Seveneves, by Neal Stephenson

I have liked Mr. Stephenson's novels. Cryptonomicon is one of my favorite books. In fact, this is the first of his books that I did not much enjoy.

All of Mr. Stephenson's books are lengthy.  The problem here is that only about 300 of the 880 pages in this book interested me.

The story line is good: the moon is broken apart and within a short time will rain destruction on the earth. It won't be safe on the surface for thousands of years. Add ons to the International Space Station become a hope for mankind's long term future. Drama ensues initially, and later in the book, as we fast forward 5,000 years, drama ensues again.

Overall too much detail about uninteresting things.

This could have been a multi-volume work, with shorter and more interesting discussion of mine- and submarine -based survivalists, along with the first parts of the story about the space station, and a dedicated book about the far future situation that better develops the human interest aspects of the political structure that evolved.

But it is what it is, and that is, the first of Mr. Stephenson's books that I actively recommend against reading.


Seveneves: A Novel

When to Rob a Bank, by Steven Levitt & Stephen Dubner

It turns out that if I had been reading the authors' Freakonomics blog all along, I'd have had no reason to read this book. It is a sampling of 132 blog entries.  But ha! The last laugh is on the authors, as I read a copy of the book borrowed from my local public library and not purchased! (See also their blog entry, "If public libraries didn't exist, could you start one today." [p14.] I guess they're okay with it either way.)


When to Rob a Bank: ...And 131 More Warped Suggestions and Well-Intended Rants

Sapiens, by Yuval Harari

Sub-titled, "a brief history of humankind," Sapiens is a macro level view of the origin of our species. It is one of the more interesting of such books that I've read because Professor Harari has a great writing style and keeps things on pace. He does have a transparently cynical nature though, which comes through repeatedly. The general tone is, with all our cognitive ability and technological ability to harness materials in innovative ways, humans are trending towards destroying the earth rather than towards improving the planet.

Even the agricultural revolution, which you might think of as a positive because it increased the amount of available food, had the cost of population explosions (with resultant health disasters due to poor hygiene and overcrowding) and the formation of a class system ("pampered elites") thus leading to an oppressive society rather than the egalitarian one of nomadic subsistence.

I've made is sound as though Professor Harari beats one over the head with a hammer with this sort of stuff and that is not the case; he uses a small and painless mallet for these occasional comments. But at the end I found that he'd made quite the case. Not that I'm eager to collect nuts and berries, but from a planetary macro perspective, he may well be right.

In my view it is worth reading.


Sapiens: A Brief History of Humankind

Don't Shoot the Dog!: The New Art of Teaching and Training, by Karen Pryor

This book isn't really about dog training.  I don't own a dog and don't plan to. The only reason I read this book was that it was recommended by Tim Ferriss (in a podcast, blog post or tweet - I can't recall which). So if you don't have a dog or other pet please don't let that get in the way of reading this really interesting and entertaining book.

What it is about is behavioral training. She uses her experiences training all sorts of creatures (from fish and aquatic mammals to horses, fish and humans) using only positive reinforcement. She covers the gamut of methods to stop unwanted habits (but only recommends a few of them).

By the end of the book her messages all come together in a better understanding of the use of a clicker in animal training and insights into the positive only training techniques that she endorses.

This book seems a good read for anyone, pet owner or not. Highly recommended.

(By the way, there's a newer edition of the book than the one I borrowed from my local public library.)

Don't Shoot the Dog!: The New Art of Teaching and Training

The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom, by Jonathan Haidt

Dr. Haidt's book is a delight.  The bulk of it is spent introducing and elaborating upon the notion that people have a duality, which he refers to as the elephant and its rider.   The elephant was "shaped by natural selection to trigger quick and reliable action, and it includes parts of the brain that make us feel pleasure and pain ... and that trigger survival-related motivations."  The rider is the controlled system, which Dr. Haidt positions as more of an advisor. And so he quotes Hume: "Reason is, and ought only to be the slave of the passions, and can never pretend to any other office than to serve and obey them."

