2023 L&H - Facilitator Notes
DECEMBER 13
Book: Toms River: A Story of Science and Salvation by Dan Fagin
Facilitator: Gretchen Case, PhD, MA
From Gretchen:
In Toms River: A Story of Science and Salvation, journalist Dan Fagin tells the Pulitzer-Prize winning story of this small community in New Jersey that found itself at the center of a legal battle over dumped toxins and cancer clusters. Toms River is nonfiction, but the people who are key to understanding this real-life story are described as thoroughly as any novel, and the dramatic arc is as compelling as any fictional narrative. Fagin’s deep reporting takes readers into a struggle for justice for the people, particularly children, harmed by corporate contributions to pollution and toxic waste. In discussing this book, we will address ideas of health and illness beyond the individual body, including how each of us interacts with our environment and depends on others to stay well.
NOVEMBER 8
Book: The Doctor Stories by William Carlos Williams
Facilitator: Hailey Haffey, PhD
Many people are familiar with the poem “The Red Wheelbarrow,” in which the speaker uses the shape of the poem (which looks like a wheelbarrow) along with powerful literary images to convey meaning:
so much depends
upon
a red wheel
barrow
glazed with rain
water
beside the white
chickens
While you may be familiar with the evocative lines of “The Red Wheelbarrow,” you may not know that its author was a physician poet. The modernist writer, William Carlos Williams, was born in Rutherford, New Jersey in 1883, attended the University of Pennsylvania, and practiced pediatric and general medicine near the place where he was raised. In addition to poetry and medicine, Williams also wrote short stories, which are collected in The Doctor Stories.
These stories provide an opportunity to explore clinical practice through Williams’ poetic lens that, like the wheelbarrow poem, illuminates crucial, qualitative factors in the everyday aspects of life. Central in the stories are the daily tasks of clinical work, to which he is keenly attentive, writing in his autobiography that “the actual calling on people, at all times and under all conditions, the coming to grips with the intimate conditions of their lives, when they were being born, when they were dying, watching them die, watching them get well when they were ill, has always absorbed me.”
This absorption is apparent as Williams brings this content to a new life through his surgical deftness with literary forms like metaphor and strategies like pacing. Such tools make these stories rich and vital as they explore the complex, healing, and sometimes troubling ways patients, caregivers, and clinicians experience health care—from how they express unexpected emotions to the diverse ways each person might feel the same passage of time. In his stories, we are able to see the results of Williams’ methods of relationality, as he writes, “I lost myself in the very properties of their minds: for the moment at least I actually became them, whoever they should be, so that when I detached myself from them at the end of a half-hour of intense concentration over some illness which was affecting them, it was as though I were reawakening from a sleep. For the moment I myself did not exist, nothing of myself affected me.” Thus, by reading these stories with attention to Williams’ seemingly religious experience of self-abandonment and recovery in his clinical work, we can understand the meaning behind his statement that “I have never felt that medicine interfered with me but rather that it was my very food and drink, the very thing which made it possible for me to write.”
OCTOBER 11
Book: Blood Orange Night by Melissa Bond
Facilitator: Sadie Hoagland, PhD
Melissa Bond's Blood Orange Night is a poetic memoir about her time as a new mother, when she was sleeping very little and her doctor casually prescribed her benzodiazepines. She takes them nightly, her body suffering consequences, until she collapses while holding her own child and learns that she has been overprescribed a medication that can be deadly to quit cold-turkey and that her journey to wellness will be a long one.
In a starred review, Publisher's Weekly says: “In this raw and captivating debut, journalist Bond chronicles her volatile descent into a benzodiazepine addiction... Pairing her unsparing candor with the same deep compassion she finds in the physician who helped her level out, Bond’s narrative casts a burning light onto the hazards of overprescribing and the threat it poses to vulnerable people. This cautionary tale stuns.”
Melissa Bond is also a Utah local, another reason to support this book and join the discussion!
SEPTEMBER 13
Book: Lessons in Chemistry by Bonnie Garmus
Facilitator: Rachel Borup, PhD
From Rachel:
Lessons in Chemistry is Bonnie Garmus’s bestselling novel about a brilliant research chemist, Elizabeth Zott, whose career is derailed by the rampant sexism of the 1950s and 60s. But career derailment is only the first chapter in Elizabeth Zott’s life. Her self-confidence undeterred, she reinvents herself as a popular cooking show host who uses her knowledge of chemistry and experience as a woman in a patriarchal culture to inspire broad social change. This novel is funny, fast-paced, and raises interesting questions about gender and careers in science.
