Books: Handle with Care

June 27, 2015

Having finished Nineteen Minutes, I decided to try another novel by Jodi Picoult and selected Handle with Care. Like Nineteen Minutes, it explores a contemporary issue from the perspectives of several characters.

This time, the issue is the idea of “wrongful birth.” Charlotte O’Keefe loves her handicapped daughter Willow and dedicates most of her time and energy to caring for her. But when she finds out that she could bring a wrongful birth lawsuit against her obstetrician for failing to diagnose Willow’s osteogenesis imperfecta early enough to terminate the pregnancy, she decides this is the best way to secure a good life for her daughter. Read the rest of this entry »

Books: Mistress of the Art of Death

May 14, 2015

The title of the audiobook, Mistress of the Art of Death, didn’t particularly appeal to me – it sounded like it might be one of those vampire novels so strangely popular these days. But then I picked up a different title by Ariana Franklin, a historical fiction novel which looked interesting. When I saw that it was a follow-up to Mistress of the Art of Death, of course I had to check that one out first.

Adelia Aguilar is a forensics pathologist, but she has few of the resources available to Kathy Reichs’ Temperance Brennan or Patricia Cornwell’s Kay Scarpetta, for the simple reason that she lives in the twelfth century. Trained at the medical school in Salerno, she is sent with a (Jewish) investigator to find out who is murdering children in Cambridge, England, both to put an end to the heinous killings and to absolve the Jews who have been accused of ritual murder.

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Cyborgs in the making?

March 18, 2014

Yesterday our younger son asked why science fiction so often portrays problems that arise from a mix of the biological with the mechanical. We had an interesting conversation about real-life instances of machines embedded in people’s bodies, such as mechanical heart valves and cochlear implants. Such devices clearly improve a person’s quality of life without raising concerns that machines could be taking over.

Science fiction, of course, is always looking at what could happen in the future based on current trends. Might we someday have implants that challenge our ability to distinguish between person and machine? Or that make the distinction meaningless?

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Books: The Russian Donation

April 15, 2013

I enjoyed The Russian Donation largely because it was different from a lot of mystery novels I have read. To begin with, it is written by a German author for a German audience, and of course set in Germany (in the 1990’s). So it depicts life in Germany matter-of-factly, not like a book written for Americans and set in a foreign country to try to make it more interesting.

It could be termed a medical mystery, as the main character is a doctor, attending physician at a teaching hospital, and most of the characters and action are related in some way to the hospital. But the issues turn out to have a lot more to do with the business side of the hospital than the medical side.

It should be no surprise to most people, considering rising healthcare costs and the various efforts made to contain them, that healthcare is a business and decisions are made as much by business administrators as by doctors. But it’s interesting to see a physician’s point of view as he goes about his daily (and sometimes nightly) duties. (Author Christoph Spielberg is himself a practicing physician, so he knows what he’s writing about.)

Early in the novel, narrator Dr. Hoffmann, having just filled out a death certificate (for the patient whose death is surrounded by the mystery Dr. Hoffmann goes about trying to unravel), comments that “I had no idea that at that moment I was almost signing my own death certificate.” I kept waiting for someone to try to murder him. But for a book described by some reviews as a thriller, The Russian Donation struck me as surprisingly undramatic. I don’t say this as a criticism – in some ways it is a welcome change from thrillers where the tension is constantly at a fever pitch.

The cover says this is “Dr. Hoffmann’s first case.” That was one reason I picked it out (among new books at our library). It’s always nice to start a series at the beginning. I don’t know how soon the English translation of another of Spielberg’s Dr. Hoffmann books will appear, but I’ll keep out an eye for it.

Books: Frameshift

December 4, 2012

A reader review of one of Robert Sawyer’s other novels commented that Frameshift is probably his best book so far. Having read it now, I am inclined to agree. The main characters are well-developed, believable, and make you care about them. The science fiction scenarios are also believable – so much so that I’m not sure exactly where the science ends and the science fiction starts.

