Month: April 2015

“You know,” he said, patting me on the back, “there is nothing more rewarding than bringing a ninety-five-year-old demented woman with widely metastatic lung cancer back to life. Well done.”

One of the most disturbing things I have realized as I’ve grown up is that, despite what I thought as a child, most adults are pretty much just winging it. I had excluded doctors from that assessment, for my own peace of mind. Of course everyone has to start somewhere and The Real Doctor Will See You Shortly is a candid memoir about Matt McCarthy’s starting point. When Matt begins his intern year at Columbia University Medical Center in New York, he quickly realizes that four years of medical school has left him unprepared for the practical work of dealing with actual patients.

Matt McCarthy is brutally honest as he details his biggest mistakes and biggest triumphs during his intern year. He struggles with connecting to patients and figuring out how much emotional involvement is too much. He introduces us to a few of the patients that made the biggest impact on his bedside manner and made me feel just as invested in their outcomes as he did.

“It occurred to me that we were all wrestling with some form of impostor syndrome, unable to internalize and appreciate our own accomplishments. There was always someone more impressive, someone who could make you look foolish if they really wanted to. Underneath the glimmering personas, some of us–including me and the women in my pod– secretly worried that we didn’t deserve to be doctors, we didn’t deserve to hold life in our hands, we weren’t the ones who should be leading complex discussions about comfort measures and vegetative states. The key to residency was figuring out ways to ignore those feelings without turning into a monster.”

The tone starts out as comedic, but it does take a more serious turn in Part 2 after he has an work-related accident that puts his own health in danger. McCarthy is a frazzled ball of stress for the first half of the book, which is completely understandable as his life becomes a complete whirlwind with minimal sleep. Much of the intern’s education is by trial and error and some of the supervisor advice seemed to boil down to “do what your heart tells you.” Who wouldn’t be panicked when the stakes are so high? McCarthy addresses his subject in a relatable way, even to those of us who aren’t doctors. Who hasn’t felt like a complete fraud, especially when starting a brand new job after college? Despite some parts that are a little unnerving from the patient point of view, you will cheer Dr. McCarthy on as he establishes a solid footing in his profession and eventually becomes “real” doctor.

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If you are curious about the transition from medical student to doctor or you are a fan of the medical-related parts of Grey’s Anatomy *, I think you will enjoy this book.

*No supply closet rendezvous, ferry accidents or plane crashes in this book!

I received this book for free from the Library Early Reviewer’s Program

“Even then, more than a year earlier, there were neurons in her head, not far from her ears, that were being strangled to death, too quietly for her to hear them. Some would argue that things were going so insidiously wrong that the neurons themselves initiated events that would lead to their own destruction. Whether it was molecular murder or cellular suicide, they were unable to warn her of what was happening before they died.”

Still Alice is the psychological portrait of Alice Howland, a successful and brilliant cognitive psychology professor at Harvard. At 50 years of age, Alice is diagnosed with early-onset Alzheimer’s disease. Early-onset Alzheimer’s affects approximately 200,000 in the United States and can produce symptoms in people as young as 30.

The narrator tells the story from Alice’s perspective. We follow Alice’s life from September 2003 to September 2005, each chapter representing a month. It covers a full spectrum of topics: the anxiety of realizing something is wrong, the denial, the frequent testing and the struggles of managing life after diagnosis. In the first chapter, Alice is running her usual route through Harvard Square when she suddenly can’t remember how to get home. She recognizes the landmarks, but she can’t piece it all together and comprehend a way forward. The moment was fleeting, but absolutely terrifying. After diagnosis, it is heartbreaking when Alice realizes that her time left as “herself” is limited and how her priorities have changed due to this new awareness. The author makes you feel so happy for Alice when she has a minor success and then pulls the rug out from under you a few paragraphs later. The highs and lows are part of the disease and the high points slowly get overtaken by the low points.

While the story was predominately about Alice and not the family, the author also showed how each family member deals with the situation differently. Her husband’s portrayal can seem a little unsympathetic, but I can understand the frustrations of seeing someone you love deteriorate before your eyes and having a difficult time witnessing it. [spoiler]Still, it was disappointing to see how much he left Alice alone and his decision at the end (even though it may have been the rational one). In a way he treated her like she was already gone and Alice felt that. I can’t help to think that things would have been different, if it had been the other way around.[/spoiler]

“The words, the information, the meaning in the woman’s questions and in Alice’s own answers were like soap bubbles, the kind children blew out of those little plastic wands, on a windy day. They drifted away from her quickly and in dizzying directions, requiring enormous strain and concentration to track. And even if she managed to actually hold a number of them in her sight for some promising duration, it was invariably too soon that pop! they were gone, burst without obvious cause into oblivion, as if they’d never existed.”

