge of a unit for patients with severe psychosis. The narrator is Berger, with Vuckovic always referred to in the third person. Together they construct composites of a number of patients, who are also shown interacting in numerous group meetings. Among these composites are: Kiesha, a delusional pregnant woman whose husband insists she not be medicated; David, a suicidal man who is given electroconvulsive therapy; Glenda, a chronic paranoid schizophrenic who is switched to the latest miracle drug; and Matt, a substance abuser who has had attention deficit hyperactivity disorder since childhood. Admission and discharge notes, replete with medical jargon and abbreviations, are included for each, possibly to lend these composites a touch of authenticity. More interesting are two scientists at McLean's research center: Ross Baldessarini and Frances Benes. Descriptions of their work provide the authors with the opportunity to give some history of psychiatric diseases and their treatments and to explain current trends in neuropharmacology and neuroanatomy. Whether intentional or not, the impression is left that psychiatry is an infant science struggling to come to terms with a bewildering variety of therapies. McLean comes off as a humane treatment center providing the best care possible given the budgetary constraints of our present system and the limits of our present knowledge. The patient notes are a trifle gimmicky, and the accounts of group meetings become tiresome, but the writing sparkles when the subject is scientific research.

Pub Date: Aug. 22, 1994

ISBN: 0-395-63413-X

Page Count: 288

Publisher: Houghton Mifflin

Review Posted Online: May 19, 2010

Kirkus Reviews Issue: June 1, 1994

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WHEN BREATH BECOMES AIR

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. 29, 2015

Kirkus Reviews Issue: Oct. 15, 2015

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GOOD ECONOMICS FOR HARD TIMES

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. 28, 2019

Kirkus Reviews Issue: Sept. 15, 2019

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