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This site is supported by Health ONE  

Singapore Med J 1998; Vol 39(12): 566 - 574

A Book I'd Recommend to a Colleague
G Baratham, C T Tan, K T Woo, Y C Chee, K Lyen, L L Chang, D S Singh, B Yeo, O L Kon, W C C Chong, C Y Wong, D Tan, D Fung

 

Truth : A History and a Guide for the Perplexed
by Felipe Fernandez-Armesto
Bantam Press, London, 1977, 257 pages

 

Felipe Fernandez-Armesto has taught modern history at Oxford since 1983. This book might be considered more a contribution to philosophy than to history. Most of us consider that truth is somewhere out there waiting to be discovered. Fernandez-Armesto demonstrates how wrong this approach is. There are ways of looking at the truth and each of these are examined in turn. Each is a method of arriving at one aspect of the truth but the search for the whole truth is unending and an inevitable part of the human condition. This is so from the earliest of communities. "...the recognition of danger or opportunity seems to be instinctive and unconscious... As soon as it becomes conscious, it reflects a concept of truth."

The author courses through countries, cultures and periods of history to demonstrate the ways in which the truth has been sought after. He speaks of how extremely primitive communities pursued this elusive quality and how their equations were different from our own but perhaps no less correct. He discusses the Nyaya doctrines where meaning did not arise from mind but was conferred on objects by the thought of God and deals with Mo Tzu who talked of universal love 400 years before Christ. Even Mo Tzu’s Confucian adversaries who burnt his works had to admit that he ‘would wear out his whole being for the benefit of mankind’. All this is done in such a casual way that one doesn’t realise that one is being educated.

Fernandez-Armesto does not offer prescriptions but in the end does come down on the side of faith in truth. "...when people stop believing in something, they do not believe in nothing; they believe in anything. Crackpot cults prosper, manipulative sects thrive, discredited superstitions revive."

The corollary is implied: those who have found and believe they have a monopoly of the truth reside in lunatic asylums or in the palatial edifices that tyrants build for themselves.

Dr Gopal Baratham
Neurosurgeon in Private Practice


The Road Less Travelled : A New Psychology of Love, Traditional Values and Spiritual Growth
by M Scott Peck
Simon & Schuster, New York, 1978

There are many books written by experts in the study of the mind for the general public, translating difficult scientific concepts into lay language to enrich the lives of many. Among them, The Road Less Travelled is one of my favourites. The book has been a best-seller in America for many years. In recent years, it has also become more popular locally. There is even a Chinese translation published by the Commonwealth Publishing Co. Ltd., Taipei.

Dr Peck is a psychiatrist from Connecticut. The theme of the book is about the path to mental health and spiritual growth. The book is divided into four sections. The first section, ‘Discipline’ starts with the premise that life is difficult, that life is a series of problems; whereas neurosis is the substitute for legitimate suffering, and the substitute ultimately becomes more painful than the legitimate suffering it is designed to avoid. Thus, discipline is the basic set of tools to solve life’s problems. Discipline involves delaying gratification, willingness to confront and accept responsibility for problems; dedication to reality and truth; openness to challenge and change. The second section is on ‘Love’. Whereas discipline is a system of techniques, the strength and energy to use the technique is love. Love is defined as the will to extend one’s self for the purpose of nurturing one’s own or another’s spiritual growth. The author explained the meaning of love, the difference between love and romance; the confusion between love and dependency, love and self-sacrifice. The third section is on ‘Growth and religion’. It answers the question: ‘Is belief in God a form of psychopathology?’ The forth section is on ‘Grace’, which is a defence of religion. The author is a Catholic.

The book is interesting firstly because of its emphasis on discipline and its positive view on the role of pain and difficulties on a healthy mental life. In this age where the meaning of life is often measured by the amount of happiness, it is reassuring to see the traditional values of discipline and suffering receiving such strong support from a modern psychiatrist. Similarly, in this age where individual fulfillment has become the yardstick for measuring the quality of life, it is refreshing to read Dr Peck’s definition of love, which is the pursuit of one’s own or the other’s virtual growth. The meaning of love has always been an important topic. As the author said: "Our use of the word ‘love’ is so generalised and unspecific as to severely interfere with our understanding of love... as long as we continue to use ‘love’ to describe our relationship with anything that is important to us... without regard to the quality of that relationship, we will continue to have difficulty discerning the difference between the wise and the foolish, the good and the bad, the noble and the ignoble. Finally, Dr Peck is a psychiatrist who places religious faith in its appropriate place. Religion is the understanding of what life is all about, our worldview, the belief as to the essential nature of the world. Since every one has some world view, everyone has a religion. As Dr Peck said, "It is possible to mature into a belief in God."

Prof Tan Chong Tin
Neurologist
University of Malaya


The Silent Cry

Kenzaburo Oe, Nobel Laureate for Literature 1995, is one of the leading writers in postwar Japan. He was born in 1935 and studied French Literature at Tokyo University and spent the 1960s in Paris. This was the time when existentialism was in vogue and he was particularly influenced by Sartre. Oe suffered a family tragedy - the birth of his brain damaged child. This event in his life has been fictionalised in his first novel, A Personal Matter and in this novel, A Silent Cry. The title is apt as it resounds Oe’s cry of anguish. I believe that in many ways, the practise of an existentialist philosophy has played a role in shielding him from life’s vicissitudes.

