5 comments about Final Exam: A Surgeon's Reflections on Mortality (Vintage).

1. Dr. Chen's book is a must read for any consumer of modern medicine. In an easy to read narrative style Dr. Chen presents a lucid view of the profession with brutal honesty. One cannot help but be impressed with her sense of mission and her call for greater compassion for the termianlly ill. Her admonistion to any doctor that she should put herslef in the shoes of the patients and ask herself "What would I do if I were the patient?" And "how can I be a better doctor?" should be the new motto for the heling profession.
   
   Although there is no fianl resolution to the conflict of how to be professionally detached so that the doctor can deliver the best of her skills yet remain compassionatley involved with the patients, by raising the question, Dr. Chen has made a tremendous contribution to the art of healing.



2. I just finished Final Exam.
   
   Three weeks ago, we marked the fourth anniversary of my son's death. In a week, we will remember him on what would have been his thirteenth birthday.
   
   I found Andrew having seizures and called the paramedics. After seven hours of surgery, the neurosurgeon could not find a way to tell me that Andrew had died. Instead, he described in horrible, excruciating detail what he had done to try to save my son and what we could expect if Andrew survived. I have only been able to repeat his words to others twice since that night, but they have been repeated in my mind many times. I could tell myself that he had been physically and emotionally exhausted by his night in the OR, but I still felt angry that he had used that level of detail.
   
   Eight months later, I was helping my mother through the last stages of her cancer when she fell at home and her neighbor called me to tell me that she had been taken to the hospital by ambulance. At that point she had lost about a third of her normal weight. When I got to the hospital, she was in pain and seemed different in her behavior. It took a day for me to realize that she had no short-term memory. If I was not in the room and the nurses asked about me, she would tell them that I lived too far away and could not come. Every time that I entered the room, she greeted me like she had not seen me for a long time. My sister-in-law believes that she had a minor stroke. Within a day, it was obvious to me that she was failing. I called my sister to tell her to come now. My mother's oncologist saw her in the hospital, and then started calling me to make appointments to start a new course of chemotherapy. I finally told him that she would no longer need his services. He could not seem to understand. My mother died four days after her fall, the day after I dismissed her oncologist. I was baffled by his attitude to her care.
   
   Pauline Chen's book has helped me to understand and appreciate how both doctors responded to these deaths. I have found a new peace with two men who had to face the fact that they could not save everyone. I am grateful to her for helping me to find a new perspective.
   
   My only quibble with her book is the use of the word "harvest" to describe the collection of organs for transplant. We donated Andrew's organs and I now volunteer for our transplant organization. Many donor families dislike that word and the California Transplant Donor Network does not use it.
   
   Her writing style drew me into what she experienced. Sometimes, I could visualize what she was seeing as if I was there. I sometimes found her descriptions of liver surgeries difficult, as we have met our liver recipient. Some reviewers have disliked the graphic style of her writing, but I believe that it is important to help us see the emotional turbulence that medical students and practitioners go through just to do their work day after day.
   
   I cannot say enough good things about how organ donation has helped our family. Meeting one of our recipients and his family has been a special gift that came from Andrew's death. They have become part of our family. Please go to donatelife.org, find the donor registry in your state, and sign up.
   
   We live in a lucky time and place when many people do not see the immediacy of death on a regular basis. Reading this book is an important reminder that this is an everyday occurrence and that those who have to see it everyday pay a deep price.



3. Autobiographical, well written and organized, sensitive and upbeat, Dr. Chen shares with us her experiences as a medical student and as a doctor. I enjoyed the chapter on dissection of the human body and the stories of patients. It reads as if one were talking to a friend. Thanks for the lovely book.



4. This book is an excellent resource for caregivers who work with terminally-ill people: clergy, social workers, hospice volunteers, family members, etc. It provides a clear picture of the daily world of professional medical personnel, offering a rare insight into the personal dilemmas and struggles they encounter, but which are not shared with others.



5. Very moving at times. The medical profession is a world of its own. Power is too concentrated. The education process is to dehumanizing. It's difficult for human beings to emerge from the process.

5 comments about Something for the Pain: One Doctor's Account of Life and Death in the ER.

