Have You Ever Been Mellow?

The Other Side of Normal: How Biology is Providing the Clues to Unlock the Secrets of Normal and Abnormal Behavior by Jordan Smoller (William Morrow, $27.99, 390 pages)

“When it comes to the human mind, we’ve long had an uneasy relationship with the concept of normal.”

Author Jordan Smoller has written a book with a purpose.   Smoller invites the reader to consider taking a new look at what is considered normal human behavior.   As an associate professor at both the Harvard Medical School and the Harvard School of Public Health, he has the background and experience that make this book a compelling read.

There are multiple threads of thought that weave together as Smoller provides a survey of the approaches taken in psychology, psychiatry and biological research since the late 1880s.   Moreover, he states that the notion of normal has historically been viewed from the extremes of abnormality.   Smoller sees a continuum of behavior with abnormality arranged at the ends.   Rather than viewing mental disorders as sitting on one side of a bright line, a new approach would begin at the center of normal and establish how far normal extends before the abnormal is encountered.

A charming phrase that stayed with this reviewer is “the intersection of genes and experience.”   Smoller and others in his field have been examining brain/mind function with the intent of clarifying whether the old nature vs. nurture concept for determining causality for behaviors holds true in the 21st Century.   In light of the recent findings related to the human genome, genes are now seen as present in a person at birth and they are often activated by experience and exposure to nature (nurturing).   That is to say, genes and nature are dependent upon each other for bringing about human behavioral development.

This is a book that approaches textbook status.   A reader is well served to have some familiarity with or a strong curiosity about perceptions of normal.   To his credit, Smoller takes the time to explain in detail the study of genes and experience that he is so committed to recasting in a new format.   The Diagnostic and Statistical Manual of Mental Disorders (DSM) is referenced frequently throughout the text.   It has been a help for practitioners in the past and now, in Smoller’s view, it has become a hindrance due to a universal perception that it is “The” source for determining a diagnosis of mental disorder.

In the DSM, diagnoses are pigeonholed within rigid parameters and, in some cases, arranged and categorized in ways that hinder helpful treatment.   Alternatively, Smoller makes a strong case for exploring methods for effective treatment that are likely found outside of the current framework.   Practitioners are seeking cures at all levels – genetics, re-conditioning therapy, cognitive and behavioral therapy, and pharmaceuticals.   A new view of their methods for determining appropriate treatment seems like a breath of fresh air.

Much is at stake as normal is being fine-tuned.   Differentiating normal from abnormal has a measurable impact when viewed from the perspective of health insurance coverage as well as the setting of qualifying criteria for disability payments.   Hopefully, Smoller and his associates will prevail in their efforts to de-stigmatize mental illness and provide better treatment for people whose position on the continuum is outside the range of normal.

Well recommended.

Ruta Arellano

A review copy was provided by the publisher.   The Other Side of Normal is also available as a Nook Book and Kindle Edition download.

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A review of The Other Side of Normal: How Biology is Providing the Clues to Unlock the Secrets of Normal and Abnormal Behavior by Jordan Smoller.

Bad to the Bone

The Complete Book of Bone Health by Diane L. Schneider, M.D. (Prometheus Books, $21.00, 491 pages)

Your skeleton is more than a bunch of bones.   Dr. Diane Schneider, a gerontologist specializing in the effects of aging on our bones, has crafted a wonderfully helpful and easy-to-use reference book – a comprehensive summary of the best research regarding osteoporosis, bone fractures and the medications that can assist in rebuilding bone mass.

All six parts can stand alone or the reader can proceed from beginning to end.   Regardless, the general layout of the narrative along with the generous use of bullet points, summary statements and anecdotal case histories makes it a go-to reference for the entire family.   There are illustrations that provide clarification of medical terms.

