WRITING DOCTOR'S BLOG by NYHWRITER.COM

DISEASES THAT HAUNT US: THE UNNAMED by JOSHUA FERRIS

Tim Farnsworth is a successful trial lawyer in Joshua Ferris's bleak novel,THE UNNAMED. Victim of an undiagnosed, strangely inscrutable, nameless disease (hence, the novel's name), he is compelled to walk without end until he collapses somewhere, anywhere, in the midst of winter. 

When the novel opens, the disease attacks again for the third time. Again, all he can do is walk and walk and walk. He has sought help from the Cleveland Clinic, the Mayo Clinic, experts in Switzerland--all to no avail. Doctors, hospitals, diets, medication, psychiatrists. Nothing helps. And nobody knows why Tim keeps walking. The cause seems neither physical nor emotional--or so he thinks.

A high-priced, successful criminal lawyer, Tim has no control over his body. His wife, Jane, who tries handcuffs, ropes, even a trail bag filled with a GPS, can't keep him home. He walks out on his client, who has been accused of murdering his wife. When Tim is forced to turn over the case to a colleague, the innocent client is found guilty.

Each of the Farnsworth family's bodies loses control. Jane succumbs to metastatic cancer. Becka, their teen-age daughter, is beset by obesity. Meantime, Tim leaves for good, constantly marching to his own drummer.

Although the first third of the UNNAMED is compelling, it soon breaks down into a repetitive series of Tim's meaningless walking. If  readers stick with the unlikeable Tim till the last page, we're still not sure why Tim walked nor why we as readers stayed. Nor are we sure what Ferris is getting at: how disease hovers over well-tended lives? how compulsion destroys the best-laid plans of careers and family? I don't know for metaphor gets let behind.

The only thing we know is how relieved we are to be quits of Tim's endless walking.

THE GREAT AMERICAN DREAM: SUCCESS AT ANY COST: THE PRIVILEGES by Jonathan Dee

The dictionary defines privileges as "...a right or advantage held as a prerogative of status or rank, and exercised to the exclusion or detriment of others." Jonathan Dee's initially exciting, finally disappointing novel describes what privileges can do to those wanting and ostensibly enjoying them.

Well-named, Adam and Cynthia Morey always want more of everything. In their book, it's money that will do the trick. Lots of money. Beginning with their wedding on a steamy day in Pittsburgh, they change--but do not grow as Adam's insider trading brings huge riches. He and Cynthia soon "have so much money that they had to hire people just to help them figure out how to give it away."

The snake in Adam's Eden is amoral self-delusion. Adam tells himself that he wants to give his family "a life in which literally anything is possible." Although this may be a definition of privileges, even with money, the family is isolated and lonely. Their money can't control everything. 

Privileges will only go so far. The heat at their wedding is impossibly oppressive. When Cynthia's father is dying, she thinks how much she longed for him through the years. When they decide to go away for a weekend, they don't know anyone who could babysit for them. When their daughter April is small, she depicts a totally different family tree for school than the one she inhabits. When Cynthia would return to work after her children are in school, no one will hire her. When Jonas and April grow up (relatively), their lives are as purposeless as those of their parents. They are remarkably friendless, awash in money-driven privileges, yet alone on their Manhattan island.

Privileges pose problems. While the singular privilege of this novel is reading Dee's brilliant prose, seeing details with his all-seeing eye, his characters eventually defeat him. With all their money, they become boring and repetitive. Despite their bulging pockets, they are finally disappointing. For readers who are willing to follow them to their strange ending, all those privileges stand in the way of our caring what happens to them.

LEARNING TO SEE: DISCOVERING PATTERNS IN MATHEMATICS AND POETRY by Marcia Birken and Anne C. Coon (Amsterdam: Rodolpi Press, July, 2008)

DISCOVERING PATTERNS IN MATHEMATICS AND POETRY by Marcia Birken and Anne C. Coon (Amsterdam: Rodolpi Press, July, 2008)
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Review by Nancy Yanes-Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, email: [email protected],

585-385-1515
16 San Rafael Drive, Rochester NY 14618
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      “My aim, above all,” said the novelist Joseph Conrad, “is to make you see.” Conrad’s injunction is the apparent aim of  Marcia Birken and Anne C. Coon in DISCOVERING PATTERNS IN MATHEMATICS AND POETRY (Amsterdam: Rodolpi Press, July, 2008). 

