“Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World” by Tracy Kidder (Adapted for Young People by Michael French)

Mountains Beyond Mountains

This was a book I borrowed from a schoolgirl in Columbus, Ohio. She has a dream of becoming a doctor and I was curious to know what she was reading. I picked three titles from her home library and ‘Mountains Beyond Mountains’ was the first one I read. Quite predictably, it was a version adapted specially for kids. The original book was authored by Tracy Kidder and published in 2004. Michael French was responsible for the adapted version.

The book is about a medical man with a noble mission. Dr. Paul Farmer, born in America in humble circumstances, goes to Duke university on a scholarship and chooses his life’s work in disease ridden Haiti, one of America’s poorest neighbours. He works and travels 24/7, treating patients, raising funds, and convincing global opinion makers that the poor must have options too, that healthcare would be ineffective if it targeted only the wealthy.

The book traces the amazing journey of an amazing individual, an inspiring saga of energy, enthusiasm and professional excellence. It’s a MUST READ for any one who has interest in the medical profession.

Paul Farmer and some of his most committed team members go on to found Partners in Health (PIH), a non-profit organization that combats diseases such as TB, AIDS and malaria in far flung places such as Peru, Kazhakhstan, Russia, Mexico, Dominican Republic, Malawi, Lesotho and Rwanda.

The book introduces us to many interesting personalities. Tim White is the ultimate philanthropist who supports Farmer’s ventures until he is down to his last penny. Jim Yong Kim, who partnered with Farmer to found Partners in Health is now President of the World Bank. Didi Bertrand is the Haitian woman who marries Farmer and shares his vagabond lifestyle while bringing up the children. She lived in Paris for years before moving to Rwanda with her husband. Ophelia Dahl, daughter of Oscar-winning actress Patricia Neal and celebrated author Roald Dahl, meets Farmer in Haiti when she was just eighteen. She finds her calling and becomes one of the prime movers behind PIH.

Overall Assessment: Great story, great subject, but a bit laboured.

Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World
AUTHOR: Tracy Kidder (Adapted for Young People by Michael French)
PUBLISHER: Random House

Contributor: Pushpa Kurup lives in Trivandrum, India and works in the IT sector.

“The Heart” by Maylis de Kerangal

The Heart.jpg

As a book lover, a strong recommendation for a book from someone you greatly respect is impossible to ignore, and that is how I came to read the book, The Heart – it was recommended by none other than Bill Gates (in a recent issue of Time magazine). Not that Bill Gates is a literary expert, but as the co-founder and former CEO of Microsoft, one of world’s most successful companies, and more recently, as the leader of the Gates Foundation, a philanthropic organization that he started with his wife, his book recommendations are certainly noteworthy. According to his blog – in which he has a dedicated section for books that he recommends – he mostly reads non-fiction but read The Heart, a novel, on the recommendation of his wife, who told him it was different from other books.

It certainly is. At its essence, The Heart is the story of a heart transplant. The heart in question belongs to a young man, Simon, just twenty years old, who meets with a fatal accident one day on the way back from an early morning surfing expedition with his friends. It was just a matter of chance that he was sitting in the middle and not wearing a seat belt. His friends, who were wearing seats belts, were also seriously injured in the accident, but they survive. The story of the  heart transplant is told through the lens of all the people directly involved in the process – Simon’s parents, who are utterly and completely devastated but eventually give their consent to the donation of his organs; the doctor and the nurse in charge of Simon at the ICU in the hospital where Simon is brought in after the accident; the liaison for the organ donation; the surgeon and nurse team who actually harvest the heart and transport it to the hospital where a recipient is being prepped to receive it; and finally, the recipient herself, Claire, a middle-aged woman whose own heart is failing rapidly and for whom a successful heart transplant is her only shot at survival.

The Heart is unapologetically a tragedy. There is no attempt to find any kind of silver lining in the situation—what can there be in the face of a young man dying so abruptly at the prime of his life? About the only positive thing in the story is the fact that Simon’s parents consent to his organs being harvested for donation, and we get to see firsthand the impact of the donation of one of these organs – his heart – and how it could potentially save the life of someone who would otherwise have died of heart failure. Other than this, the book is heart-breaking all the way through — it captures the shock and devastation of Simon’s parents so vividly and in so much detail that anyone who has lost a close family member will be able to identify completely with how they feel. In contrast to the grieving parents, it also shows how the doctors and nurses stoically go about their work — they have got to do what they do to keep our hospitals going, healing the people they can, and trying their best to save even those that they can’t.

