Wednesday, January 31, 2018

Review: The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President by Bandy X. Lee


2 stars for The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President by Bandy X. Lee.

Is Donald Trump "crazy like a fox" or is he "crazy like a crazy"?

This book is a collection of articles written by 27 different mental health professionals, citing all the reasons, to the moon and back, why Donald Trump, the 45th and current President of the United States, is now the most dangerous man in the world.

These articles, categorised into 3 parts: The Trump Phenomenon, The Trump Dilemma and The Trump Effect, are interesting and even educational in the sense that we see the application of psychological concepts on Trump behaviour. Some of these mental health professionals associate Trump with a variety of diagnoses, such as narcissistic personality disorder, antisocial personality disorder, paranoid personality disorder, delusional disorder, malignant narcissist, and even some form of dementia.

I get it that these psychiatrists and mental health experts recognize the urgency of the situation in which they come to the conclusion that the most powerful man in the world is also the bearer of profound instability and untruth. Yes, I dig it. What I don't understand is the need for repetition. Reiteration. Be it personality disorder, or dangerous individual psychological patterns, or creation of own reality, or inability to manage the inevitable crises, it is not necessary to harp on the same over and over, again and again. Seriously! I have lost count of the number of times it has been mentioned about Trump's assertion that President Obama wiretaps Trump Tower during the election campaign, or Trump's claim that he has the biggest inaugural crowd in history, or Trump's firing of FBI director James Comey, to name but a few.

In any case, the die has been cast. The choice made. What's done is done. Barring an impeachment, resignation or assassination, Mr Donald John Trump will remain president until at least the end of his four-year term: 20th January 2021.

Well, the world as we know it may cease to exist with a 3:00 a.m. nuclear tweet. If it comes to pass, so be it.

Saturday, January 27, 2018

Review: The Soul of Medicine: Tales from the Bedside by Sherwin B. Nuland


4 stars for The Soul of Medicine: Tales from the Bedside by Sherwin B. Nuland.

This book is a collection of narratives on the most memorable patient ever seen by Family Physicians, Anesthesiologists, Bronchoscopists, Cardiologists, Dermatologists, Gastroenterologists, Geriatricians, Nephrologists, Neurologists, Neurosurgeons, Obstetricians, Pediatricians, Surgeons, Urologists and some others. These personal recollections demonstrate the aspects of the ethics of medicine, the ways in which science changes and how doctors approach certain kinds of problems in their own particular ways.

The topics shared range from a simple case of a minor facial rash to a complicated one involving life threatening pneumonia and partial collapse of the lung, from treatment of a bleeding polyp to organ transplantation, from simple observation and traditional physical examination of the body to technologies that approach the most advanced that medicine now offers.

At the end of my reading, the phrase that keeps popping up in my mind is "Primum non nocere", a Latin phrase that means "first, do no harm." It is a simple dictum that the duty of the healer is "to do good, or at least to do no harm". Another way to state it is that, "given an existing problem, it may be better not to do something, or even to do nothing, than to risk causing more harm than good."

And to me, "Primum non nocere" is the real lesson of humanity for all, physicians or not, but physicians especially.

Monday, January 22, 2018

Review: How We Die: Reflections on Life's Final Chapter by Sherwin B. Nuland


4 stars for How We Die: Reflections on Life's Final Chapter by Sherwin B. Nuland.

All life has a finite span and each species has its own particular longevity.

In this book, Dr. Nuland describes in frank detail the process of dying in its biological and clinical reality, by which life succumbs to disease, violence, accident or old age.

Organised into chapters and sections on the most common disease categories of our time, How We Die covers the cardiac chapters; the sections on aging and Alzheimer’s disease; the trauma and suicide section; the AIDS chapters; the clinical and biological aspects of cancer; and last but not least, the discussion of the doctor-patient relationship.

Amidst the deep desire to understand the nature of dying, the topic on hope is never far away. The deep impression that Dr. Nuland leaves behind on me is his confession on how he tries to give his brother hope - by letting his instincts as a brother overwhelm his judgment as a surgeon who has spent his career treating people with lethal disease - by offering him the opportunity to try the experimental new treatment which only serves to intensify his brother's suffering and rob him of an easier death. Dr. Nuland's brother, Harvey, died of colon cancer in 1990.

In the face of the wildly unpredictable process of living, dying and death, it is in our favour to learn as much as we can about our bodies, their strengths, their weaknesses and their ultimate inevitable failings. By doing so, we may/will be better prepared to deal more gracefully with the end. This book is as good a place as any to start.

Tuesday, January 16, 2018

Review: The Bright Hour: A Memoir of Living and Dying by Nina Riggs


4 stars for The Bright Hour: A Memoir of Living and Dying by Nina Riggs.

A maelstrom of thoughts and emotions swirled within me each time as I pick up this book to continue from where I leave off. I want to read this book. Fast. Finish it quickly. But I also want it to last. Slow. Read it slowly.