This isn't a philosophy text, so Dr. Haidt provides clear references of scientific experiment to support his points.  All very interesting, but I got some unanticipated insights from the book as well.

I hadn't a very clear perspective on the value of a fixed moral guideline (as typically provided by religions) compared to an ethical humanist's approach to behavior.  Let me quote Dr. Haidt from the conclusion to this section of his book - and when you read this, consider that he self identifies as a liberal and an atheist:

"I believe that we have indeed lost something important - a richly textured common ethos with widely shared virtues and values. Just watch movies from the 1930s and 1940s and you'll see people moving around in a dense web of moral fibers: Characters are concerned about their honor, their reputation, and the appearance of propriety. Children are frequently disciplined by adults other than their parents. The good guys always win, and crime never pays. It may sound stuffy and constraining to us now, but that's the point: Some constraint is good for us; absolute freedom is not."

Then, quoting from sociologist James Hunter 's book The Death of Character:

"Before the Industrial Revolution, Americans honored the virtues of 'producers' - hard work, self-restraint, sacrifice for the future, and sacrifice for the common good. But during the twentieth century, as people became wealthier and the producer society turned gradually into the mass consumption society, and alternative vision of the self arose - a vision centered on the idea of individual preferences and personal fulfillment. The intrinsically moral term 'character' fell out of favor and was replaced by the amoral term 'personality.'"

 If the book concluded after these two big themes - explaining the elephant and rider metaphor and its implications, and discussing the broader context of human behavior - I'd have been delighted.  He continued, however, to discuss divinity, virtue, and the meaning of life.  Which fits the title, but I didn't find these sections quite as engaging.  Still I heartily recommend the book.


The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom

Prevent and Reverse Heart Disease, by Caldwell Esselstyn

This is a terrific book.  It does not reflect generally practiced medical care in the US.  Because, as Dr. Esselstyn says, "I believe that we in the medical profession have taken the wrong course.  It is as if we were simply standing by, watching millions of people march over a cliff, and then intervening in a desperate, last-minute attempt to save them once they have fallen over the edge. Instead, we should be teaching them how to avoid the chasm entirely, how to walk parallel to the precipice so that they will never fall at all."

The precipice that he's talking about is coronary artery disease.  Here's more from Dr. Esselstyn on this:

"The United States spends more than $250 billion a year on heart disease. ... But here is the truly shocking statistic: nearly all of that money is devoted to treating symptoms.  It pays for cardiac drugs, for clot dissolving medications, and for costly mechanical techniques that bypass clogged arteries or widen them with balloons, tiny rotating knives, lasers, and stents. All of these approaches carry significant risk of serious complications, including death.  And even if they are successful, they provide only temporary relief from the symptoms.  They do nothing at all to cure the underlying disease or to prevent its development in other potential victims."

The first part of the book explains the medical research and science behind his reasoning, in a clear and simple fashion that any layperson could follow.  The second part includes recipes and ideas for how to deal with meals.

The only problem is following Dr. Esselstyn's advice, because he strongly asserts that moderation is a killer.  To effectively reverse (or prevent) heart disease, he says you must avoid meat, poultry, fish, dairy products - so far, not that difficult - and also avoid oil, of any kind, as he says, "not a drop." That's tough.  And, generally, you can't eat nuts or avocados.   Oh, and whole grains not processed grains.

There's the rub for me and for many vegans:  the combination of oil and processed grains are the foundation of our ability to eat a (nearly) whole food plant based diet.  According to Dr. Esselstyn's research though, it is really important to cut out those fun, oops, I mean those deadly, items as well.  All of them.  Fortunately, the second part of the book has ample advice to deal with this.

All it takes, according to Dr. Esselstyn, is three months of eating this way to remove the desire for fats (oils) and other delicious (I mean deadly) foods.

