And you thought your doctor was bad

kw: book reviews, nonfiction, medicine, podcasting, humor

When we need an operation, it helps to know a surgeon's success rate, not that you can easily find that out! Perhaps more importantly, for serious work, what is the surgeon's death rate (or survival rate)? Just to show how low the bar can be set, consider Dr. Robert Liston, who performed the first surgical operation under anesthesia in England in 1846. This was shortly after the miracle of ether was first demonstrated in the U.S. It was also just a year before he died. But prior to that, what was his death rate?

According to biographer Richard Gordon, quoted by Dr. Sydnee McElroy and her husband Justin McElroy in The Sawbones Book, in one case, that rate was 300%! To quote (from p. 101 in Sawbones):

"…Liston amputated a leg in two-and-a-half minutes. The patient died in the hospital from gangrene, but that happened a lot in the days before antibiotics. …[during the operation] Liston also amputated four fingers of an assistant… [and] managed to nick a doctor observing the surgery…"

The observing doctor, fearing a mortal wound (some nick!), died of fright on the spot. The assistant caught gangrene from his wounds and also died. One surgical operation, three deaths. Has anybody else you know of had a bad day that bad? Not even your doctor, right?

The book's full title is The Sawbones Book: The Horrifying, Hilarious Road to Modern Medicine. It is based on material from the podcast Sawbones. Having listened to an episode, I find that the book's portions (hard to call them chapters) follow the style of the podcasts: Sydnee tells a story while Justin interjects humor, and draws some from her also. Five of the items are biographical vignettes in the "Misguided Medicine Hall of Fame"; witness a blurb from Pliny the Elder: treat bloodshot eyes with a woman's milk in combination with honey and a bit of daffodil or powdered frankincense. Yowza!

Even though most of the stories range from tragicomic to entirely tragic, there are a few bright spots. While surgeons such as Dr. Liston had to learn to operate very fast to minimize a patient's agony, they learned a lot of practical anatomy. And in fairness, most were more careful than Liston and had a death rate well below 100%. Rampant experimentation did turn up things that could help: honey was prescribed for just about everything you can imagine (and a few you'd do better not to imagine!), but is usually ineffective. However, it is effective as a drying agent and germ barrier for open wounds. Another supposed universal cure: Urine. It doesn't cure anything. But if you are healthy, it is a sterile fluid, and if you get a cut and have no other source of sterile water, you can safely pee on the wound to wash it out. It'll sting, of course; there's a little salt! (and if you're not healthy, you could make things worse…) Finally, the last item is about the development of polio vaccine, which was actually a competition between Dr's Salk and Sabin, and their different approaches. Both succeeded, and both vaccines are still in use and almost 100% effective. That's a good story.

Sawbones is good reading and great fun, if a bit gross at times (for instance, you learn how to quickly exhume that corpse Dr. Frankenstein needs for his experiments). So don't read it while having breakfast. Any other time ought to be fine.

A deep look at animal emotions

kw: book reviews, nonfiction, animal behavior, human behavior, behavioral science

Dr. Franz de Waal has coined a powerful word: Anthropodenial. It aptly describes the quasi-religious conviction of behavioral "scientists" who dominated the study of animal and human behavior for at least a half century. We have them to thank for the still-common view of animals as strictly instinct-driven automatons, and even of young humans as nearly the same. So babies didn't smile, we were told, they were just reacting to "gas". Fish didn't feel pain when on the hook, they were struggling against the force of the fishing line pulling them in an unexpected direction. Every reaction that "the rest of us" might interpret as an emotional response, or even, "gasp!", as a feeling, was explained in some neutral way.