The scientific focus in Frameshift is on genetics. Pierre Tardivel is a geneticist, doing research to discover the function of “junk DNA.” His concern with genetics is more than professional, however, as he learns as a young man that his biological father has Huntington’s disease, and that there is a 50% chance he also has the defective gene that will end his life early – and cause serious problems even sooner.

(One kind of mutation that Tardivel studies is a frameshift, hence the title. A frameshift is “a mutation that occurs when one or two nucleotides are added or deleted, with the result that every codon beyond the point of insertion or deletion is read incorrectly during translation.” Pierre’s wife apparently has a frameshift mutation which results in her being able to read minds (if the other person is in close proximity to her). Her telepathic power plays a significant role in the plot, but it is not central.)

In many ways, the book is as much about ethics as it is about genetics. Is it a good thing to get genetic testing that tells what conditions you are likely to develop – or pass on to your children?  Is it right for an insurance company to be able to deny coverage based on the results of genetic testing? How should society treat people who are “defective” in one way or another? What are the appropriate limits of experimentation regarding human genetics?

At the time Sawyer wrote the book, the issue of insurance companies denying coverage based on genetic testing was – I am guessing – a contentious issue. (I don’t remember now whether I was aware of debates over the issue at the time.) But since then, the Genetic Information Nondiscrimination Act has gone into effect, providing (as best as I understand it) the protection that Tardivel argues for in Sawyer’s novel.

Sawyer also devotes a significant chunk of the novel to efforts to find and prosecute Nazi war criminals – men who callously and cruelly destroyed the lives of those they considered inferior – often based on attributes that are genetically determined, whether or not the Nazis knew or cared about the role of genetics. How well that major subplot fits into the novel as a whole I’m not sure, but as usual I learned something from reading about it.

Ultimately, though, the book is even more about people than it is about science or ethics, which is why I liked it so much. In some of Sawyer’s books, I found the science fascinating but not the people, as though the characters were just there to enable Sawyer to convey his ideas. In Frameshift, I really cared what happened to the people (well, at least the good guys), and for me that’s what makes a really good book.

Books: Triggers

July 18, 2012

I’ve read a number of science fiction books over the years that deal with the idea of being able to read someone else’s mind. Triggers uses a different approach than the others, where one person gets to know another person’s memories rather than his thoughts. But considering that your thoughts about what you are experiencing right now will be in your memories within a very short period of time, it can amount to nearly the same thing.

This is the first book I have read by Robert Sawyer, and I don’t plan for it to be the last. In the past two weeks I’ve also read books by Jack Higgins and Orson Scott Card, and while they were moderately entertaining, I felt I would not have missed out on anything by not reading them. Sawyer’s book, on the other hand, gave me something to think about.

What would it be like to have access to someone else’s memories? If you’re one of the characters in this book, you suddenly found yourself in possession of memories that are not your own, and in most cases they turn out to belong to someone you never met before – and perhaps would not want to know. Meanwhile, someone else now has your memories (it is not a reciprocal arrangement).

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Anatomy of a knee

May 4, 2012

My husband has been having pain in his right knee, the result of a fall while playing racquetball back in February. (He also pulled the hamstring group of muscles in his left leg, and the pain from that was so bad that he did not notice the problem with his right knee for some weeks.) The doctor tentatively diagnosed a torn meniscus, which was confirmed last week by an MRI.

I remembered from ninth grade science that a meniscus was the curve at the top of liquid in a cylinder (such as a test tube). Obviously the term means something else in relation to a knee, but I figured (correctly) that it probably had to do with the shape. It comes from the Greek word for “crescent.”

Despite having injured my own knee back when I was 22, I never had any clear idea just what the inside of a knee looks like. After all, back in 1984 we didn’t have wikipedia, and I wasn’t interested enough to go to the library and find a book about knees. Now I can see just how complex the knee is, and I’m not surprised that the doctor who treated me was never able to determine exactly what was wrong with my knee.

