WRITING DOCTOR'S BLOG by NYHWRITER.COM

When Do We Call the Game? THE MERCY RULE by Perri Klass (Houghton Mifflin, July, 2008)

THE MERCY RULE by Perri Klass (Houghton Mifflin, July, 2008)
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Review by Nancy Yanes-Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, email: nywriter@rochester.rr.com, 585-385-1515
16 San Rafael Drive, Rochester NY 14618
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         Can women do it all? Perri Klass, the multitasking pediatrician-writer and author of THE MERCY RULE (Houghton Mifflin, July, 2008), seems to manage it. But Dr Lucy Weiss, Klass's alter ego and central character, seems less sure what she can and cannot do. As for me, I wonder what Klass is trying to say about how well working women can fulfill their responsibilities to family and patients—or whether they risk losing themselves along the way.

        Rereading THE MERCY RULE, I’m still not sure where I stand. My daughter objects to Klass, arguing that she is smug, that her tone implies that yes, certain women can do it all. But Lucy has so many balls in the air that she finally becomes partially disconnected from her family, from the lost women she works with in her job, and even from herself.

       With THE MERCY RULE, form follows function. Honing in on the complications of balancing the demands of the medical profession with the equally (even more?) demanding  profession of being as good a parent--and a wife-- as possible, THE MERCY RULE  feels more  like a group short story than a novel.
 
        The title asks questions that it does not answer. For the benefit of the non-cognoscenti like me, Wikipedia defines  the “mercy rule” as a sports expression, also known as the slaughter rule. The mercy rule ends the game  “when one team has a very large and presumably insurmountable lead over the other.” It quits when the team is ahead. In the Little League where Freddy, Lucy’s odd, mathematically sharp and socially inadept son, plays, the coach calls the game because of the Mercy Rule. A billionaire father, out to have his son outplay the boys, protests, “In life, there are no Mercy Rules.”  Although she believes that “life is full of Mercy Rules, and I follow them as much as I can,” she doesn’t say a word to the obnoxious billionaire.

          Once a foster child going from hand to mouth and foster home to foster home, Lucy was saved when  her beloved sixth grade teacher adopted her.  Lucy Weiss is then a survivor, a pediatrician  running a Boston clinic for neglected children and their forgetful, abandoning  mothers. The stories are about judging parents and children, figuring out what parents and outsiders can  do to make children’s lives better.

         Although Lucy attempts to balance her family life with her professional job, she suffers from a lack of focus, most disturbingly in the last section where the narrative voice changes and speaks dizzyingly to the reader:

         “If you are in any kind of trouble, call me,” concludes the unidentified narrator, ostensibly speaking for Lucy. “Find a way to call me. Call me from anywhere…I want to know we are connected. I will always answer…always hear…always come. Look what the phones can do, nowadays. Look how that can change the story. And the right connection at the right moment is all it takes.”

         But cell phones don’t always work. Connections falter. As a result, even though Lucy’s group short story might make an interesting selection for a  book club, it gets a little lost on the road. Finally, we don’t know where we –or Lucy—can go from here.

         Klass's Treatment Kind and Fair: Letters to a Young Doctor considers the struggle between medicine and family more clearly than this novel and leaves the reader with much more to think about. It would be a good place for Lucy to go next.

CAN WORDS REPLACE PROZAC? THE MAN WHO MADE LISTS: LOVE, DEATH, MADNESS, AND THE CREATION OF ROGET’S THESAURUS by Joshua Kendall (Putnam, April, 2008)

THE

MAN

WHO MADE LISTS: LOVE, DEATH, MADNESS,

AND

THE CREATION OF ROGET’S THESAURUS by Joshua Kendall (Putnam, April, 2008)

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Review by Nancy Yanes-Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, email: nywriter@rochester.rr.com, 585-385-1515

16 San Rafael Drive

,

Rochester

 

NY

 

14618

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            Can words replace Prozac? Well, maybe. At least, words were the treatment of choice for Scientist-Physician-Wordsmith Peter Mark Roget, creator of ROGET’S THESAURUS.  Born into a family cursed by emotional illness, suffering from an obsessive-compulsive disorder, Roget began making lists when he was only eight years old—long before he grew into the man who harnessed his fetish for order with words and most of all, their categories and relationships.

Joshua Kendall, Roget’s biographer, notes, “As a boy, he stumbled upon a remarkable discovery—that compiling lists of words could provide solace, no matter what misfortunes might befall him.  As an adult, he kept returning to the classifications of words and concepts. Immersion in the nuances of language could invariably energize him and keep his persistent anxiety at bay.”

Obsessed with his desire to impose order upon a chaotic world, trying to classify the strange relationships between language and life, focusing on words “that always constituted a means to an end…disseminating scientific knowledge that ultimately had some useful purpose,” Roget studied medicine and became a successful

London

physician.

