2.12.2016

Super Bowl 50

Professional football isn’t one of my favorite sports and I haven’t watched many Super Bowls, since the first one, 50 long years ago. But the one this year was different, so I did watch most of the game last Sunday.

With the increasing reports of brain disease in former National Football League (N.F.L.) players, I was concerned about where the game was going. C.T.E is a degenerative brain disease caused by repeated trauma that has been found in dozens of former N.F.L players.

The game is brutal, violent, fierce, a genuine battle of gladiators. When a player is tackled, there’s a mass of other players piling on one another with as much force as they can muster. The playing field is sometimes hard. Even with newly designed helmets, banging your head on that surface time and time again is jolting. So is every collision between two players that jars their head.

According to Susan Margulies, a concussion researcher at the University of Pennsylvania, “no helmet has been devised that can effectively reduce the rotational acceleration that sloshing within the head that’s happening in the brain itself.”

The data on the frequency of concussions is clear. According to Ben Shipgel (Times, 1/30/16) National Football League players sustained 271 concussions last year, an increase of 31.6 percent from 2014.

Shipgel writes, “Helmet-to-helmet contact accounted for 92 of the 182 regular-season concussions…The second-leading source was the playing surface.” Shoulder and knee contact produced a majority of the balance.

It’s those concussions, game after game, year after year that give rise to degenerative brain disease. As the players age, the signs of the disease become more frequent—forgetfulness, bursts of anger, depression, severe dementia. It is only after they die that an autopsy can reveal the extent of brain disease.

Watching the N.F.L games becomes something of a moral dilemma. Am I complicit, along with all the others who feel as I do, in supporting the game by continuing to watch it? And then there’s the added issue how the game itself might foster a certain tolerance for violence.

Greg Easterbrook writes in his book The Game’s Not over: In Defense of Football, “What does it mean that the most popular and unifying form of entertainment in America…features giant muscled men, mostly African-American, engaged in a sport that causes many of them to suffer brain damage?”

Yes, the players say they know the risks and, in spite of that are willing to keep playing. But do they really know the risks, the possibility that many years down the road, they will fall victim to a brain disease? We are woefully lacking in being able to accurately predicting our future, particularly the likelihood of those events that will befall us as we age.

Is there anything than can be done? Adam Gopnik puts the matter realistically on the New Yorker website:

“But it does not seem beyond the ingenuity of Americans…to find a way for us to play our national sport without condemning its heroes to nightmarish final years of confusion and depression. As with most social problems, a program of reasonable reform on many fronts—new helmets, however silly they may look; a roster of sensible protocols and precautions, above all new rules on tackling, …might yet rescue the game, and assure that there will be a hundredth Super Bowl, somewhere ahead.”



2.08.2016

We Die Alone

March 1943 in Northern England. Four Norwegian commandos set sail for their Nazi occupied homeland. Their mission is to organize and supply the Norwegian resistance. The commandos were betrayed, Germans were informed of their mission, and attacked by one of their ships as they approached the Norwegian coast. Only one of the four commandos survived.

His name is Jan Baalsrud. He managed to swim ashore, then continued swimming from one island to the next until the Germans lost sight of him. The story of the next 68-day ordeal is told by David Howarth in We Die Alone.

Battling bitter cold, frostbite, the loss of one of his boots and partially blinded by ceaseless snow, Jan swims, walks, crawls, climbs from one island to the next until he lay dying of cold and exhaustion on a beach.

After some time, he was found by two young girls who took him to their home, where he was fed, given new clothes and a few days of rest. He was then rowed to another island and began walking across steep mountain ranges in an effort to reach safety in neutral Sweden.

As if this wasn’t enough, the rest of Jan’s excursion was one misfortune after another. He spent most of his time alone, although he was helped from time to time by Norwegian villagers who at great risk to themselves and their family, tried to aid him, minimize his suffering, and move him closer to the border.

At one point he started an avalanche, fell at least 300 feet, suffered a concussion and all but his head was buried in the snow.

What kept him alive is a mystery. It was not hope, because he had none, and it was not any of the physical conditions which are usually supposed to be essential to human life. Perhaps it is nearest to the truth to put his survival down to stubborn distaste for dying in such gruesome circumstances.

Eventually he crawled out and continued on his trek until finally he stumbled into the cottage of Marius Gronvold and his family who took him in for a week to recover.

Gangrene had invaded his toes, Jan drained them and eventually cut off nine of them to save his legs. Since he could no longer walk, Gronvold and his friends built a sled to transport him up a 3,000-foot mountain where another group was supposed to meet him. But a winter storm developed that made it impossible for them to find him.

Gronvold was forced to leave Jan in a hole protected by a boulder. He spent the next 20 days in a sleeping bag immobilized in the snow, periodically supplied by Gronvold and other members of the resistance in the village.

Finally, a group of Laps and their reindeer came to his rescue and dragged his sled across the border into Sweden where he was treated in a village hospital for seven months.

We Die Alone is one of those World War II tales that defies belief. At the start, I knew Jan would survive. But I had to know how? No one could survive under those conditions. Somehow he did. However, he never couldn’t have done it without the help of a great many courageous Norwegians.

There was nobody who could share the pictures which were still so vivid in his own mind: pictures of endless snow, the cold, the glaring nights, the procession of faces of people who had offered their lives for his and whose names he had never known, the sound and smells of the northern wastelands, the solitude and hopelessness and pain.





2.01.2016

What If?

Encounters between people, it often seems to me, are like crossings of racing trains at breakneck speed in the deepest night. We cast fleeting, rushed looks at the others sitting behind dull glass in dim light, who disappear from our field of vision as soon as we barely have time to perceive them. Pascal Mercier

A young woman, a young man, reading a book, the same book, passing each other on trains going in opposite directions. From the November 8, 2004 New Yorker cover. What might have been if they were seated next to one another on the same train? A brewing romance? A brief conversation? Will they be getting off at the same station?

I often think about counterfactuals. How might my life had been like if I had gone to law school, rather than graduate school in psychology? Or if I had gone to the school in the east, rather than the one in the west? As for that question, I never would have met my wife, if I had gone to the eastern school.

After I graduated in psychology at Berkeley, I was offered a job at a new university in the east. My wife and I went back to meet the members of the Department and so I could give a seminar. Afterwards, we looked around for a house to buy, the lawns were brown, it was bitterly cold and my wife found it impossible to imagine living there. What might our life have been like, if we had stuck it out and remained in the east and the now-rather-prestigious university?

It was Sunday, in the early afternoon on a warm sunny day in Lucca, Italy. I was casually moseying around the Piazza Napoleone when I came across a woman looking intently at me. And then when I passed by her, she did something women never do to me--she smiled.

A few days later, I saw her again. She saw me. We practically stumbled across one another. Both of us smiled at each other broadly. But we were at the train station. I was on my way back to Florence. It appeared she was returning once again to Lucca. Should I have stopped and forgotten about the train waiting on the tracks? Should I have even smiled at her when we saw each other again? She did. What was I to do? Pretend to be blind?

Twelve years ago, Philip Roth imagined a counterfactual history of this country in his novel The Plot Against America. He wrote that the legendary aviator Charles Lindbergh defeated Roosevelt in the 1940 presidential election.

Lindbergh was an isolationist, as well as a Nazi sympathizer. In The Plot Against America he signed an agreement with Hitler that the United States would not enter the war. At the same time, the agreement had dire consequences for America’s Jewish population.

All I can think of as I recalled Roth’s novel was the current political scene in this country. Like many others, I worry about the apparent popularity of the leading candidate for the Republican nomination.

Are we approaching something similar? Can, as Roth wrote, … the shameless vanity of utter fools can so strongly determine the fate of others? Who knows? The possibility is frightening.






1.25.2016

What Do Runners Think About When They Run?

