September 2017 Reading Recommendations

I apologize for my long absence from this space.  Like all of us, I’ve had a million things going on the last few months that have robbed me of the time not just to write these reviews, but to even read the books to be reviewed.  My normally prodigious reading has been trimmed by a significant amount lately.  But I’m hoping things have lightened up a bit, and I’ll be able to have more time to both read and write going forward.

Red Notice by Bill Browder is a riveting book. What with all that’s going on right now in terms of Russia’s influencing the recent US election, it should be read by everyone.  Much of what’s in the news lately centers around the brief meeting Donald Trump, Jr. had with Russian attorney Natalia Veselnitskaya, ostensibly to get dirt on Hillary.  Turned out the real reason Veselnitskaya wanted the meeting was to plant the seeds for a deal to turn on the flow of adoptive babies from Russia in return for a repeal of the Magnitsky Act.  Red Notice was written long before this meeting, but tells the story of how the Magnitsky Act came to be and why the Russians want shed of it.

Bill Browder has an atypical American story.  His grandfather was the president of the US Communist Party.  His parents were both huge overachievers in academic fields.  Bill Browder was himself a slug academically…at the start.  He didn’t know how to stand out or make a mark in his illustrious family, so he decided to excel in underachieving, which he was well on the way to doing.  Then he came upon the notion that the only way he could shine was to shun a career in academia and become the biggest capitalist in Russia. Once set upon his goal, he bailed out of the party school he was attending (after getting his grades up), transferred to the University of Chicago, and then went on to Stanford to get an MBA.

Education finally in hand, he had a series of jobs in the financial industry with an eye towards working in Eastern Europe or Russia. After cutting his teeth on the opportunities in the newly freed countries of the former USSR, Browder decided to open an investment firm in Moscow. At the time, Russia was denationalizing all kinds of industries, and knowledgeable people – the so-called oligarchs and Browder – were able to snap them up for a song. His business thrived, but then he ran afoul of the oligarchs. Initially, he was able to overcome their treachery, because at that time Vladimir Putin had it in for the oligarchs, too.  So Browder’s company’s objectives were aligned with both Putin’s government’s and Putin’s own goals.

Putin ultimately turned on Browder, however, and threw in with the oligarchs in an effort to enrich himself. At that point, Browder’s life turned into a hell. He became persona non grata and was kicked out of Russia, which is where the book starts.  The remainder is how he managed to defeat Putin and the oligarchs in a battle for the assets of his company. But it wasn’t without casualties. Though Browder got most of his employees out, the Russian police arrested his tax attorney, Sergei Magnitsky, who was imprisoned without cause and, basically, tortured to death, despite all Browder’s attempts to get him freed.

Since then, Browder has made it his life’s mission to avenge Magnitsky’s death.  One huge accomplishment was getting the Magnitsky Act, a law preventing any Russians involved in human rights violations from visiting or keeping assets in the US, pushed through the US Congress despite major objections from both the President (Obama) and Secretary of State (John Kerry).

Browder is obviously a bright guy financially, but he is an extraordinary writer. Red Notice (the title is named after the notice of criminality the Russian government delivered to Interpol in an effort to get Browder arrested and extradited to Russia) is better than most novelistic thrillers. The action is non-stop, and your sense of outrage grows with every page. This one is a must read. You will be gripped from beginning to end and will learn much you can use in your assessment of current events.

Hillbilly Elegy by J.D. Vance is another must read for anyone wanting to know what’s going on in America these days.  It’s written by another extremely intelligent guy who provides insight into one of the forgotten cultures in the United States. I had seen the book touted all over the place, but it wasn’t until a friend of mine interviewed the author that my interest was really piqued. Reading the book made me realize why I have to fight down some of the responses I, myself, have to people who attack me in print, on the road, or in person. I always jokingly call it my redneck response, but after reading this book, I suspect it’s probably hard wired.

I was describing the interview with the author to my kid, so he got me the book for my birthday.  I already had a bunch of books queued up to read and threw it in the pile. One Saturday, I picked it out just to flip through it a bit. I ended up glued to my chair and read the frigging thing from cover to cover over a long afternoon. It is that good.

Vance grew up in a blue collar area of Ohio, where his grandparents had migrated to find work before he was born. The grandparents and their parents for generations were from a dinky town in the mountains of Kentucky, where he spent the summers of his childhood and most of his school vacations. His mother was/is an opioid addict, who ran through husbands and live-in males non-stop. Consequently, Vance had little family stability. The only reliably secure adult he could depend on was his maternal grandmother, Mamaw, and to some extent his grandfather, Papaw. Mamaw turns out to be the star of this show. Everyone needs a Mamaw.