But sorrow dogged him. Married at 46 to Mary Hobson, beautiful, smart,  rich, and 16 years younger than he, Roget was crushed by her death from breast cancer nine years later when she was only 38. Still, words supported him. Fifteen years after Mary’s death, he published the BRIDGEWATER TREATISE  “the culmination of his lifelong pursuit, begun in his childhood notebook, to organize the animate world.”

Science and medicine provided insufficient comfort. Even a mistress, whom he preferred to his depressive daughter Kate, was not enough. Finally, retiring in 1848, Roget gave new meaning to the word, “retirement.” In 1852, Roget published the first edition of his THESAURUS.  Until his death at 90, Roget continued to work on his “treasure” (the English definition of the Latin “thesaurus”), modifying, improving, tweaking as he went along.

Roget’s was not the first treatise on “synonymy” and language. Bishop John Wilkins’ 1668 Essay towards a Real Character and Philosophical Language and Hester Lynch Piozzi (Samuel Johnson’s friend)’s 1794 British Synonymy preceded the Thesaurus. But classifying, organizing, categorizing words and their relationship to each other and to experience made Roget’s a first in its own right.

For reasons unknown but guessed at, lists (there’s that word again) of the many doctors who also became writers rarely include Peter Mark Roget’s name. Yet it was his scientific training that helped him harness his penchant for organizing words into the treasure that writers still depend on today.

A glance into Microsoft’s so-called “thesaurus,” a look at the insufferability of the email clogging our computers, makes us realize how today’s world is giving short shrift to Roget’s undertaking.

Words alone do not a communicator make. Roget’s self-enclosed life proved that. But words with thought can enrich our lives and make us look beneath the surface. We owe Roget a debt. For who could ask for anything more?

CAN EMPATHY BE TAUGHT: WHEN DOCTORS BECOME PATIENTS by ROBERT KLITZMAN

WHEN DOCTORS BECOME PATIENTS by Robert Klitzman (Oxford, March, 2008)

Review by Nancy Yanes Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, email: nywriter@rochester.rr.com,
585-385-1515, 16 San Rafael Drive, Rochester, NY 14618

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       When Harcourt bought CHANGE OF HEART: The Bypass Experience, my book interviewing 1100 veterans of coronary bypass surgery, I was elated. Flush with my success, I tried to convince them to publish my next book of interviews with 100 doctors who were veterans of coronary bypass surgery.

        “Nobody will be interested,” retorted the editor. But he was wrong.

         Robert Klitzman’s important new book, WHEN DOCTORS BECOME PATIENTS, proved just how wrong one editor can be. 

         Klitzman interviewed 70 physicians, male and female, young and old—from 25 to 87, all victimized by a variety of chronic and acute diseases including lymphoma, breast cancer, skin cancer, Huntington’s disease, heart attacks, depression, bipolar distress, and an overly high incidence of HIV.

         Whatever their illnesses were, disease was isolating. Even though their different illnesses mandated a variety of diagnoses, treatment, responses,  and coping mechanisms, many sick doctors felt left on their doorsteps by calloused and unsympathetic colleagues. Since 34 percent of  doctors in Klitzman’s study were HIV positive or suffered from frank AIDs, most opted for secrecy. But the four women physicians killed by metastatic cancer within a year after Klitzman finished his book also faced “peripheralization and discrimination.”  One physician reporting that her colleagues “treated me as if I were dead.”

          Even if these doctor-patients wanted to talk to their physicians, communicating  with physicians was a tough ball game.  Here, the doctor who is sick confronts the same barriers as the non-doctor who wants to communicate with his or her physician.

          A Berlin Wall blocked the two sides of the bedside. Perhaps fearful of their own futures, healthy doctors acted threatened by their sick colleagues. Many healthy MDs expected the sick to continue toting work loads despite their diseases. Some sick physicians, denying the inroads of illness, carried their share of patient care for as long as possible. Others gave in, willingly or unwillingly, to patienthood’s unwelcome passivity. Checking up on their doctors along the way, some found better doctors to care for them, others were distressed by the MDs they found.

           Like the rest of us hit by illness, these doctors hated being sick, hated the world of patienthood, hated being burdens, hated how disease had changed them in the eyes of other doctors. Hospital gowns, patronizing paternalism, humiliated them. Superspecialists ignored them. Colleagues turned their backs.

           What did sickness teach these doctor-patients? Written on their flesh was the truth behind Kafka’s words: “To write prescriptions is easy. To come to an understanding with people is hard.”

           Klitzman believes that doctors who have been sick can learn from the ways their own doctors treated them. As a result, they “assessed this treatment with more knowledge and higher standards of comparison than do other patients…In doing so they offered insights and epiphanies that could help both other patients and providers.”

           Learning empathy from their own experiences, most of these doctor-patients became better doctors, gentler, more understanding after they had battled with illness. They learned to “put myself in my patients’ clothes, “ to ask themselves, “How would I  react?”