I always thought I must have been a deer or a horse in some former state because it was such a joy to run. Louisa May Alcott

What do runners think about when they run? Kathryn Schulz asked this question in her article on the New Yorker website. She posed this question as she began reflecting about the more than 50,000 runners who recently ran the New York Marathon, an ordeal of 26.2 miles, from the Verrazano-Narrows Bridge to the finish line in Central Park

Some of the fastest runners completed the distance in a little over 2 hours, others around 6, while others didn't finish at all. She said asking about what runners are thinking during this grueling race is a reasonable question, since running 26.2 miles inevitably involves a great deal of time to think. She writes,

“To run five or ten or twenty-six miles is, as much as anything else, to engage in a sustained way with the deep strangeness that is the human mind.”

Is it really such a reasonable question? I imagine the thoughts of runners of any distance vary as much as the number of runners. I say this in light of the fact that I was once a runner, each day of the week, no matter the weather, hot or cold, sunny or cloudy, humid or dry. My thoughts while running were never the same from one day to the next.

I am also uncertain if it is a reasonable question knowing how difficult it is to measure the thoughts of runners while running or doing anything else for that matter. Schulz cites a study that attempted to do this.

The study, conducted by Ashley Samson and three colleagues, was published in the International Journal of Sport and Exercise Psychology. Each of the ten runners were asked to describe what what they were thinking while running. Shultz writes “Afterward, the researchers transcribed those monologues, identified the thoughts they contained, and divided them up into three categories: Pace and Distance, Pain and Discomfort, and Environment.”

What is one to make of this study? The group was rather small (10), only one run was measured, and from Schulz’s description we know nothing about how long they ran, the gender of the runners or the weather conditions the day the study was conducted. With these caveats, the results indicated the runners spent most of their time thinking about their pace and how long the distance was.

The researchers wrote, “pain and discomfort were never far from their thoughts…all told, fully a third of runners’ thoughts concerned the downsides of running. The remaining thoughts pertained to the runners’ immediate environment…terrain and wildlife, and thoughts about weather, traffic, and the other people around them.”

In general, my experience confirms these findings. Some days I fretted about how cold or windy it was, other days I thought about the classes I was to teach, and then some days I worried about the dog racing after me, if he would jump on my back, crashing me to the pavement as he had done once before.

Haruki Murakami’s What I Talk About When I Talk About Running answered Schulz’s question as clearly as anyone when he wrote: “What exactly do I think about when I’m running? I don’t have a clue.” He also added that he would never know what he was thinking while running unless he put his thoughts in writing, as he did in those two sentences.

Regardless of all these weighty particulars, countless research studies have demonstrated that exercise seems to stimulate our neurons and synapses. So throw away those crossword and Sudoku puzzles and go for a swim, walk, bike ride, or run. You’ll be healthier, feel better, loose some weight, and power-up your brain.







1.19.2016

Phishing for Phools

In 1984 Robert Cialdini published Influence: The Psychology of Persuasion in which he described six compliance techniques--Reciprocity, Commitment, Social Proof, Scarcity, Liking and Authority-- that are widely used to influence behavior. Advertisers use them, government agencies use them, corporations use them.

Last year (2015), thirty-one years later, economists and Nobel laureates George Akerlof and Robert Schiller have to a large extent recast and expanded upon Cialdini’s ideas in their book, Phishing for Phools: The Economics of Manipulation and Deception.

While Cialdini’s formulation focused on how individuals respond to “professional compliance” techniques, Akerlof and Shiller offer a more general account of why free markets “make fools of us” by capitalizing on human weaknesses.

According to Cass Sunstein’s review (New York Review of Books, 10/22/15) Akerlof and Shiller distinguish between phish and phools. Phisherman such as banks, drug companies, real estate agents, automobile salesmen, and cigarette companies take advantage of human failings to do something that is in the phisherman’s interest, but not in the phools.

Human failings are any number of human errors such as overconfidence, loss aversion and short term, rather than long term bias. Sunstein writes:

Informational phools are victimized by factual claims that are intentionally designed to deceive them, …psychological phools [are] led astray either by their emotions…or by cognitive biases…

They also believe that phishing for phools “is the leading cause of the financial crises that lead to the deepest recessions.”

In his review Sunstein’s central message is that give and take of free markets are distorted by phisherman. They lead people to smoke by sowing doubt about current research; they lead people to underestimate the harmful effects of alcohol and overeating; they induce individuals to buy a product they don’t need or is unhealthy.

In these respects, the so-called “invisible hand” can readily go wrong. As a result, some kind of regulation is required to curb the phisherman’s power. It remains unclear what form regulatory interventions might take and how they can ever be implemented, let alone legislated given the current mood of this country.

In Akerlof and Shiller’s view “companies exploit human weaknesses not necessarily because they are malicious or venal, but because the market makes them do it.” Corporations seek to maximize their profits and in most cases will exploit every opportunity to do so.

In short, once we understand the extent to which individuals succumb to phisherman techniques, we will have yet another reason to call free market economics into question.

1.12.2016

Strangers Drowning

What would the world be like if everyone thought like a do-gooder? What would it be like if that happy, useful blindness fell away and suddenly everyone became aware, not just intellectually but vividly, of all the world’s affliction?

Larissa MacFarquhar’s Strangers Drowning: Grapping with Impossible Idealism, Drastic Choices, and the Overpowering Urge to Help is a morally disturbing book. It calls into question some, if not many, of our ordinary, day-to-day behaviors.

Say we want to purchase a dress or coat that costs about $200. Do we really need another coat? How might we better spend the money? Give to a charity that delivers food and medicine to those who need it? Do the same for a charity that develops clean water programs in drought-stricken areas? Contribute to a charity working to eradicate malaria, parasite infections, or promotes literacy in developing countries?

The individuals described in MacFarquhar’s book raise such questions for every expenditure they are about to make. Most of them don’t spend the money and turn instead to a life of extreme poverty, slighting their own well-being while they to devote their life to alleviating suffering. MacFarquhar writes,

This book is about a human character who arouses conflicting emotions: the do-gooder. I don’t mean a part-time, normal do-gooder—someone who has a worthy job, or volunteers at a charity, and returns to an ordinary family life in the evenings. I mean a person who sets out to live as ethical a life as possible. I mean a person who’s drawn to moral goodness for its own sake. I mean someone who pushes himself to moral extremity, who commits himself wholly, beyond what seems reasonable. I mean the kind of do-gooder who makes people uneasy. 

She profiles the extraordinary ways these individuals undertake their moral projects. Sue and Hector Badeau, who in addition to their own two children, adopted twenty children with special needs.

Murlidhar Amte, born into a wealthy family in India, founded a leper colony in India.

Dorothy Granada, braving threats of rape, moved to Nicaragua in the 1980s to build a health clinic for women deep in the jungle.

Several individuals donated one of their kidneys to a person they didn’t know, often with unforeseen consequences. And others give away nearly everything they earn to the needy, even when it means that they go hungry at times.

MacFarquhar also discusses Peter Singer’s philosophical reasoning behind these expressions of extreme altruism. Singer argues that it is immoral to buy anything but the necessities when your money could be used to save lives and reduce the suffering of others. He would like us to consider if we would buy a cappuccino and croissant, if we knew the money was enough to buy a life-saving mosquito net in a malarial area of the world? Further, would you feel responsible for a lost life, if you bought the cappuccino and croissant?

The detail and understanding MacFarquhar displays in describing these individuals is the heart of the book. She writes, “I don’t think this question [So, is it good to try to live as moral a life as possible?] can be answered in the abstract. In the abstract, there are ideas about saints and perfection. Only actual lives convey fully and in a visceral way the beauty and cost of a certain kind of moral existence.”

Reading MacFarquhar’s book made me uneasy. It called into question many of my behaviors. I never think about how the money I spend for a Caramel Macchiato could be better used to aid a sick child in Kenya or provide a family with safe water in Uganda. The logic of thinking this way about every expenditure could drive me crazy. Instead, all I can do is give more of my resources to charities that reduce suffering. And if more and more people acted similarly, a great deal might be accomplished.

She concludes, “If everyone thought like a do-gooder, the world would not be our world any longer, and the new world that would take its place would be so utterly different as to be nearly unimaginable. … If there were no do-gooders, on the other hand, the world would be similar to ours, but worse.”

1.06.2016

Abducting a German General

May 1944. German occupied Crete, the Greek island in the southern Aegean. In 1941 soon after the Germans captured the island from the British, the Cretan resistance movement was established.