Unlike most novels, The Heart is not a story that is told in a straightforward manner. The usual plot lines are simply not there. While you would expect the story to be primarily centered on Simon’s parents and on Claire, exploring their thoughts and feelings — perhaps with some profound insights on life — the book actually captures the background and personalities of each of the key people involved in the transplant. While this was interesting, I found that it seemed to detract from the overall impact and cohesiveness of the story — it was so broad that it just didn’t seem to come together. Also, some of these people got only a single chapter in the book for their story while others got several, and it wasn’t clear as to why that was the case. The Heart also goes into extensive, and sometimes excruciating, detail about the science and medical aspects of heart transplants — details that I didn’t particularly want or care to know about. Another point of departure for The Heart is the writing style, which is different and takes some getting used it. Sentences seem to go on and on, sometimes even for entire paragraphs, which, in turn, are often longer than a page.

In conclusion, I found The Heart an interesting book, with some aspects of it that were brilliant — notably in capturing the nightmare of a parent dealing with the sudden and irreversible loss of their child — but others that I could not really appreciate. Perhaps, I am too much of a traditionalist when it comes to novels to appreciate a book that is so unconventional.

Getting back to Bill Gates who strongly recommended this book, you can read his take on it at https://www.gatesnotes.com/Books/The-Heart.

The Heart
Author: Maylis de Kerangal (Translated from French by Sam Taylor)
Publisher: Farrar, Straus and Giroux (English edition)
Publication Date: 2016 (Originally published in French in 2014)

Contributor: Lachmi Khemlani runs a technology publication in the San Francisco Bay Area.

“The Immortal Life of Henrietta Lacks” by Rebecca Skloot

The Immortal Life of Henrietta Lacks

This is the amazing story of a young African – American woman who became ‘immortal’ after cervical cancer claimed her life in 1951. The cells from her cervix came to be known worldwide as HeLa cells and continued to grow and multiply ad infinitum. They were the first immortal human cells ever grown in a laboratory. They were the first living cells shipped via postal mail. They facilitated the development of the polio vaccine in 1952. They aided cancer research and virology studies, besides cloning and gene mapping. Both Russian and American scientists had managed to grow HeLa in space. But no one had ever heard of the cell donor.

Was Henrietta Lacks really a donor? Was she aware that her cells had been cultured? Poor Henrietta knew only pain and hopelessness. She didn’t know the cells that were killing her by the second were going to live forever.

The author gives us interesting details of the life and family of Henrietta Lacks and brings up interesting questions about medical ethics, informed consent, and donor rights. It was only two decades after her death that Henrietta Lacks was actually named in a publication as the source of the HeLa cells. Only then does the world realize that the cells came from a black woman. Only in 1973 do her children learn that her cells are still alive and multiplying. Only in 1975 do they understand that the cells are being bought and sold and that companies and individuals are earning profits while they themselves can barely afford medical treatment.

Henrietta Lacks, wife of David Lacks and mother of five children, died when she was just over thirty. She had been born Loretta Pleasant in Roanoke, Virginia in 1920. Her mother had died in childbirth when Loretta was only four years old. No one knows how or when Loretta became Henrietta. She was brought up by her grandfather, a poor tobacco farmer. She married her first cousin when she was twenty. By then the couple already had two children. It is a tragic tale of poverty and the acute deprivations that accompany it. Henrietta fell victim to cervical cancer, suffered acute distress, both physical and mental, and finally succumbed.

The book is as much about the life and journey of HeLa cells as it is about Henrietta Lacks and her family. You have to be greatly interested in science, anatomy, genetics and medicine to really enjoy the book. It is extensively researched, is acclaimed as a New York Times bestseller, and the subject is fascinating. Yet it is hard to sift through the scientific facts and get a grip on the story. The book unearths some unusual facts that most of us are unlikely to have heard of. “When the first humans went into orbit, Henrietta’s cells went with them so researchers could study the effects of space travel, as well as the nutritional needs of cells in space, and how cancerous and non-cancerous cells responded differently to zero gravity. What they found was disturbing: in mission after mission, noncancerous cells grew normally in orbit, but HeLa became more powerful, dividing faster with each trip.”

The sad part is that none of Henrietta’s children were able to break out of the vicious cycle of poverty and deprivation that marked their mother’s life. The paths trodden by the five children are all too predictable, given the circumstances of their birth and family history and the reader can’t help sympathizing with them. What became of Elsie, the first daughter who was committed to a mental institution while still a child, is particularly heart-rending. Deborah, the younger daughter learns of her existence decades after Elsie’s death. Neither their father nor their eldest brother, Lawrence, had ever mentioned her.