           For every doctor is a possible patient. No one is immune. The white coat is not a shield. It’s just a white coat, stained with the blood of others, with the striving, successes, and defeats of caring for others. Medical school, internship and residency, rarely teach physicians that patienthood lies waiting for each of them, ready to pounce when least expected.

          The doctors in Klitzman’s book are special.  They were willing to trust Klitzman with their stories, albeit occasionally glossed over with denial. Their illnesses taught them “that they, too, will one day be patients, that the boundary between physicians and patients is, in the end, nonexistent.”

           Readers, patients, doctor themselves must wonder: Do doctors have to be sick to understand what it means to be a patient? Is sickness a mandatory course in every physician’s education. Klitzman asks, “Can empathy be taught?” It’s a good question.

          Physicians are victimized by the same invasions of the flesh as those striking their patients. Some physicians sicken and die at an early age. Others live long but the infirmities of age, chronic disease, or acute illness beset them.

          How do physicians, trained to help others, deal with their own physical illness? Do they continue to practice? Do age or disease limit their ability to care for sick patients? Do they or their colleagues recognize what is happening to them? Does anyone help them?

           Klitzman’s study raises many questions. How do physicians deal with their medical problems? Does being a physician exacerbate their physical problems? Do colleagues help—or hinder? How do care-providers treat physician-patients? The same as other patients? Better? Worse? What do physicians learn from going through major surgery or critical illness? From living with a chronic disease? How do these experiences affect their dealings with patients? Are they better doctors? If so, why?

           Looking back, how well—or poorly—do physician-patients believe they were diagnosed, treated, monitored, and mentored? How well or poorly did they treat themselves? Will their experiences help other physicians? Help patients? Help themselves?

          The medical literature contains little about physicians trying to cope with physical disease, whether chronic or acute. Almost no studies examine the dilemmas of physicians who are care-“providers” of physician-patients. Few medical schools adequately address clinicians’ well-being. These educational lacunae  waste our most precious medical resource. For students, residents, and senior physicians all need to learn about the special problems of doctors confronting acute or chronic diseases—or even the not-so-“golden years” inflicted by the aging process.

         Physicians providing care to physician-patients need special guidance. They need to unlearn the myths about doctor-patients that might compromise their care.

          Klitzman’s book opens the door to the particular problems of sick or aging physicians. Readers everywhere, non-doctors and doctors alike should take it to heart.

SUBTITLES AND TRUTHS--PUPPY CHOW IS BETTER THAN PROZAC: THE TRUE STORY OF A MAN AND THE DOG WHO SAVED HIS LIFE by Bruce Goldstein

PUPPY CHOW IS BETTER THAN PROZAC: THE TRUE STORY OF A MAN

AND THE DOG WHO SAVED HIS LIFE by Bruce Goldstein (DaCapo Press,

Perseus Books Group, March 15, 2008)

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Review by Nancy Yanes-Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, email: nywriter@rochester.rr.com, 585-385-1515 16 San Rafael Drive, Rochester NY 14618
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          Nowadays, most books have subtitles (I should talk; my books do, too). It’s as though writers are dissatisfied with the bare bones of their titles. They want to reach out from the hidden bottom shelf of a crowded bookstore and grab you by the sleeve. “Stop!” the subtitles order. “Don’t go into somebody else’s would-be masterpiece. Read me instead!”

        Bruce Goldstein’s adoring memoir, PUPPY CHOW IS BETTER THAN PROZAC: THE TRUE STORY OF A MAN AND THE DOG WHO SAVED HIS LIFE (DaCapo Press, Perseus Books Group, March 15, 2008), is a perfect example of the popular subtitling genre. If you’re a dog lover, the subtitle will convince you to grab this book. Bend down, drop your umbrella and purse on the way, and see what Goldstein has to say for himself about his love affair with a Labrador retriever puppy.

        Victimized by a virulent bipolar disorder, out of a job, dumped by his girl, and unable to respond to psychiatric therapy and a parade of such drugs as lithium, Paxil, Wellbutrin, and, of course, Prozac, Goldstein was well on his way to giving up. He calls one early chapter before he  meets his puppy, “Mom, I Don’t Want to Go to Life Today.” And he doesn’t.

       At last, heeding his psychiatrist’s desperate recommendation to get a dog, he braves a hurricane to adopt the last (and best?) of a Labrador litter. Black as the proverbial ace of spades, his dog is dubbed “Ozzy” after heavy metal’s Prince of Darkness, the Satanic figure who haunts Goldstein’s imagination. Soon, this furry bundle takes over Goldstein’s life—while calming his lonely fears.

         With Ozzy at his side, Goldstein is lonely no more. Ozzy magnetizes women on the streets of New York. His “puppy harem” oohs, aahs, and “stuck to me like the New York Knicks defense.” Walking his dog followed by a caravan of women, Goldstein realizes, “I finally had an epiphany of sociological and biological proportions. I had finally solved the puzzle man had been trying to figure out since the beginning of time: all of these years the key to meeting beautiful women was picking up a bag of fresh puppy poop.”