I’ve got to digress a bit here. A couple of generations ago my family came from this same part of Kentucky. One county over from JD Vance’s family, in fact.  My progenitors  moved from there to the Ozark mountains in southwestern Missouri, where I grew up. So, basically, I’m from the same stock, but run through a few generations of sophistication that filed down a few, but not all, of the rough edges.  My immediate family was about the first to move away from the Ozarks, and I well remember being thought different when we did move from place to place, while my father bounced from one job to the next. One of the places we moved was to Michigan. For a while we lived next door to a women we thought was nice when we moved in, but who turned out to be a total virago. I remember an episode when my father got into it with her, and she referred to us all as a bunch of hillbillies. Until then, I hadn’t thought of that as a derogatory term, because that’s how we referred to ourselves. I found it strange that Vance used Hillbilly in the title of his book, because throughout Mamaw is always telling him why we don’t do this or we do do that because we’re hill people. Not hillbilly’s, but hill people. I guess Hill People Elegy doesn’t have the same ring to it.

The book is by turns hilarious and sad. Vance describes the cultural decline in many areas of Appalachia in terms of the behavior and beliefs of his own friends and relatives. You get the sense of how these folks talk and act, especially Mamaw. Almost all of my favorite scenes (there are many of these sprinkled throughout the book) involve Mamaw and her foul-mouthed take on things, which you appreciate even more when you’ve gotten to know her:

By Mamaw’s reckoning, God never left our side. He celebrated with us when times were good and comforted us when they weren’t. During one of our many trips to Kentucky, Mamaw was trying to merge onto the highway after a brief stop for gas. She didn’t pay attention to the signs, so we found ourselves headed the wrong way on a one-way exit ramp with angry motorists swerving out of our way. I was screaming in terror, but after a U-turn on a three-lane interstate, the only thing Mamaw said about the incident was “We’re fine, goddammit. Don’t you know Jesus rides in the car with me?”

JD Vance, like Bill Browder, was pretty much a slug and a screw off during his youth. But once he moved in permanently with Mamaw, things changed. She rode him hard, and he made a turn around. Once he graduated from high school, he decided to go to college. He wanted to go to Ohio State, but neither he nor Mamaw had the funds. (Mamaw had spent most of the money saved during her working life keeping JD’s mother out of jail and in one rehab center or another.) So, he decided to join the Marines in order to go to college on the GI Bill. When he got out, he did go to Ohio State, where he finished his four year degree in 19 months and graduated summa cum laude. His academic performance got him into Yale Law School, probably the best and most difficult law school in the country to get into. And a place in which he was a total fish out of water.

Hillbilly Elegy is a wonderful, wonderful book that speaks volumes to what’s going on today. Vance does a masterful job of exploring the difference between the actual work ethic of many people from his culture (and others) with their perceived work ethic. It explains a lot. Like Red Notice, this one is also a must read.

Destiny of the Republic by Candace Millard shows just how bad medical science was in the United States in the early 1880s. And describes how much presidential politics has changed since. James A Garfield, who came from poor and humble Ohio origins, was a brilliant student. He became a nine-term Republican congressman, fought for the North in the Civil War, and had just been elected to the Senate when he was asked to attend the 1880 Republican presidential convention in Chicago. Because of his prodigious oratorical skills, Garfield was asked to give the nominating speech for Secretary of the Treasury John Sherman, the odds on favorite to win.  Garfield did so and his speech was so galvanizing that attendees started asking why it wasn’t Garfield who was running instead of Sherman. In the first round of voting, Garfield garnered a handful of votes, but no one got a majority. As the rounds of voting continued, Garfield garnered more and more votes. Finally, on the 39th vote, Garfield got enough to win the nomination. Since he was now the Republican nominee, he didn’t assume his seat in the Senate, but instead retired to his farm in Ohio to prepare for the general election, which he won.

But his unlikely and unexpected elevation to the presidency, while interesting, isn’t really what the meat of the book is about. The main subject is Garfield’s assassination within a year after the election by Charles Guiteau, an unstable lawyer (sort of) and con man.

When Garfield took office, the presidency wasn’t what it is today. There was no Secret Service, no phalanx of guards and armored cars, and, in fact, no real security at all. Unbelievable as it sounds, pretty much anyone, who wanted an audience with the President, had but to show up to the White House and wait for an appointment.  One of the banes of a president’s existence was dealing with the steady stream of people importuning him for various jobs, positions, and offices.  Garfield was the first president to actually hire a private secretary, what, I suppose, today would be a chief of staff, to screen the many people seeking one thing or another.