1. What a great story about Dr.Paul Austin and his life inside and outside of the ER. The story was very personal and moving. This story gave me a look inside of what goes on in the ER and how it feels to the patient, and the doctor treating you. This is a book to read for inspiration and the true reality of life inside & outside of the ER.
   Buy it as a gift for someone! It will change their way of thinking.



2. In his new memoir, Something for the Pain: One Doctor's Account of Life and Death in the ER, Paul Austin takes a clear-eyed look at the profession he has chosen---that of a doctor in a metropolitan Emergency Room, who frequently works what other (less superstitious) professionals might term "the Graveyard Shift."
   
   Within the covers of this thoughtful and moving debut, Austin graciously allows us an insider's look at the struggles and rewards of his job, as well as the toll it can take on a growing family, especially when the detrimental effects of persistent sleep-deprivation fray nerves and breed frustration. (When the author finds an innovative way around these struggles, we silently cheer for his ingenuity and for the sake of his patient, empathetic wife, herself a former nurse.)
   
   Unlike many of our nation's first responders (and ER doctors are definitely first responders), Austin and his ilk often don't get the respect that a fireman (which Austin has also been) or a paramedic might, and they certainly don't receive the full measure of respect they're due. (Have you ever tried staying up all night, on constant alert, dealing with bleeding, vomiting, angry people---many of them drunk and violent---or patients with chest pains and grisly car crash wounds that need immediate attention and split-second medical decisions? All this, while frequent understaffing creates delays that in turn create patients so angry that once they are finally seen it can complicate the process of diagnosis? ...I thought not.)
   
   With equal measures of honesty and empathy, Paul Austin has created a timeless memoir that deserves a wide readership. As Richard Selzer's "Letters to a Young Doctor" helped to open the public's eyes to the general practitioner, so can "Something for the Pain" give us important insights into the working conditions for an ER physician. I do know that without a doubt, the next time I visit an ER, no matter my circumstances, I plan to extend a measure of empathy to the doctor on duty and not just expect it. And I plan to be thoroughly grateful--and definitely sober.



3. Something for the Pain is a searing account of life as an emergency physician. It's the kind of book that makes you laugh and cry out loud. It's the kind of book that is tough to put down. In prose as clean as a scalpel's shave, and as fast-moving as the pace of the emergency ward itself, Austin re-creates the atmosphere of blood and guts and heart-stopping pain, of wry humour and supercharged adrenaline that fuels a busy hospital. At the same time, he describes the ripple effects that emergency work can have on a family, and his own efforts to achieve balance in the midst of so much death and suffering - not to mention, sleep-depriving shift work. Honest, gripping, fiercely compassionate, and unafraid to pose big questions, Something for the Pain should interest anyone who is looking for a well-written memoir, and anyone who cares about the caring professions.



4. This book account from an E.R. physician places the reader on the front row of what happens and the thoughts and emotions that these heroes have during the drama and in between.Best,beleivable book I've read in quite awhile.A must read for non-fiction lovers!Hope the author writes more.



5. I picked up this book as an ER physician's wife who is in a completely different line of work. It was great to see another person's perspective of life in the ER to get a better idea of what the work entails. The book was incredibly informative as well as witty, humorous, lighthearted and heartbreaking all at the same time. The book does an excellent job of taking us through the experiences of an ER doctor (including flashbacks of the medical training) by explaining procedures, specific terms and etiquette, the hospital system, etc, while the whole time remaining accessible to readers not in the field. This is a great book for someone who is not in the medical field who would like to understand what doctors go through (and why the long wait in the ER), the emotions and decisions they wrestle with, and the juggling of work and family life. I would give this book my highest recommendation.

5 comments about The Lord God Made Them All (All Creatures Great & Small).

1. http://www.amazon.com/gp/product/0312498349/ref=cm_cr_rev_prod_title
   James Herriot's book "The Lord God Made Them All" is the final book in his series about his experiences as a Scottish veterinarian, dealing with both large and small animals. His love for his patients and their owner's shines through in every story, and takes the reader through the gamut of emotions from laughing out loud to tears of frustration and empathy.
   Dr. Herriot was, without a doubt, a man who put his patients and their owners far above financial gain, and that is what sets his stories and the loyalty of his patient's owners apart from anyone in his time. If he was called, he went, no matter what time, the weather, the circumstances.
   His love for his profession may not have made him rich, but he set a standard for veterinarians everywhere that has yet to be matched.
   This is a wonderful book with only with disappointment:that it ends when the reader finishes the final page.