          Ozzy is not only “man’s best friend,” he turns out to be “Manic’s best friend,” returning the frantic, obsessed Goldstein to the world he would leave behind. Goldstein gives Ozzy, “my mood-swing messiah” all the credit for keeping him on an even keel. “Thanks to Ozzy, I was really looking forward to my future—the place I thought I’d never get to see.”

         Goldstein ends his story with a poignant prayer, “I thank God this book was written by Bruce Goldstein. Not in memory of.”

        Is PUPPY CHOW overly sentimental? Maybe. But humor saves it. Is it for dog lovers only? Maybe. And then again, maybe not. Because the subtitle is right. Ozzy does save Bruce’s life. More, it’s about what we all, sick and well, must learn to expect from ourselves, no matter what. And finally, it’s about how the magic of love, even a dog’s love, can save us when we’re lost.

WHY CAN'T A WOMAN BE MORE LIKE A MAN? SEX DIFFERENCES IN THE BRAIN: FROM GENES TO BEHAVIOR ed by Jill B. Becker, Karen J. Berkley, Nori Geary, Elizabeth Hampson, James P. Herman, Elizabeth A. Young

SEX DIFFERENCES IN THE BRAIN: FROM GENES TO BEHAVIOR ed by Jill B. Becker, Karen J. Berkley, Nori Geary, Elizabeth Hampson, James P. Herman, Elizabeth A. Young
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Review by Nancy Yanes-Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, email: nywriter@rochester.rr.com, 585-385-1515--16 San Rafael Drive, Rochester NY 14618
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       “Why can't a woman,” moans MY FAIR LADY’s Professor Henry Higgins, “be more like a man?” Proffering his accepted superiority of men, Higgins’s litany complains, “Women are irrational,  Can't a woman learn to use her head? Why do they do ev'rything their mothers do? Why don't they grow up- well, like their father instead?” Finally, Higgins throws up his hands, ““Why can't a woman take after a man? Why can't a woman be like me?”

        Higgins isn’t the only one who wonders about sex differences. From time immemorial (and even before), the differences between the brains and behavior of men and women have teased and tantalized academicians and researchers. Husbands, wives, and lovers have all protested the hollow emptiness of “Vive le difference.” 

        Despite this, the crossroads between sex, brain, and behavior have only recently become a field for serious exploration. Sherry Marts, vice president of scientific affairs for the Society for Women’s Health Research, states in her preface to the seminal new guidebook, SEX DIFFERENCES IN THE BRAIN: From Genes to Behavior, edited by Jill B. Becker, Karen L. Berkley, Nori Geary, Elizabeth Hampson, James P. Herman, Elizabeth R. Young (Oxford U Pr, Dec, 2007): “Scientific evidence of sex differences in the brain is only regularly emerging now.”

         And emerge it has. For questions continually nag: Why are men and women so different? What factors, biological and cultural, account for their divergences and disparities? How will new and better knowledge help men and women understand each other, build better relationships in the future? How will it translate into better health care for both men and women?

        Recognizing the need for bridging the chasms in our knowledge of the health discrepancies between men and women, Doctor Becker and her five colleagues have written and edited a brilliant, long-overdue guidebook leading us to better understanding, treatment, and care of men and women.

        SEX DIFFERENCES divides in three parts, what we already know, what we need to know, and how our knowledge will affect the neurobiology of disease and the treatment of neurological disorders.

        In the very first chapter, Turk Rhen and David Crews ask the crucial question: “Why Are There Two Sexes?” After that, Margaret McCarthy and Arthur Arnold sum up what we know about sex differences in “What’s old and what’s New.”

        This introductory section examines research and methodological issues, insights and challenges, as they affect both “Hormone-Behavior Relations,” in non-human animals and most specially in human animals. Understanding and monitoring the menstrual cycle is then essential information for grasping the way that  male and female brains, stress systems, and pharmacogenomics function. Jill Becker has tellingly focused her attention on these subjects for the last two decades.

        The fascinating second section zeroes in on the interaction between neurobiology and behavior. Chapters hone in on steroid receptors and their influence on sex differences in behavior, another Becker specialty. Other topics include dissimilarities in affiliative behavior and social bonding; motivation, movement; energy, obesity, and eating;  children’s play; neurocognition of language (“why don’t you ever talk to me?”); and visuospacial perception. If they do nothing else, these researches prove how different we really are. And how important it is for us to understand those differences.

         Devoted to the neurobiology of disease, the last section covers male and female responses to infectious and autoimmune disease (why is fibromyalgia visited upon more women than men?), pain (which gender is more likely to become addicted?), anxiety, mood, Parkinsonism. As Boomers and their parents join the aging multitudes in the future that awaits all of us, the penultimate chapter on aging and Alzheimer’s diseases (yes, plural) is a particularly important resource for casual readers, clinicians (neurologist and non-neurologists), patients and families.

