Dr. Howell, a pediatrician formerly with the Harvard Medical School, offers yet another view of the beleaguered ""nuclear family"" in the midstream of change and outlines a positive direction. She begins by investigating the nature of the ""family"" unit, which she rather lyrically defines as ""two or more persons living together in a household, exchanging non-monetized service and sustaining commitment over time."" But she also examines another social complex with the same qualities as this prototypical household; that is, the extended family of relatives, friends, neighbors and communities bound by common interests or occupations. Standing between the two--and a prime cause of the average American's sense of alienation and impotence when dealing with matters most important to him (namely education, work, child and health care, etc.)--is an army of ""experts, managers and professionals"" who remain aloof and elitist. Howell believes that we should insist that help in these areas come to us on our terms, that we share the experts' knowledge and skills. This is where the caring/sharing nature of both types of families comes into play. Neighborhood teachers and health centers, for example, could act as liaison between institutions and community and help the ""clients"" help themselves. (E.g., throat cultures, TB tests, etc. could be done under supervision at a neighborhood health center by laymen, even children.) Some of Dr. Howell's practical suggestions may seem simplistic and unsettling. Her anger, mainly directed at her own professional establishment, sometimes tips sweet reason. But her manifesto is generally stimulating and, above all, hopeful.