2. I think we've all heard of ALL CREATURES GREAT AND SMALL. The book was brilliantly written in every way, and I thought that was that. But then he wrote a sequel, and I marveled that it was at least as great as the original. Then he did it to me again with a third book. The titles come from a famous poem or hymn, by the way. He used the second verse, for the creatures, then the first, then the third, and now we're at the fourth.
   
   I'm going to say it again. I believe I'm enjoying this one most of all. All the humor, all the spot-on accurate observation of animals, of both the four-legged and the two-legged variety. And, I'm feeling this time, a maturity in the veterinarian, the author, and the person. He still has the ability to write a chapter so touching or sad that I stop and wipe my eyes, and then read a few more so I can laugh before I put the book away for the evening.
   
   So I've read four in a row by this guy, and they all get five stars. I ordered all of mine from Amazon, but you in "the west" can probably just swing by your local library. Do so.



3. I read his books as a teen and loved them. Bought the whole set for my grandsons, [teens]. They laughed until they cried. [so did I].



4. I was verey satisfied with the whole process of ordering
   on-line and I will continue buying books this way.



5. As an animal lover, if I were to be restricted to a single author on my bookshelves, it would be James Herriot, hands down. All four books by James Herriot, The English Country Veterinarian, comprise a collection of stories that remain unsurpassed in all animal literature.

5 comments about The Pact.

1. This was a summer read for my daughter. She has a reading problem so this book on tape helped her. I'm so glad it was available. It was a very intereseting story. I recommend it for teens and adults as well.



2. If you know a young person who is struggling to overcome a less-than-privileged beginning, give him/her this book. I wish someone had done so for me when I was trying to be the first person in my family to attend college. The story here will make you laugh and cry--and it will definitely inspire you to never, ever stop believing in your dreams.



3. I could not put this book down. These 3 doctors stories are almost too impossible to believe. It is amazing what the human spirit can achieve with encouragement. I recommend this book to everyone who loves to read.



4. I picked up this book after my wife and I started a group reading with my son of the book; "We Beat the Streets." "We Beat the Streets" book was written by the same authors but geared toward a younger crowd (suggested ages 9 to 15y/o). The pact was a great book as a source of inspiration. Being an African American male near the same age range, I was able to relate to at least one aspect of each of the three guys. At points where Rameck had a chip on his shoulder and struggle to put the anger behind him I related to that anger when confronted by unfair situations and judgmental people throughout college. Times when set backs occurred related to bad choices, an ill family member, or failing to pass a critical exam on the first try reminded me how as a young black male you feel like you're on the edge of falling of track at any given moment. Regardless of race and sex when you spear-headed the family into a new level of educational/professional success you will feel the weight of a lot of dreams and hopes placed on your shoulders daily. Often as a young man I felt times where I just didn't want to deal with that kind of pressure.
   
   This story reminded me that it is important to stay focused and move through the rough periods in order to be in a position to help friends and loved ones. By example let them know that they can achieve there goals/dreams.
   
   Two key factors in this story will continue to give me the courage to move forward. Never forget the 3 D's; Discipline, Determination, and Dedication. Always remember that choosing the right friends may mean the difference between success and failure in my life's goals. Friends are crucial when faced with situations in life that are difficult. I am proud to say that my wife is my best friend with an ear to listen. As I pursue my second master's degree my thoughts turn to adding to my list of goals a doctorate. Thank you Doctors Davis, Jenkins, and Hunt for this wonderful gift of brotherly love!
   
   I give this book a, 5 out of 5 stars. If you're a Dad it's a must read with your son or daughter. All they see is the man you are now; let them know that God, Faith, and loving relationships got you where you are today!!



5. This book was meant for any child, teen, man or woman, who are living today without hope for a better future. The pact is about a brotherly commitment between friends to achieve their life long dreams. The reason that I use the word brotherly is because their pact was only as strong as the weakest of them. They became like family in support of one another and diligently worked together to achieve their dreams.

5 comments about Sickened: The True Story of a Lost Childhood.

1. I can't say why I chose this book to read but am very glad that I did. Such a sad story. I commend Julie Gregory on her strength to survive such an awful childhood and thank her for educating others to this awful problem.