Consisting of bands of local civilians, guerrilla fighters, and villagers from the wild mountainous interior, they inflicted heavy losses on the German forces from the very beginning.

This is the background of Patrick Leigh Fermor’s Abducting a General: The Kreipe Operation in Crete. Fermor was a member of the British Special Operation Executive (SOE) stationed in Egypt. Together with his colleague, Stanley Moss, they formulated a plan to capture the German General on Crete.

The purpose of the operation was to humiliate the Germans and boost the morale of members of the Cretan resistance. On the night of April 26 1944, Fermor and his colleagues intercepted the car carrying General Heinrich Kreipe, commander of the German forces then.

Fermor, dressed as the German General, and his British colleague-chauffeur, Moss, managed to get through 22 German checkpoints in a hair-raising prelude to an 18-day effort to spirit Kreipe away on ship bound for British controlled Egypt.

"A mood of riotous jubilation broke out in the car; once more we were all talking, laughing, gesticulating and finally singing at the tops of our voices, and offering each other cigarettes, including the general."

Fermor’s description of this 18-day trek with his band of Cretan resistance fighters was the most thrilling portion of the book. Together they moved from one concealed cave to another in the mountains of Crete—eating, reading, talking, resting, trying to sleep. It was during these days that I came to appreciate how much the Cretans meant to Fermor.

the flair [they had] for friendship, company, talk, fun and music; originality and inventiveness in conversation and an explosive vitality.

After several terrifying climbs and descents and no shortage of near misses, General Kriepe, (shown in center) along with his British captors, (Moss on left, Fermor on right) was finally was finally spirited away onto a British submarine bound for Cairo.

Was the capture of Kriepe of any military or strategic value? If so, it was negligible. And it was met with German reprisals that were not pretty. But as a pure adventure story, it was hard to beat.

In 1972, long after the War, Fermor met Kriepe once again under more peaceful conditions in Athens.

12.30.2015

Gratitude

As the year draws to a close, I know of no better way to end it than to reproduce the sentiments of Oliver Sacks in his posthumous volume, Gratitude. It was written toward the end of his life, as he was in considerable pain.

Marks in the Margin was originally conceived in 2008 as a way to post passages from the books I’ve read. As it turned out, I never really did that. Today marks the exception, as I present the passages I copied from Gratitude.

In this instance, it is better to let the author speak, rather than provide a secondary account. It is also a reminder of how much there is to be grateful for.


Mercury is element number 80, and my dream is a reminder that on Tuesday, I will be eighty myself.

Elements and birthdays have been intertwined for me since boyhood, when I learned about atomic numbers. At eleven, I could say “I am sodium” (element 11), and now at seventy-nine, I am gold.

Eighty! I can hardly believe it. I often feel that life is about to begin, only to realize it is almost over.

At nearly eighty, with a scattering of medical and surgical problems, none disabling, I feel glad to be alive—“I’m glad I’m not dead!”

I feel I should be trying to complete my life, whatever “completing a life” means.

Some of my patients in their nineties or hundreds say nunc dimittis--“I have had a full life, and now I am ready to go.”

hope that some of my books may still “speak” to people after my death.

At eighty, the specter of dementia or stroke looms.

Love and work, the two most important things, Freud insisted, in life

“Whatever has a beginning must have an ending.”

One has had a long experience of life, not only one’s own life, but others’ too. One has seen triumphs and tragedies, booms and busts, revolutions and wars, great achievements and deep ambiguities. One has seen grand theories rise, only to be toppled by stubborn facts. One is more conscious of transience and, perhaps, of beauty. At eighty, one can take a long view and have a vivid, lived sense of history not possible at an earlier age.

I do not think of old age as an ever grimmer time that one must somehow endure and make the best of, but as a time of leisure and freedom, freed from the factitious urgencies of earlier days, free to explore whatever

I feel grateful that I have been granted nine years of good health and productivity since the original diagnosis, but now I am face to face with dying.

Over the last few days, I have been able to see my life as from a great altitude, as a sort of landscape, and with a deepening sense of the connection of all its parts.

There is no time for anything inessential.

I rejoice when I meet gifted young people—even the one who biopsied and diagnosed my metastases. I feel the future is in good hands.

I cannot pretend I am without fear. But my predominant feeling is one of gratitude.

the special intercourse of writers and readers.

Above all, I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.

I was fascinated by my patients there, cared for them deeply, and felt something of a mission to tell their stories—stories of situations virtually unknown, almost unimaginable, to the general public and, indeed, to many of my colleagues.

Almost unconsciously, I became a storyteller at a time when medical narrative was almost extinct.

It was a lonely but deeply satisfying, almost monkish existence that I was to lead for many years.

The peace of the Sabbath, of a stopped world, a time outside time, was palpable, infused everything, and I found myself drenched with a wistfulness, something akin to nostalgia, wondering what if: What if A and B and C had been different? What sort of person might I have been? What sort of a life might I have lived?

And now, weak, short of breath, my once-firm muscles melted away by cancer, I find my thoughts, increasingly, not on the supernatural or spiritual but on what is meant by living a good and worthwhile life—achieving a sense of peace within oneself. I find my thoughts drifting to the Sabbath, the day of rest, the seventh day of the week, and perhaps the seventh day of one’s life as well, when one can feel that one’s work is done, and one may, in good conscience, rest.



12.23.2015

Where I Live

I live in a six story condominium in the shape of a U with approximately ten apartments on each of the three wings. There is a lovely garden on the first level, in the center of the three wings. Each morning I walk the hallway on my floor from one end to the other and, if I am not too tired, at night too.

I never see another person, the hall is as quiet as the middle of the Sahara. The door of each apartment is shut tight, in most cases locked. The inhabitants are as imprisoned as in any San Quentin cell. Were it not for my sociable wife, I’d never know who lives across the hall or down the way either. In the elevator I nod to those I don’t know and try to strike up a conversation with those I do.

Everything that happens happens inside the apartment. That is perfectly fine with me, as I am an introvert, hard of hearing, and try to deal with the pain in my back. So I sit in the chair at my desk and search for something to write about.

The Portland Streetcar stops across the street from the building’s main entrance. That is one of the attractive features of living in the neighborhood known at the Pearl District in NW Portland. The Streetcar runs on a round-trip route to the downtown area, Portland State University and what is known as the South Waterfront District.

In former times, the Pearl District consisted of vast warehouses, some of which were inhabited by local artists and a few stray mice. More recently the buildings have been renovated or torn down to make way for upscale condominiums.

The park across the main entrance of the building I live in has a community wading pool that in the summer is filled with toddlers and young children splashing around for hours on end. At the Streetcar stop there is an ice cream parlor known as Cool Moon. It is one of the most popular shops in all of the great state of Oregon. If you don’t mind waiting a few minutes, you can treat yourself to one or more of about 30 different flavors.

I first moved to this neighborhood about 15 years ago. I felt somewhat of an urban pioneer. There were only a couple of apartment houses then. Soon thereafter a building spree began; now there are numerous high rise condominiums for the countless individuals who are moving to Portland. Nearby are a wide variety of boutique shops, galleries and upscale restaurants.

Powell’s Bookstore is a short walk away and in the days when I was more mobile than I am now, I’d go there every day. Some consider Powell’s the best bookstore in this country. It is surely one of the largest. Reading a good book during the long, wet, and cold winters in this town is one of the reasons it’s so popular.

People usually visit Portland during the few months of summer there are here. This is a terrible mistake for everything appears so inviting then. So they sell their homes, pack up their furniture and head this way. Then the rains begin, the cloudy days stay around for weeks on end and it is often cold enough to snow. I wonder if they begin to have second thoughts about their decision and if a sense of buyer’s remorse takes hold of them.

Nevertheless, they remain here, contribute their share to the city’s air pollution, traffic congestion, and rising housing costs. Meanwhile, I yearn for warm climes and sunny days. Unfortunately, my life-long partner cannot imagine living anywhere else, so I am stuck with this city in the far Northwest of this land and her warm countenance.

Happy holidays to all.

12.17.2015

Time Out of Mind

On any given night, about 4,000 people sleep on the streets or in shelters in Portland, Oregon, a city with a population of 625,000 people.

