Who Says You’re Dead? Medical and Ethical Dilemmas for the Curious and Concerned by Jacob M. Appel

46221669._SY475_Drawing upon the author’s two decades teaching medical ethics, as well as his work as a practicing psychiatrist, this profound and addictive little book offers up challenging ethical dilemmas and asks readers, What would you do?

In short, engaging scenarios, Dr. Appel takes on hot-button issues that many of us will confront: genetic screening, sexuality, privacy, doctor-patient confidentiality. He unpacks each hypothetical with a brief reflection drawing from science, philosophy, and history, explaining how others have approached these controversies in real-world cases. Who Says You’re Dead? is designed to defy easy answers and to stimulate thought and even debate among professionals and armchair ethicists alike.

Review:

3.5 stars

I wasn’t sure if I should pick up this book, but when I saw that the author is not only a practicing psychiatrist but also a bioethicist and attorney, I couldn’t resist.

Appel looks at 79 dilemmas, some rare (can a millionaire advertise for a new liver?) to situations many of us will face (decisions regarding end of life care). Each case is introduced in a succinct vignette and followed up with a reflection covering legal, ethical, and personal issues that may affect the decision made. It truly is a reflection – Appel doesn’t rule for one side or the other, and he’s sure to mention factors that could make a seemingly off-putting choice rational. The setup gives you a moment to sit and reflect on what you would do in that situation. If a patient revealed that he’s gotten away with murder, would you report it to the police? Would you give someone on death row a liver transplant? What do you do when the sisters of a dying patient disagree about treatment?

The situations themselves are crafted with care. Some are edge cases pushing beyond settled law, some straddle an ethical line, and others show the most sympathetic patient for a particular treatment or intervention. While the vignettes are fictional (doctors Scarpetta, Hawkeye, and Jekyll make appearances) they’re based on actual people and cases, mostly in the US and UK. If you’d like more info there’s a robust appendix pointing to related papers, articles, and books for each dilemma.

With the heavy and at times disturbing medical content it’s not a book I can recommend to everyone, but I found it fascinating. It helped clarify (or occasionally muddy) my thinking about these ethical issues, and pointed me towards some that I didn’t even know existed. Did you know that with gene editing technology it may be possible to use ancient DNA to bring a Neanderthal to term in a human woman? It’s creepy and seems like an absolute no-go, and while Appel leans heavily in that direction he does imagine a semi-apocalyptic scenario where it might make sense.

I had small quibbles with two scenarios. One struck me as slightly ableist and used small d deaf to refer to capital D Deaf culture and people. The other talked about wrongful birth, where a doctor is negligent tying tubes and the woman becomes pregnant and ends up giving birth to a child, her fifth. Juries find it difficult to award damages for having a healthy baby, wanted or not, but the discussion didn’t touch on ways that settlement money could help the family meet the unexpected expenses of raising another child, not to mention psychological impacts. The other scenarios offer nuanced thoughts so this one felt out of place.

Those are only two small concerns, though – overall I found Who Says You’re Dead? fascinating and engrossing. I put it down now and then to take a breath – who wouldn’t after delving into the ethics of full-body transplants? – but it’s a compulsive read for medical nonfiction fans and armchair ethicists.

Thanks to Algonquin Books and Edelweiss for providing a review copy.

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Gift from the Sea by Anne Morrow Lindbergh

34374331In this inimitable, beloved classic Anne Morrow Lindbergh shares her meditations on youth and age; love and marriage; peace, solitude and contentment as she set them down during a brief vacation by the sea. Drawing inspiration from the shells on the shore, Lindbergh’s musings on the shape of a woman’s life bring new understanding to both men and women at any stage of life. She casts an unsentimental eye on the trappings of modernity that threaten to overwhelm us: the time-saving gadgets that complicate rather than simplify, the multiple commitments that take us from our families. And by recording her thoughts during a brief escape from everyday demands, she helps readers find a space for contemplation and creativity within their own lives.

