Book review: Survival of the Sickest

Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease is a most fascinating and entertaining book. In it, Dr. Sharon Moalem looks at disease through the lens of evolution, asking, "if evolution is all about survival, why would it select for deadly diseases?" He answers the question in breezy and inviting prose with plenty of science to back up his claims.

Dr. Moalem starts with the hereditary disease hemachromatosis, which produces excess iron in the blood and kills people in midlife if left untreated. He also looks at diabetes, high cholesterol, and favism (a hereditary and deadly intolerance of fava beans). He traces the diseases' history to see when they entered the gene pool and find out why such problems would remain. The answer: they protected against an immediate threat. About hemachromatosis he says, "Why would we select for a gene that will kill us through iron loading by the time we reach what is now middle age? Because it will protect us from a disease that is killing everyone else long before that" (p. 14).

From specific genetic diseases, Dr. Moalem moves on to infectious diseases like malaria and examines the relationship between humans and microbes. This chapter had a big "ewww!" factor for me, because I don't enjoy contemplating the fact that I am a host for more minute beasties than my own cells. However, the examination is interesting and well worth the read.

Dr. Moalem goes on to discuss such things as "jumping genes" (many genes are able to rearrange themselves as an editor might a manuscript), gene expression (genes can be turned on or off depending on the environment), and the utility of aging (cells that don't die become cancer). Throughout, he demonstrates a declaration he made in the introduction: "everything out there is influencing the evolution of everything else" (p. xv).

Dr. Moalem sometimes relies on controversial theories in his explanations, but he always declares them as such, and there are references at the end of the book for those who wish to follow up. A Ph.D. in human physiology, he appears to know what he's talking about and to be able to put it in layman's terms.

Survival is chock full of interesting stories and wonderful analogies and can be quite funny. In advising caution in the new scientific endeavor of changing gene expression, he says our genes are "engaged in a vast and complex dance that makes us who we are. We need to be awfully careful when we start to change the choreography, especially given our current lack of precision. When you try to move one dancer with a bulldozer, you're pretty darn certain to scoop up more than one Rockette" (p. 177).

Jonathan Prince, with whom Dr. Moalem wrote the book, was a senior adviser and speech writer in the Clinton administration and oversaw communications strategy with NATO during the war in Kosovo. One can't tell what contribution he made to the book, but I find it interesting that he was involved.

The emerging field of evolutionary genetics is something everyone should become literate in, given the pace of discoveries. Survival of the Sickest is a great introduction to the field and addition to the popular science literature. Read it, laugh, and learn.

Cross-posted to Blogcritics.

Watching Raines - or not

What is wrong with the viewing public? A repeat of Shark on on CBS beat a new episode of Raines on NBC, starring the wonderful and quirky Jeff Goldblum?! I've been following the ratings at Entertainment Now for all of two weeks, so I don't know what the numbers mean. But they make it easy to see who wins.

I'm not knocking Shark, which stars the equally charismatic and gifted actor James Woods, because I haven't been watching it. I tried it, it didn't appeal (even though it is supposed to House with lawyers). But really, people won't give up a repeat to try something new?

Raines has a wonderful premise, that of a homicide detective who hallucinates that he's talking to the victims. It has the versatile actor Matt Craven as Raines' boss, a super-good female uni cop (played by Linda Park of Startrek: Enterprise), a goofy/dopey white male uni (actor-comedian Dov Davidoff of Third Watch), a smart and slightly snarky young female desk jockey (Nicole Sullivan from MadTV), Raines' shrink (Madeleine Stowe), and occasionally, his dead partner (Malik Yoba).

Most of all Raines has Jeff Goldblum, with his sly smile, big brown eyes, his soft and sometimes stuttering delivery. Although Raines is eccentric and sarcastic, Goldblum also brings a sweetness to the role. Raines can wield a gun and has no problem using it, but he's the farthest thing from tough-guy cops like Micheal Chiklis' Vic Mackey from the Shield, which is also set in LA.