Related titles include:  The Starch Solution by John McDougall MD, Whole: Rethinking the Science of Nutrition, by T. Colin Campbell PhD, and also his book The China Study, The Spectrum by Dean Ornish MD, and this one from a more popular writer, former professional athlete and fireman, and Dr. Esselstyn's son, Rip: My Beef With Meat.


Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure

Over-diagnosed: making people sick in the pursuit of health, by Gilbert Welch

Everyone should read this book, but I fear that few will.  Partly because it is perceived as a difficult topic.  No worries there:  Dr. Welch and his co-authors make this as easy and straightforward a read as possible.  Even if you barely passed high school biology or math, you'll have no problems here:  the science is simple, the statistics are very clearly explained.

Another reason folks might not read this is that they are comfortable delegating their personal health decisions to physicians.  The facts indicate that this is not a good plan.  The whole point of Dr. Welch's research is that physicians often do things that provide no statistically significant improvement to lifespan but do have a statistically significant likelihood of negative side effects.

If your auto mechanic suggests an expensive diagnostic for your engine when you bring your well-running car in for a routine oil change, and then suggests a follow on test because the first was inconclusive, and these are expensive tests, and there's a chance that your engine will be ruined by the testing, you might want to have a better sense of what's going on.  If all this happens while your car is running perfectly well, with no symptoms of trouble, then you're in a situation quite analogous to the superfluous diagnostic medical scanning that Dr. Welch writes about.

Dr. Welch is careful to not pick on his colleagues.  Although he does note that a physician's primary sources of information tend to be funded by drug companies or medical equipment manufactures. In addition, there are many economic reasons to ignore science and statistics, sub-conscious or not.  A big factor is that a doctor, like anyone else, is often most comfortable with the "old wives tales" that they know.  This sort of thing has gone on for centuries.  One example, not from the book, is that of Dr. Ignaz Semmelweis.

Semmelweis noticed that mothers would give birth in a hospital's obstetrical clinic only to die of puerperal fever soon after -- with a mortality rate of 10% to 35%.   That's a scary amount of preventable death for a hospital.   He determined that if doctors would wash their hands with a chlorinated lime solution (similar to today's anti-bacterial soaps), they could take the mortality rate down to below 1%. You don't need to be a doctor nor a statistician to see that this is a good deal.  So what happened?

In spite of published facts, Semmelweis' observations conflicted with the established, normative medical practice of the time.  So his ideas were soundly rejected.   It took about 20 years before Dr. Joseph Lister succeeded in getting doctors to accept the science, and only then because he built on the concepts that Louis Pasteur introduced.   Most folks have heard of Listerine mouthwash, named after Lister. Nothing is named after Semmelweiss.   But lots of women died in those intervening years.

I use this example because it is so very obvious to us today that one should wash one's hands -- and yet, it took decades to get doctors to do it.  It is difficult to realize sometimes that throughout history scientists have been labeled heretics because their data did not conform to then-current practice.  In the 21st century we tend to feel as though every problem has been solved, and that we've got it all right. But maybe not so much, and Dr. Welch's book points out clear examples of facts not convincing physicians.  This problem of normal practice not aligning with the facts, but going on anyways, is old news.  It happened to Galileo, who had the audacity to propose that the earth rotates around the sun.  It happened to Semmelweiss, and many others.  And as Dr. Welch's book makes quite clear, it happens yet today.  

Okay, so back to the book for some modern day examples.  Back in 1996, the US Preventative Services Task Force (USPSTF) recommended against routine obstetrical ultrasound.  Why?  Because they found that there is just no substantive benefit.  The highly respected Cochrane Collaboration (which eschews any financial support from drug firms or equipment companies) agrees.  But every single expectant mother that I have met since 1996 gets an ultrasound; I bet that's true for you too.   The USPSTF has given up on the topic, because they recognize that this unhelpful and potentially negative scanning procedure is such a common practice that no one would listen to them anyway.   [pp112-113] Yikes.