In New York, a city of 8.5 million people, more than 56,000 homeless men, women and children sleep in homeless shelters and at least 3,300 more sleep on the streets and subways in the dead of winter. This means that one in every 143 New Yorkers is currently homeless.

The homeless problem confronts every metropolitan area of this country. In most, solutions have been hard to come by. It was against this background that I watched Time Out of Mind, a film in which Richard Gere portrays George Hammond, a homeless man on the streets, alleys, and in condemned buildings and shelters in New York.

Night after night he looks for a place to sleep, something to eat and, yes, drink. Hammond is an alcoholic and mentally-ill. His sentences are mumbled, incomplete, he has a vague look. cloudy eyes and aimless expression. He has been unable to find a job, has no identification and can’t recall his social security number.

As a result, he doesn’t qualify for the financial assistance offered by City’s social services. He is alone, even when listening to a chatty sort-of-friend, and unsuccessfully tries to connect with his adult daughter, now working in a bar. Hammond is simply down and out, drifting from one day to the next.

I watched this film hoping to find a solution to the homeless problem. None are offered, none are even suggested. What I found was a powerful depiction by Gere of what its like to be homeless on the streets in America today.

The state of Utah has developed a promising approach for homeless individuals. The state had almost 2,000 homeless individuals, many with drug or mental health problems. The approach, called Housing First, starts by giving the homeless a home, a genuine private residence rather than a shelter or halfway house.

In the Utah’s initial pilot program, 17 homeless individuals were placed in homes in Salt Lake City. According to James Surowiecki (New Yorker, 9/22/14) after 22 months, not one of them was back on the streets. Surowiecki reports that, “In the years since, the number of Utah’s chronically homeless has fallen by 74 percent.”

Utah’s program is also more cost effective than the traditional approach of first dealing with drug and mental health issues, as well as maintaining shelters. Such programs generally cost about $20,000 a year for each chronically homeless person. In contrast, placing a homeless individual into permanent house costs the state just $8,000.

Let’s assume George Hammond had a little luck and obtained an identification and social security card. Would his life be any different if he first had a home to call his own? Could he even manage its care and maintenance? Even if he lived in Utah, without a job and some kind of treatment program, I don’t imagine his life would be much different.

The approach to the homeless in Utah offers some kind of hope for what has otherwise been viewed an unfixable problem. Homes first, then a job and treatment, rather than the reverse.

You can watch a preview of the film here











12.10.2015

The Laws of Medicine

I had never expected medicine to be such a lawless, uncertain world. Dr. Siddhartha Mukherjee

You are ill, you have a pain here, another one there, you make an appointment to see your doctor. You try to describe why you are there, what ails you. You expect the doctor will tell you what the problem is and a treatment.

It is unlikely you will question his diagnosis or treatment. Yet, everything we know about medicine suggest that is precisely what you should do. Medicine like most every science is imperfect, it is based on probabilities, it is an uncertain science. The diagnosis could be wrong, the same holds for treatments.

There are always exceptions to the usual diagnosis of a medical problem. This is the central message of Siddhartha Mukherjee’s The Laws of Medicine: Field Notes from an Uncertain Science.

He writes: “It is easy to make perfect decisions with perfect information. Medicine asks you to make perfect decisions with imperfect information.” Mukherjee invokes three laws to explain why medicine is such an uncertain world.

His first law states that “A strong intuition is much more powerful than a weak test.” Here Mukherjee acknowledges the limitations of medical research. When faced with such uncertainty, hunches can often lead to an effective treatment.

He illustrates this law by describing a patient suffering from fatigue and weight loss. A comprehensive battery of tests turned up nothing. He could do nothing for the patient until he saw him conversing with a former patient who he had treated for the effects of drug use. Soon after, he realized the mystery patient was a heroin user and had contacted Aids.

Mukherjee’s second law states “Normals teach us rules; outliers teach us laws.” We usually don’t pay much attention to the exceptions to a research finding. Yet, as he acknowledges, they are the very individuals who provide an opportunity to refine our understanding of an illness.

Mukherjee illustrates this law by describing the widely held belief at one time that autism was caused by parents who were emotionally cold to their children, the “refrigerator mom” hypothesis. By paying attention to the exceptions to this notion, geneticists began examining the risk of autism between identical twins. They found a striking rate of concordance, suggesting a genetic cause of the illness.

In his third law Mukherjee holds that “For ever medical experiment, there is a perfect human bias.” Every scientific experiment is prone to any number of human biases, but he believes this problem is especially serious in medicine. Medical researchers hope their medicines will work, their treatments will work. This bias enters into the design, conduct, and analysis of the study.

…when you enroll a patient in a study, you inevitably alter the nature of the patient’s psyche and, therefore, alter the study. The device used to measure the subject transforms the nature of the subject.

Mukherjee claims many medical treatmentss thought to be deeply beneficial to patients based on considerable anecdotal evidence and decades of nonrandomized studies were ultimately shown to be harmful when they were investigated with randomized, double blind studies.

Weak tests, outliers and biases, Mukherjee’s three laws of medicine point to limits and constraints on medical knowledge. That is the state of medicine that doctors confront. It is also the problem you will confront when you have need to visit your doctor.

Is he making the correct diagnosis of your illness? Will the drug she prescribes work for you? Is the suggested treatment approach based on carefully control studies?

While medical technologies are increasingly sophisticated, uncertainties remain endemic to medicine. Once you recognize this, it is wise to keep posing questions, inquiring about alternatives, and being confident you’ve been given the right advice.


12.03.2015

Tightrope

And then she made her move. It felt like walking a tightrope, feeling the balance, knowing that a slight shift to either side might be fatal.

Marian Sutro returns to the page. The last time we saw her was in Simon Mawer’s The Girl Who Fell From The Sky. This time it is in his Tightrope. A spy story, a thriller for a change. Nothing special. A time out, so to speak.

We begin with Marian’s work for the Britain’s Special Operations Forces in World War II. She is parachuted into France, joins the resistance, her task to make contact with Clement Pelletier, a nuclear physicist and help smuggle him out of the country. She succeeds, but soon thereafter is betrayed, captured by the Nazis, after killing two SS officers.

She is tortured and sent to a German concentration camp—Ravensbruck—assumes the name of recently deceased prisoner, escapes and eventually finds her way back to England.

“You cannot tell anyone what it [Ravensbruck] was like. It wasn’t the stuff of words.”

She returns to the home of her parents where she is overly pampered, fed, treated like a child. All the while, she longs for the excitement of her life as an agent and heroine of the resistance. When her former handler temps her back into the Cold War world of espionage, she accepts at once.

At this point Marian Sutro begins a new life. We are introduced to her brother and his work as a nuclear scientist, and others who believed the West should share their knowledge with the Russians.

Once again she is drawn back in to the world of deception, double-crossing, struggle to protect her gay brother. Along the way there are various affairs, close escapes, and clandestine acts. An all pervading atmosphere of mistrust, uncertainty. And Mawer writes elegant prose, as if he knew exactly what the world of espionage was like.

“It is so very difficult to unpick the spider’s web of intrigue and betrayal, isn’t it? Some threads are irrevocably knotted together, others snap at the merest breath of inquiry.”

What makes Tightrope such a pleasure is the character of Marion Sutro, her response to the morally complex world in which she found herself, damaged in World War II, yet resilient, clever, calm, subject to great physical passions, able to hold her own at the slightest danger.

To live happily, live hidden. She’d heard the proverb years ago during her training but she’d only recently found the source…Florian’s fables…It comes in the Fable of the Cricket who survives intact while the pretty butterfly dies at the hands of children. She was like the cricket—cryptic, camouflaged, concealed. A survivor.”

In the end Marion never knew if what she had done made the slightest difference. I suppose that is the way with the clandestine world, probably the world in general.




11.27.2015

A Moveable Feast

If you are lucky enough to have lived in Paris as a young man, then wherever you go for the rest of your life it stays with you, for Paris is a moveable feast

Parisians have turned to a book in droves following the terrorist attacks. Hemingway’s Paris memoir, A Moveable Feast, has become a best seller, the most popular book in France at this time.