To be fair, Raines is not going for the realism of gritty shows like The Shield, or HBO's fantastic The Wire. The show takes it cue from Raines himself, a would-be writer who moved to LA because of Raymond Chandler mystery novels. Although set in the present, the whole show has a noir feel that harkens back to the 40's. With Jeff Goldblum as mediator, it is an entertaining mix.

So if you haven't already, I recommend giving Raines a try. What have you got to lose, except a rerun?

Cross-posted to Blogcritics.

Book review: I Thought It Was Just Me

"Shame on you!" These three words can be very damaging, and they often need not be said to women, who are prone to think, "Shame on me!" Does this surprise you? Ring true to you? Whether you are aware of shame or have never given it much thought, Dr. Brené Brown's I Thought It Was Just Me: Women Reclaiming Power and Courage in a Culture of Shame can be an eye opener. This thorough examination of shame is not only filled with examples but also presents a framework for recognizing and moving beyond shame.

What is shame and how does it differ from guilt? "Shame is the intensely painful feeling or experience of believing we are flawed and therefore unworthy of acceptance and belonging" (p. 5). Shame results in paralysis and prevents clear thinking due to the flood of emotion. Guilt, on the other hand, can be a motivator for change. The two get confused because "Guilt and shame are both emotions of self-evaluation; however, that is where the similarities end. The majority of shame researchers agree that the difference between shame and guilt is best understood as the difference between 'I am bad' (shame) and 'I did something bad' (guilt). Shame is about who we are and guilt is about behaviors" (p. 13).

Shame is inextricably linked with fear -- fear of being rejected by the group. Human beings are wired for connection, and strive for it from birth, when we require connection to survive. When people experience shame, it places a wedge between them an others which can manifest in several ways, such as withdrawal or lashing out. In other words, the disconnection of shame results in greater disconnection. It also promotes the use of shame against others, further reinforcing the cycle.

Through her research interviews with hundreds of women, Dr. Brown has developed a conceptual schema for shame. The first element is the "shame web," which identifies sources of shame starting with those closest to the person (e.g., family, friends, oneself) and radiating out to society at large (e.g., magazines, TV, advertising). The second element is the "connection network," which consists of those people with whom we can share our experiences of shame and not be further shamed. The connection network promotes affirmation, belonging, and acceptance, which are crucial because the antidote to shame is empathy, compassion, and sharing.

We can use these concepts to develop what Dr. Brown calls "shame resilience." Shame resilience has four elements: recognizing shame triggers, practicing critical awareness, reaching out, and speaking shame. We can use the shame web to recognize sources of shame and what topics we are particularly sensitive to. (Dr. Brown recounts some of her own experiences of "mother shame" because motherhood is a shame trigger for her.) We can learn test the reality of our beliefs and challenge unrealistic expectations. We can then use the connection network to reach out to those who will not judge us and tell them about our experiences. Thus we may reframe our experiences, coming to understand them in a different light that makes us more understanding and empathetic towards ourselves and others.

Although its goal is increased connection, which feels good, be forewarned that this book is not always easy to read. As Dr. Brown herself recounts, casual acquaintances don't want to hear about her shame research because it brings up so many difficult emotions. The book is friendly and approachable, but it shares this problem. It also never steps beyond the point of view of social work, Dr. Brown's field of study. She considers shame to be a "core emotion," one that brings on fear and anger and other emotions, but I am sure there are researchers who would disagree with that assessment. The danger here is overgeneralizing shame and seeing it everywhere.

The research Dr. Brown reports on in I Thought It Was Just Me is about adult women, but at the end of the book she reports on her current research on men and children. She really is trying to be inclusive and thinks we can make the world into a more compassionate place if we all pay attention to shame. It sounds like a long shot to me, but any way of looking at people that results in practical advice that will make us more compassionate is welcome.

Cross-posted to Blogcritics.

Book of poetry review: A Form of Optimism

"A form of optimism" must be what poetry is to Roy Jacobstein, a public health physician who travels the world and has seen suffering. He writes of these experiences, as in his poem "HIV Needs Assessment": "We've found needs aplenty./But let's not talk about that,/as the people do not." Jacobstein and his colleagues are rendered mute in the face of desperation. What can anyone say that would make things better? Nothing. But one can capture the moment in verse, and remind the world of what it's like.