Review:

I picked up this book in high school because, as someone who grew up nowhere near an ocean, I loved the ocean. It was probably a cover buy because, oooo, the sea! I didn’t connect with it at 17, though, so I put it aside.

Other people may enjoy it at any age, but it’s definitely a mid-life book for me. Lindbergh’s writing is timeless in style, and while written in 1955 much connects to our modern, digital lives today. She talks about how women are expected to give of themselves – to their husbands, the upkeep of their households, the rearing of kids, caring for whomever needs to be taken care of.

I believe that what woman resents is not so much giving herself in pieces as giving herself purposefully. What we fear is not so much that our energy may be leaking away through small outlets as that it may be going “down the drain”. We do not see the results of our giving as concretely as a man does in his work… except for the child, woman’s creation is so often invisible, especially today.

Chapters like this resonated with me. On the other hand, some chapters didn’t resonate with me at all. For example, there’s a section talking about what it’s like when your kids leave the nest and a woman realizes she’s left with so little… not a concern for child-free me.

So while some parts, isolated, are amazing, others I could have passed over completely. If you like this idea of this book do pick it up though – your mileage is likely to vary.

A Little Tea Book: All the Essentials from Leaf to Cup by Sebastian Beckwith

41118705._SX318_Tea, the most popular beverage in the world after water, has brought nations to war, defined cultures, bankrupted coffers, and toppled kings. And yet in many ways this fragrantly comforting and storied brew remains elusive, even to its devotees. As down-to-earth yet stylishly refined as the drink itself, A Little Tea Book submerges readers into tea, exploring its varieties, subtleties, and pleasures right down to the process of selecting and brewing the perfect cup. Featuring featuring charming, colorful charts, graphs, and illustrations by bestselling illustrator Wendy MacNaughton and Beckwith’s sumptuous photographs, A Little Tea Book is a friendly, handsome, and illuminating primer with a dash of sass and sophistication.

Review:

Beckwith, with the help of beautiful illustrations by MacNaughton, has put together an adorable book that provides a wide and just-deep-enough look at the world of tea.

He’s obviously passionate about tea and eager to share his knowledge with us. I thought I knew most everything I needed or wanted to, but I still learned some neat tidbits. We also hear about his travels in tea growing regions as part of his work sourcing ethically made, single estate tea.

I appreciate that he doesn’t shy away from tea’s sordid past – Brits outright stole the bush from China then planted it in their colonies to feed the ever expanding demand of England. Beckwith also touches on how climate change is affecting how the drink is being produced.

The text has many beautiful photographs and illustrations, and the 144 pages flew by in a little over an hour. A fine stocking stuffer or birthday present book for the tea lover in your life – be sure to pair it with some tasty loose leaf, of course.

Ocha no Jikan (Tea Time) by Masuda Miri

41ZtGQ-YydL._SX349_BO1,204,203,200_(jacket copy loosely translated by me)

Thoughts cross your mind at tea time.
We say there’s a “turning point” in someone’s life,
but does anyone make a u-turn?
You puzzle over it while drinking coffee
and forget everything once you leave the cafe.
Tea time is when we contemplate these
deep, unexpected thoughts.
–Masuda Miri–

“What is that group of women so excited about?”
“Aw, they look like they’re on a first date.”
“I wonder what he’s doing on his laptop.”
Looking around at others, your thoughts turn back on yourself.
The extremely popular Masuda Miri gives us these new, tranquil manga essays.

Review:

I love that there’s an indie bookshop close to my new apartment. I can stop in before going to the supermarket, on the way back from the station, just for the heck of it – heaven! I spotted this book on the new release shelf and was smitten as I read the first few pages.

Masuda Miri is a mangaka and essayist best known for her comic strip Su-chan. Her books vary, some with more text and some with more comics, and this book is 100% manga.