Oe is a powerful novelist. In the words of Yukio Mishima, Oe is a new pinnacle in Postwar Japanese Fiction. This book is steeped in black humour and according to the translator John Bester portrays unforgettably the existentialist despair of Japan today.

Two brothers, Mitsui (author) and Takashi (younger brother) return from Tokyo to the village of their childhood and tried to adapt to the secluded lifestyle. In a communal setting, every event gains momentous significance and involves communal sharing of experience. In the Nembutsu Dance performed at the Bon festival, spirits come back into the valley in single file procession that followed the gaveled road down from the upper reaches of the forest. They are greeted with reverence by the inhabitants because they exert a harmful influence on the present world. Any floods or rice pest is attributed to these spirits. To placate them, villagers devote much energy to the Bon festival. They perform spectacular dances in masks and coloured costumes, sometimes creating horrible figures, like during a typhus epidemic where a figure like a huge white cuttle fish was an object of terror to the children.

Mitsui had difficulty connecting with the Spirit Leader and his wife accused him of being cut off from what his brother Taka calls the ‘communal sentiments’ of the valley folk. Mitsui himself felt like an ‘outsider’. Here the reader catches a glimpse of a similarity to Camus’ work The Outsider.

I would like to do this book review from the existentialist’s viewpoint to allow the reader an insight into the existentialist mind as I belief that Oe is an existentialist writer with a unique gift. The character Mitsui, the existentialist, is also the author. He works as a translator of books. He described an afternoon scene, with the warm air drafting through the window, set in the solid storehouse wall, lapping around him like lukewarm water and thawing out the frozen hunks of head, shoulder and sides till he suddenly became one with the dictionary, Penguin book and pencil and all his other selves evaporated, leaving only the one pressing ahead with the translation.

He once visualised himself taking a walk: "I went on walking; quietly, calmly, smiling so as to keep my physical reactions under the control of my mind. The eyes of the women and old folks were watching us (Mitsui and wife). The whole scene had become absolutely alive to me. Calmly I worked to maintain my placid smile, worked with the absolute calmness I had seen in the eyes of our baby who had failed in the long run, to establish any ties of understanding with the real world. I had shut myself up, had no interest in, couldn’t be disturbed by anything in the valley. I wasn’t there on the gavelled road."

The existentialist had shown the village the face of a stranger; totally unconcerned with the rest of the valley and all its affairs. He had walked on slowly, smiling to himself, an invisible man treading an unfamiliar path.

From the very onset, the valley had not really existed for Mitsui. He had no longer any roots there nor made any attempt to put down new roots, even his ancestral house and the land was as good as nonexistent.

Even if the whole valley should charge him with being a rat, he would retort with hostility. "And who are you, to insult a stranger, whose affairs are none of yours?" He was just a transient in the valley.

Once he wrote, "I went to sleep wondering how it would feel in practice to be invaded by the soul of a dog. Its tail, which was round, plump and springy like a long whip, was curled between its back legs to hide its genitals and it gazed at me inquiringly as it floated limp in the darkness."

Here, readers will readily see the similarity to Chuang Tzu’s dream. Chuang Tzu was a disciple of Lao Tzu who belonged to a period 3 or 4 centuries before Christ. In the identity of contraries: showing how one may appear to be either of two, "Once upon a time, I, Chuang Tzu, dreamt I was a butterfly, fluttering hither and thither, to all intents and purposes a butterfly. I was conscious only of following my fancies as a butterfly and was unconscious of my individuality as a man. Suddenly I awaked and there I lay, myself again. Now I do not know whether I was then a man dreaming I was a butterfly or whether I am now a butterfly, dreaming I am a man. Between a man and a butterfly there is necessarily a barrier." The transition is called Metempsychosis.

Mitsui had a good friend who committed suicide. He hung himself stark naked after he had painted his face crimson red. Mitsui wrote: "If I were to hang myself like my friend, with my head daubed in scarlet, naked, and a cucumber stuffed up my rear, I would have to paint in a glaring green eye on my upper eyelid for my death outfit to make any greater impact than my friend’s."

According to Mitsui, we always rationalise even the truth, and the worse are writers who fictionalise truth and rationalise thus: "Writers tell something nearer the truth and survive without being beaten to death or going mad. They deceive others with a framework of fiction, but what essentially undermines the work of an author is the very fact that, provided one imposes a framework of fiction, one can get away with anything, however frightening, dangerous or shameful it may be. This communicates itself eventually to the reader, who develops a low opinion of fiction as something that never reaches directly into the innermost recesses of the soul."

I disagree with Mitsui and quote Oscar Wilde, "Fact is fiction and fiction fact."

In the chapter titled ‘The freedom of the ostracised’ Mitsui wrote: "Time passed, but the powdery snow went on falling, betraying my private hope that it would change into larger, petal-like flakes, and I remained alien to it. I stayed shut up in the storehouse, concentrating on my translation, never going out into the snow. My meals were brought to me there. I went to the main building only to replace the water in the kettle on the stove. Eventually, I discovered that I could use melted snow in my kettle and my daily life was cut off even more definitely from the main building."

His wife was no longer sleeping with him. She was sleeping with his brother Taka. She told Mitsui that there was a dead fly stuck on his knee and asked him why he did not remove it.