Dr. Schneider is able to convey critical information using a caring, but firm voice.   Her colleagues and other researchers are well-represented and acknowledged.   The many charts included in the treatment section list all the medications currently prescribed, calcium-rich foods, and study results related to bone density improvement and osteoporosis prevention.   Exercises are noted with ample warnings to avoid fractures and breaks.

Let’s hope there will be future updates to this very valuable resource.   Highly recommended.

Ruta Arellano

A review copy was provided by the publisher.   The Complete Book of Bone Health is available in hardbound and trade paperback versions, and as a Kindle Edition download.   The foreword was written by astronaut Sally Ride.

This Ain’t No Disco

A Fierce Radiance by Lauren Belfer (Harper Perennial; $15.99; 560 pages)

“There was no statute of limitations on murder.”

Lauren Belfer has produced a grand, glorious and occasionally disappointing tale of medicine, war, love and other things in this 560 page historical novel.   This is primarily a fictional account of the discovery and development of penicillin soon after the United States was dragged into World War II.   Belfer sets the scene well, convincing the reader that Pearl Harbor was an overwhelming experience for the average American; quite comparable to 9/11.

The primary character is one Claire Shipley, a photographer for Life magazine which provides her with the credentials to witness history in the making.   In this role, Claire comes to meet and fall in love with James Stanton, the physician who is heading the government’s military-based efforts to develop the new drug on a massive scale.   Claire can relate to the importance of Stanton’s mission as her daughter died from a blood-borne disease at a young age, a disease that might have been halted by penicillin.

One early surprise about this novel is that Stanton reports to a civilian authority figure in Washington, D.C. – a man by the name of Vannevar Bush.   Bush, a key scientist and organizer of the project that led to the development of the atomic bomb, comes across as a very serious and intelligent figure, yet with a touch of playfulness.   With Bush, Belfer succeeds in bringing a lesser-known historical figure to life.

She also succeeds, at least during the first half of A Fierce Radiance, in juxtaposing two stories, the story of the medicine, science and sheer luck behind the development of a life saving drug, and a love story.   Claire and James meet the love of their lives when they meet each other, but each has issues and problems that make their becoming a couple unlikely.   Each has perhaps seen too much of life by the time they’ve met.

If Belfer has played it safe to this point, she soon gambles with the reader’s patience and understanding.   This is because a murder affecting one of the major characters occurs, turning a two-headed story into a three-headed one.   Now the novel is not just about the war and medicine and love during wartime, it also becomes a murder mystery.   It seems at first a bit much especially when – wouldn’t you know it – a New York City Police Department detective (wise and grizzled) enters the scene.

Of course, the author has provided herself with a very broad field to work in here; one can tie together a lot of loose ends in close to 600 pages.   What Belfer does so well is to write in a voice that makes the reader feel “calmed and safe.”   There’s a patience and politeness in the voice that will seem familiar to readers of Anna Quindlen and to those who have read the other recent novel about life in the U.S. during World War II, The Postmistress by Sarah Blake.   It’s as if the oh-so-calm voice does take us back to an earlier time with ease.

Yet there are at least two problems with the telling.   First, the omniscient point of view of the narrator becomes tiring and also keeps the reader from knowing each of the characters as well as we would like.   Because the omniscient (godlike) narrator goes into the mind of every character, the author skimps on well-rounded character development.   This becomes frustrating to the reader and may be a major reason the omniscient voice is used less and less in today’s popular fiction.

Next, while Belfer has written a story that reads like an overly long screenplay, if it were made into a film, most viewers would be very far from satisfied with the ending.   The author does not take the easy way out…  she ends the story with a whimper rather than with a bang.   In this she may have successfully reflected the happenings of life in a truer way than it might be displayed in a tightly scripted and highly dramatic Hollywood-style ending.   This may well be to the author’s credit but it is asking a lot – in fact, far too much – of a reader to devote more than 550 pages to a story that sometimes sizzles before it blandly fizzles out.

Joseph Arellano

A review copy was received from the publisher.   A Fierce Radiance will be released in trade paperback form on March 29, 2011.