Guiteau, who was truly mentally ill, got it in his head that Garfield was going to appoint him ambassador to France. Joseph Brown, Garfield’s secretary, and other members of the administration recognized Guiteau for what he was and kept him from seeing the President. Ultimately, Guiteau developed the fantasy that instead of an ambassadorship, what he was really destined for was to kill Garfield on behalf of the nation.  Guiteau figured that once he could pull off the assassination, he would be lauded and proclaimed a hero by the entire country.  Thus were the wheels set in motion for the fateful day.

Unlike today, at that time presidents rode the train, rode carriages, walked in public, went to church along with the masses. So, getting close enough to kill a president was fairly simple. On July 2, 1881 Guiteau followed Garfield to the train station and shot him there. The bullets struck the president in his arm and his back. And then begins the main thrust of the book, which is Garfield’s medical care from the time of his shooting until his death later than year on September 19.

It’s almost unbelievable how barbarous the care was, if you want to call it that, Garfield received. The doctors acted with typical doctor arrogance and proceeded to seemingly do everything in their power to kill Garfield in the name of healing him. They ultimately succeeded, but not before putting a good man, who, apparently never complained, through multiple agonizing procedures.

The doctors of the time knew infection was bad, but didn’t really know how to prevent or treat it. Back in the days when I did surgery, we scrubbed our hands for ten minutes with antiseptic soap before each procedure. We dried with sterile towels and were gowned and gloved by nurses who had themselves gone through the sterilizing procedure known as ‘scrubbing in’. Despite all this care, we occasionally had infections in our patients, but not often. In Garfield’s case, they were probing his wound looking for the bullet with non-sterile probes inside the train station. In fact, probes were almost a part of poor Garfield’s daily routine, and they must have been horrifically painful as there was no anesthesia at the time. And when infection set in and pus started to accumulate internally, it’s unimaginable how agonizing probing into the wound must have been.

Candace Millard is a wonderful writer and has thoroughly done her research. I didn’t come across a thing that didn’t ring true from a medical perspective. And I learned a ton about what was going on scientifically in the United States at that time and was reminded of how abysmally lacking medical knowledge was then. The Great Influenza, a book I recommended previously, discussed the sorry state of medical education in the early 1900s. Destiny of the Republic shows just how terrible it was a couple of decades earlier. I encourage you to read it if for no other reason than to feel better about the state of medical care today. Had Garfield been shot in the same way today, he would have been back to work in a week or two, instead of suffering the excruciatingly painful months before his death from physician incompetence.

What is Fat For?: Re-Thinking Obesity Science by Ignatius Brady, M.D. is a strange book, almost schizophrenic in a way.  It’s worth reading to see the mainstream view of obesity. Sort of. Dr. Brady tells us that we are doomed to gain weight, no matter what. That cutting carbs helps, but not really. That adding protein helps, but not really. It’s all a matter of calories, but not really. See what I mean about schizophrenic. He more or less writes that the only way to really lose weight and keep it off is to have gastric bypass surgery. Which makes sense in a way, because he works as a doctor working patients up for gastric bypass surgery. He doesn’t operate on these people – he simply does the medical evaluations of them to determine their suitability for the surgery.

Don’t let what I wrote above put you off of reading this book, because it’s really a well-written overview of the current thinking about obesity with most of the low-carb stuff ignored. Or contradicted. Even though I didn’t believe half of what is written, I still enjoyed the book a lot and recommend it. Reading it tells me that it’s difficult to enter the obesity treatment field and not be overwhelmed with the multiplicity of ideas on how best to treat overweight people. If you go into cardiology, or just about any other specialty, there are a set of protocols on how to treat patients with various disorders within that specialty. Not so with obesity.  There are almost as many ways to treat obesity – some ranging from the outright weird all the way to major abdominal surgery – as there are doctors. Which is why it’s nice to read a book by someone grappling with the various techniques out there.

It’s obvious to me that Dr. Brady hasn’t quite clued in to who all the players are in the field. In one place he writes about a researcher who was asked after a talk he gave to provide three take aways from his lecture:

Dr. Hill spontaneously responded that he could only think of two: portion control and pedometers. I thought that was a great answer (from his perspective), and I think it qualifies him as an unbiased examiner of the low-carbohydrate hypothesis. [My emphasis]

This is James O. Hill, PhD were talking about here, and he could not be more anti-low-carb. He wrote a white paper once – to his everlasting shame – for the sugar industry in which he posited basically that sugar is nothing more than concentrated energy. He recommends not eating too much of it, not because there is anything intrinsically wrong with sugar, but because overeating it would give you too many calories. Granted sugar is a concentrated form of energy just as is fat. But it initiates a completely different metabolic response in those who consume it, so it isn’t just a concentrated energy source and nothing more.