He reflected: "We were still man and wife, with no alternative but to go on with our joint life, indefinitely in this way. We were settled with two minds that were in two bad a state and within that state, too tampered with each other to allow a divorce".

His wife told him: "Schopenhauer said, you can squash a fly, but the ‘thing in itself’ doesn’t die," she whispered.

"You’ve only killed the fly phenomenon. Dried up like this, it really does give the feeling of being a ‘thing in itself.’"

Winter was coming to an end: The sound of dripping water as the snow melted under the heat of the sun had begun to run down the thick layer on the roof heralding the end of winter.

"But the snow melted by the sun started to freeze again. Deep, reddish black forms crept around me as I went. Shadows, which had completely disappeared when snow fell, was returning to the valley. The wind had swept away the thinning clouds to reveal sunset skies.

During the morning, the sun had been free of clouds, but dust from the continent had hung a deep, yellowish brown shadow about it, weakening the sun’s rays. The same darkness had persisted even after the wind grew stronger and had finally sunk unrelieved into night. As the gale mounted, the forest gave off a deep throated roar like a stormy sea, the sound swelling till the very soil seemed to cry out." He writes lovely prose.

Mitsui had been informed that his brother Taka had raped and killed a village girl. Mitsui wished he could close his eyes and let himself fall backward, curled up like a foetus and deny the whole of reality and if reality ceased to exist, then his criminal brother and the crime itself would vanish too.

Later Takashi committed suicide and Mitsui and his wife were now together again.

"But nowadays," he wrote, "she would lapse almost at once into a profound silence, fleeing beyond the sphere of conversation. For a while after Takashi’s death, she had been in a state of constantly renewed drunkenness." Mitsui no longer cast any deep shadow

across the world of her awareness, nor she on his.

In the closing: And the owners of the forest land shut themselves up again in their snug shells with audible sighs of relief.

Mitsui walked down the valley, his eyes stung by the thick dust; snow had completely vanished, leaving the soil parched and powerless as yet to put forth new life. An air of indefinable loss, like the dead ruins of a human being, awoke an uneasiness in him as his gaze roved across the hollow.

And this is a fitting end to Mitsui’s story: An existentialist in peacetime.

The Silent Cry unveils the intricacies of the existentialist mind interwoven within the ingenuous fabrics of a master craftsman. Its raw and at times shocking imagery is a mental feast typical of Japanese writers like Mishima and Kawabata. The book evokes a nostalgia which is Camus-like, dangerously intoxicating, like eating salmon shashimi with more than the usual dose of beer mustard.

I read Oe sitting in the balcony of a London apartment with the cold wind blowing on my face gazing upon the tall trees and the wintry landscape below. As I read, it drizzled, but was pleasantly surprised to realise it was snowflakes falling on my face, arms and the open book. Reading and sipping Japanese green tea I still remember distinctly a line in the book about using melted snow to boil drinking water. One hour into my reading the whole landscape below was clad in white snow. The date 1st Feb 1995, 2.00 pm but it was already like night outside.

 

A/Prof Woo Keng Thye
Department of Renal Medicine
Singapore General Hospital


The 7 Habits of highly Effective People
by Stephen R Covey
Simon & Schuster, USA; 358 pages

 

I would recommend this book by Stephen R Covey. It was a number one national bestseller several years ago. No doubt Mr Covey has written several other books all to do with 7 habits but I have only read this book which deals with powerful lessons in personal change. We all want to improve ourselves; we want to do better; we are short of time for the things we wish to achieve; so how?

This book is subtitled, Restoring the Character Ethic. It allows us to be empowered and empowering. We seek not to be independent but we seek a higher value - that of interdependence. We start and probably end life dependent on others but somehow in between, we feel total independence is best. To some extent, that may be true but synergy comes through working with people. Globalisation is interdependence of one nation on another, so we fought for independence and achieved it but now the race is to interlink, interconnect ourselves with other peoples.

The 7 habits explained and elaborated upon in the 358 page book are: 1. Be Proactive - the Principles of Personal Vision; 2. Begin with the End in Mind - Principles of Personal Leadership; 3.

Put First Things First - Principles of Personal Management; 4. Think Win/Win _ Principles of Interpersonal Leadership; 5. Seek First to Understand, then to be Understood - Principles of Empathic Communication; 6. Synergize - Principles of Coactive Cooperation and 7. Sharpen the Saw - Principles of Balanced Self-Renewal. The first three habits relate to private victory - habits that allow oneself to be happy with one’s own life. Without this, it will be difficult if not impossible to move on to public victory, which is covered by the next three habits. And the final habit is essential to continued victories. Self-renewal, retreats, resting places for reflection and introspection _ these allow us to recharge our batteries and move forward with renewed zeal and enthusiasm. Pressures, stresses, repetitive chores and necessities of life can make us jaded, listless and apathetic.

This book is about living - a book about holistic, integrated, principle-centred approach for solving personal and professional problems; how to live with fairness, integrity, honesty and human dignity - principles that give us the security to adapt to change, and the wisdom and power to take advantage of the opportunities that change creates. For learning organisations to develop, it is a prerequisite that individuals within that organisation are personally effective people. Then together, despite all the responsibilities and demands of time, travel, work and families placed upon us in today’s competitive world, it is still possible to achieve progress and success without compromising ethics.