The author Lisa Genova graduated from Harvard with a Ph.D in neuroscience and obviously has an enormous amount of passion for her subject. She writes Alice’s story with compassion and empathy. There are only a few info dumps where you could hear the voice of the Ph.D author, a couple of which made it seem like the whole book was an extended pamphlet for Dementia Advocacy and Support Network International. Great organization, but I think the references could have been integrated more naturally and the web addresses could have been included in the postscript instead of dialogue. These instances are disrupt the flow, but do not overwhelm Alice’s story.
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Still Alice is one of the most terrifying books I have ever read. We’ve all had instances where the word we want to use is at the tip of our tongue, but remains just outside of our mental grasp. Most of us have been in the situation where we go to a room with a specific goal, but have forgotten that goal by the time we arrive at the entryway. The memory usually comes back later, sometimes within seconds. But what if those brief memory lapses were a sign of something insidious lurking deep in the recesses of the brain? What if those memory lapses started taking over your life? What if your memories were permanently destroyed, one by one? What if the destruction of memories wasn’t limited to the mundane, but also affected your most precious memories and threatened to destroy your connection to your loved ones? Who are we without our memories?

“I often fear tomorrow. What if I wake up and don’t know who my husband is? What if I don’t know where I am or recognize myself in the mirror? When will I no longer be me? Is the part of my brain that’s responsible for my unique ‘me-ness’ vulnerable to this disease? Or is my identity something that transcends neurons, proteins, and defective molecules of DNA? Is my soul and spirit immune to the ravages of Alzheimer’s? I believe it is.”

The book also mentions genetic testing. I am not sure what I would want! It is such a difficult situation. The situation gets more murky if you want to start a family. Would you still have biological children if they had a 50% chance of getting an Alzheimer’s gene?

“My yesterdays are disappearing, and my tomorrows are uncertain, so what do I live for? I live for each day. I live in the moment. Some tomorrow soon, I’ll forget that I stood before you and gave this speech. But just because I’ll forget it some tomorrow doesn’t mean that I didn’t live every second of it today. I will forget today, but that doesn’t mean that today didn’t matter.”

This is a must read for caretakers and family members of those with dementia. Still Alice gave me greater insight into the mind of someone with dementia. It is so easy to get frustrated with someone who can’t think as fast as you do or is not able to operate within their previous set of capabilities, but it is frustrating, alienating and scary for them too! There were a few mentions about how on good days people might assume there is nothing wrong or maybe the bad days were just dramatics. I hear this from people with auto-immune disorders as well. This book explains that while there are good days, the disease is still lurking, barely submerged and waiting to attack again. I also have a better grasp on the importance of funding for Alzheimer’s research.

I am a total sucker for medical fiction and non-fiction and I think this was a really good and thoughtful book. If you like this book, you might also like Brain on Fire or Me Before You.

3.5 Stars for the Book, 5 Stars for the heroine and her story! “When I was born, people in our village commiserated with my mother and nobody congratulated my father.”

When Malala was only eleven years old, she wrote an anonymous blog for the BBC detailing life under the Taliban. One of the Taliban’s many goals was to prohibit girls from getting an education. With her parent’s support, she very publicly advocated for the education of young women. On October 9, 2012, a Taliban assailant shot fifteen-year-old Malala in the head at point-blank range because of her activism. Miraculously she survived the assassination attempt and continues her advocacy to this day. Along with Kailash Satyarthi, Malala was awarded the Nobel Peace Prize in 2014 for “their struggle against the suppression of children and young people and for the right of all children to education.” She is the youngest-ever Nobel Prize Laureate.

“Education is education. We should learn everything and then choose which path to follow. Education is neither Eastern nor Western, it is human.”

I Am Malala: The Girl Who Stood Up for Education and Was Shot by the Taliban (by Malala Yousafzai & Christina Lamb) is part memoir and part history & politics lesson. The history and politics are important to understanding the context of the events in Malala’s life. I think those parts were really interesting, but it might be too dry for anyone who is easily bored by history. I really liked reading about important news events from the Pakistani perspective. I learned more about her country, her culture, and Islam. I always thought of Pakistan as a desert, so I thought she was exaggerating when she called her village “the Switzerland of Pakistan.” Google Images confirmed that it was no exaggeration; Swat Valley is gorgeous.