Even today, Dr. de Waal reports, it is rare to find a catalog of human emotions that includes love and attachment. Strict behaviorists claim that there is no "love face", as there is a face for anger, disgust, and so forth; in fact, they are generally lacking in their regard for positive emotions other than a generalized "happy face" and "play face". They might find it useful to learn from popular music, particularly the older stuff: A 200-year-old French "love" song (it's more about betrayal) that was written to a tune later used for "Twinkle Star" contains the lines, "Depuis que j'ai vu Silvandre / Me regarder d'un air tendre", which I translate, "Ever since I saw Silvandre / View me with a tender air" (I have a translation that rhymes, but loses some of the sense). What is this "tender air?" I'd claim it is the "love face", and we are so used to seeing it—I think of a bride glowing at her groom, for example—that we don't grasp its importance. A similar look is seen in a photo of my father holding our day-old son, and I see a loving look on my wife's face when she pulls our cat onto her lap. Perhaps dogmatic behaviorism has blinded its practitioners to our more positive affects.

The book is Mama's Last Hug: Animal Emotions and What They Tell Us about Ourselves, a sequel or companion volume to Are We Smart Enough to Know How Smart Animals Are?, published in 2016. The prior paragraphs refer to items on pages 50 and 168 of the book.

"Mama" in the title was an elderly female chimpanzee. The opening chapter describes the last meeting between Mama and her human friend Jan van Hooff. To enter the cage of an adult chimp alone is tantamount to suicide. But Dr. van Hooff did so in this case, and Mama, in painful sleep, slowly awoke and was then thrilled to see him. She pulled him into a big hug, and patted him as if to say, "It's OK, I am really happy to see you!". Less than a month later she died. Can anyone doubt her love and joy? She was wearing a love face, even through her pain.

For the rest of the chapter the author introduces his learnings about animal emotions and feelings (emotions are visible to others, feelings are subjective and within), and he also stresses his viewpoint, that emotions are universal among animals, so far as he can determine. Can we deny that they have feelings to go along with them? Every animal that has been studied, from spiders almost to small to see to whales, responds to stimuli, whether painful or pleasurable, with similar actions, and similar biochemical shifts. All display either approach or avoidance behavior related to any anticipation of the same stimulus, depending on whether they liked it, or not. All have memories and all can plan.

The book's chapters take us through several aspects of our emotional lives, and the way that primates, mostly (the author's own field of study), have similar emotional lives. A proud primate, from human to ape to a tiny tamarin, stands taller with chest out and chin up. A sad one can hardly look you in the eye and tends to sit partly curled up. It may be that a mammalian brain, with its neocortex, is needed to laugh, although a differently-shaped structure in the brains of birds and lizards is probably their version of the neocortex. Maybe they can laugh also; when a parrot laughs maniacally, is it mimicking something or is it truly amused?

The last full chapter is titled "Sentience". Although it shifts to a discussion of the way we treat animals captive or not, and the ethics thereof, the author dwells much on the possible self-knowledge and consciousness of animals. A few mammals and birds respond to the "mirror test" in a way that shows they can recognize themselves, and thus that they know themselves as individuals. I think our house cat, though she could never "pass" the mirror test, knows who she is, and knows she is something other than an undersize, furry human. Will a scientific experiment one day be devised that can determine what she really thinks of herself, and of us? I guess we can only "stay tuned."

This book is the latest of several I have seen in the past few years, that fully backs up something I have long contended:

It is not anthropomorphic to say that animals are like us; the proper view is that we are like them, because we came from them.

A delightful book, and not only because the author agrees with me. He has had the opportunity and the skills to back up such a supposition with scientific data. I love it.

Biography of the Cat in the Hat

kw: book reviews, nonfiction, biographies, dr seuss, theodor geisel

When I was a very early reader, among numbers of "Little Golden Books" and other "early readers," two others stand out in my memory, The 500 Hats of Bartholomew Cubbins and McElligot's Pool, by Dr. Seuss. I read them again and again. Later, when we obtained more books by Dr. Seuss, I gave them the same treatment. I find ten books by Dr. Seuss on the shelf, though one is a newer reprint of McElligot's Pool so that my old, much-bedraggled copy doesn't get worn to nothing.