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A look inside the larynx

April 19, 2012

As the doctor explained to me yesterday how my vocal cords were inflamed because of the constant postnasal drip (which could be due to either a virus or allergies, he couldn’t say which was more likely), I had a mental picture of my larynx with two thick white cords covered in mucus. Something like this, but with more realistic flesh color and oozy mucus.

Then I remembered the pictures we had been shown in a class in Voice and Diction that I took in college. At the time, I was amazed that it was possible to take pictures of the larynx – in color, no less! Somewhat to my disappointment, there were no “cords” as I had always imagined them. (Our professor told us it is more accurate to call them vocal folds – but if even my doctor calls them vocal cords, I guess the change is unlikely to catch on.)

Some of the pictures showed a larynx that was inflamed, and I tried to imagine my larynx looking that way, as it no doubt had on a number of occasions when I had laryngitis. Our professor emphasized how important it was to take good care of our vocal cords, by not straining them (e.g. from too much yelling at sports events) and not smoking. I’ve never smoked, and I’m not the sort who tends to yell, at sporting events or anywhere else. But I probably don’t rest my voice enough when I get laryngitis, which is at least once a year.

I decided to look on the Web to see if I could find pictures of the larynx like those I had seen in that class over thirty years ago. There are lots available, including videos. This one shows a healthy larynx, and you even get to watch the tiny camera snaked through the person’s nose and down her throat (a procedure I had to have done before my sleep study, to see if the opening in my throat was small enough that apnea was a reasonable diagnosis). You’ll have to wait until about the one-minute mark to see the larynx clearly.

Here is a (much shorter) video (scroll down to Example 5) showing someone with laryngitis caused by a virus. (You’ll have to have QuickTime installed in order to watch it.) I’m guessing that’s about how my larynx looks right now. And according to the doctor, it will probably keep looking – and sounding – that way until I give it enough rest so it can get better. (The laryngitis often lasts quite a while after the virus itself is gone, probably because once people feel better they want to talk again.)

An example to follow

February 26, 2012

Yesterday’s Wall Street Journal has a very interesting article in the on the choices physicians make when it comes to their own end-of-life decisions. In some ways the comments on the article are even more interesting.

What Ken Murray writes simply confirms my own thinking on the topic. But the comments present a wide variety of views, and bring up some of the practical difficulties in making appropriate end-of-life decisions for ourselves or our loved ones.

One thing that surprised me in the comments was the level of cynicism regarding the motives of the medical establishment. Some people accuse doctors of recommending and performing procedures that cost a lot but do little to improve or extend life, simply to make more money. The more reasonable (IMO) comments point out that doctors feel obliged to provide what amounts to futile care, simply to minimize the possibility of ruinously expensive lawsuits.

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The health benefits of radiation?

November 7, 2011

I remember being surprised when I read, several years ago, that cigarettes were once thought to promote health. (I was, if anything, more surprised when I read that there actually are some possible health benefits from smoking. For most people, the risks far outweigh the benefits, however.)

I was even more surprised, reading this evening about the 144th birthday of Marie Curie (recognized by today’s Google Doodle), to find out that radiation was once considered beneficial. Can you imagine wanting to brush your teeth with radioactive toothpaste?

There are times that the benefits outweigh the risks. A few months after giving birth in 1992, I was tested for low thyroid levels. The test required use of some kind of radioactive dye, and I had to stop nursing my son for a week. Rather than pump and throw out milk for a week, I decided to just wean him a month earlier than I had planned (he was about five months old). It presumably had little if any effect on my health or his, and it enabled the doctor to prescribe the medication I needed (and have been taking ever since).

Most of the time, though, radiation kills. That’s precisely its purpose when used on cancer patients – to kill the cancer cells. (And it’s an unavoidable effect that a lot of healthy cells get killed too.) It’s hard to imagine now, in a day when anyone working with radioactive materials in a lab has to wear a radiation monitoring badge, that people once thought it was a good idea to line a ceramic drinking cup with uranium. (It’s even harder for me to imagine how they thought that would reduce flatulence.)