       Birken, the mathematician, and Coon, the poet, want us to see what’s around us, what are the connections between what we think we see and what is actually there. Their book, the product of their 20-year team-taught course,  invites us on an ongoing journey aimed at the act of “discovering” –or learning to discover—mutual patterns in both mathematics and poetry.

       The book shows us how to count patterns, to see, feel, and hear  them if we would only listen. Early on, it moves from traditionally accessible  poetic forms like the sonnet to mathematic shapes such as plane figures and spirals. More complexly, it talks about “shaped poetry” while tying symmetry in poetry to symmetry in mathematics. Deeper—and more difficult yet-- it leads us through the briers of fractal patterns in nature, geometry, and images of words.

        Making the case for the role of analogy in “creating or understanding those patterns,” Birken and Coon focus on what metaphor can teach us if we would only look—and see.  Both the mathematician and the poet require “abstract reasoning and analogous methodologies” to fortify our grasp of their disciplines.

        In defining poetry, John Ciardi asked, “How does a poem mean?” (italics mine). The patterns of both poetry and mathematics, as Coon and Birken work them out, help us  see how and what they mean by themselves and in relation to each other.    

        Coon and Birken define the purpose of their journey: “In this book, we do not intend to make every reader into a poet or mathematician, but instead…we hope to ‘translate’ their languages for a general audience. Likewise, as we make these languages more understandable, we hope that the patterns of each field will become open to appreciation by a wider audience.” But in translating these special languages, they often make us struggle with the challenges of a new language.

         Finally, the most interesting chapter, “Patterns for the Mind” hones in on “the brain-teasing concepts of proof, paradox, and infinity.” It examines the ways that mathematics understands these concepts and then analyzes poetry’s imaginative depictions leading us down the endless road to infinity.

         Supported at every juncture by photographs, diagrams, outlines, and, of course, patterns, this journey across the woods and into the fields of poetry and mathematics lures us into new ways of discovery and recognition.

         Not a book to be read a glance, it repays the considerable effort it demands. For DISCOVERING PATTERNS IN MATHEMATICS AND POETRY offers new visions.  In its pages are a call to see once-ignored “patterns in the physical world and in the world of ideas, whether those patterns are based on numbers or composed with words, captured in a photograph, or exhibited in the faces in a crowd, the outline of buildings against a skyline.”

         A few caveats: First, although right-brain/left-brain explorations are central to the Birken-Coon journey, regrettably they remain undefined. Second, one of my favorite poems about poetic structure, “Patterns” by Marianne Moore, is the face on the cutting room floor.

         And most of all, a book is not a living course. Would that the poet and the mathematician were still offering their course again (are you listening, Academia?). For DISCOVERING PATTERNS IN MATHEMATICS AND POETRY is only a tantalizing way station on the road to discovering the patterns around us.

        As for me:

             I wish
             I knew
             How
             To review
             This book.
             To find
             Patterns
             That speak
         `   While I
       …………………………………………………………follow.

WHOSE PETS ARE THESE? THE PETS by BRAGI OLAFSSON translated by JANICE BALFOUR

THE PETS by Bragi  Ólafsson: Translated from the Icelandic  by Janice Balfour (Rochester, New York: Open Letter Publishing, Literary Translations from  the University of Rochester)

Review by Nancy Yanes Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, [email protected], 585-385-1515.

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              Five years ago, when I spoke at in Reykjavik, Iceland was riding high. Its financial boom looked as though it would last forever (sound familiar?) Fishermen became bankers.  Rich bankers.  Iceland’s three largest banks, Kaupthing, Landsbanki Islands, and Glitnir were lending wildly.

              The Wall Street Journal reported that “The banks’ assets reach 10 billion pounds, about 10 times the country’s gross domestic product last year, and their foreign depositors …far outnumber the island’s population.”

              But the party’s over. The government has seized the entire banking system. The krona plummeted 40% against the euro in just a few weeks.

              So what? What’s this got to do with  Bragi Ólafsson’s prescient “novel,” THE PETS . Originally published in 2001, THE PETS  was even more presciently translated by Janice Balfour in 2008.

               In the heat of the American financial crisis, the University of Rochester’s newly established Open Door Series has published this strangely cautionary tale of greed, passive-aggression—and frankly abusive aggression while  nobody minds the store. And nobody seems to care.

              THE PETS centers on two ne-er-do- wells with extra money in their pockets, their once-hateful relationship when five years before, they ostensibly took “care” of some pets in London. Failing abysmally, they angrily parted company with one paying off the other.