A/Prof Chee Yam Cheng
Department of Medicine
Tan Tock Seng Hospital


Angela's Ashes
by Frank McCourt
Scrber 1996; 364 pages

Frank McCourt’s Angela’s Ashes is a truly awe-inspiring autobiography. Indeed, it is one of the best books I have read this year. It fully deserves the Pulitzer Prize that it won in 1997. McCourt’s own authentic Irish voice narrates the story and takes you on an emotional journey from his poverty-stricken childhood in America and Ireland, through to his early adulthood.

Angela refers to his mother, who was only a teenager when she married his father, Malachy, an alcoholic who could never hold down a job. Frank was born in Brooklyn during the years of depression. When he was four, his father moved the whole family back to Limerick, Ireland. But life was equally bitter in Ireland. His mother had one baby after another, with almost no support from father. Not only did Malachy fail to gain regular employment, but he squandered what little he earned on drinks. He often came home late and in a drunken state. Fortunately, Frank was a bright kid who learnt quickly, and developed a gift for writing. At the age of ten, he developed a nosebleed and dizziness, and was admitted to hospital. He was diagnosed with severe typhoid and was at death’s door. He developed a friendship with Patricia Madigan, a girl in a neighbouring bed with diphtheria, and learnt poetry from her. She died and he survived. After he recovered, he got a job delivering telegrams and writing demand notes. From his meagre earnings he provided the only income to support his entire family, in contrast to his worthless father.

The book is deeply moving and your senses are assaulted by the gritty realism. You can smell the sewer that runs in the middle of the street and the backflow of excrement into their kitchen. You feel sorry for his proud mother who has to beg for a pig’s head for their Christmas dinner. You sympathise with McCourt when his schoolmates mock him for wearing shoes with rubber car tyres, and when he is spurned by the Catholic Church. Your blood rages when his father spends all the family’s money on alcohol, leaving the children with no food to eat, no clothes to wear in the freezing winter. You weep when three of his siblings die of starvation.

Despite the heart-wrenching sadness of such a harsh life, McCourt has the gift to make you roll over laughing as well as to make you cry. It is a beautifully written book, full of vitality and compassion, with incredible detail, and the effect is all the more powerful. And if you have never suffered from poverty or starvation, you must read this book. It will broaden your humanity.


The Rape of Nanking: The Forgotten Holocust of World War II
by Iris Chang
Basic Books 1997; 304 pages

 

 

Iris Chang’s The Rape of Nanking is an important historical account of the massacre of Nanjing civilians in 1937 by the invading Japanese army. It is well-researched and extremely readable. This massacre is sometimes referred to as the Chinese Holocaust because some 300,000 civilians of Nanjing were brutally murdered, and up to 80,000 women were raped during a period of seven weeks. The subject matter is absolutely compelling, but at times the brutalities described, together with horrific photographs, is so sad that reading becomes almost unbearable.

War brings out the best and the worst in one. Soldiers are so desensitised to killings and torture that they inflict the most hideous barbarities on their defenceless victims. No sane person would ever contemplate such cruel behaviour, but war engenders a state of temporary insanity. The Japanese soldiers in Nanjing disembowelled their victims while still alive, tossed babies in the air like a football and stabbed them with their bayonets. There are photographs taken by the Japanese recording decapitated civilians, and one which displayed a severed head with a cigarette butt inserted between the lips as a joke. Although military policy forbade rape, it carried on rampantly. Even girls as young as 8 years old and elderly women in their 70s were raped and beaten up. Usually the raped victims were killed "because dead bodies don’t talk." Iris Chang’s writing is factual, but the facts are so gruesome that I could feel the victims’ intense sufferings and could not stop crying.

This period of history has largely been neglected and forgotten. Indeed many prominent Japanese, including a cabinet minister have denied that it ever occurred. Quite recently, the Japanese have rewritten their children’s history books glossing over their involvement in the second world war.

We do not wish to blame the Japanese. Brutalities have been perpetrated by nearly every nation, every race, and by every religious group throughout the history of mankind. However, such deeds should never be forgotten. "The wise forgive but do not forget." It is only by recognising their existence that we might form a collective conscience that will help future generations avoid repeating such atrocities.

Hence Iris Chang’s book of crimes against humanity that occurred in Nanjing is too important to be neglected. I recommend it wholeheartedly.


The Diary of a Young Girl
by Anne Frank
The Definitive Edition, Viking 1997; 339 pages

It is quite late in life that I finally got round to reading Anne Frank: The Diary of a Young Girl. It records 13-year-old Anne Frank’s experiences from 1942 to 1944 during the Nazi occupation of Holland where 8 Jews from 3 families were hiding in a cramped warehouse annex. Eventually they were discovered by the Gestapo in 1944 and all of them were sent to concentration camps, where everyone died except for Anne’s father. This latest 1997 edition is one of the most comprehensive, with a new translation, and containing 30% more material than previous editions.

A remarkable book for such a young teenage girl. Honestly written, it is full of insight, humour, and humanity. In her diary, she wrote that "in spite of everything I still believe, that people are truly good at heart." Anne described their cramped quarters, their near starvation, their frustrations and conflicts living so close together, isolated from the outside world. She also related her own coming of age, which was deleted from earlier editions.