        One caveat: We hope the Becker group will continue listening carefully to men and women and recording their findings. Certainly, we hope they are at work on a companion volume to fill the lacunae in this text.  For what about such other common autoimmune diseases as arthritis and diabetes which the book does not mention? What about a more detailed discussion—apart from steroidal and hormonal levels--of the differences between male and female sexual desire, fulfillment, satisfaction, and oncomitant tendencies to infidelity (not limited to governors of New York).

        In the meantime, the inquiring reader will find it helpful to consult the plethora of books on genes (Tower lists 28 for 2008 in its catalog!). Turning to the March 18th, 2008 issue of the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (JAMA), which is devoted to genes, genetics, and genomics, will add a world of information to the Becker group’s excellent guidebook.

       While scientists and researchers have long needed a book like SEX DIFFERENCES, its readership should not be limited to academia. The questing student of any age will find answers to many thorny questions—as well as more challenges to his or her perspectives and relationships.

NEW PARTS FOR OLD--CHARLATAN: America’s Most Dangerous Huckster, the Man Who Pursued Him, and the Age of Flimflam by Pope Brock (Crown, Feb,

CHARLATAN: America’s Most Dangerous Huckster, the Man Who Pursued Him, and the Age of Flimflam by Pope Brock (Crown, Feb, 2008)

Review by Nancy Yanes Hoffman, THE WRITING DOCTOR, WWW.WRITINGDOCTOR.TYPEPAD.COM, email: nywriter@rochester.rr.com, 16 San Rafael Drive, Rochester, NY 14618. 585-385-1515

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        What makes a quack run? What drives a pseudo-doctor, “Dr” John R Brinkley, to practice  quack medicine rather than trying to heal the sick? What makes his nemesis, a power-hungry, AMA quack-buster, Dr Morris Fishbein,  pursue this charlatan for more than 25 years? And what drives countless patients, men and women, “as guileless as the wide-mouthed shad.” to the charlatan’s door for help from whatever ails them?  What turned an era, into “the golden age of quacks”  And finally, is that era it over yet?

          Ostensibly the story of one of America’s greatest quacks, “Dr.” John R Brinkley, Pope Brock’s ironic, witty chronicle of CHARLATAN (Crown, Feb, 2008) is about all the forces, individual and cultural,that contributed to Brinkley’s medical “successes” and finally, his downfall.

         Playing upon the American dream of endless youth, of  “rejuvenation,” (still alive-and-well as America’s favorite pipe dream) Brinkley’s greatest triumphs initially sprung from embedding billy goat testicles into the human scrotum and later even into women’s ovaries.

        But in 1931, medicine caught up with him.  After the Kansas State Medical Board tallied 42 countable deaths at Brinkley’s hands, with untold numbers of deaths after patients left Brinkley’s “hospitals,” it revoked his medical license. At the same time, the Federal Radio Commission, revoked his radio license. Undaunted, Brinkley ran for governor of Kansas—and almost won. His campaign pioneered airplane whistle-stops all over Kansas aided and abetted by radio promotion. In case you hadn't noticed, these innovations are still alive and kicking today.

         After the licenses' revocations and the loss of the governorship,Brinkley got the Kansas message. He moved to Texas. In Del Rio, Texas on the Mexican border, he built a mansion fit for a charlatan and a hotel-like “hospital” for prostate surgery patients. Ever the innovator, he used Mexican-based radio to promote himself and his medicine.

         And he made money. Lots of money.  He charged $750 for “gonad surgery,” but his fee for prostate surgery was only $250 a pop. Always, it was cash on the barrelhead—before the operation—just as present-day surgical offices insist on insurance cards and co-pay before the visit.

          Money made money. He bankrolled “Border Blasters,” his high-potency radio shows emanating from his million-watt station, XERA, in Villa Acuna, Mexico into the most powerful station broadcasting on American air waves. Patients heard and flocked to Del Rio for glandular injections—and later, bargain-basement prostate surgery.

         One of XERA’s claims to fame was Brinkley’s Medical Question Box. Listeners sent in letters detailing their health problems. Brinkley prescribed treatment bought from pharmacists hired to kickback percentages of sales. Something like Senator Bill Frist’s long-distance diagnosis of  Terry Schiavo’s problems. As the song goes, “ainsi c’est toujours le meme chose.”

         Del Rio was good to Brinkley. During his five years of broadcasting and prescribing, he pocketed about $12 million. But in 1938, another Del Rio doctor began stealing Brinkley’s thunder by selling the same operations for a lower fee.

          So Brinkley moved to Little Rock, Arkansas in 1938. But Brinkley's Midas touch had become tin. Things were going wrong. In 1939, he lost a libel suit against his obsessed Ahab, Dr. Morris Fishbein. Not only was Fishbein the longtime editor of the American Medical Association (JAMA) and AMA president, but he was an equally egotistical firebrand, who had spent much of his professional life committed to bringing Brinkley down.