              The two men are Emil, a prim passive  who narrates most of  this loosely knit tale from under his bed where he has fled to avoid meeting  Havard, the loud lout (are there any quiet louts?). For after a welcome five-year absence, Havard has climbed in Emil’s window to find him once again. Searching the house but not looking under the bed, Havard answers the phone, invites Emil's friends for a party, and bathes in Emil's liquor. 

              Just back from another trip to London, Emil would rather inhale the dust under his bed, feel the springs pushing against him, than confront Havard, who “didn’t seem to  be interested in anything, unless it was forbidden or contained the highest percentage of alcohol.”

             The house fills with the noise of Emil's friends who wonder where he might be. Meanwhile, lying under the bed, Emil, easily annoyed,  recalls all the little irritations of the return flight, particularly his talkative seatmate, Armann, whose glasses Emil forgets to return.  The minor annoyances vanish after he meets Greta, whom he knew fifteen years ago.  Despite the complications of a present girl friend, Emil has arranged to meet Greta once again at his house.

            Initially, the chapters alternate between Emil’s first-person recollections and Havard’s third-person descriptions but the chapters soon shift to Emil’s under-bed perspective, which is pretty dim.

             It’s tough to care about these two. Their futures end as they began. With such characters tending Iceland's meltdown, it's easy to see why its glaciers are now dripping from its financial trees.  THE PETS can only make us wonder what will happen to us as we huddle under our economic beds and ponder our future.

LOSING OUR DESTINATION: DEATH WITH INTERRUPTIONS by SARAMAGO

DEATH WITH INTERRUPTIONS  by José Saramago, Translation from the Portuguese by Margaret Jull Costa ( New York: Harcourt, Oct.6th, 2008)
 
Review by Nancy Yanes Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, [email protected], 585-385-1515.

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      The Maestro of What-If is at it again. With his new novel, DEATH WITH INTERRUPTIONS,  Jose Saramago, Nobel Laureate for literature, repeatedly asks “What if?” Just as he has in many of his previous works, he upsets the ostensibly sturdy apple carts holding the structured myths governing our lives and our behavior.

        BLINDNESS, Saramago's novel on which the newly released film is based, shows what happens when an epidemic of white blindness besets an unnamed town, implicitly asking what it means to see—and not to see. In DEATH WITH INTERRUPTIONS, Saramago asks what happens if everyone stopped dying. For on New Year’s Day,  the ten million dwellers in an unnamed land find that death is no more.

          The novel begins in media res with:

           “The following day, no one died. This fact, being absolutely contrary to life’s rules, provoked enormous, and in  the circumstances, perfectly justifiable anxiety in people’s minds, for we have only to consider that in the  entire forty volumes of human history there is no mention, not even one exemplary case, of such a phenomenon  having occurred…New year’s eve had failed to leave behind it the usual calamitous trail of fatalities.”

             Death has stopped but dying has not:

            “There was, however, no shortage of blood. ..One thing was clear, today, the victims refused to die...It was already late afternoon when the rumor began to spread that, since the beginning of the new year, more  precisely since zero hour on the first day of January, there was no record in the whole country of anyone dying.”

             Initially joyous at defeating death, people quickly learn how much they depended on her to keep their lives going.  Hospitals have no empty beds. No longer can they rely on rotating the newly sick with the newly dead. Doctors, funeral directors, insurance companies experience a financial crisis much like the one visited upon us these days.

             Debating the pros and cons of losing death as the ultimate punctuation mark to a life sentence, philosophers argue its pros and cons. Priests protest vociferously, ‘Without death, prime minister, there is no resurrection, and without resurrection, there is no church.”

             For some people, business is good. For a price, the “maphia” (Saramago’s spelling to distinguish it from its more realistic cousin) joins forces with families and the government to export the very old and the very sick to other countries where they can die in peace—and quickly.

              Eternal life turns out to be a curse. After seven months in absentia, Death herself, personified as a lonely, lovely woman sitting in her chilly apartment with her useless scythe and filing cabinets, decides to halt her experiment and return to the hapless citizenry. She mails everyone a letter explaining that she wanted “to give those human beings who so loathe me just a taste of what it would mean to live forever.” Now, she is through.

               Those designated to die will have a one-week warning. A violet envelope will tell them to get ready for Death’s arrival. But one envelope doesn’t work. Three times, it comes back to her unopened..  Astonished, Death seeks out its owner. A 50-year-old cellist lives alone with his dog. Falling in love with the cellist, Death becomes human—another curse.