Hiding in the annexe, they had to keep quiet all the time, afraid to flush the toilet and not allowed to open their window. "We’ve been strongly reminded of the fact that we’re Jews in chains, chained to one spot, without any rights, but with a thousand obligations... The time will come when we’ll be people again and not just Jews!"

With clairvoyance she wrote, "You’ve known for a long time that my greatest wish is to be a journalist, and later on, a famous writer. We’ll have to wait and see if these grand illusions (or delusions!) will ever come true, but till now I’ve had no lack of topics. In any case, after the war I’d like to publish a book called ‘The Secret Annexe’. It remains to be seen whether I’ll succeed, but my diary can serve as the basis." Little did she realise that her dream would come true, but only posthumously.

All eight fugitives were betrayed by some informer and were arrested by the Gestapo on 4 August 1944. Anne was taken to Bergen-Belsen concentration camp, where she died, age 15 years.

Read the book for a good cry. I wish I had read it many years earlier.

Dr Kenneth Lyen
Paediatrician in Private Practice


Travel Books
by Paul Theroux
Penguin Books, 1975 - 1995

It started with a curiosity about the author. Paul Theroux was a lecturer in the English department of the University of Singapore under Prof Enright from 1968 to 1971. He was also my neighbour in College Green and walked past my house daily to reach the main road. I did not know of him till he became famous (or infamous) after his remarks on Singapore got him into trouble. His novel Saint Jack was based on Singapore and was subsequently made into a forgettable film.

One day, in the late 70s, I espied his book The Great Railway Bazaar in the book shop. That was the first of the many of his travel books I was to read. It started and ended with the sentence "Ever since childhood, when I lived within earshot of the Boston and Maine, I have seldom heard a train go by and not wished I was on it." That struck a chord in me having tolerated the Malayan Railway throughout my student days but had just enjoyed the delights of the Eurail pass at that time. In his book, he travelled from England through Europe, Iran, India and parts of Asia. He had to fly or sail on parts of the route where there were no trains, ending his trip taking the Trans Siberian railway through USSR into Europe and back to England. I was enthralled by his use of language, his detailed description of places and people, his wicked humour. I was amused more than annoyed of his description of Singaporeans "... rude, aggressive, cowardly and inhospitable, full of vague racial fears and responsive to any bullying authority." It definitely was coloured by the way he had been treated during his earlier confrontation with the government.

The next book that came out, The Old Patagonian Express, took him (and me) by train through the Americas, starting from Boston and ending where the line ran out in Patagonia, southern Argentina. Three years later came The Kingdom By The Sea which saw him on the train, obsessively visiting each and every town on the coast of Great Britain. Then in 1988 came my favourite, Riding The Iron Rooster, a train ride through China. I had not been to China then and I read his book, fascinated by the stories, full of sights and smells and sounds of a great country where my forebears had come from. Having started to put a toe into the country since, I have read and reread portions of the book. The Happy Isles of Oceania which covered Australia, New Zealand and the myriads of islands in the Pacific came next and finally, last year came a grand tour of the Mediterranean, The Pillars of Hercules. This last book made a circuit of the sea starting from the Rock of Gibraltar and ending in Cueta, Morocco. He would travel on foot, by bus, train, ferry or ship with a notebook on hand, jotting down conversations he had eavesdropped on, conversations he had had with the many people he met along the way or personalities he had deliberately sought out to meet. With his sharp eye and acidic pen, he crafts a compelling travel tale which includes portraits not only of the place and the people but also the political and social scans at that period of time.

Just as the writer is obsessively compulsive in his travels, this reader is equally obsessive about reading his travel books. Perhaps it is because of a vicarious need to fulfil something I wish to do but do not have the physical or mental fortitude to embark on.

It tickled me to see that his first paperback cost me $6.30 and his last book, $24.13, with GST. All this in a span of 20 years.

Dr Chang Li Lian
Family Physician


The Coming Plague
by Laurie Garrett
Virago Press, USA, 1994, 750 pages


The Coming Plague
was first published in 1994. The author, Laurie Garrett, formerly a health and science writer for Newsday/New York Newsday is eminently qualified for this monumental task. This is not a science-fiction novel. It reads more like a textbook of microbial mysteries. The author has researched extensively and in depth into

the facts of the many epidemics that have plagued this planet in recent times.

She has detailed all the facts and has spiced the stories with a host of thought-provoking and contentious views/ideas of her own plus of many eminent virologists and epidemiologists in a clear and very readable genre. There is a wealth of scientific, medical and historical knowledge in the book.

She begins by describing the Bolivian epidemic of 1962 called the ‘Black Typhus’, then extensively reviews the spread and conquest of Malaria, Polio, Small-Pox, Tuberculosis in the middle of this century, followed by the havoc and panic generated by the epidemics caused by the Marburg, Lassa Fever, Ebola, Hanta and Aids viruses. She concludes by expounding on the dangers posed by the re-emergence of drug resistant tuberculosis, malaria and other microbial diseases plus on the theories and the reasons for the emergence of new microbes and the development of drug resistance.

She vividly traces the unfolding of the epidemics; the efforts made to elucidate the epidemiology, describes the clinical profiles and untold human suffering endured by those afflicted. It is gratifying to read of the pioneering and courageous efforts of the many who toiled tirelessly, at great personal risks, to understand and contain these epidemics. On the other hand it is disturbing to learn that mankind has played and continues to play a significant part in creating the environment for the occurrence of these epidemics.