Most of the 5-10 page pieces start with Masuda going to a cafe, meeting somebody there, and relating things she saw or thoughts she had while there. Some are pure fun – visiting a all-dessert buffet, a cafe that serves a picnic complete with checked cloth and basket at your table. One cafe serves their drinks on a tray that looks like grass, and despite the rain outside her mood is lifted. There are funny moments in the vein of observational comedy, things that we all do but don’t think about.

Masuda gets into some deeper stuff as well, like how lives diverge and change once you have kids. One of the most touching manga essays is her thoughts when she’s stuck on a train because someone completed suicide by jumping at the station ahead. Sadly this is not unusual in Japan, and the way she relates the experience is spare, eloquent, and moving.

I’m sad that Masuda’s work hasn’t been translated into English as far as I can tell, and at the same time I’m selfishly glad that I get to enjoy it in Japanese. It’s not profound, it’s not on the pulse of pop culture, but it was a fun, at times deep read that I’d like to share with more people.

The Bells of Nagasaki by Takashi Nagai

translated by William Johnson

1030303On Thursday, August 9, 1945, at two minutes past eleven in the morning, Nagasaki was wiped out by a plutonium atomic bomb which exploded at a height of five hundred meters over the city. Among the wounded on that fateful day was the young doctor Takashi Nagai, professor of radiology at the University of Nagasaki. Nagai succeeded in gathering a tiny group of survivors — doctors, nurses, and students — and together they worked heroically for the wounded until they themselves collapsed from exhaustion and atomic sickness.

As he lay dying of leukemia, Dr. Nagai wrote The Bells of Nagasaki, vividly recounting what he had seen with his own eyes and heard from his associates.

Review:

Trigger warning for the horror of war with a medical bent.

The Bells of Nagasaki is a first-person account of the bombing of Nagasaki, which is often forgotten in the shadow of the bomb dropped on Hiroshima. Nagai is in a unique position to discuss an atomic bomb because he was researching radioactivity in a medical context. He had basically given himself leukemia by being exposed to radiation during his experiments.

Much like Hersey’s Hiroshima, we hear the accounts of many people at the time the bomb went off, many colleagues of Nagai. We see how fate/blind luck determined who lived and died. A professor hollowing out a dugout shelter survived, but two students hauling out the dirt were killed immediately. A medical student was trapped in the rubble of his classroom. Fires soon started, and he listened to his classmates being consumed alive by the flames, and resigned to that fate himself, before working free and escaping.

This plurality of experience at the start soon narrows down to Nagai and his fellow doctors and nurses who took it upon themselves to treat as many people as they could. Like many survivors they made their way to the villages surrounding the city, helping those affected before being bedridden with radiation sickness themselves.

Nagai isn’t afraid to talk about the illness from a medical standpoint. At one point he outlines how you die – if not immediately, days later in this manner. If not then, weeks later from this and that. Some explanations call on high school physics but I didn’t find it overly technical. Then again, I work in hospitals so your mileage may vary.

The introduction is by the translator and does a good job placing the book in context and telling us about the whole of Nagai’s life. At the end he goes on about how big a role religion played in his thinking, which worried me. Thankfully there’s almost no mention of his faith until page 102 of a 115 page work but wow, he gets preachy fast. If religion isn’t your thing know you can safely skip those pages without missing anything.

As a side note – I knocked on Hiroshima for having a strong Catholic element, but Nagasaki is the most Catholic city in all of Japan. It had secret churches and harbored people when the government actively prosecuted Catholics, so if there’s going to be a large Christian influence anywhere in the country, it’s here.

Overall I found the book interesting and a good read, a valuable account of the bombing Americans overlook. It appears to be out of print right now, so check with your local library if you’d like to give it a try.

In Praise of Shadows by Jun’ichiro Tanizaki

Translated by Edward G. Seidensticker and Thomas J. Harper

34473This is an enchanting essay on aesthetics by one of the greatest Japanese novelists. Tanizaki’s eye ranges over architecture, jade, food, toilets, and combines an acute sense of the use of space in buildings, as well as perfect descriptions of lacquerware under candlelight and women in the darkness of the house of pleasure. The result is a classic description of the collision between the shadows of traditional Japanese interiors and the dazzling light of the modern age.