                As Death lies in bed with the cellist in her arms, the novel ends with as many questions as it raised in the telling.  Was the returned violet envelope intended for Death herself because she succumbs to love?

                The novel’s final words repeat its first ones and ask unanswerable questions about our future if death were no more: “The following day, no one died.” Does love conquer death or will Death finally arise and return alone to her old life? Saramago doesn’t say in this circular fable which ends as it began.

               With Saramago, form follows function. His deliberately endless sentences demonstrate that even words may need an ending  to their journey.

               If you read no other book during this archetypally autumnal season, read—and reread—Saramago’s what-if notes on love and death (capitalized or lower case, depending on your point-of-view). And reread John Donne’s poem “Death Be Not Proud,” which shows that love does defeat death.

730 words

APPOINTMENT IN SAMARRA: PHILIP ROTH'S INDIGNATION

INDIGNATION by Philip Roth (Houghton Mifflin, September 16, 2008)
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Review by Nancy Yanes-Hoffman, THE WRITING DOCTOR, at www.writingdoctor.typepad.com, email: [email protected],

585-385-1515
16 San Rafael Drive, Rochester NY 14618
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     I’ve read INDIGNATION , Philip Roth’s 29th novel, three times. I think I’ve figured it out. Maybe.

     Ever since his first novel, GOODBYE COLUMBUS burst on the literary scene, Philip Roth has been an American must-read phenomenon.  Singularly autobiographical, mainly honing in on writers or other luft-menschen as central characters, Roth wrote of  young and horny protagonists  when he was young. They got older when age caught him in its tentacles.

     Now 76, Roth recently seems galvanized by a new burst of energy, publishing a new book almost every year. The list of his prizes is endless. From Pulitzer to the National Medal of Arts, the Gold Medal in Fiction, the National Book Award, National Book Critics Circle award. Only the Nobel is missing.

     But INDIGNATION  is a far cry from Roth’s latest pattern.  Roth’s last two books, the brilliant, moving EVERYMAN, and the disappointing EXIT GHOST  confront the terrifying abyss of aging and dying.  INDIGNATION is also about death, but its prime mover, Marcus Messner dies “three months short of his twentieth birthday,” killed in the Korean War. Messner’s death  is an appointment in Samarra. He’s caught by that which he would escape.

     What kills Marcus? Whose fault is it that  Marcus is killed before he can grow up, dead in that long-forgotten, much-neglected  Korean War? Is it his paranoid, over-protective father who imagines death—and sex--at every corner? Is it Marcus’s flight from Newark to college in Winesburg, Ohio, to run from his father’s rages?

     (Just why Winesburg, the site of Sherwood Anderson’s brilliant group short stories, is Marcus’s unforgiving escape hatch remains one of the mysteries of his tortured tale).

     Marcus’s father is one of  Roth’s love-hate fathers, who drives him away from his bloody, kosher butcher shop to the obviously, “goyish” Ohio world where he can’t find a congenial roommate, where the anti-Semitic fraternities ban him. And where chapel attendance is required. What he does find is a sexually adept, “Blowjob Queen” in the psychologically scarified Olivia Hutton, whom he learns to love despite his mother’s protests. Castigated by the Republican, Red-baiting president of the college for his unwillingness to belong, for his quoting of  Bertrand Russell to the dean, Marcus is thrown out of school—only to be drafted, the one thing he was fighting against.

     Letting Marcus tell his story from the grave, Roth finally answers the crucial question in the novel’s last paragraph of what—or who—killed “Marcus Messner, 1932-1952, the only one of his classmates unfortunate enough to be killed in the Korean War, which ended with the signing of an armistice agreement on July 27, 1953, eleven full months before Marcus, had he been able to stomach chapel and keep his mouth shut, would have received his undergraduate degree from Winesburg College—more than likely as class valedictorian—and thus postponed learning what his uneducated father had been trying so hard to teach him all along: of the terrible, the incomprehensible way one’s most banal, incidental, even comical choices achieve the most disproportionate result.”

     It is, then, Marcus himself, his father, his unwelcoming Winesburg, Ohio school, his warring with the college president (and vomiting all over the dean), that lands him in Korea to meet his death.  For Marcus’s story depicts the powerlessness of individuals as they try to  run from their fates—only to embrace their destinies. No matter what their age, Marcus's impassioned, irrational father was right. Death does lurk just around the corner in Roth’s Samarra. And perhaps in our own as well.

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: [email protected], 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: [email protected], 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: [email protected],
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: [email protected], 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.