According to the Guardian (11/20/15) the book is No 1 on Amazon’s French site, booksellers are running out of copies and, to meet the demand, the publisher continues to print thousands of new copies.

Hemingway takes you right into the mood of being in Paris, a Paris that Parisians hope to recapture in reading the book. He goes to the cafes--sometimes to write, or to talk, at other times to hide, and then to eat or drink.

Hemingway writes about the craft of writing and how he did it and how to do it better. “Up in that room I decided I would write one story about each thing I knew about.”

Currently there is an exhibition of Hemingway’s letters, photographs, films, and corrected proofs of his books at the Morgan Library and Museum in New York—Ernest Hemingway—Between Two Wars.

In a letter to his father he tries to explain what he was trying to do. “You see I’m trying in all my stories to get the feeling of the actual life across—not to just depict life—or criticize it—but to actually make it alive. So that when you have read something by me you actually experience the thing. You can’t do that without putting in the bad and the ugly as well as what is beautiful.”

A Moveable Feast was written toward the end of his life and published posthumously in 1964, long after his youthful days in Paris. In it he traces the writers he knew there, Fitzgerald, Joyce, Gertrude Stein and Ezra Pound, each of whom took an interest in his work and responded with encouragement and appraisal.

Alison Flood, the author of the Guardian article notes that the book is published in French as Paris est une fete (Paris is a Celebration.)
She says it has struck a “chord with the mood of defiance in the wake of the attacks. This has seen Parisians drinking and eating in restaurants, cafes and bars…and posting about it under the slogan “Je suis en terrasse: on social media.”

"There is never any ending to Paris and the memory of each person who has lived in it differs from that of any other. We always returned to it no matter who we were nor how it was changed nor with what difficulties nor what ease it could be reached. It was always worth it and we received a return for whatever we brought to it."

11.24.2015

Small Miracles

Many years ago I watched a man punching buttons on a storefront machine in a residential area of Florence. It was an automatic video-cassettes (VHS tapes) vender that operates like a cash machine. He inserted his credit card, read the menu of available videos, requested a brief review of those he was interested in, selected the one he wanted, and hit the button. Bingo it came rolling out the slot. All the videos were visible behind the window of this unattended mini-store. No human intervention. No exchange of cash. No talk or banter about the films. Just the person, the card, and those buttons.

Similar DVD dispensers are now placed in markets, libraries, pharmacies, malls, really almost anywhere. They operate with the same routine—the DVD titles are displayed, with a brief description, and information about the rental costs. You don’t have to download a film on your computer or smartphone, don’t have to wait for one from Netflix or pay a monthly fee for the few films you might like to see. No, all you have to do is head down the block and pick one up at your neighborhood kiosk.

Then there’s vending machines that sell print books. Actually these ingenious devices have been around for a long time. According to John Geohegen (Huffington Post 5/25/13) the first book dispensing vending machine was built by Richard Carlile in England in 1822. He writes, Carlile was a bookseller who wanted to sell seditious works like Paine’s Age of Reason without being thrown into jail. His answer was a self service machine that allowed customers to buy questionable books without ever coming into contact with Carlile. The customer turned a dial on the device to the publication he wanted, deposited his money, and the material dropped down in front of him.

Since then the technology of book vending machines has been modernized so that now there are Book-O-Mats, Readomatics and Biblio-Mats that can be found in libraries, airports, subway stations, etc. Most of the books available on these ingenious gadgets are mass market bestsellers. You don’t find The Dialogues of Plato or The Consolations of Philosophy. For them you have to trek to the library or the ever-popular Amazon website.

An article in The Guardian (11/13/15) on short story vending machines put me in mind of all their forerunners. The article describes the free, short story story from machines in Grenoble, France that can currently be found in its town hall, library, and commuter stations. The co-founder reports that more than 10,000 stories have already been printed.

“The French publisher hopes the stories will be used to fill the dead time of a commute, in a society where daily lives are moving quicker and quicker and where time is becoming precious. In the bus, the tram or the metro, everyone can make the most of these moments to read short stories, poems or short comics. And they can be sure to enjoy the ending.”

All this is well and good, especially the fact that the stories are free. But I wonder how popular they will be for individuals who are already reading on their iPad, Kindle, smartphone or even the fast-disappearing printed book. The same holds for individuals who like to enjoy a quiet moment of reflection or conversation with their friend as they are traveling to their destination.

11.18.2015

The Spirt of Coffee Houses

It was good to learn this morning that the French are returning to their cafes and coffee houses as a show of defiance. In sympathy with the French, I am reposting this blog I wrote some time ago.

It was a pleasant café, warm and clean and friendly, and I hung up my old water-proof on the coat rack to dry and put my worn and weathered felt had on the rack above the bench and ordered a cafe au lait. The waiter brought it and I took out a notebook from the pocket of the coat and a pencil and started to write. Hemingway

Over thirty years ago I bought a book titled Coffee Houses of Europe. I don't know how I managed to save it all this time, since it is a large, heavy book, filled with beautiful color photographs of some of the most famous coffee houses in Europe. Really, it’s a coffee table book and apparently it has become quite a treasure.

I’ve also had a life-long interest in the coffee house culture and the spirit that it is said to engender. No doubt that’s because most of the cities I’ve lived in have not been blessed with coffee houses or its culture. But in those that I have visited in France and Italy, I’ve felt their warmth and congeniality.

In his Introduction to the photographic plates, the Hungarian-born writer George Mikes distinguishes between the classic coffee houses of Central Europe--Vienna, Budapest, Prague—from those of Lisbon, Paris and London. He calls the latter “places,” while those in Central Europe are “a way of life…a way of looking at the world by those who do not want to look at the world at all.”

While the distinction is untrue, the classic coffee house often becomes a habitual part of a “regular’s” daily life and for some, a place where most of the day is spent. “There were coffee houses for writers, journalists and artists, and these were the most famous, because their members were…”

Mikes must have a thing against the French because he asserts, The French simply use the cafes; they don’t live there.” He claims they actually go there to have a cup of coffee or meet a friend. That is contradicted by my brief experiences at the cafes around the Sorbonne. There I have observed lively conversations between students and their professors that have surely lasted more than the hour or so of my visit.

In The Great Good Place Ray Oldenburg writes, “The coffee house, however, was fundamentally a form of human association, a gratifying one, and the need for such a society can hardly be said to have disappeared.” This has been the case from their beginning in Istanbul, where the first coffeehouses were established during the sixteenth century.

A French observer described these early coffeehouses as settings where “…news is communicated and where those interested in politics criticize the government.” Games—chess, backgammon, checkers—were also played and writers of the days read their poems and stories. This tradition spread to England and the countries of Western and Central Europe during the following century. Again their central features were sociability marked by congeniality, conversation, and social equality.

The spirit of the classic European coffeehouse has all but vanished in this country. Instead, they have been transformed into solitary, monastery-like places of keyboards and screens. Where there was once a lively conversation, now there is silence. Where there was once a group of friends and colleagues gathered around a table, now there are solitary individuals. Where there was once writing notebooks, now there are laptop computers.

Malcolm Gladwell put this as well as anyone: “I like people around me; but I don’t want to talk to them.

11.15.2015

Paris


I find it impossible to say anything appropriate after the attacks in Paris.

Marks in the Margin will remain silent for awhile in the hope that a period of quiet will somehow provide some distance from this brutal tragedy.

11.09.2015

The Vanished World

“The love of literature, of language, of the mystery of the mind and heart showing themselves in the minute, strange, and unexpected combinations of letters and words, in the blackest and coldest print -- the love which he had hidden as if it were illicit and dangerous, he began to display, tentatively at first, and then boldly, and then proudly." John Williams

I first read Stoner long after I left the academic world. Each time I read it, it’s truth rings true to my experience, as William Stoner’s life in some respects mirrors mine.

Like Stoner I was a tenured teacher at a college I had always dreamed of going to. Like Stoner I loved teaching and always thought of it as my occupation. And like Stoner I doubt if few students remember me now or the research I did then.

