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Wednesday, Feb 24, 2010

Health care has been in the news lately, especially in the US. You might have noticed.

As I’ve been getting older and taking more control over my own personal health, I’ve become more concerned about the costs, naturally—but also more interested in why doctors do what they do.

The concept of getting a second opinion is timeless. But what are the factors that influence whether a patient gets listened to and treated appropriately? I picked up Jerome Groopman’s How Doctors Think to try to get inside their heads.

Groopman, a professor at the Harvard Medical School, writes an accessible account of his experience trying to thoughtfully comprehend medical practice in various specialty areas. Unsurprisingly, the best care seems to come from situations where patients question their doctors closely, and when doctors have the time and space to base clinical practice on the best evidence available.

When doctors are rushed, or patients are unwilling to communicate clearly and assertively, mis-diagnoses are more likely. Groopman offers a variety of anecdotes about situations where a patient moves from specialist to specialist, trying to find the correct diagnosis. The doctors who seem the most successful are those who approach every patient with an open mind and treat them as a whole person. After reading How Doctors Think, I feel better about questioning the need for a test and the reasoning behind a diagnosis. How do you feel about your next doctor’s visit?

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Wednesday, Feb 24, 2010

What if antidepressants were not just too easily available and overly prescribed by doctors—as has been argued in many venues for years now, though to no discernible effect—but didn’t even work? That’s the takeaway premise of psychology professor Irving Kirsch, Ph.D., in his new book, The Emperor’s New Drugs: Exploding the Antidepressant Myth.

By examining a broad spectrum of research, using both the published drug studies and the deep well of unpublished research which many drug companies would prefer stay hidden, Kirsch presents the all-too-plausible theory that there is essentially no positive effect from taking antidepressants. In fact, comparing test results between patients taking antidepressants and those taking active placebos (a drug that isn’t an antidepressant but has other, noticeable side effects, so that the patient can tell something is working on them), Kirsch found no statistically significant difference. Actually, he found that it didn’t seem to matter what drug patients were taking, as long as they knew they had ingested some kind of active drug, they improved by about the same degree. So much for the last few decades’ great advances in pharmacology, it would seem.

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Friday, Feb 19, 2010

When my wife and I saw the first ultrasound images of our unborn child, one image struck out. The not-yet fully formed head turned toward the imaging equipment, and when the picture snapped the “face” captured on the screen was a terrifying blur of white, horn-like points, empty black holes for eyes, and gaping mouth. “It looks like a Mexican wrestling mask,” my wife said. It did, and now every time I see the picture my head is filled with masked men and women flying about in wild flashes of color and athleticism.

Like that ultrasound picture, the photos in Malcolm Venville’s Lucha Loco are wonderful and strange. There are profiles, head and full body shots of 128 luchadores, each accompanied by a single-sentence quote from interviews Venville conducted with his subjects. The luchadores muse on their love of the sport, their lives outside the ring as accountants and lawyers, and the paradoxical freedom that comes with wearing a mask.

The faces behind the mask are never revealed, but the photos are often close enough to not just see the eyes of the subject, but the pores of their skin, the scars inflicted from years of abuse. Venville displays masks and impressive physiques of the luchadores in simple poses with unadorned backgrounds, but his photos best capture the nobility, heroism and even villainy embodied in these people. Venville guides us through the masks to reveal the people beneath.

Tagged as: lucha, luchadore, mexico
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Thursday, Feb 18, 2010

I don’t know Lily Hoang’s precise age: it changes. She is among an emergent vanguard of young(ish) innovative writers to whom the crumbling mainstream publishing industry is largely indifferent. The feeling is almost certainly mutual.

And maybe now, with three books published, an anthology co-edited with Blake Butler forthcoming from Starcherone Press, and a collection of collaborative stories in the works, Hoang has switched over into being more established than emerging. (Full disclosure: I have a story in the anthology mentioned above and know Hoang only very slightly.) If not “established”, certainly “award-winning”, in point of fact. Her first book, Parabola, won Chiasmus Press’s Undoing the Novel contest; Changing won a 2009 PEN/Beyond Margins Award. Both books are sui generis, stunning in their formal innovation. (I hesitate to call either of the works novels, as they defy generic categorization.)

I start off with Hoang’s youth as a cheap rhetorical strategy—only to contrast it with the age of her text. Hoang is a young writer; Changing is an old book.

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Friday, Feb 12, 2010
Conspicuously absent from PM’s list of the best nonfiction for 2009 is Robin D. G. Kelly’s comprehensive biography of the high priest of bop, Thelonious Sphere Monk.

In the intro to his biography of legendary jazz pianist and composer Thelonious Monk, Robin Kelley quotes one of the Maestro’s favorite quips about the phrase ‘always know’, that the ‘”know” is “Monk” spelled backwards with the “M” upside down’. That brain pretzel is a succinct commentary on Monk’s music. Taking the seemingly simple, turning inside out, tossing it upside down, and flipping it around is the hallmark of Monk’s approach to the Tin Pan Alley standards, such as “I’ve Got Rhythm”, that he helped morph into the musical revolution known as bebop. It also captures Monk’s method of playing the piano and composing originals. Written off by many in the early days as unschooled and inept, Monk has been proven over time to be one of the most innovative and sophisticated artists in the history of jazz.

Monk certainly merits top billing along with Louis Armstrong, Coleman Hawkins, and Duke Ellington in influencing the evolution of jazz to mid-20th century. Kelley, who researched and wrote most of the book while living in New York and teaching at Columbia University, sets out to make that case and by and large succeeds. Kelley had unprecedented access to Monk’s personal archives, family, friends, and colleagues and also the freedom to go wherever the evidence took him. More than a decade in the making, Thelonious Monk: The Life and Times of an American Original is exhaustive in its detail and exemplary of the biographical form. It’s also a damn fine piece of music appreciation and social history to boot. It’s a must read not only for Monk aficionados and jazz fans in general but for anyone interested in American popular culture in the aftermath of the Second World War.

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