Review:

In Praise of Shadows was recommended to me as a grumpy old man talking about Japanese aesthetics, and it’s exactly that in a wonderful way.

The book was first published in 1933 and Tanizaki is fondly looking back at the 1880s or 90s – a time before electricity, when Japanese harnessed darkness and shadow as an aesthetic element. He laments that people no longer know what it’s like to sit in a room lit by candles, with darkness existing all around the edges. How that candlelight made the soup in a dark lacquer bowl a mystery, no visual clues as to its taste.

With lacquerware there is a beauty in that moment between removing removing the lid and lifting the bowl to the mouth when one gazes at the still, silent liquid in the dark depths of the bowl, its color hardly differing from that of the bowl itself. What lies within the darkness one cannot distinguish, but the palm sense the gentle movements of the liquid, vapor rises from within forming droplets on the rim, and the fragrance carried upon the vapor brings a delicate anticipation.

As you can tell the writing and translation are beautiful. I highlighted passages not only for the insights but for how elegantly they’re expressed.

In addition to the text there’s supporting text that does just what you want. The forward whets the appetite without giving anything away, and the afterward, written by Harper, places the book in the context of Tanizaki’s life and Japanese literature and illuminates themes I missed the first time around.

If you’re interested in Japanese thought and aesthetics In Praise of Shadows is made for you. Even if you’re not, the beautiful writing will still carry you away. I plan to revisit it many times, making it a five star read.

Cozy: The Art of Arranging Yourself in the World by Isabel Gillies

42099132When we talk about being cozy, most of us think of a favorite sweater or a steaming cup of tea on a rainy day. But to Isabel Gillies, coziness goes beyond mere objects. To be truly cozy, she argues, means learning to identify the innermost truth of yourself and carrying it into the world, no matter your environment.

From old family recipes and subway rides to jury duty and hospital stays, in Cozy Gillies shows readers that true ease stems not from throw pillows and a candle, but from opportunities to feel that we are part of something bigger than ourselves, and learn to make ourselves at home no matter where we are.

Review:

This book could also be subtitled, ‘How to be Cozy Anywhere’. According to Gillies cozy is more than hot tea and fuzzy slippers, it’s knowing what calms and centers you. She finds it both in places you would expect (baths) and places you don’t (jury duty). If I had to boil it down I’d say that

cozy = self-awareness + mindfulness + self-care

The book starts on a personal scale then broadens out to feeling cozy in your home and in your community. She emphasizes that we’ll all find different things comforting, and that part of the journey is figuring out what’s cozy to us. Instead of ‘this is cozy, do this,’ it’s ‘these things work for me, your mileage may vary.’

I’m thankful for that, and it did get me thinking about what I find cozy. There’s curling up with a blanket and a good book and preferably a cat, of course. Fresh flowers on my desk. Libraries. I think Gillies and I would agree on these points. But she finds walks with friends cozy, while I would much rather go on treks across town by myself. And that’s fine.

While some of the things she mentions can be enjoyed for free many require disposable income, free time, or comfortable circumstances, and Gillies acknowledges that not everyone has those things. She’s also quite determined to find cozy in the most trying circumstances, and I personally draw the line at when you’re sick and in pain in a hospital waiting room. She concludes that the nurses’ scrubs looked soft and therefore cozy, but… yeah.

The most valuable thing I got from this book is that it shifted my perception of cozy towards situations as well as things. Tea and my reading chair are cozy, for sure, but so is visiting the library and going to the florist to pick out a flower for my desk. So while not life-changing, this book did make me more open to seeing the cozy around me and more comfortable making my own.