          Brinkley’s testimony inadvertently helped Fishbein’s case. On the stand, Brinkley admitted that his surgery was something like a vasectomy. Further, his celebrated Formula 1020 for rejuvenating male desire and performance was only dressed-up colored water.

          After Brinkley lost his appeal, the judge  accused him of being “a charlatan and a quack in the ordinary,well-understood meaning of the words.” Hearing this, disgruntled patients filed civil suit after civil suit. Down on his luck, declaring bankruptcy in 1941, Brinkley was indicted for mail fraud. With the suits pending and dogged by ill health, Brinkley died alone of a blood clot in 1942.

          What made Brinkley run? CHARLATAN, despite its wondrously deft insights isn’t sure. Whether greed alone powered his engine or a healthy (word used inadvisedly) dose of egotistical narcissism fueled his exploits remains unknown. In fact, what made Fishbein run? Fishbein was so much a mirror image of Brinkley—albeit law-abiding and medicine-upholding—that the two were American medical twins.

        If Brinkley himself was dross, CHARLATAN is gold. Brock’s history of American medicine’s feats and flaws, achievements, anecdotes, and trickery invites the reader to compare medicine then with medicine now. In one of the many nuggets of little-known Americana sparking his tale, Brock reports that more than 400 of the 526 radio stations accepted no advertising because “Radio Czar Herbert Hoover, the secretary of commerce, declared it ‘inconceivable that we should allow so great a possibility for service to be drowned in advertiser chatter.’”

         Hoover was, of course, right. Radio, television, email, the internet are awash in "advertiser chatter," offering an open-sesame to the "flim-flam" of 2008. Reading Brock's tales of these medical machiavellis is not only fun, but it  should sound a much-needed alarm about medicine's present-day gimmick-providers.

FIGHTING THE GOOD FIGHT: CANCER ON $5 A DAy**(CHEMO NOT INCLUDED): HOW HUMOR GOT ME THROUGH THE TOUGHEST JOURNEY OF MY LIFE by Robert Schimmel with Alan Eisenstock

CANCER ON $5 A Day (*chemo not included): How Humor Got Me Through the Toughest Journey of My Life by Robert Schimmel with Alan Eisenstock (DeCapo Press, Lifelong, Perseus Books, March 15th, 2008).

Review by Nancy Yanes Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, nywriter@rochester.rr.com, 585-385-1515.
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         “If you live long enough,” my father used to say, “a little rain has to fall on your parade.”  But it wasn’t a little rain that hit Robert Schimmel, the cheerfully bawdy, stand-up comedian. It was a tsunami. Actually, not one tsunami, but four (so who’s counting?).

         In one decade, Schimmel’s beloved son, Derek died of a brain tumor; a heart attack hit Schimmel when he wasn’t looking; and his 22-year marriage with his first wife, Vikki split acrimoniously. Finally, cancer sidelined him on the cusp of a big break in his career.

         Yet, Schimmel managed to keep his head above water and move on. Struck by stage-three non-Hodgkins lymphoma, he hit the treatment trail head on.  Though cancer is no laughing matter, Schimmel tried to make a joke—or several jokes—about what even he admits was “the toughest journey of my life, ” which he records in his brave new book,CANCER ON $5 A Day (*chemo not included): How Humor Got Me Through the Toughest Journey of My Life (DaCapo press, Lifelong Books, Perseus Books, March 15th, 2008).

         As Alan Eisenstock, Schimmel’s co-author observes, “Cancer gave Robert Schimmel more material to write about. But it also gave him more heart. The disease made him see the world through wider, wiser eyes. He became more patient, more resolute, and more conscious of the power of the moment…cancer taught him how to love what he has…and his gift, making people a laugh; to love every day he’s alive.”

        With cancer as their ill-gotten muse, Schimmel and Eisenstock wrote CANCER ON $5 A DAY. Their mission, they say, was to cheer the spirits of everyone—and anyone—fighting “the Big C.”

        Although Schimmel is one of Comedy Central’s 100 Greatest Comics, and although the publisher says that “he keeps us laughing by riffing” about all the battles engendered by fighting cancer, his book is actually not funny. Instead, it’s a tribute to the resilience of the human spirit when it refuses to give up.

         Aiming at the jokey side of cancer (if such there be), Schimmel reports on the ironies of cancer's travails, peculiar events like a wig salesman trying to sell him wigs for every spot denuded by chemotherapy (yes, every spot). He can’t get over his overwhelming desire for sex during chemotherapy. “Feeling horny,” says Schimmel, “is life-affirming.”

         But cancer’s dark night of the soul keeps breaking into the tale of his long, stormy treatment. So, too, does Schimmel’s predilection for erasable, deletable (not delectable) adjectives, which might make his journey a less appropriate trip for some cancer veterans.