With ease and rapidity of travel and the worldwide movement of humans, goods, materials, insects and organisms, globalisation of diseases will occur, making the potential for worldwide epidemics a reality. The consequences can be devastating, as the Aids pandemic has already shown.

In the words of an eminent virologist _ "viruses were mutating at rapid rates, rain forests were being destroyed, forcing disease carrying animals and insects into areas of human habitation and raising the very real possibility of lethal, mysterious microbes infecting for the first time, humanity on a large scale and imperil the survival of the human race".

According to another, "The problem is serious and it’s getting worse". There are 5,000 species of viruses of which only 4% have been characterised.

This is an awakening call that the author is sounding of the coming plague. She believes that an early warning system must be developed for the early detection of new microbes and re-emergence of old ones. We can ignore this only at our own peril. I.F. Stone, an American journalist said ‘Either we learn to live together or we die together.’

This book makes very compelling reading. It is factual, terrifying and thought provoking.


Dr Dhanwant Singh Gill
Department of Respiratory Medicine
Tan Tock Seng Hospital


A Year in Provence
by Peter Mayle
Hamish Hamilton, London, U K 1989; 197 pages

Toujours Procence
by Peter Mayle
Hamish Hamilton, London, U K 1991; 213 pages

 

Escape from the maddening city with its closeting work schedules and embrace a life of cheerful abandon in the heart of France. Take time to recharge one’s batteries and experience yet again the forgotten joie de vivre. These are the very reasons that I would turn to the two volumes by Peter Mayle and I would unhesitantly recommend them to anyone who wishes to take time out to shake off the dust of burnout or ennui.

The narrative is easy going, devoid of pretentious bourgeois embellishments that typify nouveau riche descriptions of escapades in France that are pervasive the market. It tells the true story of one city man’s decision to give up his career to find himself in the countryside of France. His exploits in creating his rustic home, his problems in crossing the language hurdles and the redolent accounts of warm food, succulent fruits, crisp wines and good friends form the simple yet satisfying highlights of the storyline. There are no twists of plots, sudden happenings or prolonged trials. It is a pure hedonistic foray into the perennial search for the best truffles, pate, game, meat and greens. The only tolerated murmured arguments are confined to which wines match which food and to be drunk in which order. Nothing too energetic or noisy to jar the salubrious pace of the books or to wake one up from any post-pariandal slumber.

The novels have become international best sellers and many readers have made the pilgrimage to Provence, much to the consternation of the author, who I gather, have now upped stakes and moved to New York state. Amongst many of my colleagues, I have noticed this book also having an effect on their palate, demeanour and approach in life. I can personally attest to its effect in making my in-camp reservist trainings somehow more palatable. Eating army rations in mouldy tents amidst wet foliage seem light years away from fine food and genteel ambience. However, by the evening glow, amidst stout friends in camouflage, easy camaraderie and light banter, the book does lift one’s spirits and makes one feel that all is right in the world. I am still more of a gourmand, one that eats a trifle too much, rather than a gourmet where fastidiousness to quality rather than quantity prevails. Yet, these excellent volumes offer wonderful magic carpet rides to a more simple and appetising lifestyle to anyone and everyone regardless of size, shape and evolution on the culinary palate. Settle down, relax and enjoy ... Cheers.

Dr Brian Yeo
Department of Psychological Medicine
National University Hospital


The Golden Gate
by Vikram Seth
Random House, New Tork, 1986; 307 pages

 

If the end-of-year respite allows you time only to read one book, let it be Vikram Seth’s The Golden Gate. Readers who have not discovered Seth (can there be any?) should be assured that, being a non-Booker author, Seth’s writing is delightfully different from the oeuvres of many other ‘serious’ contemporary authors who appear hell bent on making reading for pleasure a penitential experience. The Golden Gate is a page-turning novel in verse of life in archetypal 1980s California. Seth has that lightness of touch which is a mark of true talent and makes poetry accessible again to adult readers whose aversion to this literary form may have been conditioned by a childhood diet of nursery rhymes and contrived limericks, or who see much of modern poetry as poorly written prose masquerading in arty formats. Writing The Golden Gate took 13 months and put paid to Seth’s career as a PhD candidate at Stanford University for which his readers must be grateful. The world needs a gifted poet more than just another (un) talented PhD. Unlike A Suitable Boy, this novel in verse can be savoured in solitary pleasure over a holiday weekend _ surely a more cheerful prospect than the dreadful round of office parties at this time of the year.

 

Dr O L Kon
National Cancer Centre, Singapore


It's a Jungle Out There
by Gary Richmond
Harvest House Publishers, USA, 1996, 234 pages


This is an interesting book consisting of 32 short animals stories based on former zoo veterinary assistant Gary Richmond’s real life experiences at the Los Angeles Zoo. The stories underlie Richmond’s devotion to his religion, passion for the animals, the people around him and life. Through his eyes, I’m able to peer into the zoo residents’ daily lives. The birth of baby giraffe, Charlie the chimp’s frustration over family matters, coscoroba swans’ love affair and many more events are illustrated skillfully. Richmond’s real gift lies in his ability to relate what he experienced at work to our lives, using the stories as metaphors, enabling the reader to reflect on everyday life issues; events that we have not seen or refuse to see.