2. Sickened is a story displaying the depth of a child's love for her mother and the strength it took to ultimately break away and save herself. I will not give away the story. It is enough to say this is a very interesting, well written book.



3. The book was a very easy/quick read. The stories are heart breaking and tragic but good information for others to know. It is hard to imagine a mother like the one in the book but there are a lot of very sick people in the world that pass for 'normal.' Good to know that the author made it out and is recovering from the trauma.



4. It amazes me that this was allowed to go on as long as it did. Doctors, Nurses etc.. Just sad, and this is far from an isolated case, my heart goes out to this girl who is now a woman and I hope she has been able to truly put this behind her, but I'm not sure that is possible. Children are innocents and need protection, just sad.



5. I loved this book! I couldn't put it down! It really showed how this disease affected one family. The pictures in the book made it all very real!

5 comments about ADHD & Me: What I Learned from Lighting Fires at the Dinner Table.

1. ADHD & Me was amusing, interesting, and an enjoyable book to read. People don't realize the impact ADHD has on someone's life but Blake tells it like it is. My son has ADHD and Blake's story is so much like my son's.



2. Enjoyably insightful. More indepth than a lot of texts yet easy reading. Must reading for parents,teachers and disciplinarians of students with AHDH.



3. I recommend this book to anyone who has a child with ADHD or even PDD syndrome. Like many others who have placed their comments on this site, I wasn't looking for the medical version of what happens to kids with ADHD, I wanted to find out how a child was feels.
   
   I felt very connected, while reading this and it has given me such an insight, that I finally feel like I can actually help my son. The stories were relatable, the solutions that Blake recommends are practical and age appropriate. The best part, it is written by someone who's been there, and came out the other side a success.



4. I provide therapy to children with ADHD and their families. This book is extremely helpful in allowing parents to understand why their children sometimes act the ways they do. It is also something that parents can read with their children so they communicate with one another about the symptoms of ADHD. This allows other children with ADHD to see that they are not alone in their experience and to understand that there is a reason why they feel they way they do.



5. This book is amazing, so much wisdom from someone so young and with a disability such as ADHD. Blake has become an inspiration to both me and my son who has ADHD and is struggling with social skills in school. I would highly recommend this book to all children, adults, teachers, parents who has someone with ADHD. For we already know what remarkable and speacial people we have.

5 comments about Mountains Beyond Mountains: Healing the World: The Quest of Dr. Paul Farmer.

1. One of the best works of nonfiction we have ever read and a truly inspiring story of what genius + boundless caring can accomplish.



2. Loved this book, and especially loved the subject. Tracy Kidder is, not surprisingly given his track record, an accomplished and skillful writer. He tells the story of Paul Farmer and, while he is part of the story, he is careful to never become the story. The focus is always on Dokte Paul.
   
   Paul Farmer is a character who will haunt you, if you have any inclination to serve others. He does so completely and thoughtfully and, at the same time, irrationally. He treats his patients in Haiti with dignity and passion.
   
   I highly recommend this book. It's hard to resist the combination of a compelling subject and a masterful writer.



3. a really wonderful look at the work of Dr. Paul Farmer an amazing physician who has contributed greatly to help treat Aids and TB in parts of the world where noone believes they can be treated. This book will make you reexamine some of your beliefs about access to healthcare--both for the poor in this country and around the world.



4. An excellent story of the impact one dedicated person can have on the world around us.



5. Tracy Kidder's brilliant biography of Dr. Paul Farmer is at once disturbing and exhilarating: disturbing, as it points out all the inequalities in living conditions and health care between the rich and the poor and the staggering statistics about disease and the lack of available medical aid in many parts of the world, and exhilarating to read the selfless commitment of one man to change these situations. Not only is the information in this inordinately readable book fascinating but also the superb writing style of Pulitzer Prize winning author Tracy Kidder is some of the best to be published in recent years.
   
   Kidder concerns his book with one Paul Farmer, a poor lad who grew up nearly homeless (unless one calls living on a riverboat a home) in Alabama, a gifted thinker who climbed out of his beginnings to discover the inequities in the big world, went to medical school at Harvard, and then proceeded to commit his life to changing the pitiful poverty and disease-ridded Haiti, establishing not only viable medical centers but also spreading his warm personality into the hinterlands of that little country making day-long walking housecalls for the poor families who as human beings deserve as fine a quality of medicine as those who live near the wealthy comforts of the major city medical centers.
   