But that is where our similarities end. As Maggie Doherty writes in her article, “The Vanished World of Stoner” (New Republic 11/3/15) in Stoner’s day, as well as mine, most full-time faculty members were in a tenure-track position.

Doherty writes that is no longer the case, which makes an academic life increasingly precarious. In the interests of cost-cutting, administrators rely on adjunct or part-time faculty members. “In the 1970s roughly two-thirds of university faculty were tenured or tenure track. Today, only 24 percent of faculty on on the tenure track.”

Doherty is a part-time lecturer in literature at Harvard. She says she was hired on a multi-year contract and is well compensated for her work. Apparently, this makes it unnecessary for her to teach at other nearby universities. Other part-time teachers are not so fortunate.

She says the median adjunct salary for teaching a semester-long course is $2,700. How can anyone get by on that kind of salary? As a result, many adjunct professors teach courses at one or more other colleges, are not eligible for benefits and spend hours in traffic traveling from one to the other.

“…a study…found that roughly one quarter of the nation’s one million part-time college faculty receives some form of government aid.”

In my day there were a plethora of full-time tenure track jobs. Quite the opposite in true now. Doherty says this will be the third year she is applying for a tenure track position. She says there are 67 job openings in this country for scholars of American literature.

“I am qualified to apply to fewer than ten of these jobs. To say these are highly competitive positions is an understatement. I’ve heard of openings that receive upwards of 700 applications.”

This month The New York Review of Books will publish The 50th Anniversary Edition of John Williams’ Stoner. Ian McEwan said, “It’s a marvelous discovery for everyone who loves literature.” If you’ve not yet read it, I encourage you to do so.

Stoner’s colleagues, who held him in no particular esteem when he was alive, speak of him rarely now; to the older ones, his name is a reminder of the end that awaits them all, and to the younger ones it is merely a sound which evokes no sense of the past and no identity with which they can associate themselves or their careers.”

Note: After I wrote this blog, the New Yorker published a short piece on commuter teachers. It's a sad tale confirming everything Doherty wrote. If you are a New Yorker subscriber you can read it in the "Here to There Department" in the November 16th issue. Unfortunately the magazine will not allow me to post a link to it.

11.05.2015

Free Speech

In his commencement speech at Dickinson University this year, Ian McEwan delivered an impassioned defense of free speech. He said without it, democracy is a sham.

He pointed to the First Amendment as the foundation of this country, the bedrock of all the other freedoms we have, including the liberal education the students just received. Elsewhere freedom of speech is under attack.

“Across almost the entire Middle East, free thought can bring punishment or death…the same is true in Bangladesh, Pakistan, across great swathes of Africa. These past years the public space for free thought in Russia has been shrinking. In China state …[there is] a level of thought repression unprecedented in human history.”

This week (11/2/15) the director of a Ukrainian language library in Moscow was placed under house arrest for allowing access to banned Ukrainian books. In Iran two poets were sentenced to long prison terms and flogging for their poetic writings that were said to offend anti-Western factions.

In Saudi Arabia Raif Badawi was awarded the Sakharov Prize for Freedom of Thought. Badawi is a writer and blogger who has been jailed, fined, and flogged. He has been sentenced to 1,000 lashes and is serving a 10-year prison sentence for insulting Islam on his website.

The authorities also jailed Badawi’s lawyer who was sentenced last year to 15 years in prison for “undermining the government, inciting public opinion, and insulting the judiciary.”

In China over 30 individuals (doctors, lawyers, students, teachers, writers, etc,) have been detained, jailed or exiled for defending free speech or their pro-democracy views.

McEwan spoke of the brutal attacks on the French satirical magazine Charlie Hebdo and the puzzling objections of some of the writers attending the recent American PEN gathering to defend free speech throughout the world.

At times free expression has been threatened in this country. One need only remember the era of Senator Joseph McCarthy and his reckless, unsubstantiated accusations. Even during the administration of George Bush, I felt that free speech was limited in some areas. And the same was true during the Vietnam-era protests.

McEwan called on the students to remember the words of Voltaire: “I disapprove of what you say, but I will defend to the death your right to say it.”

He concluded his address by quoting George Washington: “If the freedom of speech is taken away then, dumb and silent, we may be led like sheep to the slaughter.”

We live in a privileged time in this country with unlimited freedoms that we usually take for granted. We never can be reminded too often of the liberties we enjoy. At the same time, there are always potential threats to these freedoms.

I am reminded of what Thomas Jefferson was said to have remarked, “Eternal vigilance is the price of liberty.”

10.29.2015

Night Train to Lisbon Again

The best education comes from knowing only one book. James Salter All That Is

It’s been five years since I read Night Train to Lisbon. I thought it was one of the best books I ever read. It’s time to read it again.

As I start, it is every bit as good as I remember it. The initial appeal of reading some books sometimes vanishes when you reread them. But not this one, its brilliance hasn’t faded.

Gregorious was a teacher. I was as well. Although I eventually grew disenchanted with the discipline I had been studying and teaching for years, Gregorious could never abandon his devotion to linguistics, languages and the beauty of words.

He loved the Latin sentences because they bore the calm of everything past. Because they didn’t make you say something. Because they were speech beyond talk. And because they were beautiful in their immutability. 

Recently I have felt the need to break out into something different. That is what Gregorious does, following a chance encounter with a woman about to take her life by jumping off a bridge. But it is a book written by a scholar in new foreign language that draws him away from the school he had been going to all his life, first as a student and then a much-admired teacher.

That was the moment that decided everything, he thought when he recalled the event hours later. That is, all of a sudden, he realized that he really didn’t want to wipe away the trace of his encounter with the enigmatic woman. 

I’ve forgotten so much, starting with Gregorious’s recounting of his youth. I remember that it was the questions scattered throughout the novel that appealed to me. Never before had a read a book with so many questions, none of which were answered. That only led me to think about them, mull them over for a while. It’s a good technique. I remembered only a few specific questions. Rather it was their number that stood out.

How are we to be happy without curiosity, without questions, doubt and arguments?

While, I’d not forgotten his ruminations on the long train trip to Lisbon from Bern, I did forget the businessman he met on the train who helped him a great deal upon arriving in Portugal and thereafter, as well. After a few weeks in Lisbon, he was invited to stay in his home.

…train travel as a riverbed of imagination, a movement where fantasy liquefied and passed you images from closed chambers of the soul. 

The man was Jose Antonio da Silveria who gives him the name of an ophthalmologist to fix the glasses he accidently broke on the train. He goes to her office. Doutora Mariana Conceicao Eca greets him, who we learn was a woman with big dark eyes. She is thorough, retests him several times, he admires her professionalism and it is obvious he feels more than that. Gregorious had been divorced from his wife for several years and is clearly rather lonely.

I had forgotten about the first person he visited who might have known Prado. Vitor Coutinho turned to be a bit of an eccentric old man who had seen him a couple of times in the hospital where Prado worked. They spoke for a while in an uneasy conversation and Gregorious learned the location where the house Prado and his sister, Adriana, lived. Perhaps she was still alive.

“I know that this man, a doctor, lived and worked here,” he went on in French. “I . . . I wanted to see where he lived and to talk with somebody who knew him. They’re such impressive sentences that he wrote. Wise sentences. Wonderful sentences. I’d like to know what the man was like who could write such sentences. 

As I read further, so much seems fresh, as if I was reading the book for the first time. Sometimes I come across a book that I had no idea I had read before. At least, I can’t recall anything about the story, the characters, how it ends and why I liked it. This experience is not unlike the one Sven Birkerts writes about in his American Scholar essay “Reading in the Digital Age.”

“You can shine the interrogation lamp in my face and ask me to describe Shirley Hazzard’s The Transit of Venus and I will fail miserably, even though I have listed it as one of the novels I most admire. But I know that traces of its intelligence are in me, that I can, depending on the prompt, call up scenes from that novel in bright, unexpected flashes: it has not vanished completely."

And then later he writes: “What—I ask again—what has been the point of my reading? One way for me to try to answer is to ask what I do retain. Honest answer? A distinct tonal memory, a conviction of having been inside an author’s own language world, and along with that some hard-to-pinpoint understanding of his or her psyche. Certainly I believe I have gained something important, though to hold that conviction I have to argue that memory access cannot be the sole criterion of impact: that there are other ways that we might possess information, impressions, and even understanding. For I will insist that my reading has done a great deal for me even if I cannot account for most of it.”