Dr. Brady reaches out to Gary Taubes, who responds to him about the carbohydrate or hormonal theory of obesity. Then he contacts Kevin Hall, with whom he ends up doing a study. As I say, schizophrenic.

He becomes attracted to the work of Stephen Simpson, an Australian researcher who has published on what he calls the Protein Leverage Hypothesis (PLH).  The PLH more or less states that all animals eat until their protein requirements are met, then quit eating. So, if you eat a high-carb, low-protein diet, you will have to consume a lot of calories before your protein needs are met and, consequently, will overeat. If, on the other hand, you eat a diet high in protein and low in calories, you will eat less, because you eat only to meet your protein needs. The PLH is a little more complicated than this, but my outline is fairly accurate. Dr. Simpson has done most of his work with insects, so I’m not sure how much overlap there is with humans.

Most papers have shown that substituting protein for carbs brings about weight loss and substituting protein for fat on a calorie for calorie basis does, too.  So there may be something to the PLH, but I don’t think it’s anywhere near as strong as do Drs Simpson and Brady.

Dr. Brady thinks diets pretty much don’t work, so the best and most sure way to ensure weight loss is to have a gastric bypass. Not a decision to be taken lightly.  Especially when there are papers out there showing that people who don’t undergo bypass operations, but who do follow the same diet as those who have been operated on, achieve the same results. Which, to me, makes gastric bypass surgery a stand in for will power. I could muster a whole lot of will power before I would risk my life on bariatric (weight loss) surgery. It’s interesting to note that in our practice, we saw a number of patients who had undergone bypass surgery and gained all their lost weight back.  So, the procedure for sure doesn’t provide permanent will power.

In the end, Dr. Brady would encourage people to do a high-protein, lower-carb diet, which, he believes, will make the biggest difference in the greatest number of people. But, he figures, most people won’t follow it for long anyway, and if they get large enough, they’ll fall into the hands of the bariatric surgeon.

There is one other little tidbit I got from this book. Dr. Brady mentions a medical school professor of his who told him that most people gain a pound a year after age 20. When he learned this, Dr. Brady was 26 years old and weighed exactly 126 pounds. He figured that he had probably weighed 120 pounds at age 20, so watched his own weight creep up over the years. Sure enough, when he was 30, he weighed 130 pounds, and weighed 140 pounds at age 40. He did a literature search and found a couple of papers that lent some validity to the pound per year theory.  Check it on yourself.

Didn’t work for me.  I now weight about ten pounds less than I did at age 20.  Probably the wrong ten pounds, but who’s counting.

I would really encourage you to read What Is Fat For? It’s a comprehensive overview of the science of obesity, and you’ll learn a lot. You may not agree with everything you read, but Dr. Brady is a nice prose stylist and his explanations are clear and to the point. And sometimes incorrect, in my opinion. But this is an easy short read, so I hope everyone grabs a copy.

This review has gone on to The Brothers Karamazov length, so I need to close it out. I haven’t gotten to all the books I wanted to review, so I’ll try to add them to next month’s list.

I’ll go ahead and give you a couple of titles in case you’re chomping at the bit for some fiction.

Prussian Blue by Philip Kerr

Stasi Child by David Young

Both books involve Erich Mielke, a particularly loathsome character. He was a communist in pre-WWII Germany, who gunned down a couple of policemen in Berlin, then fled to the USSR where he ingratiated himself to the powers that be there and ended up joining the NKVD, the predecessor to the KGB. After the war, Mielke was sent to East Germany, where he became the head of the Stasi, the infamous East German secret police. Mielke’s Stasi was an incredibly invasive police state, which Holocaust survivor Simon Wiesenthal considered “much, much worse than the Gestapo.”

If you read only one of the two fiction books above, read Prussian Blue. You will be in good hands with Philip Kerr. And it may kick you off on the whole Bernie Gunther cycle, all of which are great reads.

Also, this past month, I ended up binge reading (a lot of long flights) on John Le Carré. But I’ve got to quit now. I’ll pick all this up next month.

As always, if anyone has any reading recommendations for me, don’t hesitate to send them to me at mreades@proteinpower.com.

 

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