But there's more.  Also in 1996, the USPSTF recommended against routine fetal monitoring (the belt put around an expectant mother to monitor the about-to-be-born baby's heart beat).   Once again, the Cochrane Collaboration agreed, noting that monitoring increased C-section rates by 66%, and that the risk of that to baby and mother is enormously worse than the potential benefit.  What is that benefit?

About one in a thousand babies would avoid a (non-fatal) seizure compared to two in a thousand without the monitoring.  A one in a thousand change.  But even then, no improvement in baby's health as measured by Apgar score, respiration, pulse, conditions like cerebral palsy, need for ICU - nothing.   Yet, again, it is such a common practice that the agency feels it would be tilting at windmills to try to change it (even though doing so would clearly, from the numbers, save lives and reduce negative side effects).  [pp105-106]  Did I say, Yikes?

There's lots more in the book, from mammograms to PSA tests to blood pressure and diabetes.

By now you should be considering that there is real value in reading this book, if only to make us better informed consumers of the medical industry.

Dr. Welch has done an extraordinary job of stating the facts, acknowledging the ambiguities, and making it clearer for individuals to understand the tradeoffs of their diagnostic scanning choices.   Even if you continue to use screening that the facts might indicate you oughtn't, you'll have a better understanding of what the issues are.

Overdiagnosed

Whole: Rethinking the Science of Nutrition, by T. Colin Campbell

Read this book.

This is a very different book than Dr. Campbell's influential, "The China Study,"although it references his prior work.  In this book, Dr. Campbell covers four inter-related topics:

1. The whole food, plant-based (WFPB) approach to nutrition.   Here, Dr. Campbell gets to the bottom line of "The China Study" very quickly, in easy to understand language.   It is very brief.  If you're not familiar with WFPB, here's a description of it as an "alternative" treatment to costly drugs, with their dangerous side-effects:
   
   "...[WFPB] would typically resolve the root cause of the disease fairly quickly, thus ending all symptoms and increasing their life expectancy and the quality of that life.  Side effects would include achieving their ideal weight, having more energy, looking and feeling better, and even helping to preserve the environment and slow global warming."
   
   Sound crazy?   As Dr. John McDougall often says, why is it a crazy alternative therapy to try eating well but a perfectly acceptable therapy to crack open someone's chest and run their blood through a machine while sewing a piece of artery to their heart?
   
   There's ample scientific evidence to support the claims in Part I of the book.  And in work by Dr. Esselstyn, Dr. McDougall, and Dr. Ornish (who also has a more science -oriented website).


2. In Part II, Dr. Campbell explains reductionism and how it gets in the way of evaluating breakthrough science.  In short, it means that researchers might notice that apples seem like healthy eating.  They notice there's vitamin A in an apple.  So they look at the health effects of vitamin A, with a goal of making a vitamin A pill that will provide the healthy effects.  Presumably without the hassle of eating the apple.  But, unfortunately, all sorts of systems get in the way of this working out the way a pill lover might like.   All of which is clearly explained.


3. Part III might make you cynical.   Dr. Campbell exposes the financial systems that affect how health care is delivered.  Or, as he says, disease care.  As they say, just follow the money.


4. Part IV might make you even more cynical.   He exposes the funding behind the big medical charities.   Not that the participants are evil, but the driving forces are clearly not in line with helping folks.   Dr. Campbell also points out the messaging that pervades the media -- that you're a victim of environmental toxins and bad genetics -- but that one day a magic cure pill will be invented to save you.   Dr. Campbell refutes that messaging, suggesting that a huge number of people can take responsibility for their health via a WFPB diet and diminish the odds of disease (even in cases where the genetics are against you).  

If you just want to understand the basis of WFPB eating and why it helps, there are easier books to read:  Rip Esselstyn's "My beef with meat," or Dr. John McDougall's "The Starch Solution"would be at the top of my list.    If you want to understand why the mainstream of big pharma -funded organizations, from medical to charity, don't want to highlight this free alternative to drug and medical therapies, then Dr. Campbell's book is for you.