The A-Z of Gender and Sexuality: From Ace to Ze by Morgan Lev Edward Holleb

9781785923425_f78cfThere can be confusion around the appropriate terminology for trans and queer identities, even within the trans community itself. As language is constantly evolving, it can be especially difficult to know what to say. As a thorough A-Z glossary of trans and queer words from ‘ace’ to ‘xe’, this dictionary guide will help to dispel the anxiety around using the “wrong” words, while explaining the weight of using certain labels and providing individuals with a vocabulary for personal identification.

Having correct and accurate terminology to describe oneself can be empowering, especially with words and phrases that describe gender identity, sexuality, sexual orientation, as well as slang relevant to LGBTQ+ rights and anti-discrimination, queer activism, gender-affirming healthcare and psychology.

Review:

When you have a question about a term used in the LGBTQIA+ community it can be hard to find a definition that is trustworthy. There’s the internet… but it’s the internet, and some pages are sketchy.  The A-Z of Gender and Sexuality is a place to go with these questions, if you just want some info, or if you’re interested in related history.

Holleb, who is trans, bisexual, nonbinary, and uses he/him pronouns, writes with an unabashedly activist point of view that I’m glad for.  He has no problem saying that we shouldn’t use a certain word, or that a particular (often hateful) way of looking at the world is wrong.  In the introduction he also says that we, the reader, are not obliged to agree with him on everything, and are free to cross out passages and rip out pages as we see fit.  I find the invitation refreshing and welcome.

I read the book straight through, as is my wont, and had a mixed experience.  The information itself is great.  A bunch of questions that have been stewing in the back of my mind were clearly answered, and learned some words that I didn’t even know existed.  Some are terms used within the community, others are words that have fallen out of fashion or the times but nevertheless are still good to know.

However, as a whole the writing is uneven.  It feels like it’s trying to be academic in parts but sourcing is inconsistent and clunky. Some sections give lots of facts and percentages that don’t serve the reader as well as a thoughtful summary would.  More than a few glossary entries stray into essay-length reiterations of history, and while at times enlightening they are often lists of facts, like the names and dates for organizations connected with a certain cause.  The information isn’t bad, I just wanted it synthesized a little more.

Overall it’s okay.  I learned a bunch, but it could have been put together more cohesively. As a result its a bit hit-and-miss as a resource, but it will definitely start you on the right track.

Thanks to Jessica Kingsley Publishers and Edelweiss for providing a review copy.

All That Remains: A Renowned Forensic Scientist on Death, Mortality, and Solving Crimes by Sue Black

9781948924276_23ebfDame Sue Black is an internationally renowned forensic anthropologist and human anatomist. She has lived her life eye to eye with the Grim Reaper, and she writes vividly about it in this book, which is part primer on the basics of identifying human remains, part frank memoir of a woman whose first paying job as a schoolgirl was to apprentice in a butcher shop, and part no-nonsense but deeply humane introduction to the reality of death in our lives.

She recounts her first dissection; her own first acquaintance with a loved one’s death; the mortal remains in her lab and at burial sites as well as scenes of violence, murder, and criminal dismemberment; and about investigating mass fatalities due to war, accident, or natural disaster, such as the 2004 Indian Ocean tsunami. She uses key cases to reveal how forensic science has developed and what her work has taught her about human nature.

Review:

As is probably well established by now I love medical nonfiction so I was excited to pick this book up, especially because the publisher compares Black’s writing to Caitlin Doughty and Mary Roach. When I think of Doughty and Roach the first word that pops into mind is “funny”.

It’s unfortunate because while this book is many things, it’s not funny.

From the beginning it’s clear that Black is not a forensic pathologist, determining causes of death via autopsy, nor an overly science-y person all together. Her first job was at a butcher shop and she carried the experience forward, studying anatomy in college and becoming a forensic anthropologist concentrating on the bones of the deceased.