The story is told in five parts. Part One tells about her life before the Taliban and also includes family history. In Parts Two and Three, she describes the slow creep of the Taliban into Swat Valley territory and the battle between the Taliban and the Pakistani military. It is a scary and it is a story we’ve heard many times over the course of history. I was really affected by all the ordinary people trying to live their lives the best they could in the midst of extreme hardship. Part Four covers the shooting aftermath and her fight for survival. Part Five begins after she wakes up from the induced coma.
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Her father: “This is how these militants work. They want to win the hearts and minds of the people, so they first see what the local problems are and target those responsible, and that way they get the support of the silent majority. That’s what they did in Waziristan when they went after kidnappers and bandits. After, when they get power, they behave like the criminals they once hunted down.”

My favorite sections were anecdotes from Malala’s life. The best part of reading is being able to get inside the head of someone who lives a completely different life than you! Malala is so mature, wise and perceptive, it can be hard to remember that she was only 16 at the time of publication. I love how this book reminds you she is still a normal teenager who loves Twilight, experiments with hair and make-up, and quarrels with her brothers and her best friend. It just so happens that in her spare time, she works to make the world a better place! Even though Malala paid a high price for her activism, she displays amazing strength of character and never wavers from her goals. Malala is living proof that if you are passionate and you work hard, one person can make a positive impact on the world. Her parents are pretty amazing as well!

“I loved reading about Dorothy and how even though she was trying to get back home she stopped and helped those in need like the Cowardly Lion and the rusty Tin Man. She had to overcome a lot of obstacles to get where she was going, and I thought if you want to achieve a goal, there will be hurdles in your way, but you must continue.”

My only complaint about this book is that I think it was rushed to publication. The release date was exactly one year after the shooting. My reading enjoyment goes way down when I start thinking, “I sure wish the publisher would have spent more money on editing.” The personal stories and the history do not flow together cohesively and some of the anecdotes were all over the place. Because of the poor transitions, I felt like I had missed whole sentences or paragraphs. Parts read like a meandering conversation with digressions, so I wonder if Christina Lamb transcribed at least some of it from audio interviews. Many of the reviews for the Young Readers version with a different co-author claim it has better flow. I have also read that it has less history and politics, so if you think that the drier portions of the book might keep you from reading Malala’s story, the Young Readers version might be worth a try.

Memoirs aren’t my favorite genre, but Malala has an important and relevant story to tell. I recommend this book to everyone, especially those under 18. It can be so easy to take public education for granted, but unfortunately it is not a right that every child in the world is guaranteed.

“I had at least thought there would be nobility in war. I know it exists. There are so many stories, and some of them have to be true. But I see mostly normal men, trying to do good, beaten down by horror, by their inability to quell their own rages, by their masculine posturing and their so-called hardness, their desire to be tougher, and therefore crueler, than their circumstance. And yet, I have this sense that this place is holier than back home. Gluttonous, fat, oversexed, over-consuming, materialist home, where we’re too lazy to see our own faults. At least here, Rodriguez has the decency to worry about hell. The moon is unspeakably beautiful tonight. Ramadi is not. Strange that people live in such a place.”

Redeployment is a collection of twelve fictional short stories written by Phil Klay. Klay is a veteran of the U.S. Marine Corps who was stationed for a year in Iraq as a Public Affairs Officer. These stories are about the recent war in Iraq and the Marines make an appearance in all the stories. This is not a “rah-rah war” book, which some may be looking for and some may be trying to avoid. The individual viewpoints vary, but they are all thoughtful and nuanced. The stories are told from a multitude of perspectives (combat troops, Marines on leave in the US or adjusting to life back home, a chaplain, support staff, etc.), but they share common themes: the growing disconnect between civilians and the military, the mistaken perceptions that civilians have about war and the military, the conflicting emotions in a war zone and at home, and the experiences of combat troops versus that of non-combat units/support staff.

My favorite short story is Money as a Weapons System, which really highlights the absurdities of nation-building during a war. Nathan, a foreign service officer, arrives in Iraq determined to make a difference and encounters all sorts of bureaucratic entanglements. The story is told in a humorous way, but it is a more than a little depressing when you remember that the story has roots in reality.

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There is violence, sexual content, and bad language, but that is to be expected in any book about the realities of war. I think this book is important for any American of voting age. It is impossible to have a full grasp of what it is like to be a soldier in a war zone, but Redeployment does provide a little insight. Everyone’s experience will be different and Redeployment is a important and necessary companion to the more popular books about the wars in Iraq and Afghanistan.

“The weird thing with being a veteran, at least for me, is that you do feel better than most people. You risked your life for something bigger than yourself. How many people can say that? You chose to serve. Maybe you didn’t understand American foreign policy or why we were at war. Maybe you never will. But it doesn’t matter. You held up your hand and said, “I’m willing to die for these worthless civilians.” At the same time, though, you feel somehow less. What happened, what I was a part of, maybe it was the right thing. We were fighting very bad people. But it was an ugly thing.”