In the first story ‘Ups and Downs’, the excitement of anticipating the birth of baby giraffe soon turned into a great astonishment when Richmond witnessed that it is the very nature of giraffes to give birth to their young while standing and this is estimated to be ten feet high. After birth, baby giraffe is subjected to mother giraffe’s repeated kicks. This, Richmond learned, was mother giraffe’s instincts to get baby to quickly stand up firmly on his feet so that

it would not be left behind by the herd as they move along in the wild. Richmond relates this encounter as, "It’s easy for us to view trials as unwelcome intruders in our lives. But they do have a way of

prompting us to get up..." ‘Wild animals’ instincts have shown us, ‘the superior being’, a valuable lesson. Aren’t we all guilty of giving up too easily when faced with trials and worse, loving people close to us the wrong way?

Apart from these thought provoking messages, there are also light moments to be relished. His pleasant sense of humour though not utterly humourous, frequently brings on a smile as I turn the pages. Richmond’s straightforward style of writing endears readers to this book, making it one of his fortes. Whether an animal lover or not, Christian or otherwise, I’m sure that these stories would tug at your heartstrings. During this festive season, It’s A Jungle Out There allows us to relax and unwind and also helps us to review and put our lives in perspectives.

Dr Wilson C C Chong
Ministry of Health


Liar's Poker 
by Michael Lewis
Penguin, U K, 1989, 249 pages

 

In the age of the evident, unquestioned and unquestionable merits of Evidence Based Medicine (EBM), when we have to justify everything we do with a literature search or the ex-cathedra authority of a clinical practice guideline produced by some EBM zealot, we doctors really have precious little time to read. Certainly, not a 900 page tome, even for Christmas and the socially isolated.

So when I was asked to do a book review for SMJ by the Editor, I decided on Liar’s Poker. Not just because it is a short book, but more importantly, it is a funny book, irreverent, punchy yet poignant and instructive. It is a classic in the financial sector. Ask any chap worth his salt in the financial market and he will tell you Liar’s Poker is mandatory reading. Lewis is now a Senior Editor of a newspaper and occasionally his current writings are also published in our Singapore Business Times newspaper.

This is not a new book. It was first published in 1989. Yet in our current tumultuous times of financial upheaval and economic recession, this book bears reading again. It is strange what different times do to a reader’s response to one book.

It is also not a book with pristine English. It is a book written in the language of the trading floor, with the hedonistic exaggeration that only an American can dish out to maim yet magnify the otherwise pristine and reticent language that is English. And be warned that it is one of those rare Penguin books that is punctuated with 4,5, 6 and 7 letter expletives (the language of the trading floor), so the recluse, unexposed or just plain sanctimonious need read no further. It does not revel in expletives, but it correctly represents the way ideas are realised and communicated in minds of the financial world.

The book is autobiographical in nature. It chronicles the stint the author spent as a bond salesman in Saloman Brothers from 1985-1988. Many of the names in this book are familiar today. The traditionally Jewish investment bank Saloman Brothers is the precursor of Saloman Smith Barney (before it merged with Smith Barney), incidentally, the Wall Street firm that advises Malaysia today on its economy. Then, more famously or notoriously, the name of Meriwether appears right in the first chapter of the book. Meriwether, of Long Term Capital Management (LTCM) infamy kicks off the book with then Saloman Brothers Chairman and king of Wall Street, Gutfreund in a game of Liar’s Poker at a starting bet of just one million a hand. "Just" because Meriwether ups Gutfreund’s opening bid to 10 million a hand. What exactly a game is Liar’s Poker? Read the book.

Fascinatingly, Lewis ends the book too with a mention of Meriwether. Despite all his misgivings about Saloman, Lewis felt he still had faith in it and that it would rise again, as "the strength of the firm lies in the raw instincts of people like John Meriwether, The Liar’s Poker Champion of the World. People with these raw instincts, including Meriwether and his boys, are still trading bonds for Saloman". I would love to hear what Lewis has to say about that statement today.

Back to the book. After Gutfreund and Meriwether’s appetising little tete a tete on the trading floor, we go on to the main course. Lewis’ journey into the financial world begins at no less that St James Palace at a charity dinner with no less than the august Queen Mother attending. Here, Lewis gets acquainted with a Saloman director’s wife who later on gets Lewis a job in Saloman through the influence of her husband. Like medicine, connections get you a long way in finance. But not before some ditzy American lady screams to the Queen Mother in the Great Hall of St James Palace before 800 insurance agents "Hey, Queen, nice dogs you have got there!" How did the Queen Mother respond? Read the book.

The bulk of the book then devotes itself to Lewis’s evolution from a Saloman geek to a BSD, the pinnacle of a Saloman employee. BSD stands for "Big Swinging", (yes, read the book). In the process, he traces the rise and fall of Saloman Brothers in the eighties. The Rise is characterised by the advent of the Mortgage Bond Market, personified by the larger than life Lewie Ranieri, an Italian who waddled "like a penguin", "kept a collection" of long swords in his office, snipped a tie of a woman because he hated women with ties, and was made to buy suits by no less than Gutfreund himself. He bought them but never really wore them. The Fall began with an enthralling account of the infamous Michael Milken who usurped the throne of Wall Street from Saloman with the advent of this new instrument called junk bonds, ie. bonds issued by not-so-credit-worthy entities (usually companies). But the definition of credit-worthiness was really in the hands of a few credit rating agencies who Milken argued and convinced not the be-all and end-all of credit rating (sounds familiar in 1998?).