AUGUST 9
Book: Braiding Sweetgrass: Indigenous Wisdom, Scientific Knowledge, and the Teachings of Plants by Robin Wall Kimmerer
Facilitator: Hailey Haffey, PhD
In medicine—and the world—today, we recognize sweeping disparities in health and well-being that draw our attention to the need to develop more equitable and sustainable systems. It stands to reason that to develop more equitable systems of human interactions with each other and with the earth, we need to bring new ways of knowing and reading the world into the equation. But what are these ways and how do we incorporate them? In Braiding Sweetgrass: Indigenous Wisdom, Scientific Knowledge and the Teachings of Plants, Robin Wall Kimmerer teaches us that the innovation we need is already at hand in long-standing Indigenous ways of knowing that have been persistently honored in Native communities but neglected (and rejected) elsewhere. Still, resilient and generous, Indigenous wisdom holds the potential for healing human relationships with others, with our damaged global environment, and with our own bodies. Kimmerer tells us that much of this wisdom emanates from an Indigenous story of the world’s creation—the story of a Skywoman who fell through a hole in the Skyworld and was spared from falling into the water far below by a gathering of animals. These animals’ offerings for the woman’s protection created an “alchemy of…gifts” that helped to create a new world on the back of a turtle, thus called Turtle Island. Kimmerer teaches us that as the woman fell from the Skyworld, she reached for and clasped parts of the Tree of Life, and she offered what she had held onto as gifts for the new island. After she scattered the offerings from her hand, the first plant to grow was sweetgrass. According to Kimmerer, this sacred plant holds the scent of the woman’s hand and became a ceremonial plant symbolic of stories and rituals of relationality. The rites of sweetgrass teach us how reading the world with new metaphors of interconnection, attention, and meaning is at the heart of the task of reimagining our global, collective future. Thus, Kimmerer explains that she braids this book like sweetgrass, “from three strands: indigenous ways of knowing, scientific knowledge, and the story of an Anishinabekwe scientist trying to bring them together in service to what matters most. It is an intertwining of science, spirit, and story—old stories and new ones that can be medicine for our broken relationship with earth, a pharmacopoeia of healing stories that allow us to imagine a different relationship, in which people and land are good medicine for each other.”
JULY 12
Book: The Body Scout: A Novel by Lincoln Michel
Facilitator: Gretchen Case, PhD, MA
Lincoln Michel’s The Body Scout: A Novel classifies itself in the subtitle, but readers and reviewers also categorize it as “Genetic Engineering Science Fiction” “Cyberpunk Science Fiction” “Speculative Fiction” and “Murder Thriller”—clearly, we’re going deep into imagined futures with this fictional work. Centered on a mysterious murder, this story dives into the possibilities and perils that come with a changing climate, repeated pandemics, and genetic modifications on human bodies practiced both openly and secretly. Oh, and baseball. Bring your most open mind and wildest imagination for this discussion of a world full of ethical conundrums that don’t exist…yet.
JUNE 14
Book: When We Do Harm: A Doctor Confronts Medical Error by Danielle Ofri, MD
Facilitator: Susan Sample, PhD, MFA
Is medical error really the third cause of death—ahead of breast cancer, stroke, Alzheimer’s disease, and diabetes—in the United States? This question haunted Danielle Ofri, a well-known, respected physician-author. A 2016 article in the British Medical Journal estimated that more than 250,000 deaths per year were caused by medical error. Ofri, an internist who has practiced 25 years at New York’s Bellevue Hospital, was concerned that, if true, this fact pointed to a public health emergency. It also was one she didn’t yet see in her own practice. After years of research and interviews, Ofri shares her findings in When We Do Harm. As in her previous books, Ofri tells the stories of real patients—Jay and Glenn, as well as her own teenage daughter who unexpectedly became a patient during this period—to illustrate the many facets of this complex question and to propose not one answer but a combination. She suggests practical, operational responses in addition to less tangible recommendations, including changes in clinical reasoning, intellectual humility, and improved communication. These, she writes, will depend upon people who “exemplify these traits, teach these skills, and demand comparable behavior from their colleagues.” As you read, consider your roles in the health-care community—provider, patient, family member, educator, student, business professional—and how these affect and are effected by medical error, and how we each can contribute to lessening the impact of this serious problem.