By the way, this WFPB model of nutrition is not easy to do!   Why?   First, our training:  I have years of experience enjoying steak and that isn't easily overcome; I suspect it is even worse for cheese addicts!    Second, restaurants are tuned up to provide the Standard American Diet (SAD), which makes eating out a chore.   Third, you'll never see a TV or magazine add that doesn't promote some aspect of the SAD nutritional model, so there's constant reinforcement for bad habits.   Finally, there's so much money made by the dairy, meat, and pharmaceutical industries that their ability to fund ads, contribute to politicians in return for key appointments, fund medical journals, research grants, and the like, is pretty much infinite.    So even though I first read "The China Study" back in 2008, I'm still not 100% there with WFPB.   Yikes, that's just not smart.

Whole: Rethinking the Science of Nutrition

An aside about genetics.  When folks like Angelina Jolie make a public statement about their decision (in her case, to undergo a "preventative" double mastectomy because of fear that eventually she might contract breast cancer due to the detection of a mutated BRCA1 gene, it will just encourage people to follow her role model and mutilate themselves out of fear.   Gosh, why so harsh?  Look at one of the topics that Dr. Campbell discusses in this book; it is about a different gene but the lesson is the same.

The punch line of this particular study [1] is much easier to follow than the title:  146 patients showed metastasis (cancer) in the sentinel lymph node.  So standard medical practice is to cut:  remove the lymph glands.  Side effects?  Yikes.  Like maybe the loss of the use of your leg for a year, for starters.  (Chemo therapy also is indicated with all sorts of horrid effects.)  Sounds bad, but necessary, right?  Back to the study: the doctors dutifully cut all 146 patients.  But then, the removed lymph glands were examined.  Only 20% had cancer cells.  Which implies that 80% had an over-aggressive, if not unnecessary, surgery.    

So if you're one of those 80% (in this example) who even with a genetic disposition or even with a demonstrated appearance of cancer cells, can do just fine without radical surgery, then it sounds like you'd want to avoid that surgery.  Right?  But standard medical practice would just cut.   And (anti-) role models like Ms. Jolie would encourage you to cut even before the appearance of symptoms.   Golly, that seems way more harsh.   Maybe better to get ahead of the genetic predisposition by using the WFPB approach to nutrition.

[1] Dewar, D. J., Newell, B., Green, M. A., et. al., "The microanatomic location of metastatic melanoma in sentinel lymph nodes predicts nonsentinel lymph node involvement," Journal of Clinical Oncology 22, no. 16 (2004): 3345-49.

Feynman, by Jim Ottaviani and Leland Myrick

I'm feeling pretty positive about the day; having stumbled upon this book at the local public library this morning, I'm celebrating my good fortune.    Because this is one of the most interesting biographies I've come across.

Now any biography about Richard Feynman is apt to be interesting:  Nobel Prize winner, somewhat of a whack job, he was famous for probing questions in directions no one else considered.   If you're interested in physics, Feynman is a hero.

What makes this biography stand out is the approach:  it is in graphic novel format.   (As my spouse said, "you're reading a comic book?")    This really works.  It works incredibly well.

If you have any interest in science (especially physics) and in getting a sense of the personality of one of the 20th century's top American physicists, read this book.   You're going to want to follow up by reading Feynman's "Surely You're Joking, Mr. Feynman! (Adventures of a Curious Character) "   And, if you have the scientific background (or stamina), the first six chapters of his "The Feynman Lectures on Physics " is available as "Six easy pieces:  essentials of  physics explained by its most brilliant teacher."





By the way, in case you're curious about the other American scientists honored on the US postage stamp besides Feynman, they are:   Barbara McClintock, an early geneticist (whose work on maize makes me wonder if she was the innovative mind that inadvertently led to GMO crops, just as Feyman and others working on the atomic bomb with reservations afterwards about the long lived impact of their efforts);  Joshiah Gibbs, who received the first doctorate in engineering (1863) in the USA and invented vector calculus (a painful topic for some folks who struggled through differential equations);  and John von Neumann, (born in Budapest but the US takes credit for him!) who did so much breakthrough work in math, statistics, physics and computer science that I wouldn't know where to begin to describe him .