   How Kidder accompanied and observed Farmer as he sought funding and supplies and training not only in Haiti, where the diseases of tuberculosis and AIDS were decimating the population while the world just silently watched, but also extending his beneficence to Peru and to the prisons of Russia, attack tuberculosis and AIDS with the same ardor is the basis of this book. Farmer's accomplishments created the Partners in Health organization that in turn stimulated the World Health Organization to wake up to the disasters that reign in the third world countries, eventually supplying the much needed medicines, cash, buildings and personnel to begin to make a change in the world health care.
   
   Kidder's gift as a writer lies not only in his detailed and well researched biography of a modern saint, but also in his ability to allow us to get to know the very human creature named Paul Farmer. He touches on his personal life, his struggles with his own diseases (he nearly died from hepatitis), and his indomitable spirit in facing a bureaucratic conundrum that prevented the poor of the world from receiving care. It is a touching story, it is a superlative investigation into one man's spirit and selfless commitment, and it is a book that demands our attention on many levels. Tracy Kidder's sharing of Dr. Paul Farmer's life is a poignant reminder that the individual CAN make a difference: it is a matter or devotion to an ideal that can become a reality despite obstructions the world places in the path. Highly Recommended. Grady Harp, December 06

5 comments about Pretending to Be Normal: Living With Asperger's Syndrome.

1. I'm the one who is fed up with pretending to be normal like anyone else. I have been feeling distant and different from other people like she felt in her university days. I usually felt neglected, alienated, and discounted when interacting with other people. They superficially seemed nice to me, but actually they implicitly hated me. That was why I could trust nobody else. I often felt left behind like the author missed her college classes in a state of confusion in the crowd. After I was diagnosed with ADHD and Asperger syndrome(AS), I realized that I don't have to pretend to be a neuro-typical(NT) person any more! Even though I come to know my AS traits now, it has been very tough to maintain stable relationships with other people, which causes frequent job changes. Especially, unwritten rules and sudden changes get on my nerves! NT people have taken them for granted, though.
   
   Recently I have come to recognize I could find someone to go to bat for; job hunting agency staff who deal with challenged people have trying so hard to understand the specifics of developmental impairments. To my great surprise, they know the ropes more than typical hard-headed psychiatrists! Thanks to them, I can be more objective and understand both the pros and cons of AS and ADHD more than before I met them.
   
   Like Liane Holliday Willy said, people with AS can be normal with more understanding people, I'd say. Then they won't have to suppress their feelings and stress themselves out!



2. I really enjoyed Liane's story - it gave me hope that my Aspie daughter (and son) will grow up to have fulfilling lives.



3. Liane Holliday Wiley's Pretending to be Normal: Living With Asperger's Syndrome is a very insightful look into the condition, from someone who has it herself. Wiley provides entertaining, and at times heartbreaking, anecdotes of her life, as she grew up not knowing she had Asperger's, but knowing she was different in some way. The advantage of reading a book like this is that it is written by someone who has the condition, albeit undiagnosed, so it provides better insight on the condition than a parent or professional, who doesn't have the condition himself or herself. On the other hand, as another poster has stated, Wiley seems to go back and forth between accepting her Asperger's as the way she is, and saying she's better now that "her Asperger's traits continue to fade away", yet admittedly, that is how many "Aspies" feel. Bottom line: I would recommend this book, but keep in mind that it's not perfect. Especially useful for Aspies or friends and loved ones of Aspies, and anyone who wants to learn more about Asperger's Syndrome.



4. Pretending to Be Normal: Living With Asperger's Syndrome
   This book is must read for anyone dealing with Asperger's children, teens and young adults. L. Wiley's insights into her own responses and feelings enables a better understanding of the behaviors we see, and also insight into some of our goals, that may not be shared by those with whom we are working.



5. I have now read several books by adults with autism or aspergers. This is a good book to read if you want a better understanding of the autism spectrum and how it plays out in children who otherwise appear "normal". The author describes very well what life was like for her in high school and college. She also writes about her marriage and some of the challenges in that. I believe that this is the first book I have read that goes into that type of depth of close relationships. At the end of the book she has chapters such as organizing your home life, employment options and survival skills for college students. I will probably read those chapters again and in more depth when my son is older. I think that many of the suggestions would be helpful to someone on the AS.