Simple Twist of Fate

The Immortal Life of Henrietta Lacks by Rebecca Skloot (Broadway; $16.00; 400 pages)

This begins as an excellent biography of a woman who might have remained unknown but for a miracle of medicine.   “At the age of twenty-one, Henrietta stared through the train window at rolling hills and wide-open bodies of water for the first time, heading toward a new life.”   Henrietta Lacks died in 1951 of cervical cancer but her cells are still alive.   To be exact, only her cancer cells continue to live but they may live for up to 100 years if frozen.   They are the so-called HeLa cells that are used by researchers throughout the world to advance the knowledge of how to fight and halt disease.

Author Rebecca Skloot has taken on the challenge of melding a family’s story with a tale of medicine and law.   The personal story is engaging and quite well done.   The reader will come to feel that he or she not only becomes acquainted with Henrietta Lacks, but also her late daughter Deborah, and her other children and grandchildren.   And, as Skloot gracefully notes, they are quite beautiful grandchildren.

This reader felt the telling was less effective when addressing the medical and legal issues.   That’s because the case is made that Henrietta’s cells were, in effect, stolen from her by Johns Hopkins Hospital.   Yet once you’ve read through two-thirds of the book, you learn that Hopkins explicitly met the medical research standards (and the legal requirements) of the day.   Indeed, it was a different time.   A relation of this reviewer gave consent for a cancer biopsy in 1950 in a northern California hospital.   Only later did the relative learn that her stomach cells were only removed in California; the cell slides were mailed to Johns Hopkins for the medical research and analysis.

There’s also an apparent contradiction in the events.   We’re told repeatedly that Henrietta did not consent to having her cells used for medical research.   Yet, her husband did authorize an autopsy and there’s also a reference to a death-bed conversation during which Henrietta was said to have told a physician that she was pleased that others might benefit from an examination of her cancerous cell tissues.   But even if this conversation never happened, the law at the time was what it was.

The author tells  us that the rights of research subjects were largely unprotected until 1966.   Yes, and this means that a lot of time is spent reviewing and debating the medical morality of an earlier time.   It is a moot point.

Henrietta’s daughter Deborah is the appealing figure in this account.   She is the family member who argued – passionately and perhaps appropriately – that one cannot hold yesterday’s medical professionals to today’s ethical and moral standards.   Deborah, in fact, jumps off the pages of The Immortal Life of Henrietta Lacks as the person who is brought back to life in the telling.

The descendents of Henrietta Lacks have never benefited from the use of her cells, leaving aside the issue of whether they were properly appropriated.   They have not received any money, and although HeLa cells are sold for medical research, the family does not have health care.   This is truly a shame, an injustice, and it is hoped that Skloot’s account will – in highlighting this issue – change things.

Henrietta Lacks deserves to be remembered, as does Deborah Lacks.   Rebecca Skloot has provided the tombstone that Henrietta’s family could never afford.   This true account is at its best when paying tribute to a woman whose life, in death, has benefited countless individuals worldwide.

It is encouraging to hope and think (and perhaps pray) that this account will result in a better life for the children, beautiful grandchildren and great-grandchildren of Henrietta and Deborah Lacks.   That would be the greatest tribute of all.

Highly recommended.

Joseph Arellano

This book was purchased by the reviewer.   

Life During Wartime

A Fierce Radiance by Lauren Belfer (Harper, June 2010)

“There was no statute of limitations on murder.”

Lauren Belfer has produced a grand, glorious and occasionally disappointing tale of medicine, war, love and other things in this 527 page historical novel.   This is primarily a fictional account of the discovery and development of penicillin soon after the United States’ involuntary entrance into World War II.   Belfer sets the scene well, convincing the reader that Pearl Harbor was an overwhelming experience for the average American; quite comparable to 9/11.