Blink, by Malcolm Gladwell

I'm of two minds in critiquing this book:  it is extremely interesting and introduces a powerful topic in a clear and well written fashion.   But it also feels as though it is a collection of say three or four magazine articles, and I'd probably have gotten 85% of the value by reading just one of those articles.

Yet, if the tradeoff for you, dear reader, is to read this or miss out on the information, then by all means read it.    It is a fast book, and held my interest on almost every page.

Oh, so what's the key message:   much like the key message of Galvin De Becker's "Gift of Fear,"  Mr. Gladwell points out the importance of immediate, gut feel impressions.   Importantly, Mr. Gladwell explains why this is so.

The Starch Solution: Eat the Foods You Love, Regain Your Health, and Lose the Weight for Good!, by John McDougall

If you want to improve your odds of living without the symptoms of chronic disease, presented from a honest, fact and research based, non profit -oriented perspective that is focused only on your health, then read this book.

The punchline is in the title:  humans can optimize their health through a starch -based diet.  For example, rice based (as in many Asian cultures) or root vegetable based (e.g., potato) (as in some Latin American cultures).   So instead of saying:  "don't eat animal proteins for health reasons and here's your unsatisfying salad," Dr. McDougall might say "don't eat animal proteins for health reasons and here's your quite satisfying bowl of rice decorated with an assortment of vegetables."

Throughout the book Dr. McDougall posits a simple question:   is there truth in what we hear about healthy eating from advertisements (like "milk makes bones healthy") or from the USDA (the food pyramid)?   Finding the answer requires wading through an enormous number of research papers published internationally.   Finally, once he identified fact based positions, how could he present this information to the general public who would not be inclined to read medical research papers?    This book is the outcome (with tons of references for those of us who actually like to read the research reports).

Probably most folks would be surprised by the facts, and even more folks wouldn't like the facts because they're not fun.   (Just like smokers who'd rather not hear the facts about smoking and lung cancer, for folks who've spent their lives enjoying cheese products, they'd probably prefer to just not listen to the facts about them.)

Here's a sample (the editorializing tone is more mine than Dr. McDougall's, although I doubt he'd change much):

• Milk does not "do a body good."   It is really bad for you (unless you're a calf).   As for the calcium scare, you don't need milk (nor supplements) for calcium.  In spite of all the advertising (which also influences our physicians, if like most they are not nutritionists). 
  
  Calcium is a mineral; it is not generated by the cow.   The cow eats vegetation, and picks up its minerals through its food, which then make their way to its milk.    Bottom line:  the bad that milk does outweighs any good, and calcium isn't an issue if you eat even a small amount of healthy vegetables.
  
  Why does this seem so unbelievable?   Because the dairy industry spends tens of millions of dollars each year on advertising, which then enters the popular belief system.   Advertising from folks who make a profit on a product should not be assumed to be accurate.   Ask the Marlboro man.


• The US Department of Agriculture (USDA) publishes the food pyramid (renamed the food plate recently); how could we doubt that the government has our best interests in mind?    The USDA serves the agriculture industry.   Many decades ago, when family farms were a norm in America, they served a large portion of our population.   Today, when agribusiness's massive firms control the bulk of American agricultural production, the USDA leadership (not the helpful employees; our local USDA guys provide excellent assistance to small farmers and ranchers) largely serve big business.  
  
  You might be surprised that lawsuits filed against the USDA have been won, pointing out the hidden connection between lobbyists and USDA decision makers (or the revolving doors between big business and the USDA appointments).
  
  Bottom line:  the USDA dietary advice is neither accurate nor helpful.


• Supplements, from vitamins to flax seed to Omega acids, are largely unnecessary.  But they're profitable.