5 comments about Think Big: Unleashing Your Potential for Excellence.

1. I still did not get my product, I am mad, I upset and I am really annoyed that I orderd this product after high recommendation and I have been dissappointed like this. I am upset, I paid for the product, did not recieve it, I called and complained ,they said they would take care of it and the problem still exsist. I am in the USA in case someone needs to call and explain why 484-706-0989. This is one of the worst experience I have ever had in ordering online and now I am really upset!!!
   
   Kenny



2. Continuing his desire to share what he has learned in his journey to greatness, Dr. Carson lays out in very plain terms his philosophy of life and how it has become so important to him. T-H-I-N-K-B-I-G could completely overhaul this country in profound ways. It's worth the time to dig into this and find out how it can affect your life.



3. I read this book years ago when I was still in school. I read it quite a few times since then. It inspired me to be more and do more. I admire Dr. Carson, and I thank him for sharing his story and road to success with me.



4. One of the greatest stories I have ever read. It is a true reflection of one who leads by example in what he says. The author's recognition of the importance of reading and a refusal to dwell on the negatives is a true understanding of what it takes to maximize one's potential. His recognition of God is also significant in the fulfillment of one's purpose. The author is in agreement with the author of Breaking Free: The Key to Empowerment, Happiness & Fulfillmentin his understanding of the power of the mind and positive thinking. This book is a must read for all persons from the moment they can read!



5. Think Big: Unleashing Your Potential for Excellence
   
   This is an awesome book. It is a must read for students struggling in school or struggling with life.

5 comments about My Lobotomy.

1. This was an interesting book. I would not say it was my favorite but it certainly kept my attention until the end.



2. I received a free copy of this book and wondered if I would be interested. As I rode the subway home from work that day I opened the cover and read all the way until I nearly smacked into my own front door. I could not put the book down. With the aid of Charles Fleming, Howard Dully tells a riveting story of parental neglect and abuse and the terrible outcomes, but he does it with nary a sense of self pity. This book is beautifully written in simple language and puts a human face on a tragic procedure most of us today know little of. This book appealed to my love of memoirs and my interest in medical history. It is heartwrenching and yet leaves one with hope. I applaud Mr. Dully for letting the world know his story, and I encourage anyone who finds this page to get the book--I doubt you will be disappointed.



3. howard dully lost a loving mom when he was a little kid. and life was never the same. dad remarried, and the new stepmom clearly had significant issues. one way this played out was in a deep hatred for howard, which she externalized and placed all the blame for at howard's feet.
   
   by the time howard was 12, his stepmom had so convinced herself that he had uncontrollable rage, was dangerous to the family, and a host of others issues (none of which seemed to be substantiated from any other perspective), and convinced her husband (howard's birth father), and a doctor, that howard needed a lobotomy. this was the 1960s, and the doctor was walter freeman, creator of the "ice pick lobotomy" (which he performed on 3500 patients).
   
   as you might expect, howard's non-existent problems were not solved. but the life of a 12 year-old took a decided turn from bad to worse.
   
   "my lobotomy" is howard's first-person, autobiographical account of his life story. it's a seriously painful story to read, especially for youth workers who care about teenagers, and can see the stories of so many teenagers we know (even if they haven't had lobotomies!) in howard's story. it's a story of the paths one ends up walking when love, stability, encouragement, and direction aren't present.
   
   written in a simple voice that was initially a bit annoying to me, but grew so authentic, i came to deeply appreciate that it wasn't overly polished by the co-author, my lobotomy has all kinds of implications for youth workers and parents and anyone else who cares about teenagers.
   
   thankfully, it's also a story of redemption. howard, in the later years of his life, has beautifully come to terms with his story, and shows a level of grace (even toward his now-deceased father and stepmother) that is breathtaking.
   
   this is not a book of answers. but it's a real life story of hurt and healing.



4. The incredibly moving story of Howard Duffy and the ways in which his life was changed (much for the worse) at the hands of an inexplicably horrible stepmother, his mostly absent father and Dr. Walter Freeman, the American psychiatrist who championed the use of "ice pick" lobotomies to "cure" psychiatric problems.
   