         Raw language or not, Schimmel’s courage is inspiring.  For CANCER ON $5 A DAY aims at making cancer victims believe that “Schimmel got through it. Maybe there’s a chance that I can make it, too.” Of course, there are no guarantees.

        But Schimmel maintains,. “It’s those things that define who you are. That was Job’s test. Flee or fight. I chose to fight.” CANCER ON $5 A DAY is an invitation to the fight with no holds barred.

IT'S NOT SUCH A SECRET: THIS COMMON SECRET: MY JOURNEY AS AN ABORTION DOCTOR by Susan Wicklund (New York: Public Affairs, Jan, 2008)

Susan Wicklund. THIS COMMON SECRET: My Journey As An Abortion Doctor (New York: Public Affairs, 2008) Review by Nancy Yanes Hoffman, THE WRITING DOCTOR, www.writingdoctor.typepad.com, www.nyhwriter.com, nywriter@rochester.rr.com 585-385-1515

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There’s an election going on (in case you hadn’t heard). Listen to Obama and Clinton, even to McCain and Huckabee perching restlessly on the cusp of the presidency. But with all their talk about CHANGE vs EXPERIENCE, what do they think when nobody’s listening? What will they do if elected? Does anyone except McCain, Bush's "true conservative," whisper a word about ABORTION? About stem cells? Or, perish the thought, about the Supreme Court repeatedly eroding Roe vs. Wade, as it "celebrates" its 35th birthday?

Yet at least 40 percent of American women—voters all--have had an abortion. Nobody talks about it although abortion is more commonly performed than tonsillectomy or pulling wisdom teeth.

Dr. Susan Wicklund’s memoir of her life, THIS COMMON SECRET (New York: Public Affairs, January, 2008), reveals the huge sacrifices demanded by her life as an abortion provider  As an innocent high-school graduate, Susan Wicklund began her fight in the abortion battles reacting against the cruelty of in her own abortion provider. Whenever the young Susan asked a question, the doctor replied, “Shut up!”

Ever after, she couldn’t shut up. She resolved to provide better care for other women in the same boat. Somehow, this feisty young girl, "poor as a church mouse," managed to become a midwife, go to college, obtain her M.D., cope with an internship's rigors, and open a general practice.  All this, while caring for her only child, Sonja.

THIS COMMON SECRET bursts with stories of Wicklund’s life (“Call me Sue,” she instructs patients) and the lives of her patients of all ages, religions, classes, backgrounds. The abortion barricades fill its pages: protesters’ omnipresent intimidation and violence stalk her. Her daughter needs a police escort to go to school.  The protesters scream imprecations at women coming to her clinic. They follow Dr. Wicklund to the airports where she travels endlessly from one remote Western clinic to another.

But she never gives up, never shuts up. She talks to, listens to every woman coming to her distant clinics. If a woman is ambivalent about abortion, if it seems she is doing this because other people are coercing her, Wicklund advises her to wait and be sure before she goes ahead.

Nonetheless, she makes a case against the 24-hour waiting period, the rules about obtaining parental consent, the Supreme Court’s increasing restrictions. The Court asserted that government  needs “to protect women from their own decisions.” This from a Court and a political party ostensibly devoted to interfering less in people’s lives.

Wicklund particularly fears “professional protesters, "mostly men, for whom protesting is a full-time obsession. They target different regions in the country or particularly vulnerable clinics. They bring their hate-filled slogans, their planes that fly over towns and cities pulling banners depicting bloody babies, their confrontational tactics. When they come to town, I wear my bulletproof vest and carry my gun. Unfortunately, their views have infiltrated the laws and policies of our country and the lives of my patients.”

Wicklund’s life is devoted to her patients, her own choices in the war over choice. But fighting battles for women deserving the right to safe, legal abortions has been enormously costly.. The prices she paid—and those paid by people she loves and who love her—were and are egregious. Depicting them honestly, she admits her losses, without regret.

Abortion protesters have been increasingly successful in corroding women’s rights. Between 1982 and 2000, the number of abortion providers has dropped 37 percent from 2,900 in 1982 to 1,819 in 2,000. The “graying of providers,” 60 percent are older than 50, is a serious problem. Even Dr. Wicklund, now 53, had to close her abortion clinic, the only one in Montana, to help care for her ailing parents.  Lonely and alone, fighting the abortion battle, takes its toll.  Wicklund sounds as though she, too, is suffering from burnout.

Worse yet, medical schools, like politicians, are simply not addressing these trends. “Most physicians are graduating with little more than circumstantial knowledge of abortion,” reports Medical Students For Choice (MSFC.org), an organization of 10,000 medical students. trying to “stand up in the face of opposition, work to destigmatize abortion provision among medical students and residents, and persuade medical schools and residency programs to include abortion as a part of the reproductive health services curriculum. “ MSFC aims at “training a new generation of pro-choice doctors in leadership, advocacy, and organizing skills.”

THIS COMMON SECRET should be required reading for medical students, residents, patients (aren’t we all),families, and politicians waving their election flags. That’s pretty much all of us.