You can see the many problems that Dr. McDougall faces.   He's trying to use facts to fight the misinformation generated by huge advertising and lobbying budgets.  The medical establishment, either through the profit motive of current practice and pharmacology or through the ignorance of the body of research, is at best disinterested in the topic.   And worst, he's telling us the facts, which aren't particularly fun for folks who've invested a lifetime of enjoyment of cheeseburgers, yogurt, or mac and cheese!

In spite of these obstacles, Dr. McDougall does an excellent job of minimizing the ranting, maximizing the clear and straightforward presentation of facts, and providing impeccable scientific references.

His publisher probably figured out the orienting this book towards weight loss would help sell more copies.  But it is really about extending quality of life without chronic illness.   That's probably why folks like Dr. Caldwell Esselstyn (whose famous work at the Cleveland Clinic includes showing that diet can reverse heart disease) and Dr. Neal Barnard (of the Physicians Committee for Responsible Medicine) are supporters.

I'll diverge to say more about Dr. Esselstyn.  Because while Dr. Barnard does outstanding work, sometimes his association with people who avoid animal products on an ethical basis can cause folks to ignore his strong, research -based and anti -big business efforts.   In contrast, publically Dr. Esselstyn is all and only about providing beneficial, fact based health care to his patients.

Consider his 2010 editorial in The American Journal of Cardiology,106-6, , was titled "Is the Present Therapy for Coronary Artery Disease the Radical Mastectomy of the Twenty-First Century?" It is a scientific attack on the profitable and neo-traditional approach of surgery for heart disease.   The American Journal of Cardiology charges a hefty fee for a reprint, but you can read the article for free, here.   Here are some of his opening paragraphs, footnotes removed, and emphasis mine:

"To fully grasp how so many smart, right-minded people could get it so wrong, it might help to start with a quick review of medical history. Take the radical mastectomy, conceived by William Halsted in the late 19th century. The procedure was intended to remove all cancer cells of the breast, the overlying skin, the underlying muscle, and regional lymph nodes (Figure 1). It was mutilating, permanently disfiguring, and no more effective than less radical, less disfiguring procedures.

Still, because of the prestige and respect Halsted commanded as a teacher of surgeons, his disciples defended and taught the radical mastectomy at the most revered medical colleges. His extreme surgery was perpetuated for almost a century, until challenges by courageous physicians in Europe and America, along with a prospective randomized study by Dr. Bernard Fisher, finally sounded the death knell of this standardized surgical error of the century.

The 21st century analogue to this unfortunate chapter is the interventional and pharmaceutical treatment of coronary artery disease. This approach results in significant mortality, morbidity, and unsustainable expense. Neither the procedures nor the drugs that accompany them treat the cause. Standard care for coronary artery disease is nothing more than palliative. The purveyors of this treatment acknowledge that it is but a stopgap therapy.

And as in the case of the radical mastectomy, there is a far more effective, cost-effective, and sustainable treatment. It’s simple: advocate a lifestyle of plant- based nutrition, make a bold leap toward a world free of heart disease, and lessen our use of scalpels and drugs."

In Pursuit of the Unknown, by Ian Stewart

The sub-title is "17 equations that changed the world."  I was very optimistic about Professor Stewart's book and really wanted it to be great.   Sadly, that was not to be.

Why not?   With few exceptions, Stewart failed to make the complex equations understandable.   It is pretty easy to explain Pythagora's theorem.   Logarithms too, although the author didn't do a great job.  By the time we got to Euler's formula for polyhedra, things were going downhill at an alarming rate.

In fairness, it isn't easy to explain all these equations in lay terms.   But also in fairness, that was Stewart's mission; the job he took on and he failed at it.

The good news:  some interesting commentary about the figures behind the equations.

Don't waste your time, though, unless you're extremely well grounded in mathematics.

ISBN 0465029736

59 Seconds: Change Your Life in Under a Minute, by Richard Wiseman

This book could be described as what should have been a collection of magazine articles about popular psychology.   It discusses experiments around what makes an individual likable, what to put in your wallet to increase odds of it being returned if lost (a photo of a smiling baby), and the like.

