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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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BETWEEN THE WORLD AND ME

NOTES ON THE FIRST 150 YEARS IN AMERICA

This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”

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The powerful story of a father’s past and a son’s future.

Atlantic senior writer Coates (The Beautiful Struggle: A Father, Two Sons, and an Unlikely Road to Manhood, 2008) offers this eloquent memoir as a letter to his teenage son, bearing witness to his own experiences and conveying passionate hopes for his son’s life. “I am wounded,” he writes. “I am marked by old codes, which shielded me in one world and then chained me in the next.” Coates grew up in the tough neighborhood of West Baltimore, beaten into obedience by his father. “I was a capable boy, intelligent and well-liked,” he remembers, “but powerfully afraid.” His life changed dramatically at Howard University, where his father taught and from which several siblings graduated. Howard, he writes, “had always been one of the most critical gathering posts for black people.” He calls it The Mecca, and its faculty and his fellow students expanded his horizons, helping him to understand “that the black world was its own thing, more than a photo-negative of the people who believe they are white.” Coates refers repeatedly to whites’ insistence on their exclusive racial identity; he realizes now “that nothing so essentialist as race” divides people, but rather “the actual injury done by people intent on naming us, intent on believing that what they have named matters more than anything we could ever actually do.” After he married, the author’s world widened again in New York, and later in Paris, where he finally felt extricated from white America’s exploitative, consumerist dreams. He came to understand that “race” does not fully explain “the breach between the world and me,” yet race exerts a crucial force, and young blacks like his son are vulnerable and endangered by “majoritarian bandits.” Coates desperately wants his son to be able to live “apart from fear—even apart from me.”

This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”

Pub Date: July 8, 2015

ISBN: 978-0-8129-9354-7

Page Count: 176

Publisher: Spiegel & Grau

Review Posted Online: May 5, 2015

Kirkus Reviews Issue: July 1, 2015

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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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