The first third of the book reads like a memoir. In addition to telling us about her start in the field Black muses on the nature of death, the meaning of identity, and discusses the last days of three family members in great detail. There’s nothing wrong with this per ce, but it’s a hundred pages in the front that’s completely separated from what I thought I was getting – crime! Analyzing bones! Maybe some gory stuff! If you don’t know what’s coming you may be tempted to give up here.

Around a third of the way in we finally get into some cases and the narrative takes off. A lot of Black’s work revolves around disaster victim identification, or DVI. She has gone all around the world to help return those killed in war or disaster to their loved ones, from Kosovo to Thailand. As you can guess she sees the aftermath of horrific events, and the stories are quite touching (as well as possibly triggering, fair warning). I love that she talks about the cognitive and emotional difficulties of the job and the strategies she uses for her own mental health.

Luckily not every case is heartbreaking in the here and now. Black was on a BBC show where, along with a team of fellow scientists, they examined remains of people who lived hundreds of years ago in an effort to figure out who they were and how they died. She speaks of the interesting people she meets as part of her work in a university anatomy department, and delicate but not awful experiences like giving a potential full body donor a tour of the cadaver lab in use. And there are some stories from court, including the surreal experience of giving testimony and having no idea what to expect from either the prosecution or the defense.

I admire the work that Black has done over the years, from teaching to disaster response, from the BBC show to founding an anatomy lab.  She also gets love because she shouts out the interpreters her team worked in with Kosovo and recognizes to the mental and emotional toll of communicating the words of those who have been through such horrors.

But when it comes down to it the book is split into two parts – memoir and philosophy in the first 100 pages, and your standard forensic nonfiction in the rest.  The accounts of her parents’ deaths can be skipped over completely with no loss, so I wonder why they’re given so many pages in the first place.

The last two thirds make for a solid, but not outstanding, addition to a shelf about death. Just know that you can gloss over the aforementioned sections and you won’t miss a thing.

Thanks to Arcade and Edelweiss for providing a review copy.

The Fifth Risk by Michael Lewis

FifthRisk.inddWhat are the consequences if the people given control over our government have no idea how it works? Across all departments, similar stories were playing out: Trump appointees were few and far between; those that did show up were shockingly uninformed about the functions of their new workplace. Some even threw away the briefing books that had been prepared for them.

Michael Lewis takes us into the engine rooms of a government under attack by its own leaders. In Agriculture the funding of vital programs like food stamps and school lunches is being slashed. The Commerce Department may not have enough staff to conduct the 2020 Census properly. Over at Energy it’s not clear there will be enough inspectors to track and locate black market uranium before terrorists do.

If there are dangerous fools in this book, there are also heroes, unsung, of course.  Michael Lewis finds them, and he asks them what keeps them up at night.

Review:

This is my first book by Michael Lewis but by all rights it shouldn’t be, considering that he’s written Moneyball and The Big Short. Here he looks at how three government agencies have transitioned from the Obama administration to the Trump administration.

…it didn’t go well. Surprise, surprise.

In a book slim enough to feel like three extended essays Lewis goes over the highly varied missions of three federal agencies, what they normally do, and how that’s all been turned upside down by the incoming administration. Remember the news stories about the Trump transition being anemic and ill-planned? We see all of that in its full glory.

But it’s more than tales of woe. Lewis also highlights former administrators and the work they did fixing government. You’ve probably never heard of them, but they’ve kept the rusty wheels of bureaucracy turning with smarts and a dedication to public service. It’s inspiring how many people work for the government with this sense of duty.

And the potential disasters that keep them up at night can be truly frightening – misjudging North Korea and inadvertently starting a war, nuclear waste flowing into a major river due to poor storage. Others “merely” bode poorly for our long term prospects, like the lack of funding for cutting-edge scientific research.

Other than these facts, what struck me most is Lewis’ assured and slightly casual writing style. It never felt academic and always welcomed me back to the page.

At the same time, I can’t say I’m blown away. It’s an interesting and well-written book but it will fade from memory all too soon, which is a shame considering the subject area.