Given this topic set and that Mr Wiseman writes specifically about what makes people positive about something (e.g., negative gossip gives a bad impression of the gossiper) it was astounding to me that he chose to alienate more than 50% of his US audience.   How so?   A rude remark about former President Bush.

How does this bother more than 50% of the audience?   Part of it is because the author is British.   He's annoyed two groups, the "We liked Mr Bush,"  and the "He may not have been great, but he's our not great."   I assert that this covers a large percentage of his American readership.

This is a massive turn off.   Don't buy the book.

Through the Language Glass, by Guy Deutscher

The sub-title is, "Why the world looks different in other languages."   In it, Mr Deutscher discusses linguistics in the context of cultures.

By page 77 it occurred to me that my prior decisions to not study linguistics were well founded.  By page 146 I became convinced that most introductory linguistic texts are rampant with pseudo-science, again confirming the good decision to have avoided the topic this long. 

By the end, page 232, I knew that I deserved a stiff drink but that a coffee might be preferable given how sleepy I was.   And I wasn't looking forward to either the epilogue or the appendix.

101 Things You Need to Know, by Tracey Turner & Richard Horne

This book, I didn't realize until I picked it up from the library and started reading it, is optimized for middle -schoolers.   With chapters like, "what makes farts so smelly."   That said, it was still fun for me to read; mostly science facts presented in a light hearted way.

Toward a Zero Energy Home, by David Johnston & Scott Gibson

This is a terrific book: interesting, credible, thought-provoking. Reading it made me very interested in building a near-zero energy home, or at least in understanding even more on the topic.

How Doctors Think, by Jerome Groopman

This was a disappointment: it was painful to read and it lacked useful and well organized information.

Why painful? The author makes his points through anecdotes which are invariably depressing. Attribution error leads to mis-diagnosis: the patient looks a certain way which distracts the physician from even considering other causes then the most obvious. This is similar to the mental prototypes that get in the way of complete diagnoses. Then there's diagnosis momentum, where a choice is made and rationalized even as conflicting data, e.g., test results, appear. People are ignored, erroneously diagnosed, put near death, all due to physician error.

The goal of Groopman's book might have been to help physicians do a better job. Hard to imagine this organization structure would do so; which busy doctor, seeing ever increasing numbers of patients under the scrutiny of insurance payer guidelines, would take the time for this?

The goal might have been to alert patients as to how to minimize if not eliminate such defects in their personal medical care. But there is no clear advice on what information to present, in what fashion, or what specific questions to ask, to reduce the risk of medical failure.

When the author, himself a physician, described years of failure in treating his own medical problem, complete with details of horrible malpractice by three out of four specialists he saw, I just about threw in the towel. My conclusion -- although it is not clear this was Groopman's goal -- is that if you have a medical problem outside the typical 75% of diagnoses, you're screwed. Might as well offer goat's bones to a mushroom scarfing shaman as have optimism in a US teaching hospital or their well-published specialists.

But I told you up front that this was painful to read...

Fragment, by Warren Fahy

It would have been easy to stop reading this after only a few dozen pages, that's how uninteresting the character development and writing are. But I kept going on this Jurassic Park riff (compared to which Fahy does not deserve comparison against Crichton's writing skill), and in the end I'd give it a C+. Surely there will be a sequel, and the author is no doubt shopping the script to Hollywood.... maybe the movie will be better than the original.

Six Easy Pieces, by Richard Feynman

This book provides a taste of Fynman's lecture style. It comprises the six easiest chapters of his "Lectures on Physics."

I'm not sure I'd use the word easy to describe them. They are accessible, but for me, also fairly intense. I'd describe the book as one which requires access to unlimited espresso.

But I imagine it might have been really fun to be a physics student at CalTech during Feynman's tenure there (1952 - 1987).

Influence, by Robert Cialdini

A must read. Explains why certain sales approaches work.