THE SEARCH FOR THE FATHER: MY FATHER'S HEART by Steve McKee

         “A man,” said Freud in Mourning And Melancholia, “doesn’t become a man till his father dies.” But as Wall Street Journal reporter Steve McKee tell his father’s story—and his own--, he does not become a man until he wrote My Father’s Heart (Da Capo Press, Perseus Books, January, 2008) nearly 40 years after his father’s death.

          Steve McKee’s father “dropped dead,” as they call it, in 1969, when Steve was 16 and his father was only 50. Ironically, he and his father had just finished watching “The Immortal,” a television movie about a man whose blood gave him immunity to disease, including heart disease. After that, another medical show, “Marcus Welby, MD” was beginning.

         These medical televisionaries were no help to John McKee, Steve’s father. “A heart attack slammed him off the back of the couch while we were watching television.” As simply as that. Days before, a doctor’s checkup had “declared him fine.” Nothing new here. The family’s cardiac curse had killed all the McKees in their 40s or early 50s often after a doctor’s verdict had announced a clean bill of health.

          When Steve told his sister Kathy that he’d finished the book about their father, “Kathy let a short silence hang between us on the phone. ‘I hope,’ she finally said, ‘I hope that when you’re done with this that you’ll like Dad more and think better of him...And I hope you can forgive him for dying when he did, and the way he did.’”

          McKee quickly changes the subject. He reports that 80 million Americans have some form of cardiovascular disease, that 325,000 individuals “will die from what is termed ‘out-of-hospital’ or ‘emergency room’ sudden cardiac arrest.” 

          Repeatedly he joins statistics with the personal adding, “the classic heart attack of popular lore, just like Dad’s on September 30, 1969.” Again and again, McKee says, “It was just the two of us at home that night. He was fifty. I was sixteen,” a fact he cannot get over as he tries to figure out how and why his father had to die.

         In McKee’s search for the father, for finding out who his father was and by extension who he is, the son left behind,  he tries to learn why his father did so little to prevent his second heart attack  He portrays his father as a chain-smoking, hard-drinking, job-hating Type A, reminiscent of Willy Loman in Arthur Miller’s Death of a Salesman. It seems to the son that the father gave up the fight after his first heart attack. But why?

        Again and again, pegging statistics to the personal, McKee reminds himself  that every heart attack happens to a someone who is a husband, a wife, a father, a mother, a checkout clerk, or someone at the gym…”The lives and then the deaths of every one of these people will affect millions, millions, millions of others…. I know. It happened to me. It is the story I’ve been writing all my life. The father leaves; the son remains.”

        Why does it take McKee almost four decades “to finish the story I have been writing all my life. Finally.”? He has to grow up --and older--before he can forgive his father for dying. He has to learn on his own flesh how little his obsessive self-discipline and exercising did to avert the evil decree. Until he recognizes his genetic complicity, until he sees that he never knew his father—and his father didn’t know him, he can’t forgive his father for dying—for leaving him to learn on his own.

         Once he is older than his father was when he died, he can come to grips, at least partially, with his father’s death.. Early on, his coach tells him, “Your father just died and you will never get over it…but you will get used to it.” Kind as the coach may have been, neither Steve McKee nor the rest of us who lost a father to a sudden heart attack, ever “get used to it.”  McKee says of his father’s witnessing his own father’s heart attack, “Maybe Dad never got used to it.”

          My Father’s Heart rambles. The writing sometimes lapses into unfortunate, everyday Buffalo-York vernacular. But when the story returns to McKee’s father, to his empty life, his early death, to what his death has taught Steve McKee, the writing tightens and reaches out poignantly across the page.

         In writing about his father’s heart after learning that he, the son, is also a prisoner of heart disease, McKee finally realizes that his father’s death gave him life and taught him how to live. “The night I watched Dad die, I watched me die, too. My life began the night his ended. Learn from me, he said. And so I did. I have become who I am because of him…And I am alive.”

         This book, “an attempt to share the memory of my father,” helped Steve McKee grow up. As My Father's Heart ends, Steve McKeee can run a five-kilometer race with his adopted son Patrick. Freed from the McKee curse, Patrick is a victim of juvenile diabetes. Patrick's diabetes taught Steve "we are who we are, whoever that is."

        As they race together, McKee rejoices, “Father and son, shoulder to shoulder.” My Father's Heart may be the talisman keeping Steve alive to race into the future with his son.

The Writing Doctor Changes Her Tune

So much medicine, so much health care, so many people sick, so many people offering advice. So-oo, the Writing Doctor has decided to specialize. From now on, we will only be reviewing books about medicine, be they by physicians, medical students, interns (see our latest offering), patients, and possible patients, which includes all of us.

If you're an author, a publisher, or a veteran of illness, send us your book for review ASAP. Be sure to include the pub date and any and all pertinent info about the author, the book, and what it will mean to the reading public.