The primary character is one Claire Shipley, a photographer for Life magazine which literally provides her with the credentials to witness history in the making.   Claire eventually meets and falls in love with James Stanton, the physician who is heading the government’s military-based efforts to develop the new drug on a massive scale.   Claire can relate to the importance of Stanton’s mission since her daughter died from a blood-borne disease at a young age, a disease that might have been halted by penicillin.

One early surprise about this novel is that Stanton reports to a civilian authority figure in Washington, D.C. – a man by the name of Vannevar Bush.   Bush, a key scientist and organizer of the project that led to the development of the atomic bomb, comes across as a very serious and intelligent figure, yet with a touch of playfulness.   With Bush, Belfer succeeds in bringing a lesser-known historical figure to life.

She also succeeds, at least during the first half of A Fierce Radiance, in juxtaposing two stories, the story of the medicine, science and sheer luck behind the development of a life saving drug, and a love story.   Claire and James meet the love of their lives when they meet each other, but each has issues and problems that make their becoming a couple unlikely.   Each has perhaps seen too much of life by the time they’ve met.

If Belfer has played it safe to this point, she soon gambles with the reader’s patience and understanding.   This is because a murder affecting one of the major characters occurs, turning a two-headed story into a three-headed one.   Now the novel is not just about the war and medicine and love during wartime, it also becomes a crime mystery.   It seems at first a bit much especially when – wouldn’t you know it – a New York City Police Department detective (wise and grizzled) enters the scene.

Of course, the author has provided herself with a very broad field to work in here; one can tie together a lot of loose ends in almost 530 pages.   What Belfer does so well is to write in a voice that makes the reader feel “calmed and safe.”   There’s a patience and politeness in the voice that will seem familiar to readers of Anna Quindlen and to those who have read the other recent novel about life in the U.S. during World War II, The Postmistress by Sarah Blake.   It’s as if the oh-so-calm voice does take us back to an earlier time with ease.

Yet there are at least two problems with the telling.   First, the omniscient point of view of the narrator becomes tiring and also keeps the reader from knowing each of the characters as well as we would like.   Because the omniscient (godlike) narrator goes into the mind of every character, the author skimps on well-rounded character development.   This becomes frustrating to the reader and may be a major reason the omniscient voice is used less and less in today’s popular fiction.

Next, while Belfer has written a story that reads like an overly long screenplay, if it happened to be made into a film, most viewers would be far from satisfied with the ending.   The author does not take the easy way out, not at all…  Instead she ends the story with a whimper rather than a bang.   In this she may have successfully reflected the happenings of life in a truer way than it might be displayed in a scripted and highly dramatic Hollywood-style ending.   This may well be to the author’s credit but it is asking a lot – in fact, far too much – of a reader to devote more than 500 pages to a story that sometimes sizzles before it blandly fizzles out.

A review copy was received from the publisher.

Forever

The Immortal Life of Henrietta Lacks by Rebecca Skloot

This begins as an excellent biography of a woman who might have remained unknown but for a miracle of medicine.   “At the age of twenty-one, Henrietta stared through the train window at rolling hills and wide-open bodies of water for the first time, heading toward a new life.”   Henrietta Lacks died in 1951 of cervical cancer but her cells are still alive.   To be exact, only her cancer cells continue to live but they may live for up to 100 years if frozen.   They are the so-called HeLa cells that are used by researchers throughout the world to advance the knowledge of how to fight and halt disease.

Author Rebecca Skloot has taken on the challenge of melding a family’s story with a tale of medicine and law.   The personal story is engaging and quite well done.   The reader will come to feel that he or she not only becomes acquainted with Henrietta Lacks, but also her late daughter Deborah, and her other children and grandchildren.   And, as Skloot gracefully notes, they are quite beautiful grandchildren.