The book and Lewis’ journey on Wall Street starts to end with as much a bang as an unlikely beginning as an austere dinner in St James Palace. It begins in September 1997 with an aborted hostile takeover of Saloman by noted corporate trader Ronald Perelman, ironically financed by junk bonds. The bid was aborted with intervention from the man himself, Warren Buffet (the 2nd richest man in the world, after Bill Gates, but as you may realise, Bill Gates was not in the picture then yet).

Lewis ends by recalling how he was paid in his last full year at Saloman, 1987, US$225,000 for bonus. Not bad for a 27 year-old that had been in the business for 3 years in the eighties. His starting salary in 1985 was 46,000 a year excluding bonuses, which was incidentally already twice of what his chaired professor in his forties at LSE earned. So much for academia.

Yet Lewis quit Saloman in early 1988. Perhaps the most inspiring part of Liar’s Poker is in the Epilogue, when Lewis explains the rationale for his departure from Saloman, explained in part by what he perceived as a deranged view of the value of money that he was developing while in Saloman. That may be what Liar’s Poker is all about, not just a story of money, but a story of the value of money to a man.

Dr Wong Chiang Yin
Honorary Secretary
Singapore Medical Association


Mother in The Middle: Searching for Peace in the Mommy Wars
by Deborah Shaw Lewis and Charmaine Crouse Yoest
Zondervan Publishing House, Grand Rapids, Michigan USA, 1996

 

The authors begin by relating the ‘voices’ of mothers in different circumstances. There is Victoria, the corporate star employee who struggles to balance the heavy demands of her job against her wish to fit in more time with her two young children. She is caught in the middle between the two sides of her life. Does she have the best of two worlds, or the worst? At the other end of the employment spectrum is the young mother Liz, who enjoys being with her baby so much that she would prefer not to return to her previous job. However, the family cannot manage on one salary; so she and her husband opt to juggle their work schedules so that one of them will be at home to care for the baby. This is not a satisfactory solution, but they cannot afford the luxury of their preference.

Work outside the home confers an identity and a recognised worth on a person which a part-time employee or an ‘at-home mother’ does not receive. Changing from a job outside the home to minding children at home therefore represents a loss, not only of income, but of status and identity as well. Women are torn apart by jobs, husband and children. The authors relate stories of more satisfying options for mothers, and suggest changes for government policies.

Like parents in Singapore, parents in the USA have a hard time looking for good child care. The problems, advantages and disadvantages of different types of child care and the pitfalls of available research data on childcare are reviewed. The authors conclude: "Day care homes provide a more healthy place for preschoolers....Good day care homes are the ones where the caregiver has some education and experience; the caregiver reads often to the the children in her care, engages in games and music activities with the children, and talks to them in warm, non-authoritative ways. And in good day care homes, children watch little television."

The authors: Lewis holds a masters degree in early childhood education and is a speaker and writer on parenting and family issues. Yoest worked for the US Family Research Council before going on to pursue a PhD in government at the University of Virginia. Both are wives and mothers.

Dr Dixie Tan
Cardiologist & Family Therapist


Eccentric and Bizarre Behaviours
by Louis R Franzini, John M Grossberg
John Wiley & Sons Inc, USA, 1995, 244 pages

 

When I was young, one of my favourite reads was a magazine called Ripley’s believe it or not!. It emphasised that fact was often stranger than fiction. Recently, I picked up a fascinating and accurately titled book while browsing in a large local bookstore. Eccentric and bizarre behaviours is a collection of real life accounts of very strange behaviour indeed. As the authors state in their preface, "nothing is as inspiring, as tragic, as sensational, as captivating, or as powerful as real life." The book delves into the tortured worlds of people whose unrequited love becomes a preoccupation out of touch with reality, of mothers who feign illness in their children to gain attention, of kidnapped victims who fall in love with their captors, of ‘vampires’ who murder and drink the blood of their victims, of men paralysed by the terrifying fear that their penises are disappearing into their bodies, of compulsive hair-pullers who pluck the hairs off flesh, of excessively suspicious people who think that an evil twin lurks and stalks them. From clearly psychotic behaviour to sexual perversions, these stories will astound the uninitiated. Written by 2 psychologists practising in San Diego, this non-fiction work reads like short stories with many illustrative case examples and is reminiscent of Dr Oliver Sacks’ books about neurological disorders. It also tries to give theoretical explanations in a simple way. I compared their readable work to the more scholarly piece by Professors Enoch and Trethowan (uncommon psychiatric syndromes) and I must say that this book is easier to understand for the average person. Of local interest is the chapter on Koro, which was endemic in this region.

Although it is likely to be of special interest to doctors with a forensic background, this book will appeal to all doctors for several reasons; it provides rare glimpses into psychological conditions which most doctors are not aware of, it recounts how patients are treated and ‘rescued’ from their weird behaviours, and it tries to to help readers empathise with conditions that we would normally be repulsed. Don’t read this book with a full stomach but do it if you want to increase your wisdom and compassion towards fellow human beings whose extreme behaviours have imprisoned and tormented them.

Dr Daniel Fung
Child Guidance Clinic
Institute of Health