MAY 10
Book: The Body Keeps the Score by Bessel van der Kolk, MD
Facilitator: Mark Matheson, DPhil
I look forward to gathering with you and discussing Bessel van der Kolk’s The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. The book is something of a phenomenon. Though published in 2014, it’s enjoyed remarkable popularity over the last three years, and it continues to be on the top-ten New York Times bestseller list, with its run now at 135 weeks. I think we ought to discuss what this demand for the book suggests about our larger cultural moment. The text itself is lengthy and dense, filled with medical studies, stories, and case histories from Dr. van der Kolk’s clinical experience, and the evolution of his own understanding of trauma. One goal for our discussion might be to establish the paradigm view of trauma and its healing that emerges from the book—and then to consider how compelling we find it. The text relates the traumas of war veterans, abused children, and victims of domestic violence, and it explores how these overwhelming experiences are imprinted in the body. Dr. van der Kolk’s analysis points to a wide range of possible therapies for healing such trauma, including mindfulness, yoga, and theater. I think it will be rewarding for us to consider both the argument of the book and the prominence of trauma as a concept in current medical practice and our cultural understanding of human experience.
APRIL 12
Book: Joan is Okay: A Novel by Weike Wang
Facilitator: Rachel Borup, PhD
As a Chinese-born American, raised with training in public health and creative writing, Weike Wang is the perfect person to tell the story of Joan, a hard-driving Chinese-American attending physician in a New York ICU, who has checked all the boxes of career success but still wonders whether she’s living her best life. Whether she’s OK. The novel, Joan Is Okay, investigates issues such as the de-humanizing potential of a career in medicine, the challenges of being an immigrant in the U.S., and the difficulty of balancing a personal and professional life, especially for women. Add to this mix, the beginnings of the Covid-19 pandemic and Joan’s acerbic wit, and you have an entertaining and thought-provoking novel that is both funny and serious.
MARCH 8
Book: The Heart of Caring: A Life in Pediatrics by Mark Vonnegut
Facilitator: Mark Matheson, DPhil
Mark Vonnegut is not the first to warn that “[t]he current conflict between the money of medical care and the mission of medical care is a major public-health issue.” He is, however, a talented storyteller who draws upon more than 40 years as a practicing pediatrician to support his argument. The myriad short chapters that make up his memoir range from poignant stories of patients he treated to stinging criticism of the corporatization of health care to pithy, ironic wisdom gleaned during his 75 years, including memories of his well-known father, novelist Kurt Vonnegut. We’ll begin our discussion by sharing chapters that had the most impact on each of us and entertaining questions we’d like to pose to the pediatrician-writer.
FEBRUARY 8
Book: True Biz by Sara Nović
Facilitator: Sadie Hoagland, PhD
Sara Nović’s novel True Biz begins with the evocative image of a nine-year-old girl stabbing herself in the ear with a pencil. The nine-year-old girl’s name is February Waters and she’s a CODA, a child with deaf parents. She’s also the headmistress for the River Valley School for the Deaf, the setting for most of True Biz - an expression in ASL that translates to something like “seriously.” The book follows several characters as they navigate their identities in relation to Deaf culture, including February who is trying to save the school from closure; Charlie, a student who has a botched cochlear implant and parents who were told not to teach her ASL; and Austin, a fifth-generation deaf student who has grown up largely without stigma. Another thread is the disturbing and true Advanced Bionics case in which dangerous side effects of cochlear implants were ignored, and which helped to inspire the book.
The New York Times writes that “True Biz is moving, fast-paced and spirited — we have vivid access to all of the main characters’ points of view — but also skillfully educational: The lessons Charlie learns about A.S.L. and deaf culture are interspersed in the text and illustrated by Brittany Castle. Nović, who is deaf and spent time at deaf schools researching the novel, makes an urgent and heartfelt case for the schools’ importance in providing language access, and in nurturing community and a sense of self.”
In summary, this book should provide a great discussion!
JANUARY 11
Book: Together: The Healing Power of Human Connection in a Sometimes Lonely World by Vivek H. Murthy, MD
Facilitator: Mark Matheson, DPhil
I was struck back in early 2018 by the announcement that Great Britain was appointing a Minister for Loneliness. A 2017 study revealed that 9,000,000 people in that country said they were ‘often or always’ lonely. Over 200,000 older people had not had a conversation with a relative or friend in over a month. This was before the pandemic. The New York Times article that reported the action by Britain’s government also mentioned an article in the Harvard Business Review by Dr. Vivek Murthy, who addressed how workplaces could be more effective in preventing people from becoming lonely. Dr. Murthy had been Surgeon General of the United States during the Obama administration, and he has now been reappointed to this position by President Biden. In 2020 Dr. Murthy published a book based on his sustained interest in loneliness and its effects on health: Together: The Healing Power of Human Connection in a Sometimes Lonely World. It’s this text we’ll be discussing at our January meeting. Dr. Murthy writes about the causes that have made loneliness a public health crisis, how it interrelates with broad issues like social media and political polarization, and how the problem might be successfully addressed. I look forward to hearing your responses to Dr. Murthy’s analysis--and about your own experiences with patients and others for whom loneliness is a serious health concern.