This reader felt the telling was less effective when addressing the medico-legal issues.   That’s because the case is made that Henrietta’s cells were, in effect, stolen from her by Johns Hopkins Hospital.   Yet once you’ve read through two-thirds of the book, you learn that Hopkins explicitly met the medical research standards (and the legal requirements) of the day.   Indeed, it was a much different time.   A relation of this reviewer gave consent for a cancer biopsy in 1950 in a northern California hospital.   Only later did the relative learn that her stomach cells were only removed in California; the cell slides were mailed to Johns Hopkins for the medical research and analysis.

There’s also an apparent contradiction in the events.   We’re told repeatedly that Henrietta did not consent to having her cells used for medical research.   Yet, her husband did authorize an autopsy and there’s also a reference to a death-bed conversation during which Henrietta was said to have told a physician that she was pleased that others might benefit from an examination of her cancerous cell tissues.   But even if this conversation never happened, the law at the time was what it was.The author tells us that the rights of research subjects were largely unprotected until 1966.   Yes, and this means that a lot of time is spent reviewing and debating the medical morality of an earlier time.   It is a moot point.

Henrietta’s daughter Deborah is the appealing figure in this account.   She is the family member who argued – passionately and perhaps appropriately – that one cannot hold yesterday’s medical professionals to today’s ethical and moral standards.   Deborah, in fact, jumps off the pages of The Immortal Life of Henrietta Lacks as the person who is brought back to life in the writing.

The descendents of Henrietta Lacks have never benefited from the use of her cells, leaving aside the issue of whether they were properly appropriated.   They have not received any money, and although HeLa cells are sold for medical research, the family does not have health care.   This is truly a shame, an injustice, and it is hoped that Skloot’s account will – in highlighting this case – change things.

Henrietta Lacks deserves to be remembered, as does Deborah Lacks.   Rebecca Skloot has provided the tombstone that Henrietta’s family could never afford.   This true account is at its best when paying tribute to a woman whose life, in death, has benefited countless individuals worldwide.

It is encouraging to hope and think (and perhaps pray) that this account will result in a better life for the children, beautiful grandchildren and great-grandchildren of Henrietta and Deborah Lacks.   That would be the greatest tribute of all.

Highly recommended.

Reprinted courtesy of the New York Journal of Books.

Potential is a heavy burden

“There’s no heavier burden than a great potential.”   Charlie Brown

I’m usually a cheerleader for stories involving animals but this one lacked something, I’m not exactly sure just what…   excitement, charm, humor, human relevance?   The Gerbil Farmer’s Daughter: A Memoir is the true tale of a woman whose father literally raised up to 9,000 gerbils at a time.   The publicity for the book made it seem as if the father did this to promote medical research for the condition (cystic fibrosis) that killed the author’s sister.   But sister Gail died well before the mega gerbil farm was established.

It may also be that the author’s father – the prime character here, more than the author –  is simply not someone the average reader will identify with.   A retired navy commander, he comes off as gruff and argumentative; someone who uses and abuses his wife and children.   (At one point he fires his wife from the family business replacing her with his mother.)Then there’s author Holly Robinson, who displays some odd contradictions.   For example, at one point (pages 140-142), she asks her high school classmates, “Why do you hate me so much?   I haven’t done anything.”   She asks this as the victim of mean behavior and bad language.   But then just one  page later (143) she uses very negative language to make fun of some neighbors:   “…the Albino children wore plastic bread bags wrapped around their feet instead of boots.”   The Albinos, a derogatory term adopted by Holly’s mother, are poor – “The one thing they all had in common besides missing teeth was their white-blond hair and pink-rimmed eyes…”

As far as the reader can tell, the neighbors never did anything to the author and her family…   So why did they hate their neighbors so much?   Simply because they were poor?

Once we realize that there’s no nexus (connection) between the gerbil farm and life saving research, a lot of the assumed charm and relevance (if not romance) of the story melts away.   Robinson might have been better off writing a straight biography of her life – with her family members as secondary figures – or a cute modern guidebook to raising gerbils (an updating of the books her father used to write).   As it is, there was just something missing in this book’s 289 pages.