What is the point of reading? I like the question. And think of answers other than what we recall. Pleasure. Learning. Escape. Companionship. Truths.

We forgot so much of our life that reading is really no different than anything else. And the subtle influences of the books we read surely operates in the same way as any other factor that shapes our life.

I read more. Gregorious slowly tracks down the people who might have known Prado. And I think why? He’s not going to write a biography. He’s surely not going to remain in Lisbon. Or maybe he will.

And why had he never had a friend as Jorge O’Kelly had been for Prado? A friend with whom he could have talked about things like loyalty and love, and about death? 

And then I remember the question Prado poses: Can you understand yourself any better by trying to understand the life of another person? Does Gregorious want to do that? He never explores the matter or write about how understanding Prado by talking to those who knew him, clarified his own life.

Gregorious goes to visit Prado’s favorite teacher, Father Bartolomeu, now living in a retirement home for the elderly. He has not lost his wits and recounts what a marvelous student Prado was--energetic, forceful, argumentative, passionate, informed well beyond his years. And then he recounts for Gregorious the speech he gave at graduation, one that astonished his listeners and lambasted them for their religious views. I had forgotten all this too, including Gregorius’ return to the school to read Prado’s speech. Mercier describes the close, almost intimate relationship the two had, yet I did not remember it.

Years later, he had written these lines to Father Bartolomeu: There are things that are too big for us humans: pain, loneliness and death, but also beauty, sublimity and happiness. For them we created religion. 

I had completely forgotten that Gregorious returned to Bern after being in Lisbon for a while. He wanted to be back home, to hear the language he knew, to walk through the old familiar streets. He collected his mail, snuck around his school, and in a day or so returned to Lisbon. It’s the details that have disappeared. Rather I remember only the general outline of the story and a few of the questions, the endless unanswered questions in The Goldsmith of Words.

How are we to be happy without curiosity, without questions, doubt and arguments? Without joy in thinking? 

Then there was the serious incident when some food caught in Adrianna’s windpipe. She couldn’t breathe, Amadeau, who was studying for his medical exams then, tried the Heimlich maneuver. It didn’t work. He had studied tracheotomies, took a knife, cut a hole in Adriana’s windpipe, grabbed a pen to block the flow of blood and saved her life. I recalled none of that dramatic scene. It took her two weeks to recover in the hospital.

I am reading the book more slowly now. And I’m reading it in the Kindle e-book version on my iPad. I am surprised by how little difference it makes.

Of course, I’m seeing things I never noticed before. Prado’s real love was never Fatima, his wife. It was a girl who he had loved since his school days. She went to the girl’s section of the one he had studied in. He told her everything. And then toward the end it was the beautiful Estifania, a resistance fighter who he drove over the border to escape from Salazar’s assassins. He fell in love with her, but their time together was not long.

“You’re too hungry for me. It’s wonderful with you. But you’re too hungry for me. I can’t want this trip. You see, it would be your trip, yours alone. It couldn’t be ours.” And she was right: you mustn’t make others into the building blocks of your own life, into water bearers in the race for your own bliss. 

There was a party at the family villa of the man he met on the train. They were aristocrats. Silveira invited him, he went, behaved like a clown and everyone fell into the mood. Why had he never done anything like that before? I remembered none of it. It was a refreshing chapter in an otherwise very formal novel.

I have finished. There is sadness in coming to the end. If someone had asked me how it ended, I would not have been able to say. I had forgotten the bouts of dizziness that had overcome Gregorious, the stopover at Salamanca to hear the lecture of Estefania Espinhosa, to visit with her. Nor did I remember the conversations they had.

He says goodbye to everyone he had met in Lisbon, revisits the places he had gone, and eventually returns to Bern. There he arranges with his friend and doctor, Dioxides, to visit a clinic where they will perform some tests to learn what might be the source of his dizziness.

What do they reveal? Does he return to the Gymnasium and resume teaching classes or to Lisbon where he settles to start a new life? The answers remain unknown, best left for readers who wonder about these things.

Can we better understand ourselves by studying the life of someone else is one of the central questions Prado ask in The Goldsmith of Words. The question leads Gregorious to abandon his post at the Gymnasium in a quest to learn as much as he can about Prado, his family, friends and life he led in Lisbon. But like the other questions in Night Train to Lisbon, it is never answered or ever considered by Gregorious.

All we know is how difficult it is to know one another or ourselves. We remain in the dark about our wishes and intentions and the sources of our actions. And indeed, we do not know if the stories we tell about our self are any truer than what others tell about us. Above all, as Prado wrote: Life is not what we live; it is what we imagine living.

These issues interests me and at the end, I knew no more about them than I did before I read the book the first time. Neither does Greorgious, I imagine. Perhaps a biographer might have view? Or Peter Beiri, the pen name of Pascal Mercier, as his novel is essentially the biography of Amadeau Prado, a fictional creation but one who is given a complete life on the page.


10.23.2015

Max Planck: The Tragic Choices

How do you decide to act when confronted by a morally objectionable situation? Do you remain silent, escape or resist? This general question is sympathetically depicted by Freeman Dyson in describing (New York Review of Books, 10/22/15) a recent biography of the German physicist Max Planck (Planck: Driven by Vision, Broken by War).

To provide a framework for his discussion, Dyson invokes the work of the economist Albert Hirschman in his book Exit, Voice, and Loyalty. According to Hirschman, when faced with a gross failure, say the war in Vietnam, individuals, especially those in positions of responsibility, have to chose between three alternative responses.

“Exit meant to quite the enterprise. Voice meant to stay on the job but speak out for a change of direction. Loyalty meant to stay on the job and give support to the continuation of failing policies.”

Consider the situation of the two German physicists, Max Planck and Albert Einstein after Hitler had come to power. Both had made significant contributions to physics and were close friends, yet they responded differently when Einstein had seen the disaster coming, he moved to America and never returned to Germany again.

Einstein chose Exit, while Planck chose Loyalty, choosing to remain in Germany throughout the war and lend support to Hitler’s policies, including the racial laws. Like most Germans, Planck never chose Voice, to speak out against Hitler. To do so meant suicide.

It was his allegiance to Germany, to German society and its history, even when it fell under the spell of a mad despot, that made Planck’s life such a tragedy. I am reminded of something Virginia Woolf once wrote about foolish loyalties.

You must rid yourself of pride of nationality in the first place; also of religious pride, college pride, family pride, sex pride and those unreal loyalties that spring from them.

I also find Hirschman’s tripartite classification of wide generality. Those who choose exit in response to a gross failure, say a bankrupt business or unjust situation, can have only a small effect. Those who choose loyalty act to maintain the situation. Only those who choose voice can have any impact on correcting mistakes and injustices. But they must be fearless and persistent in speaking out against them, even if there is considerable risk in doing so.

When each of us look at our life and the responses we have made to failed and unjust policies, we can have a better idea of whether we have or have not behaved in accordance with our beliefs and fundamental values. Have we acted in accordance or inconsistently with them? And what does this reveal about our character?

The words of Stephane Hessel in his powerful manifesto Indignez-Vous are a reminder of what is possible.

The motivation that underlay the Resistance was outrage. We, the veterans of the Resistance movements and fighting forces of Free France, call on the younger generations to revive and carry forward the tradition of the Resistance and its ideas. We say to you: take over, keep going, get angry! Those in positions of political responsibility, economic power and intellectual authority, in fact our whole society, must not give up or let ourselves be overwhelmed by the current international dictatorship of the financial markets, which is such a threat to peace and democracy....

It is up to us, all of us together, to ensure that our society remains one to be proud of: not this society of undocumented workers and deportations…not the society where our retirement and other gains of social security are being called into question; not this society where the media are in the hands of the rich.

The worst possible outlook is indifference that says, “I can’t do anything about it: I’ll just get by.”

10.18.2015

The Hunters

He was moving in a current of destiny quite alone, as alone as a man dying.”