Dr. George Gey was the man who cultured the first HeLa cells. This was at John Hopkins. He gave them away to anyone who asked for them. He had no profit motive. But soon the distribution of HeLa cells became commercialized and a multi-million dollar industry was born. Samuel Reader, the owner of Microbiological Associates was first to make big money out of this. But it was John Hopkins that Henrietta’s children were wary of. The author traces the history of this world renowned institution which makes interesting reading. “John Hopkins was born on a tobacco plantation in Maryland where his father later freed his slaves nearly sixty years before Emancipation. Hopkins made millions working as a banker and grocer, and selling his won brand of whiskey, but he never married and had no children. So in 1873, not long before his death, he donated $7 million to start a medical school and charity hospital.” And the rest, as we know, is history.

The author informs us that, “A search of the US Patent and Trademark Office database turns up more than seventeen thousand patents involving HeLa cells.” The 1980 Supreme Court decision in the case of Ananda Mohan Chakrabarty, who had been denied a patent for a genetically engineered bacterium that could consume oil and help clean up oil spills was an interesting piece of information.

Overall Assessment: Interesting, though not an easy read.

Title: The Immortal Life of Henrietta Lacks
Author: Rebecca Skloot
Publisher: Crown Publishing Group
Year of Publication: 2010

Contributor: Pushpa Kurup lives in Trivandrum, India and works in the IT sector.

“Switched On: A Memoir of Brain Change and Emotional Awakening” by John Elder Robison

Switched On

How much of what we are, what we think and feel, and what we do is determined by the “wiring” of our brains? This question is at the heart of Switched On, a fascinating memoir of one man who was a participant in a TMS (transcranial magnetic stimulation) research study conducted at the Neurology Department of the Beth Israel Center, which is a teaching hospital of Harvard Medical School. TMS is a magnetic method used to stimulate small regions of the brain, allowing doctors to change brain activity without surgery or medication. It has been in research and development for over twenty years, which seems like a long time, but is actually quite short in the medical research field, which is why most of us have never even heard of it. I learnt of TMS during a Fresh Air broadcast featuring John Elder Robison, the author of Switched On, and the neurologist, Alvaro Pascual-Leone, who led the TMS study at Beth Israel and worked closely with Robison throughout the time he was receiving TMS. The main reason behind inviting Robison to be a participant in the study was that he has autism, and the researchers wanted to investigate whether a non-invasive technique like TMS could help in any way.

Much of the book is a methodically detailed log of the author’s day-to-day experience with the study, including how he met the researchers, how he was invited to participate, why he agreed, what he was hoping for, the buildup to every session, what happened at every session, and what were the effects that he experienced afterwards. He also shares details about his family, his work, his autism, and the impact that TMS had on different aspects of his life. These details, in and of themselves, are not especially riveting—after all, who wants to know about the mundane details of the day-to-day events in our lives?

What we do want to know, however, is—does it work? Does TMS change our brains and consequently, our emotions and our actions? And if so, are the effects temporary or long-term? And since Switched On is a first-person account of someone who has actually received TMS, we actually get to know the answers to some of these questions. Robison does a terrific job of describing both the short-term and long-terms effects that he experienced after each TMS session, including being much more open to people and experiences, the ability to “read” people a lot better and understand nuances which had earlier escaped him thanks to autism, and even the ability to be moved to tears by a sad story, even if it was just in the newspaper or told to him by someone he had just met. Fortunately, being so overcome with emotion that life becomes difficult was not a long-term effect of TMS. At the same time, having had the experience of empathy and connectedness—however short-lived—provided him with a “knowledge” of these emotions that is helping him to better understand “normal” (non-autistic) people on an ongoing basis.

Of course, Switched On is one person’s account of the effect of TMS, and it’s possible that other participants in the study experienced somewhat different reactions and effects. It would be good to know more, and I hope the TMS researchers can compile their findings not just into research papers for the academic community but also articles and books for the rest of us. It is fascinating to think that everything we think and do—including this thinking!—comes from our brain chemistry. Does this mean that at some point, we will be able to manipulate brains to create “designer thinkers,” similar to how we could potentially manipulate genes to create “designer babies?” Another interesting question, brought to the forefront by Switched On.

Switched On: A Memoir of Brain Change and Emotional Awakening
Author: John Elder Robison
Publisher: Spiegel & Grau
Publication Date: March 2016

Contributor: Lachmi Khemlani runs a technology publication in the San Francisco Bay Area.