Fast-forward a lifetime: When our son was in high school, a decade after adding much wear and tear to my old books and his newer ones, his school put on Seussical, the Musical. He was lucky to be in a high school that doesn't just have a drama club, but also engages in one full-blown musical production yearly, for which they recruit younger siblings and a few parents to assist. For a special performance, they invited a local operatic Bass to sing the Grinch's, which he did with great delight (and ours also!).

The first thing I learned while reading Becoming Dr. Seuss: Theodor Geisel and the Making of an American Imagination, by Brian Jay Jones, is that "Seuss" is pronounced "soice", to rhyme with "voice"! Well, that may be the way Ted Geisel pronounced it as part of his name. As his pen name, however, millions (maybe over a billion!) of us know him as "Doctor Soose", and that's the way it will continue.

I had a tendency to feel a little sad, reading of the life of Ted Geisel. He literally agonized over every word and every picture of his books. He had a hard time when younger getting his work placed with publishers, of magazines or books alike, that would pay him more than a pittance, if they would pay him at all. He didn't achieve financial comfort until he was in his fifties. But I realized that he was doing what he loved, and that, agony and all, he'd have created his fantastical characters and animals whether they made him wealthy or not, or even paid the bills.

Indeed, for decades he paid the bills with advertising illustrations; he coined the phrase "Quick, Henry! The Flit!" (Flit was a bug spray brand he promoted with ads like the one shown here; image courtesy of the UCSD Mandevill Special Collections Library).

This is from 1927. These ads, with their humorous animals and fantastical creatures (the mosquito in particular) show where he honed his craft during the long years when his books didn't yet sell all that well. It took America a while to get used to him.

Get used to him we did! In the 1950's and early 1960's, a good year might see sales of one of his books approaching 10,000 copies. By the 1970's a new Dr. Seuss book might sell millions of copies in just a few years.

An aside I kinda regret: Biographer Jones dwells much too much in early chapters on the "failure" of Ted Geisel to meet the "sensitivity" standards of this generation. He bemoans an apparent bias against women; he repeats—a few too many times—a description of Japanese as caricatured by Geisel during World War II, as slit-eyed dwarves; and he has several other such quibbles. He could have made his point much more effectively with a glancing notice, and just gone on. This stuff detracts from the book. Furthermore, it is dramatically unfair to judge the actions of someone in the 1930's or 1950's by the standards of the 1990's or 2010's. How will our great-grandchildren of the 2060's look back at us, and our comparatively "primitive" behavior? And further-furthermore, today's "standards" are procrustean and overly censorious. I predict they will be the subject of future ridicule!

Considering that millions of words have already been written about Ted Geisel, and possibly about this biography, I think it best simply to say that, knowing his purported faults (heavy smoker, persistent social drinker), I loved the genius that was Dr. Seuss, and I still do. He had an imagination like no other. Younger writers of children's books who tried to emulate his style, and whom he frequently mentored, sometimes produced marvelous books of their own, but had to find their own voice to truly excel. His best-loved character, the Cat in the Hat, was his alter ego: impish, sly, subversive, and messy, but willing to clean things up once the fun was done. The Cat is his fitting companion in this statue at the Geisel Memorial Library on the campus of UCSD, La Jolla, in the town he made his home.

Three for the ash can

kw: rejected books, policy

It has been too long since my last post. In that time I have read major portions of three books, and in each case, stopped reading and decided not to review the book. In such cases I decline to give the author or title any exposure at all. I have a few reasons for not continuing to read a book, including writing too poor to hold my interest and subject matter that is explained too poorly to be of use (in my estimation); I'll reject a book most quickly when I determine that I don't want to take in what is being offered. It seems all three of these criteria "hit the fan," one after another. There are other reasons, but those three are chief.

So I have begun reading another book, a biography of Dr. Seuss (Ted Geisel). It's long, so at least another week must pass before I finish it and review it here. I can happily report that this book is one I am sure to finish, and with much enjoyment.