And that seems to be what this book of poetry is about: not saving the world, but showing it to us, in small glimpses - the awful and the everyday. There are slices of Jacobstein's own life: his mother, whose name meant "mother" in Arabic; the scariest movie he ever saw as a child; his malamute-border collie mix dog; his observations of Greece and Turkey. He shows a depth of knowledge of the world and its literature (and for those of us not quite so well-read, there are some explanations of the titles of some of the poems at the end), but that doesn't mean he won't compose a poem about the Three Stooges ("Moe"). There is also the stark and moving "Immortality," in which Jacobstein lists the names of gun designers, whose immortality means death.

Topically, I enjoyed the poems that arise out of Jacobstein's personal history the best, but it's where he goes with them that makes them work. In "Sighting," he ponders noses and recalls an incident in Italy many years ago, where two widows decide he has a Jewish nose. The poem starts out with his memory of a clown nose, but by the end wends its way to the "fatal science," concluding, "and the Aquiline nose of Sheba, so long/admired in the West, marked the Tutsi in Rwanda for the machete and the grave." Jacobstein uses personal anecdotes to bridge the distance from the personal to the universal.

Even to someone like me who doesn’t typically review poetry, Jacobstein’s poems are both accessible and powerful. I did find the layout of about half the poems distracting, however. Why break sentences into separate paragraphs? I've heard that poetry is an aural medium, meant to be heard rather than read. I would love to hear Jacobstein read the poems laid out this way, so I could know the intention behind the written form.

Jacobstein is an award-winning poet. A Form of Optimism won the 2006 Morse Poetry Prize, and his first book of poetry, Ripe, won the Felix Pollak Prize. His work has also been included in Literature: Reading Fiction, Poetry, & Drama (McGraw-Hill, 2006). Don't let this pedigree scare you off. A man who can write a poem about the Three Stooges and HIV is, at heart, a poet of the people.

Cross-posted to Blogcritics.

Book review: Con Ed

Would you like to learn how to run a really big con and swindle somebody out of millions of dollars? Then go no further than Con Ed, by Matthew Klein. This funny and fast-paced novel will not only educate you, but also entertain you mightily.

Kip Largo is a con man from a family of grifters and learned the trade at his father's knee. He tried to go straight and actually made it big for a while selling a legit diet strategy on TV. Unfortunately, the temptation to make money on the side caught up with him and he ended up going to prison for securities fraud.

Back out on the street, Kip is trying to make an honest living again, this time working at a dry cleaner in Palo Alto. It's the height of the Internet boom in Silicon Valley and he's lucky to rent an apartment from a 90-year-old immigrant who doesn't know the value of his land.

Kip is minding his own business one evening, having a beer at a bar, when he is approached by a beautiful woman who appears out of nowhere with an idea for a con. Kip hesitates until his ne'r-do-well son, Toby, shows up owing money to the Russian mob. Kip is lured back into the world he knows best.

Told in Kip's voice, Con Ed has a 40's noir sensibility to it; one could almost imagine Humphrey Bogart narrating. Klein lays out the story in a masterful fashion and intersperses chapters explaining classic cons. This being a book about the trade, all is not what it appears. Klein gives you the clues to figure out what's going on, but will you?

I'm a bad judge of whether or not Con Ed has a plot you can figure out. I certainly didn't, but I am very willing to suspend any disbelief and not try to figure out mysteries before the end. If a plot is obvious, I can tell. Con Ed was not obvious to me. I was surprised about the true con (although I did see the coda coming).

Klein's style is breezy and filled with funny observations and asides. It is perfect for the genre. With summer coming on, it wouldn't surprise me if Con Ed found its way to many a beach blanket. There’s no need to wait, though. If you need a fun read, grab Con Ed. Just don't take this education too seriously.

Cross-posted to Blogcritics.