The Hunters is James Salter’s first novel. It’s a moody novel, the mood is dark. Cleve Connell is one of a squadron of fighter pilots stationed at Kimpo Air Base during the Korean War. Their mission is to take on the North Korean MIGs.

There are endless days of rain, the missions are grounded, tedious days of boredom.

They watched the sky through dismal days. It was never blue. It was like a layer of grief. Almost unnoticed because it brought no change…The weather remained sullen. The rain fell drearily from swollen skies. It seemed as everlasting as the surf.

On other days the MIGs do not appear, they fly back to base, a wasted mission. Cleve is alone, trapped with a group of pilots who view him as a has-been. His vision is not what it used to be, his confidence is eroded and he is unlucky.

Open eyed on his cot, he suffered through the darkness. Then, more than at any other time, there was the constant feeling that he was being consumed, drained: and he did not know the extent of his reserves.

As his tour draws to a close, he and his wing-man Hunter fly well beyond the Yalu River, they remain in the area too long, and start back low on fuel. Cleve spots 4 MIGs, one of which is the dangerous “Casey Jones.” They follow him, Casey tries an impossible diving maneuver, Cleve somehow follows, shoots him down with a burst of his cannons.

…he had met and conquered a legend…victorious at last and feeling as little a desire to live as he had ever known.

He and Hunter run out of fuel, they try to glide back to base, Cleve makes it, but Hunter doesn’t, dies in crashing.

But Cleve’s camera failed to function, there is no way to confirm the kill. Cleve responds in a way he never imagined.

I can confirm it. Hunter got him…the sweeping magnanimity that accompanies triumph, but, as soon as he said the words, he realized there were no other that would have made it right.

Two missions later, a new wing-man loses sight of Cleve who does not return to base.

Death could be slighted or even ignored close by; but when the time came to meet it unexpectedly, no man could find it in himself not to cry silently or aloud for just one more reprieve to keep the world from ending.

The Hunters is exciting, tense, clouded by distress at Cleve’s plight. It also anticipates the many novels and short stories Salter would later write. The notes for the novel were written while he was serving as a fighter pilot in the Korean War. After it was published, he resigned from the Air Force to become a writer.

10.12.2015

The Nearest Thing To Life

Art is the nearest thing to life: it is a mode of amplifying experience and extending our contact with our fellow men beyond the bounds of our personal lot. George Eliot

I marvel at the depth and erudition of James Wood’s literary reviews in the New Yorker. His new book, The Nearest Thing to Life impresses me in the same way. The book is a blend of analysis and memoir drawn from some of his previous commentaries.

Wood retraces his youth in an intellectual and religious household in Durham, England. He describes how his discovery of literature liberated him from the hold of his churchgoing upbringing.

Literature, specifically fiction, allowed an escape from these habits of concealment… I still remember that adolescent thrill, that sublime discovery of the novel and the short story as an utterly free space, where anything might be thought, anything uttered.”

Throughout the book, Wood illustrates the way great literary writers are skilled in the art of noticing. What he calls the “life surplus of a story” consists in its details. The details are the instances that illustrate the more general form. He writes of Chekhov’s short story “The Kiss:”

Chekhov appears to notice everything. He sees that the story we tell in our heads is the most important one…for Ryabovich, his story has grown bigger and bigger and joined in real time the rhythm of life.”

For Wood, fiction allows us to see a life in all its “performance and pretense.” By noticing individuals carefully, we can begin to understand them. A reader would be wise to follow this practice in general.

In the last two chapters Wood recalls some of the books that meant most to him during his childhood. He also writes about the significance of leaving England for this country. He says he has made a home in this country, but not quite a Home. And he writes movingly about Edward Said’s essay “Reflections on Exile:”

Exile is strangely compelling to think about but terrible to experience. It is the unhealable rift forced between a human being and a native place, between the self and its true home: its essential sadness can never be surmounted. And while it is true that literature and history contain heroic, romantic, glorious even triumphant episodes in an exile’s life, these are no more than efforts meant to overcome the crippling sorrow of estrangement. The achievements of exile are permanently undermined by the loss of something left behind forever.

It is clear Wood also feels displaced and disconnected between two places, at home in neither, and now finds it difficult to return to the land of his youth. Many years ago he made a large choice,

… that did not resemble a large choice at the time; that it has taken years for me to see this; and that this process of retrospective comprehension in fact constitutes a life—is indeed how life is lived. Freud has a wonderful word, “afterwardness,” which I need to borrow, even at the cost of kidnapping it form a very different context. To think about home and the departure from home, about not going home and no longer feeling able to go home, is to be filled with a remarkable sense of “afterwardness:: it is too late to do anything about it now, and too late to know what should have been done. And that may be all right.”

Wood’s The Nearest Thing to Life is a beautiful book, filled with eloquent noticing, abundant literary references, a book to keep nearby, to turn to now and then.

10.05.2015

Oliver Sacks

You mustn’t confuse the poem with the poet. Thom Gunn

Early this year I learned that Oliver Sacks had terminal cancer (Times, 1/19/15). On Sunday (8/30/15) Sacks died. He was 82 and had lived a remarkably varied life throughout those many years.

At once the news saddened me. In On the Move, his recently published memoir, he describes his early life in England during the War when he was sent away to a cruel private school in the country, his studies at Oxford, where he obtained his medical degree, his mother (surgeon) and father (general practitioner) and his Jewish Orthodox upbringing, his brothers, one of whom was schizophrenic and then his migration to this country where he wrote most of his memorable articles and books.

Sacks used to swim a mile every, broke weight lifting records on Santa Monica beach and for a period experimented with drugs, including LSD and amphetamines, which he became addicted to for a while. He used to drive his motorcycle for miles every day, sometimes all day to Las Vegas, Death Valley, the Grand Canyon and back again at night.

There is a direct union with oneself with a motorcycle, for it is so geared to one’s proprioception, one’s movements and postures, that it responds almost like part of one’s own body. Bike and rider become a single indivisible entity…

Sacks was a deeply empathetic clinician who emphasized the importance of case studies. He argued this was essential to understanding individual lives, finding it useful in treating and explaining the disorders he sought to explain--migraines, Tourette’s syndrome, color blindness, autism, sleeping sickness and Parkinson’s.

Sacks devoted his life and writing to narrative medicine on these problems, relevant to both lay readers and medical professionals. In On the Move he wrote, “All sorts of generalizations are made possible by dealing with populations, but one needs the concrete, the particular, the personal too.”

Sacks learned much from his literary friendships with Auden, Thom Gunn and Jonathan Miller and in several respects his essays and journal articles are stories that read like fictional explorations. He attributes his great desire to write directly to his parents:

My mother was a natural storyteller. She would tell medical stories to her colleagues, her students, her patients, her friends. And she had told us—my three brothers and me—medical stories from our earliest days, stories sometimes grim and terrifying but always evocative of the personal qualities, the special value and valor, of the patient. My father, too, was a grand medical storyteller, and my parents’ sense of wonder at the vagaries of life, their combination of a clinical and a narrative cast of mind, was transmitted with great force to all of us.

When he learned he had terminal cancer he said he wanted to live in the months remaining to him “in the richest, deepest, most productive way I can.” There is little doubt he was able to do that, writing every day, continuing to publish articles, and books visiting his friends, and loved ones.

The act of writing, when it goes well, give me a pleasure, a joy, unlike any other. It takes me to another place—irrespective of my subject—where I am totally absorbed and oblivious to distracting thoughts, worries, preoccupations or indeed the passage of time.

In a review of On the Move in the New York Review of Books (5/21/15), Jerome Groopman concluded “Oliver Sacks inspired my efforts as a physician-writer, as he has for so many others. I am, in a sense, one of his students. Now, in settings like my seminar, his work inspires the next generation to think and create. I will add On the Move to our reading list. His writing, like the light from a distant star, will continue to illuminate the lives of his readers, long after its source is extinguished.”

I was struck by Sacks predominant feelings when he learned that he had terminal cancer. It was “one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and written. I have had an intercourse with the world, the special intercourse of writers and readers.”

I must remember that sentiment for in every respect I share them--gratitude for long life, a life of learning and advantage for as long as I can remember.