Fast because I cannot wait to find out what happens next, to Nina, to her mother, to her good friend Ginny, to her father's dog, to the chasm between living and dying.

Slow because I cannot bear for the story to come to an end. I feel that as long as I am still reading the book, the events and happenings on the page that I am reading are taking place in the present. The book is alive; Nina, the protagonist, the author, is alive.

With short, easy-to-manage chapters, the collection of reminiscences is poetic, nostalgic and reflective of the writer's natural capacity for irony and deadpan humour. It is also very much doused with endless expressions of love, joy, fear, denial, anger, guilt, happiness, sadness, relief, longing, hope and acceptance.

In a wink, a blink, a flicker, I have reached the end of the memoir. Nina is no longer alive. I am overcome with sadness and a sense of loss and emptiness.

The Bright Hour is another good reminder to us that life is short. Live a life - work to live, not live to work. Laugh more often - laughter is the best medicine. Love with your heart - love encompasses all. Live, laugh, love.

Friday, January 12, 2018

Review: When Breath Becomes Air by Paul Kalanithi


5 stars for When Breath Becomes Air by Paul Kalanithi.

This is one powerful little book, small on the outside but big on the inside.

In his memoir, Paul Kalanithi describes his search for life's meaning, why he chooses neurosurgery as his specialty, when he reaches the pinnacle of residency, why he sheds his surgeon's coat to put on a patient's gown only to swap it back again, and how he starts to view the world through two perspectives - see death as both doctor and patient - the moment he is diagnosed with a terminal illness.

Central to the book is one big question: What makes life meaningful enough to go on living?

Like his patients, Paul Kalanithi has to face his mortality and try to understand what makes his life worth living. He has to figure out what is most important to him.

Heartwarming and yet heartbreaking at the same time, Paul Kalanithi writes with a focused fluency even as he wrestles with death in every step of the way to share his pains and gains and losses.

The fact of death is unsettling. Yet there is no other way to live. ~ Paul Kalanithi


Sunday, January 7, 2018

Review: Being Mortal: Medicine and What Matters in the End by Atul Gawande


5 stars for Being Mortal: Medicine and What Matters in the End by Atul Gawande.

Deciding on the book to kick-start Year 2018 with is tricky business. In the past, I will never have given much thoughts to this first book. However, my way of thinking starts to change since 2015, when by chance, I started that year with The Walk series by author Richard Paul Evans. Somehow or other, the story brought me hope, faith and a sense of peace and helped to set my reading mood for that year.

This New Year, I ask myself "what kind of mood and tone am I looking at to set my reading in the coming days, weeks and months?". I look at my reading list many times before I realise that the answer has been staring me right in the face all the while. I have decided. It is time to confront mortality (via reading), the condition of being mortal.

Being Mortal: Medicine and What Matters in the End.

This is a book about the modern experience of mortality — what it is like to live, grow old, fall sick and die, and how medicine has changed the experience and how it has not.

The author, a surgeon, writer, and public health researcher, stresses time and again, the importance of managing end-of-life issues with patients and their families. By trying not to think about the final phase of the human life cycle, oft-times people end up with institutions (hospitals, assisted living facilities, nursing homes) that address any number of societal goals — from taking burdens off families’ hands to coping with poverty among the elderly — but never the goal that matters to the people who reside in them: how to make life worth living when they are weak and frail and cannot fend for themselves anymore.

There are invaluable lessons to be learnt from this book about aging, attitude to death, quality of life, consequences of sacrificing time now for time later instead of living for the best possible day today, and terminal care. These lessons are of vital importance because people die only once and there is no prior experience to draw on.

The foremost question in my mind now is "Will I have an ending whereby I am able to make the choices that meant the most to me?"

This, in turn, brings me to the four questions of paramount importance that I have learnt from Dr. Gawande; questions that, I will in all likelihood have to ask myself and provide the answers some day.

(1) What is my understanding of the situation and its potential outcomes?

(2) What are my biggest fears and concerns?

(3) What are the trade-offs (sacrifices I am willing to endure now for the possibility of more time later) I am willing to make and not willing to make?

(4) What is the course of action that best serves this understanding?

Indeed, I have chosen a heavy topic to read. Medicine and what truly matters in the end certainly provides food for thought. What makes life worth living when we are old and frail and unable to care for ourselves? Do we get to live the way we wish and with our families around us right to the end?

Being Mortal is a book for everyone; a must-read for all. Eventually, death will come knocking on our doors one day and we need to prepare ourselves for the inevitable to happen. Even then, for all our preparations and whatever we think we have learnt, we may not be ready for it when that day arrives. If you have yet to seriously think about what matters in the end, this is an excellent book to get you started.

Last but not least, I like to say that there are so many well written and meaningful passages in this book that I find myself reading and rereading them before moving onto the next section. Initially, I have wanted to quote only a few lines out of the whole passage but I find that once truncated, the intended meaning and impact is lost. So, I have taken verbatim from the whole passage, rearrange into shorter paragraphs for easy reading, and list them under notable passage 1, 2, 3, and so forth.