   Seeking to rid her home of Howard (whom she viewed as the "problem child") his stepmother shopped around for a psychiatrist who would support her opinions and "fix" the 12 year old Howard. Sadly for Howard, she found Walter Freeman. The mechanization that then went on to keep Howard out of the family's home are simply mind boggling -- he was eventually sent to an psychiatric facility for a year because, although he did not have serious psychiatric issues, there was "no place left to put him."
   
   A very sad book that speaks to the necessity of the oversight of psychiatric treatment and serves as a warning to us all about the dangers of The system."My one issue with the book is that it states that the 1920's were an "exciting time in neurology" because of the large number of servicemen who returned from WWI with Traumatic Brain Injuries. Which is no doubt true. However Duffy then states that this was due to the use of penicillin ("In earlier wars, because there was no penicillin, soldiers like that would have died from their wounds. Now many of them came home alive, but brain damaged." pg.62). Since Alexander Fleming didn't discover the famed penicillin in the bread mold until 1928, that's just not possible. The survival of said soldiers may have been due to other factors (improved surgical techniques, more hygienic surgeries, better armor, etc.) but is for sure wasn't due to penicillin, which only went into widespread use in WW2.



5. This is not a whodunit. We know whodunit. It was Lou Dully, Howard Dully's stepmother. She engineered a lobotomy for twelve-year-old Howard in 1960 because she hated him and found him irritating.
   
   Howard's mother died of cancer when he was five. This death may well have contributed to Howard's less than stellar behavior as a child. Also likely impacting Howard's behavior was his father, Rod, who was a cold, sometimes cruel, man.
   
   In the years before his lobotomy, Howard seems to have been rather slovenly and a bit insensitive. The child probably just needed the love and affection that his parents wouldn't give him; instead, he got an ice pick in the brain. If Howard "needed" a lobotomy, so did the majority of the country.
   
   Actually performing the surgery was Walter Freeman. He performed some 2,500 (one source says 3,500) lobotomies from 1936-1967. It is a shameful reflection on the medical community/the government/society that Freeman could slice brains for so long.
   
   Many of Freeman's patients (the book indicates fifteen percent) died as a result of the operation. Many survived as "vegetables." Others lived out their lives in a passive state, not "vegetables," but unable to survive independently. Many showed no long-range change in the behavior that had led to the lobotomy. Enough showed improvement in their (usually depressed or aggressive) behavior to lend credibility to the procedure.
   
   The lobotomy severs the connection between the frontal lobe and the rest of the brain. This seems to block the development of strong emotions that can lead to depression, defiance, and aggression.
   
   After the operation, Howard drifted about for decades. During his teen years, Lou did not want him in the family home, so he went from institution to institution. The experts who examined him agreed that he was "normal." But there seemed to be no other place for him. He later moved from job to job, and lived for long stretches on small welfare checks. He shacked up with various women. He drank heavily and used drugs. He wrote bad checks for flop-around money. Once after he was busted for bad checks the police gave him a choice: get admitted to an institution for the insane or go to jail.
   
   Friends and family (never Lou) helped him from time to time. His father maintained contact and occasionally helped.
   
   Howard finally pulled himself together in his forties. He got an associate degree and started driving buses. He got married and settled down. In the final chapter, Howard described an MRI examination of his brain in 2007 which showed the serious damage that Freeman had caused, but indicated that he was "lucky" to have been victimized at age twelve because his brain was still growing and the new growth helped to compensate for the lobotomy's damage. This likely is why Howard kept his personality and intellect intact.
   
   Howard attracted national attention in 2005 when he appeared on an NPR broadcast during which he interviewed other lobotomy victims, Freeman's sons, and, touchingly, his own father. Rod Dully refused to accept blame for his son's lobotomy, claiming that he was "manipulated" and tricked by Lou. But, in the end, Rod had approved the operation, although he had stated just days before that Howard was "normal."
   
   I think it was all summed up beautifully on page 270 of the paperback edition: "We are all the victims of what is done to us. We can either use that as an excuse for failure, knowing that if we fail it isn't really our fault, or we can say, 'I want something better than that, and I'm going to try to make myself a life worth living.'" Perhaps these are mostly the words of Charles Fleming, the former Newsweek correspondent who cowrote the book. If they are the words of Howard Duffy, it's a miracle.
   
   I highly recommend this book as an account of the lobotomy insanity. It also is an interesting memoir of a man with little ambition and virtually no direction living in semi-poverty at the mercy of come-what-may in the late twentieth century.